Current through Register Vol. 56, No. 18, September 16, 2024
(a) BGS staff shall
function distinctly and independently from the service components and shall
maintain independent decision-making from the service components.
(b) The needs of the individual are
paramount; therefore, BGS shall make reasonable efforts to select the most
appropriate course of action that is the least restrictive of the individual's
freedom, rights and ability to control his or her environment. To that end, BGS
staff shall make reasonable efforts to accomplish (b)1 through 10 below:
1. Build a relationship with the individual,
to the extent possible, that is based upon mutual respect and trust in order to
advocate for what the individual wants, or be able to make decisions in the
best interest of the individual, should the individual be unable to express his
or her wishes;
2. Protect the
individual from actual or potential injury, neglect, exploitation, undue
influence and abuse. BGS staff will, where appropriate:
i. Report suspicions to appropriate Division
staff;
ii. Initiate an Unusual
Incident Report;
iii. Provide input
into investigations;
iv. Advocate
for needed interventions; and
v.
Initiate legal action;
3. Safeguard the individual's rights in
accordance with statutory and case law, and regulations. BGS will, where
appropriate:
i. Inform the individual of his
or her rights and responsibilities;
ii. Explain the content and meaning of the
guardianship court order;
iii.
Advocate with appropriate staff;
iv. Initiate Unusual Incident
Report;
v. Report violations of
individual rights to the Human Rights Committee if all other levels of
resolution have been exhausted; or
vi. Consult with outside sources including,
but not limited to:
(1) Ethics
Committee;
(2) Disability Rights
New Jersey;
(3) Law Enforcement
Agencies; and
(4) Legal
Consultation and Representation;
4. Encourage the individual's participation
in decision-making by:
i. Seeking the wishes
of the individual;
ii. Giving due
respect to the individual's wishes;
iii. Advocating for the individual's
wishes;
iv. Recognizing and/or
developing opportunities for decision-making; and
v. Encouraging/promoting self-reliance,
independence, self-care and self-advocacy;
5. Make decisions in accordance with the
authority granted in the court order, utilizing the principle of informed
consent and in consideration of the individual's identification with particular
ethnic, religious and cultural values. In evaluating a requested action or
treatment, the guardian will, as appropriate:
i. Review the nature of the requested action
or treatment;
ii. Gather adequate
information on the issue by using available resources including, but not
limited to:
(1) Search the Internet;
(2) Read books and articles; and
(3) Consult with experts in the
field;
iii. Gather
needed reports;
iv. Discuss the
proposed action or medical treatment with involved professionals;
v. Seek input from the individual, family and
caregivers;
vi. Explore possible
alternatives;
vii. Explain the
proposed action or treatment and possible alternatives to the individual in the
presence of family, involved professionals and caregivers, as
indicated;
viii. Seek the voluntary
assent of the individual;
ix.
Ensure that the individual's assent is free of coercion;
x. Weigh the risks, benefits, alternatives
and anticipated outcomes of proposed action or treatment;
xi. Refer to an ethics committee if
needed;
xii. Give or withhold
consent using substitute judgment;
xiii. Give or withhold consent using the best
interest standard;
xiv. Communicate
the decision to the individual, involved professionals, family and caregivers;
or
xv. Evaluate outcome of
decision;
6. Encourage
the individual to maintain contact with his or her family and respect and
support the individual's wishes with regard to contact with family unless such
contact is not in the best interest of the individual. Where appropriate,
discuss family contact with the individual during the annual visit or at the
service plan meeting and facilitate family contact at the request of the
individual;
7. Encourage and
support the development of social relationships that contribute to the
well-being of the individual by:
i. Advocating
for opportunities for positive social interaction; and
ii. Taking steps, where applicable, to
determine the individual's capacity for consensual sex and to provide the
needed education and information in order for the individual to exercise the
right of sexual expression, including information about sexual health, birth
control and assistance in choosing the most appropriate form of birth
control;
8. Contribute
to the service plan by:
i. Representing the
individual at the service plan meeting through personal attendance or by
providing written or verbal suggestions/recommendations prior to the meeting,
if not able to attend;
ii.
Encouraging the individual's participation at the meeting;
iii. Reviewing the completed service plan and
provide written input, as needed;
iv. Reviewing decisions made by the
individual during the year;
v.
Reviewing the individual's understanding of guardianship;
vi. Reviewing the individual's perception of
his or her need for guardianship;
vii. Reviewing the appropriateness of
guardianship;
viii. Recommending a
referral to the psychologist for guardianship assessment, as needed;
ix. Recommending, as applicable, that the
individual be provided with needed education and information;
x. Advocating for a burial plan to be
included in the service plan; and
xi. Giving or withholding approval for the
service plan;
9. Make
end-of-life decisions in accordance with N.J.A.C. 10:48B; and
10. Protect the individual's right to privacy
by giving or withholding consent for:
i.
Release of confidential information, including protected health information in
accordance with the Health Insurance Portability and Accountability Act (HIPAA)
45 CFR Parts 160 and 164;
ii.
Photographing the individual, if the photograph is to be used for display or
public dissemination in accordance with
10:41-3.3.
(1) Consent for photographs for any public
purpose shall be contingent on the individual's willingness to participate;
and
iii. Audio taping
and videotaping the individual for other than treatment purposes or health care
operations in accordance with
10:41-3.3.
(1) Consent for audio taping and videotaping
for any public purpose shall be contingent on the individual's willingness to
participate.
(c) In accordance with the individual's human
rights and the authority granted in the court order, BGS staff shall have the
responsibility and authority to act in areas that include, but are not limited
to:
1. Reviewing the adequacy of the services
being provided;
2. Communicating
with interested parties, especially family, caregivers and staff regarding the
status, needs and wishes of the individual;
3. Providing or withholding consent for any
change in residence or program, transfer or discharge; and
4. Providing or withholding consent for the
following:
i. Elective medical or dental
procedures that require specific authorization, as well as the general consent
sufficient for routine medical or dental care;
ii. The use of behavior support plans with
identified behavior risk elements;
iii. The service plan;
iv. The release of records or other
confidential information and for the publication of photographs, newspaper
articles, books, etc., that identify the individual;
v. The use of psychotropic medication as part
of an on-going treatment plan to address maladaptive behavior; or
vi. Visits, vacations, trips or other
absences from the residence or day program. General permission may be granted
for recurring absences with parents, family members or other approved
individuals.