Since  our report was issued, some states have strengthened their guardianship  programs and some efforts have been made to lay the groundwork for  better collaboration. However, there continues to be little coordination  between state courts and federal agencies in the area of guardianships. While State Court Procedures Vary in Their Oversight of Guardianships, Some States Have Recently Strengthened Their Guardianship Programs

In our 2004 review we determined that all 50 states and the District of  Columbia have laws requiring courts to oversee guardianships. Alaska, for example, established requirements for the licensing of private  professional guardians and, in January of this year, New Jersey began  requiring the registration of professional guardians. “Exemplary” Courts Focus on Training and Monitoring

In our 2004 report several courts were identified as having “exemplary”  programs. State Courts and Federal Representative Payee Programs Serve Many of the Same Incapacitated Elderly People, but Continue to Collaborate Little in Oversight Efforts

There is also a role for the federal government in the protection of  incapacitated people. Limited Progress Has Been Made on Recommendations from 2004

Only limited progress has been made on our recommendations. In one  recommendation we suggested that SSA convene an interagency study  group to increase the ability of representative payee programs to protect  federal benefit payments from misuse. Although VA, HHS, and OPM  indicated their willingness to participate in such a study group, SSA  disagreed with this recommendation. We checked  with SSA recently and learned that its position has not changed. Coordination among federal agencies and between federal agencies and  state courts remains essentially unchanged, according to agency and court  officials we spoke with. In 2004, we also recommended that HHS work with national organizations  involved in guardianship programs to provide support and leadership to  the states for cost-effective pilot and demonstration projects to facilitate  state efforts to improve oversight of guardianships and to aid guardians in  the fulfillment of their responsibilities. HHS has taken a step in this direction by supporting  the inclusion of questions about guardians in the National Center on Elder  Abuse’s annual survey of state adult protective services agencies. Only 11 states provided information about the source of  reports of abuse. Finally, we also recommended that HHS facilitate a review of state policies  and procedures concerning interstate transfer and recognition of  guardianship appointments to facilitate efficient and cost-effective  solutions for interstate jurisdictional issues. The National Conference of  Commissioners on Uniform State Laws (NCCUSL) met in July 2006 and  issued a discussion draft for a Uniform Adult Guardianship and Protective  Proceedings Jurisdiction Act. This implementation session  developed a series of 45 action steps that could be taken at the national,  state, and local levels in order to accomplish a select subset of the  recommendations made at the 2001 Second National Guardianship  Conference--the “Wingspan Conference.” These action steps fall into five  main categories: the development of interdisciplinary guardianship  committees at the national, state, and local levels; the development of  uniform jurisdiction procedures, uniform data collection systems, and  innovative funding mechanisms for guardianships; the enhancement of  training and certification for guardians and the encouragement of judicial  specialization in guardianship matters; the encouragement of the most  appropriate and least restrictive types of guardianships; and the  establishment of effective monitoring of guardianships. In our 2004  report we concluded that the prospect of increasing numbers of  incapacitated elderly people in the years ahead signals the need to  reassess the way in which state and local courts and federal agencies work  together in efforts to protect incapacitated elderly people.
Why GAO Did This Study

The Senate Special Committee on Aging asked GAO to follow up on its 2004 report, Guardianships: Collaboration Needed to Protect Incapacitated Elderly People, GAO-04-655 . This report covered what state courts do to ensure that guardians fulfill their responsibilities, what exemplary guardianship programs look like, and how state courts and federal agencies work together to protect incapacitated elderly people. For this testimony, GAO agreed to (1) provide an overview and update of the findings of this prior work; (2) discuss the status of a series of recommendations GAO made in that report; and (3) discuss the prospects for progress in efforts to strengthen protections for incapacitated elderly people through guardianships. To complete this work, GAO interviewed lawyers and agency officials who have been actively involved in guardianship and representative payee programs, and spoke with officials at some of the courts identified as exemplary in the report.

What GAO Found

GAO's 2004 report had three principal findings. First, all states have laws requiring courts to oversee guardianships, but court implementation of these laws varies. Second, those courts recognized as exemplary in the area of guardianships focused on training and monitoring. Third, there is little coordination between state courts and federal agencies or among federal agencies regarding guardianships. At present, these findings remain largely the same, but there are some new developments to report. Since GAO's report was issued, some states have strengthened their guardianship programs. For example, Alaska established requirements for licensing of private guardianships and New Jersey and Texas established requirements for the registration of professional guardians. However, there continues to be little coordination between state courts and federal agencies or among federal agencies in the protection of incapacitated people. GAO's report made recommendations to federal agencies, but to date little progress has been made. GAO recommended that SSA convene an interagency study group to increase the ability of representative payee programs to protect federal benefit payments from misuse. Although VA, HHS, and OPM indicated their willingness to participate in such a study group, SSA disagreed with this recommendation, and its position has not changed. Second, GAO recommended that HHS work with national organizations involved in guardianship programs to provide support and leadership to the states for cost-effective pilot and demonstration projects to facilitate state efforts to improve oversight of guardianships and to aid guardians in the fulfillment of their responsibilities. HHS did support a study that surveyed the status of states' guardianship data collection practices. HHS also supported a National Center on Elder Abuse survey of adult protective services agencies to collect information including the extent to which guardians are the alleged perpetrators or the sources of reports about elder abuse. Third, GAO recommended a review of state policies and procedures concerning interstate transfer and recognition of guardianship appointments. A National Conference of Commissioners on Uniform State Laws, held in July of this year, issued a discussion draft for a uniform state law addressing these issues. Following issuance of GAO's 2004 report, a joint conference of professional guardianship organizations agreed on a set of action steps to implement previously-released recommendations from a group of experts on adult guardianship, known as the Wingspan recommendations. Among other things, these action steps call for licensing, certifying, or registering professional guardians.