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HomeMy WebLinkAbout05-09-12._,., CJ _ ~~ Susan J. Hartman, Esquire ~ !' _ =~. _ ._.,~ - _ a Attorney ID #65184 ,- ',_ ,. Duncan & Hartman, P.C. `l' ~ - 1 Irvine Row ~„ Carlisle Penns lvania 17013 ~`-~_~ ~~ Y Attorney for Petitioner ~_„~ ;. _,: -~=; Telephone: (717-249-7780) Dawn M. Sm~zer r,~, `" ~~ IN RE: : IN THE COURT OF COMMON PLEAS OF EMILY A. SMOKER :CUMBERLAND COUNTY, PENNSYLVANIA ORPHANS' COURT DIVISION . No: ~~_~Z _,~.y0 PETITION FOR APPOINTMENT OF GUARDIAN TO THE HONORABLE, THE JUDGES OF SAID COURT: Petitioner, through her undersigned attorney, petitions Your Honorable Court for her appointment as GUARDIAN of the person of EMILY A. SMOKER, and in support thereof respectfully request: 1. Petitioner, Dawn M. Smoker, of 104 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania, 17050, a sui juris adult. is the natural mother of EMILY A. SMOKER. 2. EMILY A. SMOKER, is an 17 year old single adult female whose birthday is August 21, 1994. 3. EMILY A. SMOKER, resides with the Petitioner at 104 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania 17050 and does not receive residential services. 4. EMILY A. SMOKER attends the Northwestern Human Services Autism School, 898 Waggoner's Gap Road, Carlisle, Cumberland County, Pennsylvania. 5. EMILY A. SMOKER, is an alleged mental incompetent as is evidenced by a letter from Jeannette C. Ramer, M.D. and Stephen J. Krebs, M.D., who indicate that EMILY A. SMOKER has severe mental disabilities, including mental retardation, low functioning autism, aggressive behavioral problems and she has limited verbal abilities and is unable to communicate. Said letters are incorporated by reference and attached at Exhibits "A" & "B". 6. The proposed Guardian has no interest that is adverse to those of EMILY A. SMOKER. 7. The Petitioner is willing to serve as Guardian of EMILY A. SMOKER, an alleged mental incompetent, and she has signed a consent letter which is attached as Exhibit "C". 8. The natural father, John Smoker V, is divorced from the Petitioner and has consented to this Petition. A copy of his consent is attached hereto as Exhibit "D". 9. It is the position of the Petitioner that Guardianship is necessary in order to secure medical and social services on behalf of EMILY A. SMOKER. 10. EMILY A. SMOKER, is unable to manage her property, or is liable to dissipate it or become the victim of designing persons and lacks sufficient capacity to make or communicate responsible decisions concerning her person. 11. The Petitioner is the mother of EMILY A. SMOKER. 12. The Petitioner believes that there exists no less restrictive alternative in view of the mental disabilities of EMILY A. SMOKER. 13. No other petition has been filed for the appointment of a Guardian for the alleged incompetent. WHEREFORE, Petitioner respectfully request that she be appointed Plenary Guardian of her daughter, EMILY A. SMOKER, both of her person and of her property. Duncan & Hartman, P.C. ~; ~` -~ Susan J. Hartman, E`squi Attorney for Petitioner -~ w- -~ ' ~ . ~(~( ~:..Z VERIFICATION I verify that the statements made in the foregoing Petition for Appointment of Guardian Complaint are true and correct. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. Section 4904 relating to unsworn falsification to authorities. r ~,', Date : `~ -_>> -~ ~ ,~ ~ /~~.. _~ _,~ ~ ~ =__- ~ _ _ ~,~..~. Da n M. Smoker PENNSTATE Children's Hospital Department of Pediatrics Penn State Children's Hospital Tel: (717) 531-8414 Roger L. Ladda, MD Division of Human Genetics, Penn State Milton S. Hershey Medical Center Fax: (717) 531-0276 David S and Amy S Goldberg Growth & Development Department of Pediatrics, H085 Professor of Genetics 500 University Drive, P.O. Box 850 and Pediatrics Hershey, PA 17033-0850 Chief, Division of Human Genetics, Growth and Development February 22, 2012 Patricia L. Gordon, MD Assistant Professor of Pediatrics Jeanette C. Ramer, MD Professor of Pediatrics Director, Medical Pediatric Rehabilitation Developmental Pediatrician Cheryl D. Tierney, MD, MPH Assistant Professor of Pediatrics Developmental Pediatrician Mark Domoto, MEd Developmental Specialist 717 531 7776 Tel Susan L. Sell, MS, CGC Certified Genetic Counselor Ms. Dawn Smoker 104 Louisa Lane Mechanicsburg, PA 17050 RE: SMOKER, Emily A. Birthdate - 8/21/94 MSI-~.4C #0911747 To Whom It May Concern: This letter is to certify that Emily Smoker has severe Autism and moderate to significant cognitive impairment. The degree of overall impairment is such that she would not be able to manage her own affairs, understand use of money or even complete activities of daily living. She needs supervision at all times because of very poor judgment, as well as assistance with taking medication and supervision of toileting. I have been treating Emily since 2002 and have continued to follow her to the present time. Her last visit was in October 2011. In my professional opinion, she will not materially change in her ability to understand the world around her or manage her own affairs, and, therefore, will continue to be dependent and in need of guardianship. Her mother has always acted in Emily's best interests, provides excellent care for her, and administers medications as appropriate If additional information is needed, please contact my office at 717/531-8414. Sincerely, Jeanette C. Ramer, M.D. Developmental Pediatrician JCR/jw EXHIBIT An Equal Opportunity University CARLISLE PEDIATRIC ASSOCIATES A PROFESSIONAL CORPORATION STEPHEN J. KREBS, M.D. h10LLY C. HOFFMAN, M.D. J. LYNN HOFFMAN, M.D. ELISEO ROSARIO, JR., M.D. DEBORAH RAUBENSTINE, M.D. ELENA MAN, M.D. STEPHANIE R. WATERS, M.D. QIANNA RUDY, PA-C 804 BELVEDERE STREET, CARLISLE, PA 17013 243-1943 February 15, 2012 I '' To Whom It May Concern: Emily Smoker is not capable of self-care. She will need a guardian to look after her physically and to take appropriate decisions for her. She is not capable of doing these by herself due to severe autism. Practice Phone Number: 717-243-1943 Sincerely, ~~~ ~ Stephen J. Krebs, M.D. EXHIBIT IN RE: : IN THE COURT OF COMMON PLEAS OF EMILY A. SMOKE :CUMBERLAND COUNTY, PENNSYLVANIA AN INCOMPETENT :ORPHAN'S COURT DIVISION . NO: CONSENT TO BE APPOINTED GUARDIAN Dawn M. Smoker, being duly sworn according to law, deposes and say that she agrees to serve as the guardian for her daughter, EMILY A. SMOKER. My residence is 104 Louisa Lane, Mechanicsburg, Cumberland County, Pennsylvania. My occupation is medical reimbursement technician for Lebanon V.A. Hospital. I speak, read and write in the English language. I do not have any interest adverse to EMILY A. SMOKER. I am not a fiduciary or an officer or employee of a corporate fiduciary of an Estate in which the alleged incompetent has an interest; not the surety, or an officer or employee of a corporate surety of such a fiduciary, Dawn M. Smoker Sworn to and subscribed before me this `3 day of May, 2012. ~~ Notary COHIMONWEALTH OF~~ P~NNS~LVANIA NOTARIAL SEAL JOAN D. ADAMS, Notary Public Carlisle Boro., Cumberland County My Commission Expires March 15, 2015 EXHIBIT ~°i February 19, 2012 To Whom It May Concern, I acknowledge that Dawn Smoker is the guardian for Emily Smoker (born August 2~, 1994), and will be once Emily reaches the age of 18. She will have the authority to make any and all decisions concerning Emily's health and well-being, including financial and living arrangements. With this decree, I am stating that Ms. Dawn Smoker will be the sole person to make any decision for Emily Smoker now and once she becomes an adult. In the event of Dawn's death, Dawn will have the authority to make the choice of guardian in her will, or however she chooses to make that known. ~ ~ John;tienry ~rrho~e~ 1 -, `' ~~~ _5~5-~~7~1 EXHIBIT