Role of Clinical Evaluation Professionals in Adult Guardianship Proceedings: Survey of State Statutes

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Role of Clinical Evaluation Professionals in Adult Guardianship Proceedings: Survey of State Statutes State & Citation Uniform Guardianship and Protective Proceedings Act of 1997 306 Alabama Code 26-2A-102(b) Alaska Stat.13.26.106(c) & 13.26.195(b) Arizona Rev. Stat. Ann. 14-5303(c) If the court orders the evaluation, the respondent MUST be examined by a physician, psychologist, or other individual appoint by the court who is qualified to evaluate the respondent s alleged impairment. Court SHALL appoint a physician or other qualified person who shall submit a written report to the court. Court MAY also appoint a public or charitable agency to evaluate the person s condition to make appropriate recommendations to the court. For guardian appointment Court SHALL appoint visitor to arrange for evaluations to be performed and prepare a written report to the court. Court SHALL appoint an expert who has expertise in regard to the alleged or admitted incapacity. For conservator appointment Court MAY direct that the person to be protected be examined by a physician designated by the court, preferably a physician who is not connected with any institution in which the person is a patient or is detained. Court SHALL appoint a physician, psychologist or registered nurse. If the alleged incapacitated person has an established relationship with a physician, psychologist or registered nurse who is determined by the court to be qualified to evaluate the capacity of the alleged incapacitated person, the court MAY appoint the alleged incapacitated person's physician, psychologist or registered nurse pursuant to this subsection. Page 1 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Arkansas Code Ann. 28-65-211(b)(2) & 212(a)(2) California Prob. Code 1513 Colorado 15-14-306 Connecticut C.G.S.A. 45a-674 Court SHALL require that the evidence of incapacity include the oral testimony or sworn written statement of one (1) or more qualified professionals, whose qualifications shall be set forth in their testimony or written statements.. If the alleged incapacitated person is confined or undergoing treatment in an institution for the treatment of mental or nervous diseases or in a hospital or penal institution, one (1) of the professionals SHALL be a member of the medical staff of that hospital or institution. The evaluation SHALL be performed by professional(s) with expertise that is appropriate for the respondent s alleged incapacity. For the purpose of writing the report authorized by this section, the person making the investigation and report SHALL have access to the proposed ward's school records, probation records, and public and private social services records, and to an oral or written summary of the proposed ward's medical records and psychological records prepared by any physician, psychologist, or psychiatrist who made or who is maintaining those records. The physician, psychologist, or psychiatrist SHALL be available to clarify information regarding these records pursuant to the investigator's responsibility to gather and provide information for the court. Court MAY order a professional evaluation of the respondent and SHALL order the evaluation if the respondent so demands. If the court orders the evaluation, the respondent MUST be examined by a physician, psychologist, or other individual appointed by the court who is qualified to evaluate the respondent's alleged impairment. Court SHALL receive evidence as to the condition of the respondent, including a written report or testimony by a Department of Developmental Services assessment team appointed by the Commissioner of Developmental Services or his or her designee, no member of which is related by blood, marriage or adoption to either the petitioner or the respondent and each member of which has personally observed or examined the respondent within forty-five days next preceding such hearing. The assessment team SHALL be comprised of at least two representatives from among appropriate disciplines having expertise in the evaluation of persons alleged to have intellectual disability. Page 2 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Delaware District of Columbia DC ST 21-2041(d), (f) Florida Stat Ann. 744.331(3)(a) Georgia Code Ann. 29-4-11(d)(1) No information provided. The court SHALL appoint an appropriately qualified examiner who shall submit a report in writing to the court. In the case of an individual whose incapacity is alleged to arise out of an intellectual disability, preference is for the appointment of an examiner and visitor who are qualified development disability professionals and who can collectively give a complete social, psychological, and medical evaluation of the individual. Court shall appoint an examining committee consisting of three members. One member must be a psychiatrist or other physician. The remaining members must be either a psychologist, gerontologist, another psychiatrist, or other physician, a registered nurse, nurse practitioner, licensed social worker, a person with an advanced degree in gerontology from an accredited institution of higher education, or other person who by knowledge, skill, experience, training, or education may, in the court's discretion, advise the court in the form of an expert opinion. One of three members of the committee must have knowledge of the type of incapacity alleged in the petition. Unless good cause is shown, the attending or family physician may not be appointed to the committee. If the attending or family physician is available for consultation, the committee must consult with the physician. Court shall appoint an evaluating physician who shall be a physician licensed to practice medicine under Chapter 34 of Title 43, a psychologist licensed to practice under Chapter 39 of Title 43, or licensed clinical social worker or, if the proposed ward is a patient in any federal medical facility in which such a physician, psychologist, or licensed clinical social worker is not available, a physician, psychologist, or licensed clinical social worker authorized to practice in that federal facility, other than the physician, psychologist, or licensed clinical social worker who completed the affidavit attached to the petition pursuant to subsection (c) of Code Section 29-4-10. Page 3 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Hawaii 560:5-306 Idaho 15-5-303(b) State & Citation Illinois Ann. Stat. 5-11a-3 Indiana Iowa I.A.C. 633.551(4) Kansas K.S.A. 59-3064(a) Court may order a professional evaluation of the respondent and shall order the evaluation if the respondent so demands. If the court orders the evaluation, the respondent shall be examined by a physician, psychologist, or other individual appointed by the court who is qualified to evaluate the respondent's alleged impairment. The person alleged to be incapacitated shall be examined by a physician or other qualified person appointed by the court who shall submit his report in writing to the court. The court may, in appropriate cases, appoint a mental health professional, defined as a psychiatrist, psychologist, gerontologist, licensed social worker, or licensed counselor, to examine the proposed ward and submit a written report to the court. The person alleged to be incapacitated also shall be interviewed by a visitor sent by the court. The court MAY adjudge a person to be a person with a disability, but only if it has been demonstrated by clear and convincing evidence that the person is a person with a disability as defined in Section 11a-2. No information provided. The court SHALL consider credible evidence from any source to the effect of third-party assistance in meeting the needs of the proposed ward or ward. However, neither party to the action shall have the burden to produce such evidence relating to third-party assistance. The court SHALL order the proposed ward or proposed conservatee to submit to an examination and evaluation to be conducted through a general hospital, psychiatric hospital, community mental health center, community developmental disability organization, or by a private physician, psychiatrist, psychologist or other professional appointed by the court who is qualified to evaluate the proposed ward's or proposed conservatee's alleged impairment. Page 4 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Kentucky KY ST 387.540 State & Citation Louisiana LSA-C.C.P. Art. 4545 Maine 18-A M.R.S.A. 5-303(b) (1) Prior to a hearing on a petition for a determination of partial disability or disability and the appointment of a limited guardian, guardian, limited conservator, or conservator, an interdisciplinary evaluation report shall be filed with the court. The report may be filed as a single and joint report of the interdisciplinary evaluation team, or it may otherwise be constituted by the separate reports filed by each individual of the team. If the court and all parties to the proceeding and their attorneys agree to the admissibility of the report or reports, the report or reports shall be admitted into evidence and shall be considered by the jury. The report SHALL be compiled by at least three (3) individuals, including a physician or an advanced practice registered nurse, a psychologist licensed or certified under the provisions of KRS Chapter 319, and a person licensed or certified as a social worker or an employee of the Cabinet for Health and Family Services who meets the qualifications of KRS 335.080(1)(a), (b), and (c) or 335.090(1)(a), (b), and (c). The social worker shall, when possible, be chosen from among employees of the Cabinet for Health and Family Services residing or working in the area, and there shall be no additional compensation for their service on the interdisciplinary evaluation team. (2) At least one (1) person participating in the compilation of the report SHALL have knowledge of the particular disability which the respondent is alleged to have or knowledge of the skills required of the respondent to care for himself and his estate. After the filing of a petition for interdiction, the court MAY appoint an examiner who has training or experience in the type of infirmity alleged. The person alleged to be incapacitated must be examined by a physician or by a licensed psychologist acceptable to the court who SHALL submit a report in writing to the court, providing diagnoses, a description of the person's actual mental and functional limitations and prognoses. Page 5 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Maryland MD Rules, Rule 10-202 (a)(1), (a)(3)(b) Massachusetts M.G.L.A. 190B 5-303(b)(11) Michigan M.C.L.A. 700.5304(1) (a)(1) The petitioner SHALL file with the petition signed and verified certificates of (A) two physicians licensed to practice medicine in the United States who have examined the disabled person, or (B) one licensed physician who has examined the disabled person and one licensed psychologist or certified clinical social worker who has seen and evaluated the disabled person. (a)(3)(b) If the court finds after a hearing that examinations are necessary, it SHALL appoint two physicians or one physician and one psychologist or certified clinical social worker to conduct the examinations or the examination and evaluation and file their reports with the court. Petition SHALL set forth a statement: (A) that a medical certificate dated within 30 days of the filing of the petition or, in the case of a person alleged to have an intellectual disability, a clinical team report dated within 180 days of the filing of the petition, is in the possession of the court or accompanies the petition; or (B) of the nature of any circumstance which makes it impossible to obtain a medical certificate or clinical team report which shall be supported by affidavit or affidavits meeting the requirement set forth in Massachusetts Rule of Civil Procedure 4.1(h), in which case the court may waive or postpone the requirement of filing of a medical certificate or clinical team report. The court MAY order that an individual alleged to be incapacitated be examined by a physician or mental health professional appointed by the court who shall submit a report in writing to the court at least 5 days before the hearing set under section 5303. Page 6 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Minnesota M.S.A. 524.5-304(a), (f) Mississippi Code Ann. 93-13-255 Missouri Ann. Stat. 475.075(4), (5) Montana Code Ann. 72-5-315(3) The court SHALL set a date and time for hearing the petition and MAY appoint a visitor. The duties and reporting requirements of the visitor are limited to the relief requested in the petition The visitor SHALL promptly file a report in writing with the court, which must include: (1) recommendations regarding the appropriateness of guardianship, including whether less restrictive means of intervention are available, the type of guardianship, and, if a limited guardianship, the powers to be granted to the limited guardian; (2) a statement as to whether the respondent approves or disapproves of the proposed guardian, and the powers and duties proposed or the scope of the guardianship; and (3) any other matters the court directs. The chancery judge SHALL be the judge of the number and character of the witnesses and proof to be presented, except that there SHALL be included therein at least two (2) physicians who are duly authorized to practice medicine in this state, or another state or one (1) such physician and a psychologist, licensed in this state or another state, each of whom SHALL be required to make a personal examination of the subject party, and each of whom SHALL make in writing a certificate of the result of such examination. The court MAY direct that the respondent be examined by a physician or licensed psychologist or other appropriate professional designated by the court The court-appointed physician, licensed psychologist or other professional SHALL submit his report in writing to the court and to counsel for all parties. The person alleged to be incapacitated MUST be examined by a physician appointed by the court who SHALL submit a report in writing to the court and must be interviewed by a visitor sent by the court. Whenever possible, the court SHALL appoint as visitor a person who has particular experience or expertise in treating, evaluating, or caring for persons with the kind of disabling condition that is alleged to be the cause of the incapacity. Page 7 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Nebraska Neb.Rev.St. 30-2619(c) Nevada Rev. Stat. 159.044(2)(j) New Hampshire New Jersey N.J.S.A. 3B:12-24.1(d) The person alleged to be incapacitated MAY be examined by a physician appointed by the court. The physician SHALL submit his or her report in writing to the court and MAY be interviewed by a visitor A summary of the reasons why a guardian is needed and recent documentation demonstrating the need for a guardianship. If the proposed ward is an adult, the documentation MUST include, without limitation: (1) A certificate signed by a physician who is licensed to practice medicine in this State or who is employed by the Department of Veterans Affairs, a letter signed by any governmental agency in this State which conducts investigations or a certificate signed by any other person whom the court finds qualified to execute a certificate, stating: (I) The need for a guardian; (II) Whether the proposed ward presents a danger to himself or herself or others; (III) Whether the proposed ward's attendance at a hearing would be detrimental to the proposed ward; (IV) Whether the proposed ward would comprehend the reason for a hearing or contribute to the proceeding; and (V) Whether the proposed ward is capable of living independently with or without assistance; and (2) If the proposed ward is determined to have the limited capacity to consent to the appointment of a special guardian, a written consent to the appointment of a special guardian from the ward. No information provided. Physicians and psychologists licensed by the State are authorized to disclose medical information, including but not limited to medical, mental health and substance abuse information as permitted by State and federal law, regarding the alleged incapacitated person in affidavits. Page 8 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

New Mexico N. M. S. A. 1978, 45-5-303(D) New York Mental Hygiene Law 81.09(a), (b)(1) North Carolina N.C.G.S.A. 35A-1111(a), (b) North Dakota Cent. Code 30.1-28-03(3) Ohio R.C. 2111.031 The person alleged to be incapacitated SHALL be examined by a qualified health care professional appointed by the court who SHALL submit a report in writing to the court. The court SHALL appoint a court evaluator. [ ] the court MAY appoint as court evaluator any person including, but not limited to, the mental hygiene legal service in the judicial department where the person resides, a not-for-profit corporation, an attorney-at-law, physician, psychologist, accountant, social worker, or nurse, with knowledge of property management, personal care skills, the problems associated with disabilities, and the private and public resources available for the type of limitations the person is alleged to have. The clerk, on his own motion or the motion of any party, MAY order that a multidisciplinary evaluation of the respondent be performed. If a multidisciplinary evaluation is ordered, the clerk SHALL name a designated agency and order it to prepare, cause to be prepared, or assemble a current multidisciplinary evaluation of the respondent. Upon the filing of a petition, the court SHALL set a date for hearing on the issues of incapacity, appoint an attorney to act as guardian ad litem, appoint a physician or clinical psychologist to examine the proposed ward, and appoint a visitor to interview the proposed guardian and the proposed ward. The court MAY appoint physicians and other qualified persons to examine, investigate, or represent the alleged incompetent, to assist the court in deciding whether a guardianship is necessary. Page 9 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Oklahoma Stat. Ann. 30 3-108(A), (B) Oregon Rev. Stat. 125.150 A. After the filing of the petition, the court MAY, on its own motion or at the request of any party to the proceeding, if the court determines it to be for the best interest of the ward, order an evaluation of the subject of the proceeding B. Any evaluations made pursuant to the Oklahoma Guardianship and Conservatorship Act, as appropriate for the condition or alleged condition of the person being evaluated, SHALL be performed by: 1. a physician; 2. a psychologist; 3. a social worker with a graduate degree in social work and field training or experience in working with incapacitated or partially incapacitated persons; or 4. other expert with knowledge of the particular incapacity or disability which the individual is alleged or has been found to have, or knowledge of the skills required to meet the essential requirements for the individual's physical health or safety or to manage that individual's financial resources. The court SHALL appoint a visitor upon the filing of a petition in a protective proceeding [ ] A visitor MAY be an officer, employee or special appointee of the court. The person appointed MAY NOT have any personal interest in the proceedings. The person appointed MUST have training or expertise adequate to allow the person to appropriately evaluate the functional capacity and needs of a respondent or protected person Page 10 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

20 Pennsylvania C.S.A. 5511, 5518 Rhode Island Gen. Laws 33-15-4(a)(1) South Carolina Code 1976 62-5-303(b) Section 5511: The court, upon its own motion or upon petition by the alleged incapacitated person for cause shown, SHALL order an independent evaluation which shall meet the requirements of section 5518 (relating to evidence of incapacity). The court SHALL give due consideration to the appointment of an evaluator nominated by the alleged incapacitated person. Section 5518: the petitioner must present testimony, in person or by deposition from individuals qualified by training and experience in evaluating individuals with incapacities of the type alleged by the petitioner, which establishes the nature and extent of the alleged incapacities and disabilities and the person's mental, emotional and physical condition, adaptive behavior and social skills. One such decision making assessment tool MUST be completed by the respondent's primary care physician, if one exists and is available, otherwise by a physician who has examined and treated the respondent. The probate court MAY consider such additional decision making assessments tools signed and submitted by one or more non-physicians or consulting physicians. The person alleged to be incapacitated SHALL be examined by two examiners, one of whom shall be a physician appointed by the court who SHALL submit their reports in writing to the court. Page 11 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

South Dakota Codified Laws Ann. 29A-5-306(8), (9) Tennessee Code Ann. 34-3-105(a) Vernon s Texas Statutes Codes Ann. Estates Code 1101.103(c) The petition SHALL include a report evaluating the condition of the person alleged to need protection which SHALL contain [ ]: The signature of a physician, psychiatrist or licensed psychologist, and the signatures of any other individuals who made substantial contributions toward the report's preparation The date of any assessment or examination upon which the report is based and if any of the assessments or examinations were performed more than three months prior to the date of the filing of the petition, a statement by a physician, psychiatrist or licensed psychologist that there has been no material change in the condition of the person alleged to need protection since the dates that such assessments or examinations were performed. If the respondent has been examined by a physician or, where appropriate, a psychologist or senior psychological examiner not more than ninety (90) days prior to the filing of the petition and the examination is pertinent, the report of the examination SHALL be submitted with the petition. If the respondent has not been examined within ninety (90) days of the filing of the petition, cannot get out to be examined or refuses to be voluntarily examined, the court SHALL order the respondent to submit to examination by a physician or, where appropriate, a psychologist or senior psychological examiner identified in the petition as the respondent's physician, psychologist or senior psychological examiner or, if the respondent has no physician, psychologist or senior psychological examiner, a physician, psychologist or senior psychological examiner selected by the court. If the court determines it is necessary, the court MAY appoint the necessary physicians to examine the proposed ward. The court MUST make its determination with respect to the necessity for a physician's examination of the proposed ward at a hearing held for that purpose. Not later than the fourth day before the date of the hearing, the applicant SHALL give to the proposed ward and the proposed ward's attorney ad litem written notice specifying the purpose and the date and time of the hearing. Page 12 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

Utah Code Ann. 75-5-303(4) Vermont Stat. Ann. Tit. 14 Section 3067(a), (b) Virginia Code Ann. Section 64.2-2005(A) Washington Rev. Code Ann. 11.88.045(4) The person alleged to be incapacitated MAY be examined by a physician appointed by the court who SHALL submit a report in writing to the court and MAY be interviewed by a visitor sent by the court. The court SHALL order an evaluation of the respondent [ ] The evaluation SHALL be performed by someone who has specific training and demonstrated competence to evaluate a person in need of guardianship. A report evaluating the condition of the respondent SHALL be filed, under seal, with the court and provided to the guardian ad litem, the respondent, and all adult individuals and all entities to whom notice is required under subsection C of 64.2-2004 within a reasonable time prior to the hearing on the petition. The report SHALL be prepared by one or more licensed physicians or psychologists or licensed professionals skilled in the assessment and treatment of the physical or mental conditions of the respondent as alleged in the petition. If a report is not available, the court MAY proceed to hold the hearing without the report for good cause shown, absent any objection by the guardian ad litem, or MAY order a report and delay the hearing until the report is prepared, filed, and provided. In all proceedings for appointment of a guardian or limited guardian, the court must be presented with a written report from a physician licensed to practice under chapter 18.71 or 18.57 RCW, psychologist licensed under chapter 18.83 RCW, or advanced registered nurse practitioner licensed under chapter 18.79 RCW, selected by the guardian ad litem. If the alleged incapacitated person opposes the health care professional selected by the guardian ad litem to prepare the medical report, then the guardian ad litem shall use the health care professional selected by the alleged incapacitated person. The guardian ad litem may also obtain a supplemental examination. The physician, psychologist, or advanced registered nurse practitioner shall have personally examined and interviewed the alleged incapacitated person within thirty days of preparation of the report to the court and shall have expertise in the type of disorder or incapacity the alleged incapacitated person is believed to have. Page 13 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016

West Virginia Code 44A-2-3 Wisconsin WI ST 54.36(1) Wyoming State & Citation The petition shall include a report by a licensed physician or psychologist evaluating the condition of the alleged protected person. Whenever it is proposed to appoint a guardian on the ground that a proposed ward allegedly has incompetency or is a spendthrift, a physician or psychologist, or both, shall examine the proposed ward and furnish a written report stating the physician's or psychologist's professional opinion regarding the presence and likely duration of any medical or other condition causing the proposed ward to have incapacity or to be a spendthrift. No information provided. Page 14 ABA Commission on Law and Aging www.americanbar.org/aging As of July 29, 2016