![]() ![]() Lastly, the HCBS Settings Rule explicitly talks about informed consent when establishing modifications. If there are disagreements, conflict resolution is critical including: 1) addressing through the planning/treatment team/person-centered planning process 2) involving the ISC agency and 3) involving an advocacy agency or involving the court where the guardianship was established for challenging disputes. In addition, with the new modification of the Settings' rights process through the person-centered planning process, the personal plan should note a modification to Settings rights that is temporary and should be revisited and outlines the safety concerns and the implementation strategies should follow suit. The guardian should have a reason for saying no and not following the person's wishes rather than just unilaterally and in a vacuum saying no. The ward's wishes and the guardian's reasoning all come into play. If the guardian has a concern about access to a lock posing a safety risk of some kind, that would justify saying no. The guardian still has the final legal authority to make the decision, assuming it's a plenary guardianship, but they should make the decision according to the ward's wishes. The Probate Act's Substituted Judgment standard for decision-making has been updated, and it now requires the guardian to make decisions in conformity with the ward's wishes unless they will cause substantial harm. This means that when addressing Settings implementation (lockable doors, visitors, etc.), ISCs and providers should work with the guardian and person receiving services. It instructs the guardian on how to make decisions incorporating the ward's wishes. The substituted judgment standard flows between guardian and ward, not service provider and ward. This is based on feedback received from the Guardianship and Advocacy Commission/Office of State Guardian and is a correction/update to information shared during a previous training regarding access to locks for people receiving HCBS. ![]() Update on Room and Board for Residency AgreementsÄDD wants to clarify how to address Home and Community-Based Services (HCBS) Settings-related issues between people receiving services and guardians.New Resource - Training for DSPs on Settings.Guardian Engagement in Settings Clarification. ![]()
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