Unless prohibited by agreement or court order, the surviving parent of a minor may appoint by will one or more guardians and successor guardians of the person of an unmarried minor. The guardian need not be approved by or qualify in any court.

On petition by any person interested in the welfare of the minor, and after notice and hearing as prescribed by the Maryland Rules, the court may appoint a guardian of the person of an unmarried minor if the court finds, by a preponderance of the evidence, that: The appointment is in the best interests of the minor; No testamentary appointment has been made; and No parent is willing or able to serve as guardian of the person of the minor; Each parent consents to the appointment of the guardian of the person; or No parent files an objection to the appointment of the guardian of the person. If the minor is at least 14 years old, and if the person otherwise is qualified, the court shall appoint a person designated by the minor, unless the decision is not in the best interests of the minor. This section may not be construed to require court appointment of a guardian of the person of a minor if there is no good reason, such as a dispute, for a court appointment. This subsection may not be construed to provide that the appointment of a guardian of the person of a minor requires the termination of any parental rights with respect to the minor under Title 5 of the Family Law Article. Venue in proceedings under this subtitle shall be as prescribed by the Maryland Rules. The contents of the petition and the manner of giving notice of the hearing on the petition shall be as prescribed by the Maryland Rules. If there is no victim’s representative who can adequately assert the minor’s rights as a victim of a crime or a delinquent act and no court has appointed a guardian ad litem to protect the minor’s interests, the rights, duties, and powers that the court may order the guardian to exercise shall include serving as a victim’s representative to assert the minor’s interests.

The guardian of the person of a minor may not be required to post any bond or to file any accounts. Unless otherwise provided by the will appointing a guardian of the person, the guardian of the person may not be entitled to any compensation for serving as guardian of the person.

The court may: Superintend and direct the care of a disabled person; Appoint a guardian of the person; and Pass orders and decrees respecting the person as seems proper, including an order directing the disabled person to be sent to a hospital. Procedures in these cases shall be as prescribed by the Maryland Rules and in accordance with the provisions of this subtitle and Title 13.5 of this article. On the filing of a petition for attorney’s fees made in reasonable detail by an interested person or an attorney employed by the interested person, the court may order reasonable and necessary attorney’s fees incurred in bringing a petition for appointment of a guardian of the person of a disabled person to be paid from the estate of the disabled person. Before ordering the payment of attorney’s fees under paragraph (1) of this subsection, the court shall consider: The financial resources and needs of the disabled person; and Whether there was substantial justification for the filing of the petition for guardianship. On a finding by the court of an absence of substantial justification for bringing the petition for guardianship, the court shall deny a petition for attorney’s fees filed under paragraph (1) of this subsection. The court may not award attorney’s fees under paragraph (1) of this subsection if the petition for guardianship is brought by: A government agency paying benefits to the disabled person; A local department of social services; or An agency eligible to serve as the guardian of the disabled person under § 13–707 of this subtitle.

On petition and after any notice or hearing prescribed by law or the Maryland Rules, a court may appoint a guardian of the person of a disabled person. A guardian of the person shall be appointed if the court determines from clear and convincing evidence that: A person lacks sufficient understanding or capacity to make or communicate responsible personal decisions, including provisions for health care, food, clothing, or shelter, because of any mental disability, disease, habitual drunkenness, or addiction to drugs; and No less restrictive form of intervention is available that is consistent with the person’s welfare and safety. Procedures and venue in these cases shall be as described by Title 10, Chapters 100 and 200 of the Maryland Rules. Notwithstanding the provisions of paragraph (1) of this subsection, a petition for guardianship of a disabled person shall include signed and verified certificates of competency from the following health care professionals who have examined or evaluated the disabled person: Two licensed physicians; or One licensed physician; and One licensed psychologist; One licensed certified social worker–clinical; One nurse practitioner; or One licensed physician assistant. An examination or evaluation by at least one of the health care professionals under paragraph (2) of this subsection shall occur within 21 days before filing a petition for guardianship of a disabled person. Subject to paragraph (2) of this subsection, unless the alleged disabled person has counsel of the person’s own choice, the court shall appoint an attorney to represent the person in the proceeding and may require the deposit of an appropriate sum into the court registry or the appointed attorney’s escrow account within 30 days after the order of appointment has been entered, subject to further order of the court. If the person is indigent, the State shall pay a reasonable attorney’s fee. The court may not require the deposit of an appropriate sum into the court registry or the appointed attorney’s escrow account under subparagraph (i) of this paragraph if payment for the services of the court–appointed attorney for the alleged disabled person is the responsibility of: A government agency paying benefits to the disabled person; A local department of social services; or An agency eligible to serve as the guardian of the disabled person under § 13–707 of this subtitle. In any action in which payment for the services of a court–appointed attorney for the alleged disabled person is the responsibility of the local department of social services, unless the court finds that it would not be in the best interests of the alleged disabled person, the court shall: Appoint an attorney who has contracted with the Department of Human Services to provide those services, in accordance with the terms of the contract; and In an action in which an attorney has previously been appointed, strike the appearance of the attorney previously appointed and appoint the attorney who is currently under contract with the Department of Human Services, in accordance with the terms of the contract. The person alleged to be disabled is entitled to be present at the hearing unless the person has knowingly and voluntarily waived the right to be present or cannot be present because of physical or mental incapacity. Waiver or incapacity may not be presumed from nonappearance but shall be determined on the basis of factual information supplied to the court by counsel or a representative appointed by the court. The person alleged to be disabled is also entitled to present evidence and to cross–examine witnesses. The issue may be determined at a closed hearing without a jury if the person alleged to be disabled or the person’s counsel so requests and all hearings herein shall be confidential and sealed unless otherwise ordered by a court of competent jurisdiction for good cause shown. The court shall hear and rule on a petition seeking appointment of a guardian of the person of a disabled person in connection with medical treatment on an expedited basis.

An adjudication of a disability for purposes of appointing a guardian of a person may not be the basis for commitment of the disabled person to a mental institution. Appointment of a guardian of the person: Is not evidence of incompetency of the disabled person; and Does not modify any civil right of the disabled person unless the court orders, including any civil service ranking, appointment, the right to apply for voluntary admission to a facility under § 10–611 of the Health – General Article, and rights relating to licensure, permit, privilege, or benefit under any law.

Persons are entitled to appointment as guardian of the person according to the following priorities: A person, agency, or corporation nominated by the disabled person if the disabled person was 16 years old or older when the disabled person signed the designation and, in the opinion of the court, the disabled person had sufficient mental capacity to make an intelligent choice at the time the disabled person executed the designation; A health care agent appointed by the disabled person in accordance with Title 5, Subtitle 6 of the Health – General Article; The disabled person’s spouse; The disabled person’s parents; A person, agency, or corporation nominated by the will of a deceased parent; The disabled person’s children; Adult persons who would be the disabled person’s heirs if the disabled person were dead; A person, agency, or corporation nominated by a person caring for the disabled person; Any other person, agency, or corporation considered appropriate by the court; and For adults less than 65 years old, the director of the local department of social services or, for adults 65 years old or older, the Secretary of Aging or the director of the area agency on aging, except in those cases where the department of social services has been appointed guardian of the person before age 65; and On appointment as guardian under item (i) of this item, directors of local departments of social services, directors of area agencies on aging, and the Secretary of Aging may delegate responsibilities of guardianship to staff persons whose names and positions have been registered with the court. A person specified in a priority in subsection (a)(2), (3), (5), or (6) of this section may waive and nominate in writing a person, agency, or corporation to serve in the person’s stead. A nominee of a person holding priority has the same priority as the person making the nomination. Among persons with equal priority the court shall select the one best qualified of those willing to serve. For good cause, the court may pass over a person with priority and appoint a person with a lower priority. If a guardian of the estate has been appointed, the court may select the guardian of the estate to be guardian of the person, regardless of priority. Subject to paragraph (2) of this subsection, nonresidence does not disqualify any person from serving as guardian of the person. A nonresident who is appointed may not qualify until the nonresident files with the register or clerk an irrevocable designation by the nonresident of an appropriate person who resides in the State on whom service of process may be made in the same manner and with the same effect as if it were served personally in the State on the nonresident. A local department of social services, local office on aging, or the Secretary of Aging, may be appointed as a guardian of a person regardless of whether that person resides in a State or private residential facility.

The court may grant to a guardian of a person only those powers necessary to provide for the demonstrated need of the disabled person. The court may appoint a guardian of the person of a disabled person for the limited purpose of making one or more decisions related to the health care of that person. The court may appoint a guardian of the person of a disabled person for a limited period of time if it appears probable that the disability will cease within 1 year of the appointment of the guardian. Subject to subsection (a) of this section, the rights, duties, and powers that the court may order include, but are not limited to: The same rights, powers, and duties that a parent has with respect to an unemancipated minor child, except that the guardian is not liable solely by reason of the guardianship to third persons for any act of the disabled person; The right to custody of the disabled person and to establish the disabled person’s place of abode within and without the State, provided there is court authorization for any change in the classification of abode, except that, except as provided under § 10–611 of the Health – General Article, no one may be committed to a mental facility without an involuntary commitment proceeding as provided by law; The duty to provide for care, comfort, and maintenance, including social, recreational, and friendship requirements, and, if appropriate, for training and education of the disabled person; If it is in the best interest of the disabled person, the duty to foster and preserve family relationships including, as appropriate, assisting to arrange visitation and communication by telephone calls, personal mail, and electronic communications; The duty to take reasonable care of the clothing, furniture, vehicles, and other personal effects of the disabled person, and, if other property requires protection, the power to commence protective proceedings; If a guardian of the estate of the disabled person has not been appointed, the right to commence proceedings to compel performance by any person of the person’s duty to support the disabled person, and to apply the estate to the support, care, and education of the disabled person, except that the guardian of the person may not obtain funds from the estate for room and board that the guardian, the guardian’s spouse, parent, or child provide without a court order approving the charge, and the duty to exercise care to conserve any excess estate for the needs of the disabled person; If a guardian of the estate has been appointed, the duty to control the custody and care of the disabled person, to receive reasonable sums for room and board provided to the disabled person, and to account to the guardian of the estate for funds expended, and the right to ask the guardian of the estate to expend the estate in payment of third persons for care and maintenance of the disabled person; The duty to file an annual or biannual report with the court indicating the present place of residence and health status of the ward, the guardian’s plan for preserving and maintaining the future well–being of the ward, and the need for continuance or cessation of the guardianship or for any alteration in the powers of the guardian; and On receipt of a report under item (i) of this item: The court shall renew the appointment of the guardian if the court is satisfied that the grounds for the original appointment stated in § 13–705(b) of this subtitle continue to exist; If the court believes such grounds may not exist, the court shall hold a hearing, similar to that provided for in § 13–705 of this subtitle, at which the guardian shall be required to prove that such grounds exist; If the court does not make these findings, the court shall order the discontinuance of the guardianship of the person; and If the guardian declines to participate in the hearing, the court may appoint another guardian to replace the guardian pursuant to the priorities in § 13–707(a) of this subtitle; and The power to give necessary consent or approval for: Medical or other professional care, counsel, treatment, or service, including admission to a hospital or nursing home or transfer from one medical facility to another; Withholding medical or other professional care, counsel, treatment, or service; and Withdrawing medical or other professional care, counsel, treatment, or service. Notwithstanding the powers conferred to a guardian under subsection (b)(8) of this section, and except as provided in paragraph (2) of this subsection, where a medical procedure involves, or would involve, a substantial risk to the life of a disabled person, the court must authorize a guardian’s consent or approval for: The medical procedure; Withholding the medical procedure; or Withdrawing the medical procedure that involves, or would involve, a substantial risk to the life of the disabled person. The court may, upon such conditions as the court considers appropriate, authorize a guardian to make a decision regarding medical procedures that involve a substantial risk to life without further court authorization, if: The disabled person has executed an advance directive in accordance with Title 5, Subtitle 6 of the Health – General Article that authorizes the guardian to consent to the provision, withholding or withdrawal of a medical procedure that involves a substantial risk to life but does not appoint a health care agent; or The guardian is: Within a class of individuals specified in § 5–605(a)(2) of the Health – General Article as authorized to make health care decisions for the disabled person; and Determined by the court to be familiar with the personal beliefs, values, and medical situation of the disabled person. A petition seeking the authorization of a court that a life–sustaining procedure be withheld or withdrawn is subject to the provisions of §§ 13–711 through 13–713 of this subtitle. Notwithstanding subsection (a) of this section, and in addition to the rights, duties, and powers which the court may order under subsection (b) of this section, the court may order the relief provided under this subsection. If a guardian of the estate has been appointed, a guardian of the person may ask the guardian of the estate to expend the estate in payment of care and maintenance services provided directly to the disabled person by the guardian of the person at the rate of reimbursement established under this subsection. The guardian of the person shall maintain appropriate records to document the care and maintenance services provided directly to the disabled person to receive any payment under this subsection. To implement the provisions of this subsection, the court may: Adopt guidelines for the rate of reimbursement for care and maintenance services provided directly by the guardian of the person to a disabled person; Establish appropriate procedures for records, inspections, audits, or other requirements to monitor care and maintenance services provided directly by the guardian of the person for which the guardian of the person is reimbursed; and Order any act necessary for the best interests of the disabled person. Notwithstanding subsection (a) of this section, and in addition to the rights, duties, and powers that the court may order under subsection (b) of this section, the court may order the guardian of a person with a disability to serve as a victim’s representative to assert the person’s interests if: There is no victim’s representative who can adequately assert the person’s rights as a victim of a crime or a delinquent act; and No court has appointed a guardian ad litem to protect the person’s interests.

A law enforcement officer shall transport an adult to an appropriate medical facility, which shall immediately notify the next of kin and the director, when, from personal observation of the officer, it appears probable that: The adult will suffer immediate and serious physical injury or death if not immediately placed in a health care facility; The adult is incapable of giving consent; and It is not possible to follow the procedures of this section. The medical care provided under paragraph (1) of this subsection may not be rendered in a State mental facility other than, in an appropriate case, the Walter P. Carter Community Mental Health and Retardation Center and the Highland Health Facility unless authorized by the courts in a civil commitment proceeding. The director shall file a petition for any adult transferred under this subsection pursuant to subsection (b) of this section within 24 hours after the transfer of the person has taken place. The court shall hold a hearing on the petition and render its decision within 48 hours after the transfer has occurred. Upon petition by an interested person, a court may issue an order authorizing the provision of protective services on an emergency basis to an adult after finding on the record, based on clear and convincing evidence, that: For the purpose of this section the person lacks capacity under the standards enumerated in § 13–705(b) of this subtitle; An emergency exists, as defined in § 13–101 of this title; and No person authorized by law or court order to give consent for the person is available to consent to emergency services. In issuing an emergency order, the court shall adhere to the following limitations: Only such protective services as are necessary to remove the conditions creating the emergency shall be ordered; the court shall specifically designate the approved services in its order; Protective services authorized by an emergency order shall not include hospitalization or a change of residence unless the court specifically finds such action is necessary and gives specific approval for such action in its order; Protective services may be provided under an initial emergency order for not more than 144 hours, and the initial order may be renewed as provided in paragraph (5) of this subsection; In its order the court shall appoint the petitioner, another interested person, the director, or the Secretary of Aging as temporary guardian of the person with responsibility for the person’s welfare and authority to give consent for the person for the approved protective services until the expiration of the order; Notwithstanding the provisions of paragraphs (3) and (4) of this subsection, the court may extend the terms of the emergency order and the appointment of the temporary guardian until appointment of a guardian of the person pursuant to § 13–705 of this subtitle, on petition of the temporary guardian, the director, or the Secretary of Aging, as appropriate, and after a showing that the conditions found to exist in subsection (b) of this section will probably continue beyond the expiration of the extended emergency order; A petition under subparagraph (i) of this paragraph shall be filed before the expiration of the 6–day period provided for in paragraph (3) of this subsection and shall be accompanied by a petition for appointment of a guardian of the person pursuant to § 13–705 of this subtitle; and A petition for appointment of a guardian of the person under subparagraph (ii) of this paragraph shall be heard on an expedited basis no more than 60 days after the filing of the petition; The issuance of an emergency order and the appointment of a temporary guardian shall not deprive the person of any rights except to the extent provided for in the order or appointment; and To implement an emergency order, the court may authorize forcible entry of the premises of the person for the purpose of rendering protective services or transporting the person to another location for the provision of protective services only after a showing to the court that attempts to gain voluntary access to the premises have failed and forcible entry is necessary; and Persons making authorized forcible entry under subparagraph (i) of this paragraph shall be accompanied by a law enforcement officer, the director or the director’s representative, and if appropriate, a representative of the local department of health. The petition for an emergency order shall set forth: The name, address, and interest of the petitioner; The name, age, and address of the person in need of protective services; The nature of the person’s disability, if determinable; The proposed protective services; The petitioner’s reasonable belief, together with supportive facts, as to the existence of the facts stated in subsection (b)(1) through (3) of this section; and Facts showing the petitioner’s attempts to obtain the person’s consent to the services and the outcomes of the attempts. Notice of the filing of the petition for an emergency order shall be given as required in the Maryland Rules and to the director. The notice shall be given in language reasonably understandable by the intended recipients at least 24 hours before the hearing for emergency intervention. The court may waive the 24–hour notice requirement on a showing that: Immediate and reasonably foreseeable physical harm to the person or others will result from the 24–hour delay; and Reasonable attempts have been made to give notice. Notice of the court’s final order shall be given to the same parties as required under paragraph (1) of this subsection. The hearing on a petition for an emergency order for protective services shall be held under the following conditions: The person shall be present unless the person has knowingly and voluntarily waived the right to be present or cannot be present because of physical or mental incapacity; and Waiver or incapacity may not be presumed from nonappearance but shall be determined on the basis of factual information supplied to the court by counsel or a representative appointed by the court; The person has the right to counsel whether or not the person is present at the hearing; Subject to paragraph (2) of this subsection, if the person is indigent or lacks the capacity to waive counsel, the court shall appoint counsel; and If the person is indigent, the State shall pay reasonable attorney’s fees; and The person may present evidence and cross–examine witnesses; and The hearing shall be held no earlier than 24 hours after the notice required in subsection (e) of this section has been given, unless such notice has been waived by the court. In any action in which payment for the services of a court–appointed attorney for the person is the responsibility of the local department of social services, unless the court finds that it would not be in the best interests of the person, the court shall: Appoint an attorney who has contracted with the Department of Human Services to provide those services, in accordance with the terms of the contract; and In an action in which an attorney has previously been appointed, strike the appearance of the attorney previously appointed and appoint the attorney who is currently under contract with the Department of Human Services, in accordance with the terms of the contract. The court shall issue for the record a statement of its findings in support of any order for emergency protective services. The person, the temporary guardian, or any interested person may petition the court to have the emergency order set aside or modified at any time, notwithstanding any prior findings by the court that the person is disabled. If protective services are rendered on the basis of an emergency order, the temporary guardian shall submit a report describing the circumstances including the name, place, date, and nature of the services, and the use of forcible entry, if any, to the court and the director. The report under this subsection shall become part of the court record. The person or the guardian of the person may appeal any findings of a court under subsection (b) of this section. Such appeal shall be handled on an expedited basis by the appellate court.

Any person filing a petition, participating in the making of a good–faith report, or participating in an investigation or in a judicial proceeding resulting therefrom, pursuant to § 13–705 or § 13–709 of this subtitle or Title 14, Subtitle 3 of the Family Law Article, shall have the immunity from civil liability or criminal penalty described under § 5–618(a) of the Courts and Judicial Proceedings Article. A law enforcement officer who transports an adult to an appropriate medical facility under § 13–709 of this subtitle shall have the immunity from civil or criminal liability described under § 5–618(b) of the Courts and Judicial Proceedings Article.

In this Part III of this subtitle the following words have the meanings indicated. “Best interest” means that the benefits to the disabled person resulting from a treatment outweigh the burdens to the disabled person resulting from that treatment, taking into account: The effect of the treatment on the physical, emotional, and cognitive functions of the disabled person; The degree of physical pain or discomfort caused to the disabled person by the treatment, or the withholding or withdrawal of the treatment; The degree to which the disabled person’s medical condition, the treatment, or the withholding or withdrawal of treatment results in a severe and continuing impairment of the dignity of the disabled person by subjecting the individual to a condition of extreme humiliation and dependency; The effect of the treatment on the life expectancy of the disabled person; The prognosis of the disabled person for recovery, with and without the treatment; The risks, side effects, and benefits of the treatment or the withholding or withdrawal of the treatment; and The religious beliefs and basic values of the disabled person receiving treatment, to the extent these may assist the decision maker in determining best interest. “Life-sustaining procedure” means any medical procedure, treatment, or intervention used to sustain, restore, supplement, or supplant a spontaneous vital function in order to prevent or postpone the death of a disabled person. “Substituted judgment” means a determination by a court that a disabled person would, if competent, make the same health care decision regarding a life-sustaining procedure taking into account any information that may be relevant to the decision, including: The current diagnosis, prognosis with and without the life-sustaining procedure, and life expectancy of the disabled person; Any expressed preferences of the disabled person regarding the provision of, or the withholding or withdrawal of, the life-sustaining procedure at issue; Any expressed preferences of the disabled person about the provision of, or the withholding or withdrawal of, life-sustaining procedures generally; Any religious or moral beliefs or personal values of the disabled person in relation to the provision of, or the withholding or withdrawal of, life-sustaining procedures; Any behavioral or other manifestations of the attitude of the disabled person toward the provision of, or the withholding or withdrawal of, the life-sustaining procedure; Any consistent pattern of conduct by the disabled person regarding prior decisions about health care; Any reactions of the disabled person to the provision of, or the withholding or withdrawal of, a comparable life-sustaining procedure for another individual; and Any expressed concerns of the disabled person about the effect on the family or intimate friends of the disabled person if a life-sustaining procedure were provided, withheld, or withdrawn.

The court may approve a request for the withholding or withdrawal of a life-sustaining procedure from a disabled person on the basis of a substituted judgment. The court may make a substituted judgment under subsection (a) of this section only on the basis of clear and convincing evidence that the disabled person would, if competent, decide to withhold or withdraw a life-sustaining procedure under the circumstances. Evidence of the intentions or wishes of the disabled person regarding the withholding or withdrawal of a life-sustaining procedure that might otherwise be inadmissible may be admitted, in the discretion of the court, if it is: Material and probative; and The best evidence available.

If the court is unable to make a substituted judgment under § 13-712 of this subtitle, the court may approve a request for the withholding or withdrawal of a life-sustaining procedure from the disabled person if the court determines, on the basis of clear and convincing evidence, that the withholding or withdrawal is in the best interest of the disabled person. The decision of whether life-sustaining procedures should be provided, withheld, or withdrawn shall not be based, in whole or in part, on either a patient’s preexisting, long-term mental or physical disability, or a patient’s economic disadvantage.