Thursday, April 19, 2012

MDCH Proposal to change Self-Determination Policy and Practice Guidelines

Update: The comment period has been extended until 5 p.m., May 11, 2012. The e-mail address for sending in comments has not been working properly. Send comments, including those that were sent to Ellen Hyman after April 17, to Cynthia Gilpin at .

Comments due Friday, April 20, 2012

Self-Determination is a method of delivering services to people with developmental disabilities that allows individuals to have more control over the services they receive, the people who provide the services, and the expenditure of public funds to pay for the services. This is an option that must be made available by CMH agencies for anyone who desires it, including people with the most severe disabilities who have guardians who speak on their behalf. People who want and need a more traditional program of services may choose not to use Self-Determination.

The Michigan Department of Community Health (MDCH) proposal to revise guidelines for Self-Determination includes encouragement of Community Mental Health (CMH) agencies to police guardians and circumvent their authority to make decisions. Guardians are appointed by the probate court for adults who are unable to make decisions for themselves in all or some areas of their lives. The vast majority of guardians are parents or other family members of adults with developmental disabilities who have intimate knowledge of the needs and preferences of their family members.

Among other things, the proposed guidelines say that CMH must "…support  individuals who have guardians who are using arrangements that support self-determination to identify an independent advocate."(emphasis added). Presumably, you could find yourself at a Person Centered Planning meeting with an advocate you do not know and did not choose to be there, representing the interests of your family member.  The proposal goes on to say that when guardians "restrict the individual's rights", CMH can terminate the self-determination arrangements, even though the individual and the guardian have chosen this method of service delivery.

If adopted, this wording would become part of the contract language for CMH agencies with the state.

This is from Tom Bird of ddAdvocates of Western Michigan: 

"…DCH [Department of Community Health] has repeatedly tried to intervene in the Court's authority over guardianship. The Legislature has, in the past, issued 'boilerplate' restrictions on DCH using it's funding to usurp guardianship. Could this just be one more misguided attempt to assert the DCH 'superior wisdom' on services over the wishes of the family and guardians of those who may not be able to communicate their wishes effectively for themselves? The Bureaucratic arrogance of the 'professionals' who think they know better than everyone else must be tempered by the rights of the consumer and his/her guardian. This is the core principle of PCPlanning and 'choice' of the consumer in service delivery. It should apply equally in the area of self determination.

"Guardianship, when necessary, is firmly established in the state Mental Health Code as a matter under the authority and oversight of the Judicial Branch. If there are cases of guardianship abuse or neglect, then the proper manner of handling that is to bring it to the Courts to decide the matter, not for the DCH to overrule the guardian unilaterally. Watch out!!!"

Resources for understanding and commenting on the MDCH proposals: 

  • Self-Determination Guidelines with changes in "Bold": Pages 10 - 13 are specifically about guardians. 
  • Summary of proposed changes 
  • "Proposed Policy diminishes role of guardians…" from 2010 in The DD News Blog. This was a similar attempt to change the Self-Determination Guidelines in 2010. Here the emphasis was on encouraging CMH agencies to challenge guardianships in court when CMH determined that guardians were not living up to their responsibilities.
  •  Links to all sections of Michigan's guardianship law for adults with developmental disabilities
Comments are due tomorrow (!), 4/20/12. If you have comments prepared, send them to Ellen Sugrue HymanE-mail the Director of the Department of Community Health Olga Dazzo asking that the comment period be extended so that more families have a chance to weigh-in on these proposals. If the MDCH does not extend the comment period beyond tomorrow, send your comments anyway, but to more people. Here are others who need to hear from you: Lynda Zeller, Deputy Director of Mental Health and Substance Abuse Administration; state Representatives and Senators from Washtenaw County; Governor Rick Snyder at

I will try to post my comments on the guidelines tomorrow.

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