Since 2014 the Institute has brought together community leaders, policy-makers, scholars and other advocates statewide to develop better policy for the unmet guardianship needs in Massachusetts. In addition to initiating research and organizing scholarly exchange, the Institute participates in a Steering Committee that coordinates the efforts of a number of individuals and groups who are interested in guardianship reform.

The goal of advocacy is a more inclusive, effective and flexible public system for decisional support services in Massachusetts. The Institute supports policy changes, including legislative reform if needed, in order to fill the gaps in public services. Legislation recently was filed to create a Public Guardian, through a public-private partnership in which a new state office, comprise of a few key employees, would oversee a larger, privately-funded non-profit service provider. The Institute supports this proposal.

The Institute’s view of guardianship reform also includes increased use of guardianship alternatives, such as supported decision-making, in appropriate circumstances, in order to maximize the amount of control and self-determination retained by persons in need of decisional support. It also includes wider use of Health Care Proxies and Durable Powers of Attorney to avoid any need for guardianship.

In addition to creating a Public Guardian, the Institute supports legislation filed by the Massachusetts Medical Society to enable healthcare providers to designate surrogate decision-makers through a statutory designation of priority, and a bill filed by the Alzheimer’s Association to require physicians to receive specific training in how to diagnose dementia and talk about it with the individual or their family.

A proposed Public Guardianship bill was filed in January 2017, as House No. 3027 and Senate No. 1177 . The bill was recommended for “further study” in May 2018, effectively ending its viability in the 2017-18 Legislative Session.


2019-2020 Bill


2017-2018 Bill