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HomeMy WebLinkAbout06-14-11ANNUAL REPORT OF GUARDIAN OF THE PERSON COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION r~ a ~~ ~. ~ f~ ~-- z ~C;,~ ~ .~ ;::. ~ ± o° ~ _-. ' -~- ~ ~. --- ~~ ~ c. Estate of Susan J Myers , an Incapacitated Person No. 21-10-0220 I. INTRODUCTION Patricia A.M. Havens was appointed ®Plenary ©Limited Guardian of the Person by Decree of J• Wesley Oler, Jr. , J., dated Apri126, 2010 © A. This is the Annual Report for the period from Apri126 , 2010 to Apri126 2011 (the "Report Period"); or ^ B. This is the Final Report for the period from to (the "Report Period"), and is filed for the following reason: 1. The death of the Incapacitated Person. Date of death: 2. The Guardianship was terminated by the Court by Decree of For a Final Report, o`rtit Sections II through IV. Form G-03 rev. 10.13.06 Page 1 of 4 "1 J., dated Estate of Susan J. Myers , an Incapacitated Person II. PERSONAL DATA Age of the Incapacitated Person: 58 Date of Birth: November 15, 1952 III. LIVING ARRANGEMENTS A. Current address of the Incapacitated Person: 1004 Havenwood Court, Mechanicsburg, PA 17050 B. The Incapacitated Person's residence is: ^ own home /apartment © nursing home boarding home /personal care home © Guardian's home /apartment [~ hospital or medical facility ~ relative's home (name, relationship and address) other: Townhouse owned by a Special Needs Trust for Susan J. Myers C. The Incapacitated Person has been in the present residence since 2002 If the Incapacitated Person has moved within the past year, state prior residence and reason(s) for move: Page 2 of 4 Form G-03 rev. l0.13.06 Estate of Susan J. Myers , an Incapacitated Person D. Name and address of the Incapacitated Person's primary caregiver: (1) Guardian - Patricia A.M. Havens,1235 Crestfield Drive, Williamsport, PA 17701 (2) Community Treatment Team- Carla Tanzmore, Director, 114 North Hanover Street, Carlisle, PA 17013 IV. MEDICAL INFORMATION A. The major medical or mental problems of the Incapacitated Person are as follows: Schizoaffective Disorder, Gigantic ventral hernia, Diabetes, Hyperlipidemia, Hypertension, Gastroesophageal Reflux Disease, Cardiac right bundle branch block, Obesity, severe Gingivitis B. Specify what, if any, social, medical, psychological and support services the Incapacitated Person is receiving: Cumberland County- NHS The Stevens Center Community Treatment Team (717-218-1066) per the attached document V. GUARDIAN'S OPINION A. It is the opinion of the Guardian of the Person that the guardianship should: Q continue Q be modified ^ be terminated Page 3 of 4 Form G-03 rev. 10.13.06 Estate of Susan J. Myers an Incapacitated Person The reasons for the foregoing opinion are: Ms. Myers requires support regarding her medical conditions, medications, interactions with doctors and dentists and oversight of her finances. B. During the past year, the Guardian of the Person has visited the Incapacitated Person 30 times with the average visit lasting 12-24 hours, minutes. The report of a social service organization employed by the Guardian to oversee and coordinate the care of the Incapacitated Person for the period covered by this Report may be attached to supplement this Report. I verify that the foregoing information is correct to the best of my knowledge, information and belief; and that this Verification is subject to the penalties of 18 Pa. C.S.A. § 4904 relative to unsworn falsification to authorities. o /~ // Date Form G-03 rev. 10.13.06 ~~ Signature of /Guardian of the Per/sin lo~T~~/~/ti. !/~Ol~l S Name of Guardian of the Person (type or print) /~~ ~ ~~s~~~l~' ~r ~ Address ~.~//l~~~nf©~ t~~ / 77o i city, stare, zi~ Telephone Page 4 of 4 NHS The Stevens Center: Community Treatment Team -Cumberland Behavioral Health Network of Care Page I of 2 . tinrne Visit Our Other Health Sites ~ . . _.._ J~,B~A~,~~ ... , et:r,tccti j G o f / rr /! / / r>lte7rrurrtl^ f'-/~>rrll`~t ji ~ % irlet~.~'ut•k t)f (:art; . tt :~~., ` Services cout~ --:,n::•.avr^y Library _ ~'~ if is `.. Service Directory Leeitslate Links NHS The Stevens Center: Community Treatment Team lnformatfon provided by Cumberland-Perry Counties Mental Heatth/Mental Retardatrot- and '- -nsUrar,r;a O A.ctd to P~Sy fnlctcr Eady fnfervenflo» Servlces ~F 'f'riCQ r •"~ ~' ` r ••• based on 0 reviews view Rate This Agency 'Support ~ 'OCaC l~(l < y ; I The Community Treatment Team (CTT) is a self- contained program staffed by multi- '`!~ n}y f 7irlerr~ disciplinary staff who function interchangeably as a team to ensure ongoing habilitation and support services in the community for t ;ajt;l~l> , re individual{zed treatmen individuals with severe and persistent mental illness. Find Services An individual needing these services can request an Intake and referral by contacting Add or Correct Info one of the Base Service Units at one of the following locations: How to Use the Database , NHS -The Stevens Center - 717.243.6033 x225 or x234 About Our Database .Holy Spirit Behavioral Health Services - 717.763.2219 COMPASS clo Address 114 North Hanover Street Carlisle, PA 17013 View Map Details Phone Number: Website Address: 717.218.1066 ~~~.n^~ nhsonline oralpagP-!fit mental health.htm @Ilgibiliry Requirements: Consumer must meet medically necessary criteria for this level of cars. Ocher Topics That May 13e Usefu[ Recordlasf updated on June 09, 2009 http a/Cumberland.pa.networkofcare.org/mh/resource/agencydetail.cfm?pid=NHSTheStevensCenterCommuni... 6/9/2011