Common Questions

Client's under guardianship come with unique procedures and paperwork. I am not a lawyer. I have been a professional guardian for over ten years. If you have questions, please speak to a lawyer. The information on this page is only for professionals to reference information.

It is my hope to help professionals understand the complex paperwork, unique processes, and different legal requirements per a client under guardianship may require. The information on this page is for reference only and pertains to clients under guardianship in the Commonwealth of Massachusetts. 

ANTIPSYCHOTICS MEDICATIONS & ROGERS TREATMENT PALN

A client who is appointed a guardian and prescribed ANY kind of antipsychotic medications must have a court approved Rogers Treatment plan. 

 

The following antipsychotic medications are commonly found on a Rogers Treatment plan and need to be approved by the court:

 

  • Abilify (aripiprazole)

  • Abilify Maintena (Aripiprazole)

  • Aristada (Aripiprazole Lauroxil)

  • Caplyta (Lumateperone)

  • Clozaril (clozapine)

  • Geodon (ziprasidone)

  • Haldol (haloperidol)

  • Haldol Decanoate (Haloperidol Decanoate)

  • Invega (Paliperidone)

  • Invega Sustenna (Paliperidone Palmitate)

  • Invega Trinza (Paliperidone Palmitate)

  • Latuda (Lurasidone HCl)

  • Loxitane (loxapine)

  • Mellaril (thioridazine)

  • Moban (molindone)

  • Navane (thiothixene)

  • Prolixin (fluphenazine)

  • Prolixin Decanoate (Fluphenazine decanoate)

  • Serentil (mesoridazine)

  • Seroquel (quetiapine)

  • Stelazine (trifluoperazine)

  • Thorazine (chlorpromazine)

  • Trilafon (perphenazine)

  • Rexulti (Brexpiprazole)

  • Risperdal (risperidone)

  • Risperdal Consta (Risperidone Consta LAI)

  • Zyprexa (olanzapine)

  • Zyprexa Relprevv (Olanzapine Pamoate)

The client's Rogers Treatment plan must be reviewed, and approved, by the court every year.

 

 

 

 

 

WEEKEND MEDICAL CARE FOR CLIENTS

Guardians cannot answer their phone 24 hours a day, 7 days a week, 365 days a year.  If a client is receiving medical care on the weekend, PLEASE TREAT THE CLIENT. 

  • DOCTORS = Please provide LIFESAVING medical care to clients on the weekend. 

  • If a client swallowed something, and the X-ray shows the client will die unless the item is immediately removed = Please do an endoscopy and remove the object.

    • If a client swallowed something, and the X-ray shows client will not die if the item is allowed some time = LET'S GIVE THE ITEM SOME TIME.  A liquid died never hurt anyone. Please place the client on a liquid diet and allow nature to move the item out naturally. 

    • Constant endoscopies to remove objects leads to considerable tooth and esophageal damage. Please think twice if you do an endoscopy as it is likely not the client's first. 

  • You are the medical doctor. I am not. If you believe a medical treatment must happen, then treat the client.​

  • A doctor does not need the legal guardian's approval when providing lifesaving medical treatment to a client.

  • If the client receives medical care, please email me or send me a message regarding the reason and the outcome. I appreciate the communication!

 <><><>< GROUP HOMES ><><><>

  • DO NOT SCHEDULE A CLIENT'S MEDICAL PROCEDURES ON A WEEKEND!!!!!

    • Yes, this sounds obvious but client are still scheduled for routine medical care such as a colostomy or endoscopy on the weekends. ​

    • I will not always answer my phone on the weekends and, therefor, cannot give legal consent for anesthesia and the procedure.

COURT GUARDIANSHIP PAPERWORK DOES NOT EXPIRE

PROBATE COURT GUARDIANSHIP paperwork does not expire until the Probate Court appoints the client a new guardian. The guardian does not receive new guardianship paperwork from the Probate Court ever year with a new date.

If the client has a Rogers Treatment Plan, (an antipsychotic medication order signed by a Judge), the guardian will receive yearly paperwork with updates pertaining to the client's renewed Rogers Treatment Plan. The client's court guardianship paperwork will always be dated the original date the guardian was appointed. THE SYSTEM WILL NOT CHANGE.

HOW TO VERIFY ONLINE WHO IS THE COURT APPOINTED LEGAL GUARDIAN OF A CLIENT IN THE COMMONWEALTH OF MASSACHUSETTS -- Two ways --

1. If the client has an active Rogers Treatment Plan, the Probate Court will mail the legal guardian updates. 

 

2. Please the see instructions on how to access MASS COURTS PUBLIC DOCKET  

NOTICE OF INTENT TO ADMIT TO A NURSING FACILITY FOR SHORT TERM SERVICES.

FOR A CLIENT to be placed in a nursing home by a guardian, the first box on the second page of a client's guardianship paperwork needs to be checked off.

For the multitude of clients who require short-term nursing home rehab (or nursing home care due to decline), there must be a way for clients to immediately access the appropriate level of care.

 

The probate court has a solution to enable guardians to ensure clients can access the appropriate level of care regardless of boxes checked on court paperwork. The solution is the mpc829 form titled: 'NOTICE OF INTENT TO ADMIT TO A NURSING FACILITY FOR SHORT TERM SERVICES.' The form is commonly referred to as the '60-day notice to admit' form. As the title infers, clients are only allowed up to 59 days of nursing home level of care.

 

By day 30 of the client's nursing home stay the client's overall ability is being assessed, and (if needed) appropriate legal paperwork is being sent to amend the guardianship for nursing home placement authority. 

OBTAINING A CLIENT'S

IDENTIFICATION CARD

Many clients are unable to obtain a legal state identification card or Social Security Card due to mental health reasons.

To obtain a Social Security Card, send the following in to the local Social Security Administration Office:

  • Legal Birth Certificate of the client

  • Print out or discharge for a hospital which lists the client's name, date of birth, and social security number on the hospital or clinic paperwork. The SSA will call and verify the hospital / clinic information. 

  • The client's current physical address located in MA.

  • Valid/legal court guardianship paperwork of the client

To obtain a valid, state-issued Mass ID, Send the following in to the local MA RMV:

  • Legal Birth Certificate of the client.

  • Letter from Psychiatrist/Medical Doctor on valid medical letterhead stating why the client cannot physically come into the RMV. Helpful if the doctor documents the client's current physical address in the letter. Just another verification for the RMV.

  • The client's valid Social Security Card (with their name on it) and SS number.

  • The client's current physical address located in MA.

  • Valid/legal court guardianship paperwork of the client

THE MASS COURTS

PUBLIC DOCKET

There is a way, through the Mass.gov court system, to verify online if a client has a court appointed guardian and the name of the appointed guardian. 

VERIFY a guardian is assigned

to a client's case:

  • Please go to "MASS.GOV, trial court docket"

  • Click the bottom button the search public records to verify you are not a robot.

  • The next page is MASSACHUSETTS TRIAL COURTS ELECRTONIC CASE ACCESS

  • From Court Departments, Please select "PROBATE COURT"

    • Please Select "PLYMOUTH COUNTY" - Whatever Probate court the client has his guardianship out of. 

  • Please look the client up by last name and first name.

  • Please press enter at the bottom of the page

    • From the list given blue, please select the correct docket number assigned to that client. 

** If the client has an active Rogers Treatment Plan, the Probate Court will mail the legal guardian updates.

WHEN DO CLIENTS NEED A COURT APPROVE ROGERS TREATMEN PLAN?

IF A CLIENT is appointed a legal guardian and is prescribed antipsychotic medications, that client must have an approved Rogers Treatment Plan = antipsychotic medication order signed by the Judge.  A client under guardianship cannot take antipsychotic medication without the approval of the court and a Rogers Monitor assigned to the client's case.  A Legal Guardian and a Rogers Monitor are two separate positions. General Laws (G.L. c. 123, § 8B) of the 191st General Court of the Commonwealth of Massachusetts;

A guardian who serves in this (monitor) capacity is often referred to as a “Rogers Guardian,” a term that has resulted in much confusion and that should be avoided. The correct term is Rogers Monitor. The Rogers Monitor's responsivities are to visit with the client, review the efficacy of the treatment and the provider’s compliance with the treatment plan. The Rogers Monitor will immediate notify the court and counsel of noncompliance, adverse side effects, or a substantial change in the client’s circumstances or condition.

A client's Rogers treatment plan USUALLY expires every twelve months.

HOW ARE DMH GLE CLIENTS APPROVED FOR NURSING HOME LEVEL OF CARE

THE FOLLOWING ONLY applies to DMH clients who reside in DMH state-contracted service provider managed GLEs. 

As a guardian of of a DMH client, I cannot ask the DMH legal office to amend a client's legal guardianship to include nursing home authority.  

BayCove, Vinfen, AHA, North Suffolk, Open Sky, ect. has a contract with DMH and is legally responsible for the client's placement.  BayCove, Vinfen, AHA, North Suffolk, Open Sky, ect. is the DMH state-contracted service provider.

If a client under the care of the DMH state-contracted service provider requires a higher level of care, only the DMH state-contracted service provider can contact DMH Legal with this information. The client's legal guardianship decree will needs to be change (AMENDMENDED). When a client requires SNF (Skilled Nursing Home) level of care, the DMH state-contracted service provider would contact the DMH legal office and notify them regarding the circumstances of the client's needs.

Just like a recipe, everything must happen in a certain order, by certain people.  The DMH legal office will only start the court process of amending the client's guardianship to include SNF care (Skilled Nursing Home) once the DMH state-contracted service provider has a discussion with them regarding the client's level of care needs. 

Once the DMH state-contracted service provider has informed DMH legal, there will be a few documents that must be filled out and obtained by the client's providers.  The client will also need to be be evaluated by a MassHealth RN to be 'Leveled' for SNF care. 

There always seems to be confusion regarding who ultimately directs the client's placement and care when talking to DMH legal. The answer is always the DMH state-contracted service provider for the client.