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HomeMy WebLinkAbout08-27-09IN RE: SVEN O. JENSEN, An alleged incapacitated person IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION PETITION FOR THE APPOINTMENT OF EMERGENCY PLENARY GUARDIAN OF THE PERSON AND ESTATE Y IN ACCORDANCE WITH 20 P S §5513 AND FOR PERMANENT PLEN GUARDIAN OF THE PERSON AND ESTATE PURSUANT TO 20 P.S. X5511 AND NOW COMES THE PETITIONER, the Cumberland County Aging & Community Services, in and for Cumberland County, Pennsylvania, by its solicitor, Anthony L. DeLuca, Esquire, who represents and avers as follows: 1. The Petitioner is the Cumberland County Aging & Community Services, in and for Cumberland County, Pennsylvania, with its office located at 16 West High Street, Carlisle, Cumberland County, Pennsylvania. 2. The alleged incapacitated person is Sven O. Jensen, age 71, who currently resides at New Cumberland, PA 17070, Cumberland County, Pennsylvania. 317 Carol Street , ~o _ ~ r~ ~ _ r _.,~~.7 _. _~ rn The known relatives of the alleged incapacitated person are: _-~' ~; ~ ._ tv ~_. ; ~ -;~.~ .,.~ _ ; ; ~- ; r ~ J ~ -r~ a. Barbara Fowler -spouse ~ ~ _ . ~ -r -~ .:-=; ~. Green Ridge Village © ` 210 Big Spring Road Newville, PA 17241 b. There maybe two (2) children from a former marriage who reside in Europe and who are estranged from their father. 4. The Petitioner is not related to Sven O. Jensen. 5. The Petitioner's interest is that of a welfare agency concerned with his welfare and is familiar with his case. 6. Sven Jensen has, for at least the last three (3) months, been incapable of managing and caring for himself and his financial affairs. 7. Sven Jensen exhibits symptoms of mental incapacity, including but not limited to dementia, of the Alzheimer's type, or possibly alcohol related. 8. Sven Jensen's mental incapacity prevents him from managing and caring for the affairs of his person and estate. 9. Until July,2009, Mr. Jensen had been employed as a maintenance supervisor but had retired to care for his wife who has been diagnosed as having primary progressive Multiple Sclerosis and was confined to bed requiring 24 hour care. 10. During the past several months, his wife had requested help because he drank too much and this resulted in him becoming aggressive, breaking doors, and exhibiting other conduct that placed his wife at risk. 11. On or about August 18, 2009, the Petitioner received a report of need of Protective Services at the home of Sven O. Jensen and his wife and, when visited by Petitioner's authorized representative, the following observations were made: A. He was forgetful; B. He had been drinking; C. He punched Petitioner's authorized representative, Priscilla Whitman; D. He placed his hands on an aide attending his wife and slammed a railing on his wife's bed; and E. His conduct resulted in his wife leaving the house and thereafter placed at Green Ridge Village in Newville, Pennsylvania 12. On or about August 21, 2009 the Petitioner offered in home services to Sven O. Jensen but he was unable to properly relate to what was being offered and, at times, his behaviors were inappropriate. 13. On or about August 24, 2009, the Petitioner visited the home with Dr. John Hume to assess the cognitive status of Sven O. Jensen. 14. The Petitioner believes, and therefore, avers that Sven Jensen's income consists of $1,250.00 from Social Security and possibly a lump sum from his retirement.. 15. Petitioner requests that it be appointed Emergency Plenary Guardian of the Person and Estate Sven O. Jensen. 16. Petitioner also requests that it be appointed Permanent Plenary Guardian of the Person and Estate Sven O. Jensen. 17. The proposed Guardian has no interest which is adverse to the interest of Sven O. Jensen. 18. Petitioner believes and, therefore, avers that Sven Jensen does not already have a Guardian. 19. Petitioner asserts that Sven Jensen is incapacitated as defined in Chapter 55 of the Probate Estates and Fiduciaries Code. 20. Because of his impaired mental and physical condition, Sven Jensen lacks the capacity to provide for his own personal care and maintenance. 21. Because of his impaired mental and physical condition, Sven Jensen is unable to manage his financial affairs, property and business and is unable to make and communicate responsible decisions relating thereto. 22. A power of attorney would be a less restrictive alternative than Guardianship but Sven Jensen currently does not have anattorney-in-fact and he lacks the capacity, at present, to appoint one. 23. To Petitioner's knowledge, no previous application has been made for the order herein requested or for a similar order. 24. No other Court has ever assumed jurisdiction in any proceeding to determine the capacity of Sven Jensen. 25. Petitioner avers that Sven Jensen has sufficient assets which would enable him to pay for services rendered by the Guardians of his Person and Estate. 26. If appointed as Permanent Plenary Guardian of the Person and Estate of Sven Jensen, Petitioner would seek payment for its services pursuant to the Guardianship Fee Schedule which is attached hereto, marked as Exhibit "A", and incorporated herein by reference. 27. At such time that Sven Jensen no longer has sufficient assets to pay for Guardianship services, then, and in such event, Petitioner would seek payment under the Medical Assistance Regulations. 28. Medical Assistance regulations as set forth in Nursing Care Handbook instructions allow for the payment of Guardian fees as a deduction when determining contribution toward cost of care. 29. The amount of the Guardian's fee that is allowable as a deduction is the actual fee paid subject to a maximum of 10% of the person's gross monthly income or $100.00 per month, whichever is less. 30. Petitioner believes and, therefore, avers that it is entitled to receive payment of a Guardianship fee as allowed by Medical Assistance regulations and that said fee be a deduction toward the cost of the care of Sven Jensen. WHEREFORE, the Petitioner respectfully requests that: 1. The Court appoint Cumberland County Aging & Community Services, in and for Cumberland County, Pennsylvania as Emergency Plenary Guardian of the Person and Estate of Sven O. Jensen pending a final hearing on this Petition and such other powers and restrictions the Court deems proper; 2. Pursuant to 20 Pa.C.S.A. §5513, the Court finds that the emergency necessitating the filing of this Petition will continue beyond seventy-two (72) hours from the date of any Emergency Order; 3. Pursuant to 20 Pa.C.S.A. §5513, the Court schedules a final hearing on or within 23 days from the date of any Emergency Order; 4. The Court appoint Cumberland County Aging & Community Services, in and for Cumberland County, Pennsylvania as Permanent Plenary Guardian of his Person and Estate; 5. Cumberland County Aging & Community Services is authorized to obtain payment for its services pursuant to the attached Fee Schedule; and 6. Cumberland County Aging & Community Services is authorized to obtain payment of a Guardian fee subject to a maximum of 10% of Sven Jensen's gross monthly income or $100.00 per month, whichever is less, at such time, that Sven O. Jensen no longer has sufficient assets to pay for Guardianship services and would qualify for Medical Assistance Respectfully Submitted, Dated ~ ~d'd ~ cr `~ Anthony L. uca, Esquire 113 Front Street P.O. Box 358 Boiling Springs, Pennsylvania 17007 (717) 258-6844 ID No. 18067 VERIFICATION I hereby verify that the facts and information set forth in the foregoing Petition for the appointment of Emergency Plenary Guardian of the Person and Estate in accordance with 20 P.S. §5513 and for Permanent Plenary Guardian of the Person and Estate pursuant to 20 P.S. §5511 of Sven Jensen are true and correct to the best of my knowledge, information, and belief. I understand that any false statements contained herein are subject to the penalties of 18 Pa. C.S. Section 4904, relating to unsworn falsification to authorities. Dated: Z Q~d~~~l Priscilla Whitman COl~~IMUNITY SERVICES AGING & 16 WEST HIGH STREET, SUITE 100 CARLISLE, PA 17013 (717) 240-6110 OR 1-888-697-0371 EXT 6110 FAX: (717) 240-6118 The below listed Fee Schedules are applicable to individuals who have assets d or income that excludes them from the Pennsylvania Department of an / Aging Medicaid Waiver Program. GUARDIANSHIP FEE SCHEDULE One Time Initial Start up Guardianship Fee - $350.00 Cumberland County Aging and Community Services shall charge a one time, initial start up, Guardianship Fee of $350.00 when it is appointed guardian of the person of an alleged incapacitated person or guardian of the person and estate of an alleged incapacitated person. Thereafter, Cumberland County Aging and Community Services shall charge a monthly Guardianship Fee as Guardian of the Person or as Guardian of the Person and Estate at the rate of $150 per month. Monthly Guardianship Fee for Guardian of Person & Estate Rate - $150.00 • The $150 per month includes managing of finances; attendance at quarterly care plan meetings; monthly visits; review of medical care and medical charts, annual reports, shopping for clothes and personal items, EX~IIBIT "A" EMAIL US AT agjng@ccpa.net OR VISIT OUR WEBSITE AT wvvw.ccpa.net/aging routine medical and dental appointments, application for benefits such as but not limited to veterans benefits, funeral arrangements. Monthly Guardianship Fee for Guardian of Person - $100.00 • This includes attendance at quarterly care plan meetings; monthly visits; review of medical care and medical charts; annual reports; shopping for clothes and personal items; routine medical and dental appointments. In the event that Cumberland County Aging and Community Services, as a Guardian, is required to provide any services outside the scope of routine Guardianship care, including but not limited to travel to/from non-routine medical appointments, travel to visit with family that are not able to visit in the facility; locating and/or moving to a new facility, overseeing the disposition of personal property or any special circumstances not listed above, then, and in such event, Cumberland County Aging and Community Services shall be entitled to charge $50 per hour for said services. In Excess rate - $50/hour • This includes anything beyond the scope of routine guardianship care; such as but not limited to travel to/from non-routine medical appointments, travel to visit with family that are not able to visit in the facility; locating and/or moving to a new facility, overseeing the disposition of personal property or any special circumstances not listed above. POWER OF ATTORNEY FEE SCHEDULE One Time Initial Start up POA Appointment Fee - $150.00 Cumberland County Aging and Community Services shall charge a one time, initial start up, Power of Attorney Fee of $150.00 when it is appointed Power of Attorney of the person of an alleged incapacitated person or Power of Attorney of the person and estate of an alleged incapacitated person. Thereafter, Cumberland County Aging and Community Services shall charge a monthly Power of Attorney Fee as Power of Attorney of the Person or as Power of Attorney of the Person and Estate at the rate of $75 per month. Monthly POA Fee - $75.00 • This includes managing of finances; attendance at quarterly care plan meetings; monthly visits; review of medical care and medical charts, shopping for clothes and personal items, routine medical and dental appointments, application for benefits such as but not limited to veterans benefits, funeral arrangements. In the event that Cumberland County Aging and Community Services, as a Power of Attorney, is required to provide any services outside the scope of routine Power of Attorney care, including but not limited to travel to/from non- routine medical appointments, travel to visit with family that are not able to visit in the facility; locating and/or moving to a new facility, overseeing the disposition of personal property or any special circumstances not listed above, then, and in such event, Cumberland County Aging and Community Services shall be entitled to charge $50 per hour for said services. In Excess rate - $50/hour • This includes anything beyond the scope of routine Power of Attorney care; such as but not limited to travel to/from non-routine medical appointments, travel to visit with family that are not able to visit in the facility; locating and/or moving to a new facility, overseeing the disposition of personal property, or any special circumstances not listed above.