Final Project
The use of “Best Practice” in Guardianship

Student: Takysha Crawford tcrawford@waldenu.edu
Student ID # A00487277
Program: PhD in Human Services
Specialization: Family Studies and Intervention Strategies

Walden University
May 18, 2014

Introduction
My specific area of human services would is guardianship of incapacitated adults who need guardians to help them provide food, clothing or shelter, or to care for his or her own physical health, and to manage his or her own financial affairs. When we think of guardianship, we often think about children who have no one and need people to serve as guardians but we really don’t think about the adults who, due to physical or mental incapacity, need someone to serve as their guardian. These people need someone to help make financial, medical, and personal decisions on their behalf. The Uniform Guardianship and Protective Proceedings Act, considers an incapacitated adult as one who is unable receive and evaluate information or make or communicate decisions to such an extent that the individual lacks the ability to meet essential requirements for physical health, safety, or self-care, even with appropriate technological assistance (Demakis, 2013). To date all 50 states have passed some type of guardianship reform: however these reforms vary considerably from state to state (Kubik & Woods, 2005). According to Demakis (2013),
First, a petition is made to the court, most often by a family member, in which an individual, considered the respondent or presumed ward (the terminology differs by state), is alleged to be incompetent/incapacitated. Next, a hearing or series of hearings is conducted in which the respondent is represented by an attorney or guardian ad litem appointed by the court or a privately retained attorney. The hearings may include testimony from the petitioner, respondent, and family members, as well as experts assigned by the court. Psychologists currently serve in this role in most states.
As a result of the hearing, the judge or legal officer makes a determination as to whether the respondent is incompetent/incapacitated or not based on the relevant statute. If the respondent is found incompetent or incapacitated, a guardian is subsequently assigned. Guardianship may be of the person or estate (i.e., regarding financial affairs) depending on the type and severity of the individual’s impairments.
Best Practice According to the National Guardianship Association (2007), the Standards of Practice outline principles that are NGA ideals for service delivery, and are indicated as current, but evolving “best practices”. Because of changes in laws, people, and technology change over time the adoption of the best practice model suits this area of human services. The NGA best practice approach focuses on the guardian’s duty to recognize and respond to the person as an individual with needs, desires, and the potential for growth (National Guardianship Association, 2007). In order to fulfill the best practice approach a person serving as a guardian must learn as much about the individual that they are serving. This includes learning about the person’s background, culture, religion, family, and personal preferences. This knowledge is used to help the guardian make decisions that are best practice decisions and in the best interest of the person that they are serving. Best practice is defined as, a technique or methodology that, through experience and research, has proven to reliably lead to a desired result (Rouse, 2007). Any field that uses best practice uses all resources available so that success can be obtained. In guardianship success is measured in how well the person being served is taken care of. Without the use of every available resource a guardian will not be able to successfully take care of their client. Because every client and situation is different the best practice method allows the guardian to use the resources and research that has proven to be reliable with each client that they may have. In this way they are not limited to one technique in providing services to clients. There are some instances where best practice is used before the appointment of guardianship takes place. A judge can use information provided to her by attorneys, doctors, and social workers to determine the level of guardianship that is required. Not all clients are in need of guardianship to have full authority. For instance an individual with a visuospatial impairment may no longer be able to drive or manage a checkbook but could still participate meaningfully in medical and housing decisions (Kubik & Woods, 2005).
History and Culture
Culture has played a very significant part in the practice of human service. The changing culture and times have also changed how human service has been performed over time. Changes in legislation, the use of technology, and changes in population, are just a few of the factors that have changed over time and continue to change. With these changes the face of human service has had to change as well to adapt not only to specific parts of the culture but to the ever changing world of needs. There have been very substantial changes in the culture of Guardianship. There was not even considered a need for the program until 2003. There was consideration for minors who needed guardians but no real consideration for an organization for incapacitated adults who had the need for someone to be able to make decisions for them, and help provide basic necessities. There were a growing number of these adults who had no one to take care of them. This in itself showed a shift in the culture. Culture had shown that in times before, that family took responsibility for these family members and were willing to take them in and provide for them. Now we are seeing more families that are less willing to do so. There is an increase in mental health issues such as, Bipolar disorder, Schizophrenia, PTSD, and Alzheimer’s. I feel that there is a gap in education that leads many families not to know how to deal with such issues and therefore causing family member suffering with these illnesses to be left alone. There have also been major changes in legislation that have led to the opening of such programs like guardianship. According to the National Conference of State Legislators (2013), House Bill 413 was signed by the Governor of Texas Rick Perry May 15, 2012. House Bill 413 States: This bill allows the attorney general to file a civil action against a person or caregiver who abuses, neglects, or exploits a vulnerable adult or against a person or caregiver who negligently allows another person or caregiver to abuse, neglect, or exploit a vulnerable adult. Not only has there been a shift in culture when it comes to caring for incapacitated adults but there has also been a change in the way that crime is being committed over time. There are those who see these incapacitated adults and take advantage of their incapacity. Exploitation and neglect has risen over time, which has caused the government to pay attention and pass legislation to protect these adults.
Ethics
The Code of Ethics that the Harris County Guardianship Program adheres to the Texas Guardianship Certification Board. This Board is approved and governed by the Texas Supreme Court. On December 12, 2006 the Texas Supreme Court approved the Guardianship Certification rules, fees, and code of ethics (Texas Courts Online, 2014). Texas Government Code Section 111.011(a) provides that the Guardianship Certification Board is composed of eleven members appointed by the Supreme Court of Texas and four public members appointed by the Supreme Court of Texas from a list of nominees submitted by the governor (Texas Court Online, 2014). This board is composed of five committees; rules committee, minimum standards committee, exam committee, application committee, and disciplinary standards committee. Certification is a major part of rules and ethics of the Guardianship Certification Board. In 2007 the board mandated that there are guardians that must pass a certification exam in order to serve in Texas as a guardian. There are four categories of guardians according to the ethics and standards of Guardianship Certification Board that must be certified. These individuals are; individuals, other than attorneys or corporate fiduciaries, who are private professional guardians, individuals, other than volunteers, who provide guardianship services to wards of the Texas Department of Aging and Disability Services (DADS), individuals, other than volunteers, who provide guardianship services to wards of a local, county, or regional guardianship program, and Attorneys who provide guardianship services in a capacity other than private professional guardian must be certified (Texas Court Online, 2014). The Code of Ethics is enforced by the Guardianship Certification Board. When there is a complaint due to violation of ethics it must be sent in writing to the Guardianship Certification Board. Any person can put in a complaint to the Board. The complaint must include the allegation of the violation and how it is a violation according to the Code of Ethics. It must also include the name and contact information of the certified guardian that is being complained against, an actual factual basis for the allegation, and any necessary and supporting documentation (Texas Courts Online, 2014). If this Certified Guardian is considered to be in violation there certification can either be suspended of or terminated depending on the level of the violation. When a license is suspended a person will never be able to serve as a certified guardian in the state of Texas.

Professional Associations The National Guardianship Association is open to all Nationally Certified Guardians in the United States. This association was formed in order to advance the standards of excellence in guardianship and to ensure that those appointed to the care of guardians, conservators and fiduciaries deserve quality services and that every person should be provided respect, due process, rights, and dignity in guardianship (National Guardianship Association, 2014). One of the major impacts that this association has had, not just on guardianship agencies such as the Harris County Guardianship Program, but to individual guardians as well was to put in place standards of practice. In order to ensure that these standards of practice are learned a prospective guardian must pass an exam to become a certified guardian. If this test is not passed within two years of provisional certification then guardian status will not be granted.
The NGA was formed due to the growing number guardianship professionals all over the United States. In 1988 Over 200 people gathered in Chicago for a special session determine if there was sufficient interest and commitment to form a national organization (National Guardianship Association, 2014). One of the major issues that came forth was the difference between state laws and how standards of practice could be formed with these differences. In spite of the differences the National Guardianship Association was formed in January 1989 and was formally incorporated in the state of Illinois as a non-profit corporation (National Guardianship Association, 2014).
The major goals of the NGA in its early years were to develop a uniform Code of Ethics, Standards of Practice, and training and education curriculum. A Model Code of Ethics, authored by Michael D. Casasanto, Mitchell Simon, and Judith Roman, was adopted by NGA in July 1991 and later NGA went on to create and adopt a baseline of seven Standards of Practice for Guardians (National Guardianship Association, 2014). In 1997 a comprehensive certification examination was created as a means of testing the knowledge of those who wanted to become Certified Guardians.
The original seven Standards of Practice were expanded to twenty-three Standards of Practice between 1998 and 2000 and later, additions were made in 2002 and again in 2007 to comprise NGA’s current twenty-five Standards of Practice (National Guardianship Association, 2014). These standards are what the certification examination and based on, and are the foundation on which guardianship practices are formed. The National Guardianship Association Standards of Practice for individuals and agencies provide specific principles and commentary designed to improve a guardian’s process of decision-making. Thus, professionals, family members, and volunteers will be willing to act as guardians for people in need, and the decisions made are based upon a set of agreed-upon principles that are ethically and morally sound (National Guardianship Association, 2014). The NGA has helped to make strides in regards to the protection and care for incapacitated adults. The NGA helped to get Bill S1744, Guardian Accountability and Senior Protection Act passed (National Guardianship Association, 2014).
“The bill provides funding for State courts to assess and improve the handling of proceedings relating to adult guardianship and conservatorship, to authorize the Attorney General to carry out a pilot program for the conduct of background checks on individuals to be appointed as guardians or conservators, and to promote the widespread adoption of information technology to better monitor, report, and audit conservatorships of protected persons” (National Guardianship Association, 2014). Once a guardian is certified he or she can choose to join the National Guardianship Association. Regardless of whether you are a member of the NGA or not, if you serve as a Certified Guardian the association plays a major part in the guardianship work and service that is done. As time progresses and technology changes, the standards of practice may need to be altered. Being a part of the NGA helps the Certified Guardian to have a voice in those changes.
Future Endeavors The Center for Guardianship Certification Have worked for years to make an impact on the nationwide public policy when it comes to adult guardianship. Delivery of Guardianship services has been a major focus. Guardianship stakeholders, public policymakers and legislators have been calling for assistance to develop public policy that improves the delivery of guardianship services. In 2009, the Board of Trustees of the Center for Guardianship Certification determined that responding to this request was vital to the mission and purpose of the Guardianship Certification Center (Center for Guardianship Certification, 2011). It was at this time that they decided to interview Guardianship stake holders from all over the nation. By doing this they were able to come up with a public policy statement. The basis of this statement is to ensure that guardians are tested and certified in every state. This testing helps to ensure that legal guardians are qualified to give the services that they render. Along with testing, this statement stresses the importance of the continued training and education that are mandatory requirements of certification. This policy statement has helped to ensure that 24 states are states that must have tested certified guardians. In the future the Center for Guardianship Certification will continue to advocate for the change of public policy. The goal is to have all 50 states with tested certified guardians.
The fight to end exploitation of incapacitated adults is also a fight that must continue into the future. Damakis (2013) writes: Individuals may have relatively intact activities of daily living and perhaps only minor cognitive or communication difficulties issues, if any, but still remain vulnerable to exploitation. In some cases and in some states, these individuals may not technically meet criteria for incompetency/incapacity with a statutory focus solely on activities of daily living. The classic case is an elderly individual living alone without family or friends preyed on by telemarketers or other sales people. Legal protection of these individuals is important, particularly with the aging of the U.S. population, as well as the increasing movement of individuals and fragmentation of families. The more that time goes on and technology advances the needs for guardians will change. An increase in technology will lead to an increase in the number and the ways that incapacitated or partially incapacitated individuals will be exploited. It will be the law makers to use best practice so that research and experience can be used to come up with a successful outcome. Conclusion
Guardianship services are very vital to the lives of many Americans, and as baby boomers get older, will continue to be a very relevant part of society. Whether a person is serving as a private guardian or works for an organization, the best practice method is one that is very important to utilize. In guardianship success is measured in how well the person being served is taken care of. Without the use of every available resource a guardian will not be able to successfully take care of their client. Because every client and situation is different the best practice method allows the guardian to use the resources and research that has proven to be reliable with each client that they may have. In this way they are not limited to one technique in providing services to clients.

References

Center for Guardianship Certification: Public Policy. (2011). Retrieved May 7, 2014, from http://www.guardianshipcert.org/public_policy.cfm
Demakis, G. J. (2013). State statutory definitions of civil incompetency/incapacity: Issues for psychologists. Psychology, Public Policy, And Law, 19(3), 331-342. doi:10.1037/a0032827
Langen, W. (1978). Public guardianship: Protecting the interests of the ward. Law And Human Behavior, 2(3), 267-282. doi:10.1007/BF01039084
National Conference of State Legislators (2013). nscl.org. Retrieved March 18, 2014 from http://www.ncsl.org/research/financial-services-and-commerce/financial-crimes-against-the-elderly-2012-legis.aspx
National Guardianship Association: Mission, Overview, and History. (2014). Retrieved April 24, 2014, from http://www.guardianship.org/overview.htm
National Guardianship Association: Legislation. (2014). Retrieved April 24, 2014, from http://www.guardianship.org/legislation.htm
National Guardianship Association: Standards for Agencies and Programs Providing Guardianship Services. (2007). Retrieved May 16, 2014, from http://www.guardianship.org/documents/Agency_Standards.pdf
Rouse, Margaret (2007). Best Practice. Retrieved May 16, 2014 from http://searchsoftwarequality.techtarget.com/definition/best-practice
Texas Courts Online: Members. (2014). texascourts.gov, Retrieved April 13, 2014, from http://www.txcourts.gov/gcb/members.asp
Texas Courts Online: Rules, Standards, Policies. (2014). texascourts.gov, Retrieved April, 13, 2014 from http://www.txcourts.gov/gcb/rules.asp
Texas Courts Online: Complaints/Disciplinary Procedures. (2011). texascourts.gov, Retrieved April 13, 2014 from http://www.txcourts.gov/gcb/procedures.asp
Wood, S., & Kubik, J. (2005). Presenting the Complex Client in Court: Practical Issues Related to the Assessment of Capacity. Rehabilitation Psychology, 50(3), 201-206. doi:10.1037/0090-5550.50.3.201