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F I S C A L I M P A C T R E P O R T
SPONSOR Silva
ORIGINAL DATE
LAST UPDATED
02/08/07
HB 686
SHORT TITLE Alternatives to Guardianship of Disabled
SB
ANALYST Geisler
APPROPRIATION (dollars in thousands)
Appropriation
Recurring
or Non-Rec
Fund
Affected
FY07
FY08
$200.0
Recurring
General
(Parenthesis ( ) Indicate Expenditure Decreases)
Duplicates: SB 147
SOURCES OF INFORMATION
LFC Files
Responses Received From
Aging and Long-Term Services Department (ALTSD)
Developmental Disabilities Planning Council (DDPC)
SUMMARY
Synopsis of Bill
House Bill 686 bill creates a guardianship alternatives program within the Aging and Long-Term
Services Department (ALTSD) that would provide training and assistance in finding alternatives
to guardianship and also establish microboards of family members and friends who would be
responsible for the care of persons with a disability who might otherwise require a guardianship.
FISCAL IMPLICATIONS
House Bill 686 contains a recurring $200.0 appropriation for the guardianship alternatives
program. Any unexpended or unencumbered balance remaining at the end of a fiscal year shall
not revert. This appropriation is not contained in the executive or Legislative Finance
Committee budget recommendations.
SIGNIFICANT ISSUES
ALTSD provided the following discussion:
pg_0002
House Bill 686 – Page
2
HB 686 does not specify all the alternatives that could or should be pursued by this program,
although it specifies the inclusion of microboards. There are legal implications to providing
alternatives to guardianship. Defining what the alternatives are is a significant issue, e.g., case
management, power of attorney, establishment of surrogates under the Uniform Health-Care
Decisions Act. Establishing boundaries and expectations of those providing alternatives would
be important.
Micro boards are a less restrictive alternative to guardianship that is being utilized to some extent
in at least a few states (including Tennessee and Nevada) and across Canada. According to a
Nevada 2003-2004 Legislative Report: "A microboard is a self-directed support corporation,
which is a circle of support for an individual with a disability. A microboard allows the person to
practice 'assisted competence' as he/she plans an independent life. microboards are often used in
states where there are significant restrictions on Medicaid funds being used for self-directed
services (like Nevada). A Microboard is usually comprised of up to nine family members and
friends of a person with a disability, all of whom are interested in greater independence for him
or her. The microboard forms a non-profit organization and becomes a provider for one person.
Microboards have been very successful and cost-effective in several states and throughout
Canada."
New Mexico has a strong commitment to self-direction and least restrictive alternatives in the
provision of services, as evidenced by the development of the self-directed Medicaid Waiver
(MiVia) program. The establishment of a model such as microboards would be consistent with
the philosophical and programmatic direction New Mexico has taken in the provision of services
to persons with disabilities.
ALTSD, through the Adult Protective Services (APS) program, may petition for the appointment
of a guardian for a person who has been found to be abused, neglected or exploited and lacks
decisional capacity and for whom less restrictive alternative arrangements are insufficient,
inappropriate or unavailable. Thus, it is within the purview of APS to identify alternatives to
guardianship in specific cases. In addition, publicly funded guardianship is currently under
funded and, thus, more cost effective alternatives are desirable.
The Developmental Disability Planning Council (DDPC) operates the Office of Guardianship,
which is responsible for providing public guardianship. The DDPC is also charged with
providing training and information to interested persons on guardianship, including alternatives
to guardianship. Thus, a conflict may be created by funding ALTSD to do the same.
ADMINISTRATIVE IMPLICATIONS
ALTSD notes that Microboards would be a new model for New Mexico and would require the
establishment of guidelines and possibly regulations governing their operation. Training and
educational outreach programs, for Microboards and other alternatives, would have to be
developed in coordination with DDPC, the courts, attorneys, advocates, consumers and other
stakeholders.
TECHNICAL ISSUES
ALTSD notes that the New Mexico Office of Guardianship in the Developmental Disabilities
pg_0003
House Bill 686 – Page
3
Planning Council is already charged with providing information and training on alternatives to
guardianship and, thus, may be a more appropriate agency to administer.
OTHER SUBSTANTIVE ISSUES
DDPC notes that any alternative to guardianship must provide the disabled person the needed
care and rehabilitative services and the disabled person must enjoy the greatest amount of
personal freedom and legal rights. DDPC suggests that the guardianship alternatives program
should be considered a pilot project based upon the bill’s broad and expansive language. DDPC
suggests the following issues relating to microboards would need to be addressed:
(1) Who appoints the members to the microboard. If the incapacitated person has the power to
appoint, then he has capacity, therefore it would seem more like a power of attorney, which
would allow the incapacitated person to override any decision the microboard might make.
(2) Is there any due process for the incapacitated person. What authority would the microboard
have to take away the civil rights of the person.
(3) Is there a level of functioning that the incapacitated person must meet in order to qualify to
have a microboard instead of a guardianship.
(4) What training will be required for members of a microboard.
(5) Who can fire the members of the microboard and what are allowable causes for firing.
(6) What do microboards do that guardians would not do or do at a greater cost to the
incapacitated individual.
(7) Since the microboard would be independent of the courts, who would be responsible for the
oversight to make sure that the decisions are in the best interest of the incapacitated ward.
(8) What are the microboard’s duties under the law (like fiduciary duties.)
(9) What happens if there is a clash within the micro board – between the best interest of the
ward and another member who wants to carry out the ward’s wishes.
10) Do microboards rule by majority or expertise.
DUPLICATION
HB 686 is duplicated by SB 147.
GG/mt