Comment #1: Self-Determination and Guardianship

On March 19, 2012, the Michigan Department of Community Health (MDCH) issued a request for comments on changes to the “Behavioral Health and Developmental Disabilities Self-Determination Policy & Practice Guideline”. As so often happens, the request for comments was not widely distributed among people directly affected by the proposed changes.  I read the proposed changes only three days before the end of the comment period and then distributed the request for comments to people on my e-mail list for Friends of the Developmentally Disabled. Other family groups and advocates for people with developmental disabilities did the same. Many requests were made to extend the comment period beyond the April 20th date in the initial request for comments. The comment period has been extended to May 11, 2012.


Here is a copy of my general comments with background information on Guardianship and Self-Determination. Here are specific wording changes that I recommended to MDCH.

My comments are my own observations and views on guardianship, developmental disabilities (DD), and Self-Determination based on what I hear from families and what I know about my two adult sons who have severe DD and profound Intellectual Disabilities (ID).

The Guideline uses the acronym PIHP/CMHSP that stands for Prepaid In-patient Health Plans and Community Mental Health Services Program. Both organizational structures are part of Michigan’s Community Mental Health system. In my comments, I refer to Community Mental Health or CMH, a more familiar phrase to most people, to include PIHPs and CMHSPs. I use the term Guardian to refer to a court-appointed legal representative of a person with DD who is found by the Probate Court to have mental and adaptive limitations that limit the individual’s ability to make reasonable decisions.

The proposed changes to the Guideline on Self-Determination appear to be primarily for the purpose of limiting the participation of court-appointed guardians of people with DD in the planning and implementation of Self-Determination. The changes would allow CMH and others involved in person centered planning to mediate perceived disagreements between the guardian and the ward and even to exclude an individual from participation in Self-Determination because of perceived disagreements with the guardian.  Changes would also require that CMH help individuals find  “independent” advocates to represent the person’s interests in planning when the individual already has a legal guardian.