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Home My WebLink About02-22-05 INRE: Joseph A. Hoffman, an Alleged Incapacitated Person : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA : ORPHANS' COURT DIVISION ~ NO. 21-05 - Ill} : GUARDIANSHIP t-,",...) <'~/'l PETITION FOR APPOINTMENT OF A TEMPORARY GUARDIAN OF THE ESTATE AND PERSON PURSUANT TO 20 PA. C.S.A. 5513 r.'.,_.... i0 C.) 0:. 1) Your Petitioner is Robert L. O'Brien, Esquire, Solicitor for the Cumberland/Perry County Mental Health/Mental Retardation Office. 2) Respondent is Joseph A. Hoffman, an incapacitated person, currently receiving care at West Shore Health and Rehabilitation Center, 770 Poplar Church Rd., Camp Hill, PA 17011. Respondent is an adult individual being presently 59 years of age with a birth date of December 27, 1945. 3) The proposed guardian is Barry Claypool who has known Mr. Hoffman for ,I :i a number of years through his work with CPARC. He requests that she be appointed a temporary guardian to arrange for to arrange for Mr. Hoffman's discharge from West Shore Health and Rehabilitation Center and his admission to Manor Care Health 1: !i d 'I I, " ,I II '. Ii Services in Carlisle, PA. Thereafter he requests that he be appointed plenary guardian of the estate and person in a permanent capacity. A determination has been made that, due to Mr. Hoffman's low intellectual functioning, he is unable to act in any capacity in reference to his needs for placement and care. I 4) The proposed Guardian has no interest adverse to that of Mr. Hoffman. 5) Mr. Hoffman has, in addition to his limited mental capacity, been diagnosed with terminal alzheimer / dementia and has significant health problems that prevent him from attending court. WHEREFORE, Petitioner, Robert L. O'Brien, respectfully requests that the Court order that Respondent Joseph A. Hoffman be adjudged an incapacitated person and Barry Claypool be appointed emergency Guardian of the Person and Estate. Respectfully submitted, O'BRIEN, BARIC & SCHERER BY --.' /1 ~(A,(j~v-:- Robert L. O'Brien, Esquire Solicitor for the Cumberland/Perry County MH/MR Office I.D. # 28351 19 West South Street Carlisle, Pennsylvania 17013 (717) 249-6873 I verify that the statements made in the foregoing Petition for an Extension of Appointment of an Emergency Guardian Pursuant to 20 PA. C.S.A. ~ 5513 are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. ~ 4904, relating to unsworn falsification to authorities. ~~~ Robert L. O'Brien, Esquire Dated: .2/22/{;S- , , INRE: Joseph A. Hoffman, an Alleged Incapacitated Person : IN THE COURT OF COMMON PLEAS : CUMBERLAND COUNTY, PA : ORPHANS' COURT DIVISION : NO. 21-05 - : GUARDIANSHIP CONSENT OF GUARDIAN The undersigned Barry Claypool, proposed Guardian, consents to his appointment as Guardian of the Estate and Person of Joseph A. Hoffman. I verify that I have no interest in this appointment that is adverse to the interest of Joseph A. Hoffman. I verify that these statements are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. 9 4904, relating to unsworn falsification to authorities. I IN THE MATTER OF IN THE COURT OF COMMON PLEAS COUNTY, PENNSYLVANIA Joseph A. Hoffman AN ALLEGED INCOMPETENT ORPHANS' COURT DIVISION IN RE NO. PETITION FOR APPOINTMENT OF A TEMPORARY GUARDIAN OF THE PERSON PURSUANT TO 20 Pa. C.S.A. 5513 The Petition of , respectfully represents: 1. Your Petitioner IS - --R>b.....c--+ l. O'f>~I~~" g~. 2. Joseph A. Hoffman is currently receiving care at West Shore Health & Rehabilitation Center, 770 Poplar Church Rd., Camp Hill, P A 17011(phone 717-763-7070) 3. Joseph A. Hoffman domiciled at 829 Lisburn Rd., Camp Hill, P A 17011 4. Joseph A. Hoffman IS 59 years of age having been born on 12/27/1945 5. Joseph A. Hoffman marital status IS never married 6. Those persons, if any, who are Joseph A. Hoffman's next-of-kin and their relationship to same, of whom your Petitioner has knowledge are as follows: None. 7. No other Court within the Commonwealth of which Petitioner has knowledge has appointed a guardian for Joseph A. Hoffman 8. Joseph A. Hoffinan is mentally retarded. 9. Because of mental deficiency, Joseph A. Hoffinan lacks sufficient capacity to make or communicate responsible decisions concerning hislher person as set forth in the attached Affidavit prepared by , marked as Exhibit A and made a part hereof. 10. Joseph A. Hoffinan is in need of residential mental retardation services. 11. Joseph A. Hoffinan has been accepted for placement at West Shore Health & Rehabilitation Center (plans to move to ManorCare Health Services in Carlisle) upon the condition that a guardian ofthe person be appointed to consent to said placement on hislher behalf. 12. Barry Claypool , having no interest adverse to Joseph A. Hoffman , has agreed to act as Temporary Guardian of the Person of Joseph A. Hoffinan ifthis Honorable Court shall so appoint. WHEREFORE, Petitioner prays this Court place under the temporary guardianship of Barry ClayPool , pursuant to 20 Pa. C.S.A. 9 5513 and empower said temporary guardian to provide substitute consent for such community-based or institutional services as may be necessary to provide for hislher needs. I BY: 02/09/05 11:34 FAX 17172492611 CPARC tal 03 IN THE MA ITER OF AN ALLEGED INCOMPETENT IN 1lIE COURT OF COMMON PLEAS COUNTY. PENNSYLVANIA ORPHANS' COURTDMSION IN RE NO. COMMONWEAL m OF PENNSYL V ANlA SS#: COUN1Y OF ,~r~ ;:;< -;oU J iY(IJ , being duly swom ""cording to law, deposes and say that: 1. He IS a licensed, practicing physician who is employed at /Jt4r/~,. .421?/~~ ~rc7G. where on d /9,/ tJS . he examined patient therein: , vi%: (Name) J oJ ~ pff ,In t? n , (Age) (Sex) J"Y1 A1 c:.- . who was admitted from / ,//3,/05' on , with a history of At the examination, the following symptoms were observed: ~n-~ 000/\ 'j r/~e r ;-12- G~ I ~ A ~~..-Q' W /7/1 ~d)O /~~/ ~/vY<2 - ,/'Zo~ C rt.6e;e.~~ S~~ 727" /1i:f?1 ~1JYrn ;p./ ~~ Q... <2) {, ~ Pc.-oV~ . 02/09/05 11:34 FAX 17172492611 CPARC ~04 from which the diagnosis made is: OV'tv/) ~ J ~/? ck/1? e ~ ~)? ~/"1-'.nl' J L?~~..,?q L , / ' with a prognosis ,/YI,/:TA-f/i/7 ,I. (/~/T~~ ~,..,/S as follows: ~)/nrJle. ,(/'ve'l ~c,7 ?-ehJ. / , ...-.. /~h-t. , 2. On the basis of the foregoing history and examination, the affiant is of the opinion that foJ r/i / ~ #-J'I't /'h-J . because of mental deficiency t lacks sufficient capacity to make or communicate responsible decisions concerning hislher choice to receive COlnD"I'Qity-based or institutional services for the mentally retarded. 3. Because of the physical or mental condition of said patien~ bislher welfare would/would not be promoted by hislher presence in Court. SWORN TO AND SUBSCRIBED BEFORE ME TInS ~ DAY OR. ~ ~.JMU4(f CJ..oii$ . ;I s NOTARY PUBUC ~A;)1Q~ '~'~~"""':.- :::,' ~"L~':.'~=~;'''''' ... ": " . .... . ". ..' ) . ',~,'" _' i'" ,~ 12;'i~li~:;;L~-::::j COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND AFFIDA VIT -~k + !- ~ e' (Sr\'~ , Petitioner in this A-\-\c~~ \ sworn according to law, do depose and state that I am of Co"'-l~ \CM,...J ~Q.'\'r-\ V\\ HMR... ~<::Q and that the matter, being duly facts set forth in the foregoing Petition are true and correct to the best of my knowledge, information, and belief. , r ~J~~ Petitioner SWORN TO AND SUBSCRIBED BEFORE ME, THIS ~ J. 'r:lA I=e.-b~Q'j DAY OF , 20 05 . ~"A~ NutARy PuBLIC COMMONWEALTH OF PENNSYLVANIA