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Changes to Iowa’s Guardianship Laws

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In the 2019 legislative session, the Iowa Legislature unanimously passed House File 610, which changes how guardianships and conservatorships in Iowa will be established and maintained. The goal of the new law is to improve protections for people who are under guardianship or are alleged to lack decision making capacity, since appointing a guardian for an adult means stripping them of some of their basic rights and freedoms. Here are a few things you should know about the new law if you are a guardian or a person who has a guardian.

New Terminology

The new law eliminates use of the term “Ward” and “Proposed ward.” It replaces “ward” with “protected person” and “proposed ward” with “respondent.”

Elimination of “Voluntary” guardianships

The old law distinguished between “voluntary” guardianships, where someone could agree that they need a guardian without a hearing, and “involuntary” guardianships where someone else assigned a guardianship through a hearing. This meant that vulnerable people could be coerced into consenting to guardianship and losing their rights without a hearing. Now, all new guardianships will require a hearing and reasons the guardianship is necessary. A person can still ask the court for a guardian, but a hearing must be held before anyone is appointed. For people who have existing voluntary guardianships that were set up before changes to the law, their guardianships will continue but may be subject to additional requirements.

Initial care plans

The new law aims to get guardians to think in detail about what they plan to do for the protected person, and make a plan. This means guardians have to give the court an initial care plan detailing how they will use their decision making authority and what their plan is for the protected person. In response to some confusion about how existing guardianships would be affected, the Supreme Court issued an order stating that, “Guardians […] have continuing authority to perform acts concerning the protected person that were authorized prior to January 1, 2020 through the date of the guardian’s previously scheduled annual report.” The Supreme Court has also provided an Initial Care Plan form that is mandatory for guardians who are filing reports without an attorney. Currently serving guardians should file this initial care plan with their next annual report.

Changes to annual reporting requirements

Under the old law courts could, and frequently did, set the reporting period for guardianships at three or five years, or in some cases waive reporting requirements entirely. This led to a lack of reliable records of actions taken by the guardian on behalf of the protected person, which can be a problem if there were ever any questions about the guardianship.. The new law requires annual reports on every guardianship, meaning that waivers or extended reporting periods are no longer permitted. Existing guardians must now file reports annually, but it is not clear whether those who previously had a waiver should file before the end of the year, or just begin with their next scheduled report. A guardian in this situation can call the clerk of court in their guardianship’s county and ask how the court would like them to proceed. As with the initial care plan, the Supreme Court also issued a form for annual reporting.

Background checks

As of January 1, 2020, all new prospective guardians will have to undergo a background check for criminal history, sex offenses, and abuse registries. Courts can review the results of background checks when deciding whether to appoint a guardian – there is nothing that automatically disqualifies a person from serving. This requirement does not affect guardians who were appointed prior to January 1, 2020.

This information is not legal advice. Individuals should contact an attorney for advice on their specific situation before proceeding.

Caucus Access for All

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This Fourth of July, Americans will come together to celebrate our independence and the incredible patriots who made it possible. But those patriots were not just wealthy landowners in powdered wigs. Patriots come in all shapes and sizes. They are found on our battlefields, in the backs of buses, or in the hallways of a nursing home. They are anyone who holds in their heart the values of independence for all and insist on making those values central to the American experience. And two such patriots helped to provide the independence for a generation of people with disabilities

This month people with disabilities celebrate our own landmark of independence, the Supreme Court’s Olmstead Decision. Two women with mental health challenges had long sought to live and work in the community, and were continually denied that opportunity. Forced to living in a hospital setting despite these wishes, they went to court and fought for their right to receive government services in a setting of within the community, a right to the essential supports that allow people with disabilities to live lives of their choosing. Such a decision is what allowed thousands of American’s with disabilities to leave nursing homes, and live as fully independent members of the community.

As we celebrate our independence this week, we must take the time to think of the millions for whom it remains is an elusive, unreachable goal. Take time to acknowledge those who remain needlessly segregated and restricted in institutions, live under unnecessary guardianships or even feel just by being a person with a disability that their choices are less important. Independence was won by those who came before us and must be won continually, an evolution which will allow our nation to one day finally embody the lofty principles on which it was founded.

But we also have time to be thankful for how far we have already come. To think of those brave women who made the Olmstead Decision possible, and in doing showed as a way to our independence. People with disabilities and our nation made better for their bravery.

Ten Ways Public Establishments Can Become #IAccessible

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Nearly 30 years after the initial passing of the Americans with Disability Act (ADA), navigating public spaces is still a challenge for those living with a disability. DRI has worked with the Access Earth app in order to draw attention to local businesses that are and aren’t accessible and why. The app allows individuals to rate and review restaurants, bars, shops, hotels, parks, and more to check their accessibility.

What the app uncovered was while some establishments in Iowa are making a clear effort to become more accessible, others are sorely lacking.

Here are 10 things that public establishments in Iowa can do better in order to become #IAccessible.

  1. Lower the counter and table heights.

Although they seem to be all the trend right now, having high countertops and tables for your restaurant or bar is in no way inclusive. For restaurant seating to be accessible, it needs to be between 28 and 34 inches and have a knee space of 30 inches wide and 27 inches high. This is the one time where raising the bar isn’t a good thing.

  1. Update entryways.

An essential for all establishments, all entryways should be accessible. Step free access (a ramp) or lift access (don’t lock the lift) should be in place, along with a accessible parking spaces and a ground level lobby and restroom.

  1. Create and print Braille menus and information sheets.

Having a handful of Braille menus and information sheets on hand at your establishment will never be a bad idea. Additionally, having menus and information sheets printed in a large font will ensure that elderly individuals and those will sight issues will be able to navigate through their experience at your establishment.

  1. Update restrooms.

All restrooms should be on the first floor, just for the convenience of all guests. Additionally, a accessible restroom stall should have two grab bars (one behind the toilet, one on the side), stall handles, a 5-foot by 5-foot area to move in, and a low sink. Without these things, a restroom isn’t truly accessible.

  1. Ensure everyone can respond to an emergency signal.

An emergency signals must have flashing lights and audible signals to alert all consumers. Additionally, all permanent signs must have raised letters or Braille text. These two items allow those with a disability to feel safe, even during an emergency situation.

  1. For parks, ensure there are ramps.

A ramp option should be in every level of a park, not just one or two. This allows all individuals to participate in all activities at the outdoor attraction. Additionally, if there are docks in the park, ensure that those are accessible.

  1. For hotels, make an effort.

There are many items that a hotel needs to have in place to ensure that their rooms are accessible. These include, but are not limited to, having a low hanging space in a closet, ensuring that there is room to maneuver on each side of a bed, and having a roll in shower available. Without these items, those with mobility issues will not be granted a pleasurable or relaxing experience.

  1. Always have an elevator on the first floor of an establishment.

If an elevator is in the establishment, ensure that it’s on the first floor. This eliminates the difficult journey from a flight of stairs to an elevator in order to get from Place A to Place B.

  1. Train staff to understand their establishment’s accessibility options.

All members of a staff should be aware of the accessibility options in their place of work. Whether it be where the handicapped restroom is or where a party with a wheelchair user can sit, everyone on staff should be able to assist with these inquiries.

  1. Nothing about us, without us.

It sounds like common sense, but it’s important to ask those actually living with a disability about what changes they would like to see from your business. This will ensure that the changes made will be useful and effective.

Access Iowa

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I’m an Iowa boy. At 29, I’ve spent 24 years calling Iowa home. I grew up here, went to college here, and now I’ve settled down and chose to call this place home. But, for all that I love about Iowa, I can never shake the feeling that this state doesn’t know I exist.

Like anyone who has mobility challenges, inaccessibility has been a pervasive and begrudgingly accepted part of my life. When I go on walks with friends, I often lead us on winding, nonsensical paths because it is the only accessible route. When heading out to restaurants, my choices are driven by the accessibility of the restaurant bathroom, or if I can even get through the door. Sadly, these choices are common for people with disabilities.

We shop based on whether the clerk will make a scene when helping someone who is deaf. We favor Lyft or Uber based on how many times drivers have speed away to avoid having to transport our service dog. We twist and turn a million little ways to navigate a city that fails so often to accommodate us. It feels as though access is the exception rather than the rule, our needs an afterthought, if considered at all. When people with disabilities aren’t allowed access, we don’t disappear, we struggle, and push forward, reaffirming our right to live full, self-directed lives, regardless of the barriers in our way.

As Iowa continues to grow and develop, as our towns and cities transform to meet the changing needs of their citizens, we demand that they be accessible and inclusive for all. Our state will only be welcoming to people with disabilities if we make clear we won’t settle for less, if we insist that our leaders make universal, accessible design a key component of Iowa’s future.

That is why I’m so excited that Disability Rights Iowa and Access Earth are giving Iowans a new way to demand access state-wide by sharing which places are welcoming and accessible. Join Disability Rights Iowa this summer during our #IAccessbile campaign as we highlight how technology is empowering people with disabilities to address barriers wherever they find them!

As a community, we can fulfill the promise that the American’s with Disabilities Act represents. Inclusive, accessible communities benefit everyone. Please share your stories, talents and energy to spur change as we make Iowa #IAccessible!

DRI to Launch Accessibility Awareness Campaign #IAccessible

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This Fourth of July, Americans will come together to celebrate our independence and the incredible patriots who made it possible. But those patriots were not just wealthy landowners in powdered wigs. Patriots come in all shapes and sizes. They are found on our battlefields, in the backs of buses, or in the hallways of a nursing home. They are anyone who holds in their heart the values of independence for all and insist on making those values central to the American experience. And two such patriots helped to provide the independence for a generation of people with disabilities

This month people with disabilities celebrate our own landmark of independence, the Supreme Court’s Olmstead Decision. Two women with mental health challenges had long sought to live and work in the community, and were continually denied that opportunity. Forced to living in a hospital setting despite these wishes, they went to court and fought for their right to receive government services in a setting of within the community, a right to the essential supports that allow people with disabilities to live lives of their choosing. Such a decision is what allowed thousands of American’s with disabilities to leave nursing homes, and live as fully independent members of the community.

As we celebrate our independence this week, we must take the time to think of the millions for whom it remains is an elusive, unreachable goal. Take time to acknowledge those who remain needlessly segregated and restricted in institutions, live under unnecessary guardianships or even feel just by being a person with a disability that their choices are less important. Independence was won by those who came before us and must be won continually, an evolution which will allow our nation to one day finally embody the lofty principles on which it was founded.

But we also have time to be thankful for how far we have already come. To think of those brave women who made the Olmstead Decision possible, and in doing showed as a way to our independence. People with disabilities and our nation made better for their bravery.

Iowa’s New Concussion Protocol – What’s it really Like?

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Introduction

If you don’t know any high school athletes who had a concussion recently, you might not know that Iowa has new laws in effect to protect kids from getting re-injured. Getting another concussion before the first one has healed can make a concussion worse, or even lead to a deadly condition known as “second impact syndrome.” Iowa’s new laws make sure that kids are fully ready to be back in the classroom with no accommodations (return-to-learn) before they can start being in sports again (return-to-play).

Guests writers with Disabled Country are here to offer a first-hand look at concussion recovery from the perspective of a high-school athlete; 17-year-old Max and his mom Shari were kind enough to share their story with us.

Max’s Story

The Injury

This winter I had two separate concussions in the span of a little over a month. The first happened when I was running on a treadmill and I slipped and hit my head. The second came 2 days after I was medically cleared from the first concussion. I went on a weekend-long ski trip. While I didn’t take any direct hits to the head, I came back from the ski trip with much more severe symptoms than I had after the first concussion. It was after the second one that we decided to go to ChildServe.

The worst symptom that I experienced was the nausea. The nausea came and went pretty suddenly, but when I felt it, I couldn’t even shift my position in my seat without immediately feeling like I was going to be sick. While that was the most extreme symptom that I felt, the ones that bothered me the most were the symptoms that made it nearly impossible for me to do any school work. The difficulty concentrating, and the mental “fog” caused me problems with everything that I did. I couldn’t pay attention in class at all, so I didn’t learn anything about the subjects we were covering, I couldn’t do any writing or reading, and I couldn’t take any tests. Those symptoms made everything that I normally do in my daily life way more difficult.

I was completely sidelined from almost everything. I couldn’t do any sports, I didn’t go to band or gym class for almost a month, I couldn’t do any tests in school, and I couldn’t even watch T.V. for a couple weeks because it bothered me so much.

Finding Support

When we started going to ChildServe’s Concussion Clinic, the team of Brain Injury Specialists did lots of tests to get measurable statistics for how my brain was functioning. I would do mental work (like being given a set of words to remember and trying to recite them), word searches, basic mental math, and other things of the sort. I would also do physical some activities like balancing, along with reaction time tests using a piece of technology called a Dynavision board.

As I began to get better, the team could repeat the tests to see how my brain was recovering. They also gave me a lot of suggestions for school like taking breaks, not doing tests right away, and not eating lunch in the cafeteria. At home, they suggested limiting screen time at first.

These guidelines were easy to follow because I needed them and I felt better when I followed them. The most important thing is that the guidelines were tailored to what I needed. Someone else might have different guidelines based on their experience and symptoms.

Return-to-learn and Return-to-play

The return-to-learn and return-to play guidelines were beneficial for me because it felt good to know that I could get all the assistance that I needed at school. My teachers were legally required to help me or make adjustments if I needed it.

The requirement that you have to complete the return-to-learn before starting return-to-play was very frustrating. The specialists at ChildServe taught me that it’s recommended for people who are recovering from concussions to do some light physical activity as you start to feel better. Over time I was ready to start exercising a little bit, and some of my therapy at ChildServe even included some jogging on the treadmill so they could make sure it didn’t start my symptoms up again. Meanwhile at school, I couldn’t join in on any practices with my team because I had to complete the return-to-learn process first.

It felt like it took forever to get cleared, and I was so desperate to get back into athletics. I didn’t feel like I needed all the treatment that I was getting at the time, but when I look back at it, I’m very glad that I was required to go through all the steps, because I really did need them. Even though I wished I could be active at school sooner, I do think that allowing kids to start return-to-play while they are also doing return-to-learn would cause problems because kids would go back into sports before their brains are completely healed and be at risk for serious or deadly re-injury that can come with second impact syndrome.

A Parent Perspective, from Max’s Mom:

When Max had his concussion I really didn’t know where to go. Even though I knew many people who had children who had concussions, this was our first experience with it. I had no idea what concussion recovery was supposed to be like. I was worried that Max would reinjure himself or push himself too much or too early. My biggest concern was CTE. The high school nurse referred us to ChildServe which was incredibly helpful.

It was a huge relief to be able to rely on ChildServe’s expertise and experience. Their whole team evaluated Max on our first visit and they developed a plan based on their assessment of his needs. I was very comfortable with the process and felt like he was getting the best assessment and care possible.

With the weekly visits, I was able to track his progress and see how he was improving. ChildServe also worked very closely with the high school nurse so that she had all the information she needed to move Max along the established protocols at school and with sports. With Max being unable to attend class, focus, or do homework for weeks, it was very helpful to have the communication between ChildServe, the high school nurse, trainer, and me. Everyone had all the information we needed for both the return-to-learn and the return-to-play protocols. The nurse was able to keep the teachers informed of what Max needed and the teachers were very supportive.

One challenge was the backlog of homework that he had since mental fogginess was an issue for a long time. The teachers reduced the amount required, which was helpful, but he still ended up trying to work through quite a bit of late work at the same time he was trying to keep up with his classes. Another challenge, for him especially, was that he had to complete return-to-learn before he could start return-to-play. This meant he couldn’t practice with his team until mid-way through the season so he is having to catch up with that as well.

We’ve learned a lot throughout this experience! First of all, we learned that a concussion can show up in different ways and can often show up several days later than the original injury. With Max’s first concussion, he didn’t have symptoms until a couple days later and even then, it wasn’t obvious – he didn’t feel right and he couldn’t concentrate. Secondly, I highly recommend coming to the ChildServe Concussion Clinic (and I don’t have to say that)! It was so helpful to be able to rely on their expertise, they were great to work with, and it relieved our concerns.

Afterword

The Iowa Concussion Consortium (ICC) and Brain Injury Alliance (BIAIA) has been committed to helping schools have better guidelines for students after concussion and brain injury. The ICC identified the REAP (Reduce • Educate •Accommodate • Pace) Protocol as the best-practice concussion management program. The REAP program was developed in Colorado by Dr. Karen McAvoy, recognizing that outcomes are optimal when a “multi-disciplinary team” approach is utilized, involving and educating school administrators, teachers, coaches, athletic trainers, school nurses, school psychologists and counselors, as well as parents and community medical professionals, to coordinate care and recovery from concussion. ICC works to bring REAP to each multi-disciplinary team statewide. ChildServe is a valued partner in this effort.