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Jordan Institute works to reform adult guardianship policies, practice

After spending the past year examining policies and practices around adult guardianship, the UNC School of Social Work’s Jordan Institute for Families is moving forward with a state-funded initiative to educate others and raise awareness about less restrictive alternatives to the court-ordered process.

The project, which developed in partnership with the N.C. Council on Developmental Disabilities and the N.C. Division of Aging and Adult Services, is the latest effort to ensure that individuals with disabilities or mental health issues have the best opportunity to live their lives as independently as possible. Professor Gary Nelson, an associate director for the Jordan Institute, is the project’s principal investigator; Tamara Norris, director of the Family Support Program, is the project coordinator; Sarah Marsh, a social research associate with the Jordan Institute, and Mary Anne Salmon, a clinical associate professor with the Center for Aging Research and Education, round out the research team. (Barbara Leach, a project coordinator with the Family Support Program, and Sunni Walker, a second-year MSW student, also have assisted with the state project.)

Although there is limited data on the number of individuals within the guardianship system, the National Center for State Courts estimates that “the number of active pending guardianship cases could range from fewer than 1 million to more than 3 million” nationwide.

Guardianship, which is considered a legal “last resort,” occurs when a court orders that one individual or entity be placed in charge of another individual’s decision-making, including over personal and/or financial matters. Generally, the process can be used when frail adults or persons with disabilities or mental health issues are no longer considered competent to handle their own affairs. Family members are often appointed guardians, but in cases where an adult does not have relatives, state agencies such as departments of social services, or hospitals or nursing homes, are allowed to petition the courts for the right to serve as legal decision-makers for these individuals. (In North Carolina, departments of social services serve as public guardian). Because the process, including determinations of incompetency, vary from court to court, advocacy groups and others have pointed to problems within the system, including a lack of monitoring of individual cases and instances of physical or financial abuse.

Such worries have resulted in calls for policy and practice reform, including for the use of less restrictive alternatives to guardianship, Norris said. Some of these alternatives include: powers of attorney, in which one person gives another the legal authority to act on his or her behalf; advanced health care directives, which allow individuals to make certain medical decisions in advance; and supportive decision-making, in which a group of trusted advisors helps an individual make various decisions.

Over the past year, as the Jordan Institute’s research team surveyed clerks of court across the state and worked closely with stakeholder focus groups, one fact became clear, Norris said. Many, including family members, are not aware of alternatives to guardianship.

“So a lot of what’s needed is education, and that’s something we will focus on in the next year,” she said.

Over the long-term, Norris and fellow team members hope the Jordan Institute’s work will lead to a sustained effort that promotes the use of less restrictive alternatives and encourages changes at the policy, legislative and practice levels.

“Our goal is to make changes in the existing system,” she said, “to focus on where guardianship really isn’t necessary and to have other things in place to ensure that our system in North Carolina is the best that it can be.”