What is Lifetime Advocacy Plus [LA+]? Lifetime Advocacy Plus, a federal, nonprofit, 501(c)3, has served as Guardian in Washington state since 1963. It has had a Quality Assurance Program specifying the minimum levels of personal and financial monitoring that must be met by LA+staff. Lifetime Advocacy Plus fully endorses the Standards of Practice presented by the Certified Professional Guardian Board. LA+trongly endorses the federal Rehabilitation Act of 1974 and the American Disabilities Act as is easily noted by a reading of the LA+ Mission and Vision statements. Lifetime Advocacy Plus utilizes the least restrictive guardianship level possible.
What does “Least Restrictive Environment” mean? It means that each citizen with disabilities has the right to live and function in settings that provide the fewest restrictions while at the same time providing safety. It means having access to shops, schools, jobs, activities in the community where each person lives. It means using the least number of medications to assure health, particularly the least psycotropic medications.
What language does the Court use when referring to people with disabilities who are under guardianship protection? The Superior County Court and legal community refer to people under guardianship protection as “Incapacitated Person” or “Ward.” Prior to guardianship being established, the individual is referred to as “Alleged Incapacitated Person.”
What does “People First” language mean? People First is an Association of people who experience disabilities. This group issued a statement about the time that the federal American with Disabilities Act was passed requesting the use of language that responds to the whole person as opposed to language that focuses on just one aspect of the person.
What language, referring to people served does LA Plus use? We use the word “clients” for each individual we serve.
Where does LA Plus serve as Guardian? Lifetime Advocacy Plus offers Guardianship Services in Washington State. Guardians are appointed and monitored by the Superior Court in the county of the current residence of the person with a disability. Guardians are required to formally report as requested by the Court as to the status of the person and/or estate served.
Who monitors Guardians? The Superior Court monitors through guardianship reports due whenever a substantial change happens in the life of the people, and through required annual, biennial or triennial guardianship reports and accountings.
Are all guardianships the same? No, guardianships can include both Guardian of the Person and Guardian of the Estate or just one of the above. In addition, guardianship may be “limited” in either personal or financial guardianships, depending on the need of each individual.
Who appoints Guardians? Guardians are appointed by a Superior County Court. This appointment occurs after an independent Guardian ad Litem has investigated a case and reported to the Court that a person is unable to make specified decisions or keep themselves safe from injury or exploitation.
When does one need a Guardian? When an individual is unable to make decisions that provide appropriate care for him/herself, it may be that a guardianship would be beneficial. You may contact us or in addition, you may also contact Adult Protective Services, facility Ombudsman, DDD/DSHS, and/or an attorney specializing in guardianship law.
Can a family member or friend be a “lay” Guardian? Yes. The Court first considers the possibility of a family or non-professional “lay” Guardian.
When does one need a Professional Guardian? Professional Guardians are appointed in the absence of family members or, conversely, if family members prefer not to take on this role. Some family members prefer to remain in the role of son, daughter, or sibling and remain as “persons of interest.” Persons of interest receive copies of the annual, biennial or triennial reports to the Court and are informed of major changes in the life of their loved one.
Is Guardianship an “All or Nothing” situation? Guardianship of the Person and/or of the Estate can be “Limited” to specific functions, thus tailoring the Guardianship to fit the needs and honor the abilities of each individual.
What kind of staff will be interacting with my family member? Lifetime Advocacy Plus staff has two groups of experts who are delegated the task of monitoring client well- being and taking appropriate action if our client’s well-being is, or appears to be, at risk. These individuals serve as Guardian Representative for the Person or for the Estate. The first group is comprised of specialists in personal issues; the second group is comprised of specialists in financial issues. It is not unusual to have two staff members assigned to one individual, if a guardianship including both “person” and “estate” has been put in place. Both groups are expert in the state law which specifies duties of a guardian and the challenges confronting individuals under guardianship as well as being knowledgeable with relevant federal laws, such as the American with Disabilities Act and the Federal Rehabilitation Act. Six out of nine of the staff members who are directly involved with clients have completed state guardianship certification training and complete annual mandatory training.
Additional Support Offered to Staff. In addition to mandatory training provided by the state, further training days are provided to staff members by the agency. Supervisors and Management provide consultation/support for extraordinary issues that may arise in the life of any individual, whether personal or financial in nature. Further, LA+ Volunteer Expert Committees regularly provide consultation as needed, in both Guardian of Person and Guardian of Estate situations. Finally, experts necessary to consult, including attorneys, tax attorneys, medical/mental health practitioners, behavior specialists and others are hired separately as needed to provide consultation/guidance as situations required specialists occur.
Do LA Plus Guardian Representatives make efforts to establish a warm, friendly relationship? Yes, Relationship is the Heart of an LA+ Guardianship: Guardianship entails a relationship between the Guardian of Person Representative and the individual receiving guardianship care. LA+ meets with each potential client prior to appointment and then, since 1993, has required a minimum of a monthly in-person monitoring visit. In addition to a long checklist of safety and staffing issues, the monitoring visit includes a visit between the LA+ client and the LA+ representative. Lifetime Advocacy Plus Guardians of Person remember each individual with birthday and holiday cards and gifts to celebrate life’s moments. Lifetime Advocacy Plus Guardians of Person are available 24 hours, seven days per week through the use of a professional after-hours answering service and emergency paging system.
How long do Guardian of Person Representatives tend to stay with your agency? At this time, we have a range of longevity from a minimum of 3 and up to 19 years of service.
Does LA Plus authorize any meetings pre-appointment to establish rapport between the agency representative and the prospective client? Yes, Lifetime Advocacy Plus Guardian Representatives have always met, pre-appointment, with individuals who request our involvement. The purpose of this meeting is to assure that LA+ is able to meet the guardianship issues presented and to see if a good rapport can be established with the agency Representative and the individual. Further, this early meeting—along with reviewing the Guardian Ad Litem Report—starts the Guardianship Representative on the path to being knowledgeable regarding issues particular to that individual. These issues might be related to state benefits, special healthcare needs, finding or maintaining a safe home or home-like setting and many other relevant financial/personal issues./
What is the LA Plus stance toward friends and family members? Guardian Representatives also develop and/or maintain family and peer relationships that are important to the person in question. Agency Representatives are expert at locating “lost” family members. Guardian of Person Representatives are dedicated to integrating each individual served into their community and are also committed to helping each individual achieve, to the fullest extent possible, his/her dreams. Family members’ concerns, background information and understanding of their loved one is always encouraged and requested by our Guardian of Person Representatives to assist in their decision making for and with the client. LA+ guardians are committed to maintaining or engaging clients in their cultural identity.
How soon do agency representatives begin to act once appointed? Guardian of Person Representatives have “pre-appointment” meeting, have read the court appointed Guardian Ad Litem reports and often have to take action on the day appointed, or shortly thereafter, dependent on the situation. Guardian of Estate Representatives are also knowledgeable of the Guardian Ad Litem report and always begin work on the day of appointment.
What does LA Plus mean by “monitoring visits?” Lifetime Advocacy Plus Guardians of Person Representatives protect the health and safety of the person with a disability through oversight of personal care staff and other relationships. The Monitoring Visit is one of the key components to assure ongoing well-being as well as opportunities to actualize life opportunities are available to our clients, as reasonable and possible. Monitoring visits are un-announced, occur at different times of the day or evening throughout the week or week-end. Guardian of Person Representatives use a basic checklist and also follow up on any concerns or interests related to a given client. For instance, LA+ staff evaluate the residence on a monthly basis to insure that it is safe and clean, that medications are locked and accurately given and documented, that fresh food is available at all times, that the person with a disability is treated with respect and dignity, that their heritage and faith are honored, that they maintain as much independence as is safe and that they have rights to privacy, intimacy and choice. LA+ Guardian of Person representatives also note the level of staffing.
Does LA Plus require regular monitoring of the results of DSHS/DDD housing surveys? The Guardian of Person Representatives reviews the license and reviews survey results of all homes, supported living programs and facilities on a regular basis. We consistently advocate for the person with a disability to live in the least restrictive setting that matches their needs. Guardian Representatives insure that routine fire and earthquake drills are completed and emergency kits are maintained in the home. Each failure to comply must be reported to LA+ management and appropriate action is always taken to ensure the safety, well-being and happiness of our clients.
How does the Guardian “keep up” with the health needs of its clients? Guardianship by Lifetime Advocacy Plus includes monitoring medical and mental health care for each individual served by attending medical appointments as needed, reviewing all medical records on a regular basis usually no less than monthly, by attending care planning meetings, nursing and other assessments and through discussion with care providers, medical practitioners and case managers. Lifetime Advocacy Plus Guardian Representatives always advocate for the lowest effective levels of medications. Lifetime Advocacy Plus Guardians of Person work with the person with a disability, their family and/or other trusted persons, our own Ethics Committee and with primary physicians to develop emergency medical treatment plans and end of life decision making. State required Physicians Orders for Life Sustaining Treatment or POLST forms are reviewed on a regular basis, along with LA Plus’ Recommendations to Physicians Forms. Lifetime Advocacy Plus Guardians of Person are available 24 hours, 7 days a week to provide consent for medical and emergency treatment.
How would anyone reach you in an emergency: Calls are coded by the use of the word “Emergency.” For responses needed immediately by hospitals for instance, a call will be forwarded to the appropriate Representative, then to the Supervisor to assure a rapid response.
High Quality Teamwork on behalf of LA Plus client: Lifetime Advocacy Plus Guardian Representatives work with the Estate Manager, Trustee or Representative Payee to insure that every LA+ client has adequate, seasonally appropriate clothing and personal care items, that they are not approaching resource limits that effect benefits, that they use their funds for their assistive technology or other medical needs and that they save for funeral planning if such a plan is not fully in place.
When does my family member need a Guardian of Person? A Guardian of Person is appointed for a person who cannot make all of their own decisions either because they can’t fully understand or communicate the decision or because they cannot discern risk and could be harmed or exploited. Sometimes, a family member prefers maintaining a familial relationship, such as sibling, rather than take on the financial or personal care oversight implicit in a Guardian’s role. Sometimes a family member lives too far away or has too many other responsibilities to take on this role. Choosing LA+ as Guardian provides an experienced, un-biased decision maker, a voice for the person with a disability and allows the family to return to enjoying family interactions.
Will I still be able to help and advise my family member? Yes. Lifetime Advocacy Plus will honor each client’s wishes and will honor input from friends, clergy, physicians and significant others, as appropriate, to make the best life for your family member.
What rights will my family member lose? In the case of a full Guardianship, the following rights are withheld: TO MARRY, DIVORCE, OR ENTER INTO OR END A STATE REGISTERED DOMESTIC PARTNERSHIP; TO VOTE OR HOLD AN ELECTED OFFICE;
TO ENTER INTO A CONTRACT OR MAKE OR REVOKE A WILL;
TO APPOINT SOMEONE TO ACT ON their BEHALF;
TO SUE AND BE SUED OTHER THAN THROUGH A GUARDIAN;
TO POSSESS A LICENSE TO DRIVE; TO BUY, SELL, OWN, MORTGAGE, OR LEASE PROPERTY; TO CONSENT TO OR REFUSE MEDICAL TREATMENT; TO DECIDE WHO SHALL PROVIDE CARE AND ASSISTANCE and TO MAKE DECISIONS REGARDING SOCIAL ASPECTS OF YOUR LIFE.
Is there any chance that a person could regain their rights after a guardianship has been established?
Yes, there is such a chance. Lifetime Advocacy Plus Guardians of Person routinely assess whether an individual has regained the competency to make some or all of their decisions. For instance, LA+ sometimes asks the court to limit the Guardianship. LA+ assesses, for instance, whether a person has the understanding to vote. At all times, LA+ encourages each served individual to assist in choosing care providers that meet specific criteria and to be highly involved in choosing social and other activities that are safe and promote respect, dignity and independence. On occasion, although somewhat rarely, an individual regains all rights, LA+ requests the right to withdraw and guardianship is removed.
How will you know my family member well enough to make decisions? Lifetime Advocacy Plus Guardians of Person will visit your family member and spend quality time with them every month. They will interview care providers, review medical and other records, visit at job sites, activity or volunteer programs, and interact with state case workers and others involved in the person with a disability’s life, planning, healthcare, housing and benefits. They will be knowledgeable of whatever issues are a part of the guardianship – whether having to do with ethnic or religious beliefs, specific disabilities or other needs, such as the desire to work.
How will you know if my family member is safe and well cared for? Guardian Representatives are supervised by management and consult with Volunteer Expert Committee members. LA+ sends out surveys to care providers on a regular basis to review the quality of work as perceived from the providers’ viewpoint. We track DSHS surveys on all residential placements. Guardian of Person Representatives work as a team member with DSHS/DDD case-managers, Social Security representatives, a wide spectrum of medical, residential and other care providers all of whom have access to LA+. The attorney for each case and well as the Superior Court also review each case.
How will I and other interested family members reach you? What if there is an emergency? The office is staffed weekdays, and, we employ a professional 24 hour answering service. Guardian of Person Representatives can be paged 24 hours, 7 days a week and all holidays for emergency. It is possible for out-of state family members to be provided with a regularly scheduled update.