Colloquium on Guardianship

Presented virtually in two half-day sessions:
Thursday, May 20 and Wednesday, May 26, 2021
1:35 pm – 5:00 pm Eastern

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Day 1 Schedule
Day 2 Schedule
Educational Credits

NGA’s Colloquium on Guardianship, offered once every several years, is a one-day event designed to provide an in-depth look at one theme, something that can’t be achieved during NGA’s full conference. The Colloquium is being offered virtually this year, in two half-day sessions. The theme, Details of Decision-Making, focuses on medical decision-making for various populations. Designed as education for more experienced guardians, the Colloquium will provide participants with tools for helping make medical decisions for people in their care.

Day 1 | Thursday, May 20, 2021
Times shown are Eastern Daylight Time

What Every Great Guardian Should Know About Health Care Decision-Making, Parts 1 and 2

Making decisions about a person’s health care is often one of the most challenging responsibilities a guardian may face. The role of the guardian to make, or assist a person to make, health care decisions ranges widely from scheduling routine appointments to authorizing serious surgical procedures and end-of-life decisions. While the definition of a guardian’s roles and responsibilities varies from one state to the next, guardians generally have the broad responsibility and authority to make independent decisions regarding the care, services, and treatments for persons in their care, and are expected to access all of the necessary information available to ensure those decisions are informed. The workshop presenters will explore the guardian’s role in making health care decisions for a variety of populations, and will provide an overview of existing laws, ethics, standards, practices, and tools that offer critical guidance in this area.

1:35 pm – 1:45 pm | Opening Remarks

1:45 pm – 3:15 pm | Part 1
The Ethics of Health Care Decision-Making As A Guardian
Michael Jenuwine, PhD, JD, University of Notre Dame Law School

Generally, guardians are charged by state statute with exercising “substituted judgment” for or acting in the “best interest” of the protected persons in their charge. The legal meaning for these concepts is most often not clearly understood and, in the context of health care decision-making, they can also be particularly problematic. This session will provide attendees with a general road map for understanding legal and ethical decision-making in the health care arena.

Critical Health Care Decision-Making Considerations for Adults with Intellectual and Developmental Disabilities
Mary R. Ciccarelli, MD, Indiana University

Intellectual and developmental disabilities may involve conditions that impose limitations upon a person’s ability to care for themselves, express themselves, or live independently. Guardians are expected to understand the factors that can contribute to these limits particularly regarding health care choices, and ultimately support them in making their own health care decisions with as much self control and reliance as possible. This session will provide attendees with an overview of the health care decision-making needs of persons with disabilities, and offer insights and tools to provide support for the decision-making roles of both the person and the guardian.

3:15 pm – 3:30 pm | Break

3:30 pm – 5:00 pm | Part 2
Critical Health Care Decision-Making Considerations for Adults With Mental Illness
Tracy D. Gunter, MD, Indiana University School of Medicine, Department of Psychiatry

Persons with mental illness who are under a guardianship court order are generally considered to have a level of impaired decisional capacity that interferes with their ability to understand and appreciate the nature and consequences of the decision-making that allows them to reach their own informed decisions. While a person’s functional ability is based on a number of factors, it is important for guardians to understand that decision-making capacity exists on a continuum, is highly contextual, and can be intermittent. This session will provide attendees with an overview of the decision-making capacity of persons with mental illness, appreciation for the roles of the treating doctor and forensic consultant in guardianship matters, and will challenge them to consider alternatives to guardianship in the management of persons with intermittent incapacity.

Critical Health Care Decision-Making Considerations for Aging Adults
Rajarajeswari Majety, MD, CMD, Franciscan Physician Network

Health care decision-making directly impacts the quality of life and quality of care for aging adults, particularly for those who are in hospitals or long term care nursing facilities. The process of making timely, appropriate, and cost effective health care decisions can be challenging in these cases. The role of the guardian in making, or assisting the aging person to make, health care decisions must include understanding and appreciating the nature and consequences of the decisions, including the benefits, risks, costs, and alternatives to any proposed health care in order to reach an informed decision. This session will provide attendees with key content to support health care decision-making for aging persons, and practical considerations for ways to fulfill the role of the guardian.

5:00 pm | Day 1 Closing Remarks

Day 2 | Wednesday, May 26, 2021
Times shown are Eastern Daylight Time

1:35 pm – 1:45 pm | Opening Remarks

1:45 pm – 3:15 pm | How to Make (and NOT Make) End-of-Life Decisions
Anthony Palmieri, JD, Clerk and Comptroller, Division of Inspector General, Palm Beach County
Tonia A. Wells, MSW, CSW, CBIS, Kentucky Cabinet for Health & Family Services, Division of Guardianship
Mary Ailiff, RN, Kentucky Cabinet for Health & Family Services, Division of Guardianship

The story of a Florida guardian accused of filing unauthorized “do not resuscitate” orders and other misconduct made national news. The investigation will be discussed by the state’s Chief Guardianship Investigator, along with lessons every guardian can learn about why, how, and when to file — or not file — DNR orders. Our presenters will discuss the process of end-of-life decision-making in depth, including why one state developed a special medical decision-making protocol and how it is implemented.

3:15 pm – 3:30 pm | Break

3:30 pm – 5:00 pm | Rosemary Kennedy and Britney Spears: A Comparative Discussion of Medical Decision-Making in the 20th and 21st Centuries
Terry W. Hammond, JD, Texas Guardianship Association

Rosemary Kennedy, who has been referred to as the ” Lost Kennedy Daughter,” suffered from chronic mental illness. She was lobotomized in 1941, at the age of 23, upon the approval of her father.

Entertainer Britney Spears has reportedly been diagnosed with a mental illness, and was placed under conservatorship by her father in 2008 when she was 27, drawing the wrath of many under “#freebritney.”

This session will provide insight into factors that have led to evolution of surrogate decision-making practices over the past century, while analyzing ongoing challenges to reform and protect the individual rights of those requiring protection.

5:00 pm | Colloquium Closing Remarks

About Continuing Education Credits

Attendees participating in all live sessions can earn a potential of 6.0 credit hours. Participants who attend recorded sessions following the Colloquium may be limited, as not all accrediting bodies accept recorded sessions for credits. Because each accrediting body must approve the program prior to assigning credits, the specific number of credits accepted by each state and for each type of credit will not be definite until May. Keep in mind that not all hours will be deemed acceptable for all types of credit. Questions about continuing education credits can be sent to Kelly Dolan at or by calling NGA at 877-326-5992, ext. 2.

Proof of Attendance
NGA moderators and presenters will announce three codes during each session: one at the beginning of the session, one during the session, and another at the end of the session. Codes MUST be entered on attendance verification forms to receive proof of attendance. Should you miss one of the codes, please insert the time you arrived/left the session in place of the code. Moderators, staff, and other attendees are unable to repeat these codes, as this is a requirement to verify attendance for continuing education credit. Falsifying information can result in loss of education hours for all attendees. Attendance forms must be completed and submitted to receive any credit; NGA strongly advises that all attendees submit attendance verification forms to document your participation should you need record of it in the future.

Verified Certificate of Attendance
The Colloquium registration includes a verified certificate for every attendee who submits an attendance verification sheet which uses a code system for each session. This certificate can be submitted as proof of attendance to areas of education where NGA did not seek preapproval.

Guardianship Credits
NGA’s Colloquium is approved for guardianship continuing education credits by the Center for Guardianship Certification (CGC) and the California Fiduciary Bureau. The verified certificate is accepted as proof of attendance for these organizations, as well as for Texas Guardianship Certification. NGA also applies to CE Broker (Florida Public Guardian Office) and Professional Guardian Certification Board of Washington State. Certificate fees apply to receive Guardianship CEUs for Florida and Washington.

Social Work Credits
NGA applies for social work credits with the NASW. Please verify that your state accepts the NASW approval. For a certificate documenting the pre-approved social work credits, a fee will be required.

Continuing Legal Education Credits
While NGA typically applies to an event’s host state for CLE credits, it is unable to do so for a virtual event. Individuals seeking legal credits should contact their state bar associations prior to the Colloquium to determine the steps needed to receive credit. If you need assistance with supporting documents, please contact A verified certificate is included in the Colloquium fee.

Issuing of Certificates
To issue your certificate in a timely manner, NGA must receive your attendance code verification form promptly. Colloquium sessions will be available to view for one month following the event, and forms will be accepted until July 7. If received after this date, a late fee of $25 will be charged. Certificates can be downloaded online. All certificates ordered before the Colloquium will be issued by August 7. Registered attendees will receive a virtual Colloquium packet prior to the event, and this document will include the most current continuing education information.