Maryland’s highest court concludes that a juvenile court had the statutory authority to order the state to continue to provide full-time nursing services to a young adult with severe special needs beyond his 21st birthday until the adult guardianship and Medicaid systems could coordinate his ongoing care.  In re: Adoption / Guardianship of Dustin R. (Md., No. 24a15, Dec. 21, 2015).

Dustin R. was born with severe special needs that became increasingly complicated as he grew older, to the point that he received around-the-clock Medicaid-funded nursing services.  Although Dustin lived with his foster parents, they had limited guardianship authority to make medical decisions for him, and the Anne Arundel County Department of Social Services was his permanent guardian.  For several years prior to his 21st birthday, Dustin petitioned the juvenile court for an order directing the state Department of Health and Mental Hygiene (DHMH) to continue to provide his current level of medical care after he aged out of the juvenile court system.  

At several hearings that took place shortly before Dustin’s 21st birthday, DHMH argued that the juvenile court did not have the authority to order it to provide any services to Dustin after his 21st birthday, and that the court, in general, could not prescribe what services DHMH provided to anyone.  Several days before Dustin’s 21st birthday, the juvenile court did in fact order DHMH to continue its current care plan for Dustin.  DHMH appealed, but the Court of Special Appeals dismissed the request, holding that the juvenile court had not properly issued a final order and therefore the appeal was not timely.  Both parties (who agreed that the juvenile court had, in fact, issued a final order) filed Writs of Certiorari with the Court of Appeals, arguing over whether the juvenile court had the authority to order ongoing services for Dustin.

The Court of Appeals of Maryland, the state’s highest court, rules that the Court of Special Appeals improperly dismissed the state’s appeal.  The court goes on to find that “under the plain language of [several statutes], the juvenile court had both the jurisdiction and statutory authority to order DHMH to develop and approve a written plan of clinically appropriate services in the least restrictive setting that ensured that Dustin would continue to receive the services that he was then receiving, where Dustin was not yet twenty-one years old when the juvenile court issued its order . . . to bridge the gap as Dustin transitioned from his juvenile guardianship case to the adult guardianship system.”

To read the full text of the court’s decision, go to:  http://www.mdcourts.gov/opinions/coa/2015/24a15.pdf