Legal authority

Minn. Stat. §252A.01 to §252A. 21, Uniform Guardianship and Protective Proceedings Act (Minn. Stat. §524.5-101 to §524.5-502), Minn. Stat. §626.557, subd. 10(c), 2-3, Minn. R. 9525.3010 to 9525.3100

Overview

The county-designated public guardian must receive the DHS commissioner’s written approval to give:

The following sections explain the approval process for each non-delegated, public guardianship power.

DNR/DNI orders

To request the power to give a DNR/DNI order, the county-designated public guardian must:

1. Obtain a health summary from the person’s physician that documents the physician’s recommendation for DNR/DNI orders and at least one of the following:

2. Prepare a request that documents the following:

3. Submit all of the materials, including the health summary, to the DHS Public Guardianship Office.

Additional information

If any interested party objects to DNR/DNI orders (e.g., the person’s family), a medical ethics committee should review the request before the county-designed public guardian submits it to the DHS Public Guardianship Office.

LMT orders (including hospice)

To request the power to give an LMT order, the county-designated public guardian must:

1. Obtain a health summary from the person’s physician that documents the physician’s recommendation for LMT orders and at least one of the following:

2. Prepare a request that documents the following:

3. Submit all of the materials, including the health summary, to the DHS Public Guardianship Office.

Additional information

The request for the power to give an LMT order may be for either:

Choosing hospice restricts other treatment and payment. This choice may affect the care the person receives from residential providers. For more information, refer to CBSM – Hospice.

If any interested party objects to LMT orders (e.g., the person’s family), a medical ethics committee should review the request before the county-designated public guardian submits the request to the DHS Public Guardianship Office.

Consent to participate in research

To request the power to give consent for the person to participate in research, the county-designated public guardian must:

1. Prepare a request that includes all of the following:

2. Include the following information in the request if the research involves more than minimal risk:

3. Submit the request to the DHS Public Guardianship Office.

Additional information

Research is a study in which a person or group of people receives a treatment/intervention and is compared to another similar person or group of people who receive either no treatment/intervention or an alternative treatment/intervention. The study must be conducted under a formal design. Research does not include:

Consent for temporary care at a regional treatment center

To request the power to give consent for the person to temporarily receive care at a regional treatment center, the county-designated public guardian must:

1. Prepare a request that includes all of the following:

2. Submit the request to the DHS Public Guardianship Office.

Additional information

If the person is expected to stay at the regional treatment center more than 90 days, the county-designated public guardian must follow the civil commitment process (refer to Minnesota Judicial Branch – Mental health and civil commitment).

Consent for electroconvulsive therapy, experimental treatment or psychosurgery

To request the power to give consent for the person to receive electroconvulsive therapy, experimental treatment or psychosurgery, the county-designated public guardian must:

1. Visit the person to observe their condition.

2. Inform the person of the procedure, potential risks and reasons for the procedure in a way they can understand.

3. Obtain the nearest relative’s opinion, to the extent possible.

4. Obtain a physician's recommendation that includes the following:

5. Make a recommendation for or against the procedure.

6. Prepare a request that includes verification that the county-designated public guardian met the requirements above.

7. Submit all of the materials, including the physician’s recommendation, to the DHS Public Guardianship Office.

Additional information

If any interested party objects to the person receiving electroconvulsive therapy, experimental treatment or psychosurgery, a medical ethics committee should review before the county-designated public guardian submits the request to the DHS Public Guardianship Office.

Requests for the power to give consent for electroconvulsive therapy, experimental treatment or psychosurgery also require court approval.

Consent for sterilization

To request the power to give consent for the person to receive sterilization, the county-designated public guardian must do all of the following:

1. Have a qualified professional provide the following documentation:

2. Submit all of the materials to the DHS Public Guardianship Office.

Additional information

The following professionals may provide the documentation required in step 1:

Requests for the power to give consent for sterilization also require court approval.

How to submit and receive documentation

The county should submit the required materials to the DHS Public Guardianship Office via either:

If the county does not submit all the required materials, the DHS Public Guardianship Office may request more information before the DHS commissioner approves.

When the DHS commissioner approves the county-designated public guardian to exercise one of the non-delegated powers, the DHS Public Guardianship Office will send the documentation to the county via encrypted email.