In a quiet office in upstate New York, a guardian opens a folder filled with a client’s documents: medical reports, housing records and correspondence from service providers. The person they are appointed to support once lived independently and made their own choices, but now, due to illness, disability or isolation, they cannot manage entirely on their own. What the guardian sees is not just an individual in need, but a system struggling to respond.
Across New York, judges routinely report difficulty finding qualified guardians for people who need them. Thousands of New Yorkers — older adults, people with disabilities and individuals without family or financial resources — require decision-making support to remain safe and housed, access health care, and live with dignity.
Yet New York remains one of the few states without a publicly funded guardianship program. Instead, access to guardianship depends largely on geography, philanthropy and the willingness of under-resourced nonprofits to stretch limited budgets even further.
Under Article 81 of the Mental Hygiene Law, guardianship is a vital protection for people who cannot fully care for themselves due to illness, injury, cognitive impairment or disability. When done well, guardianship is narrowly tailored, person-centered and focused on preserving autonomy while ensuring safety and well-being. But the system can only function if there are guardians available — and today, there are not enough.
There is a solution: the New York State Good Guardianship Act. The legislation would establish a statewide, publicly funded guardianship program, ensuring that people who need guardianship and have no one else to turn to can access qualified, well-supported guardians regardless of where they live. The measure would also strengthen oversight, promote person-centered practices and help build capacity in underserved regions.
New York’s guardianship crisis is not new, and it is not temporary. The state’s population is aging rapidly, dementia rates are rising, more people are aging without family supports, and more New Yorkers are living longer with complex disabilities and limited incomes. These realities have collided with a guardianship system that was never designed to meet statewide need.
The result is a patchwork approach that leaves judges with few options, guardians stretched thin, and vulnerable people waiting — sometimes for months — for help. In some cases, individuals remain stuck in hospitals, shelters or unsafe housing simply because no guardian is available to act on their behalf.
Investing in guardianship is not only the right thing to do; it is fiscally responsible. A recent cost-benefit analysis of a person-centered guardianship model in New York found that over nearly a decade, the program saved approximately $142 million in Medicaid expenditures by avoiding unnecessary nursing home placements, reducing hospitalizations and recovering liens. When accounting for avoided shelter placements for people at risk of homelessness, total public cost reductions ranged from $155 million to $166 million for just 236 clients — nearly $67,000 per person per year.
But this issue is about more than dollars. It is about dignity, justice and basic fairness.
New York’s Master Plan for Aging recognizes the importance of supporting alternatives to institutionalization and investing in systems that allow people to remain in their communities. A robust, publicly funded guardianship program is essential to achieving those goals — not as a substitute for other services, but as a necessary complement when individuals cannot navigate systems on their own.
The guardian at their desk, surrounded by files, is doing work that the state depends on but has never fully supported. The Good Guardianship Act offers New York a chance to correct that imbalance and build a guardianship system that is equitable, sustainable, and worthy of the people it serves.
Kimberly George is the president and CEO of Project Guardianship. State Sen. Cordell Cleare of Harlem represents the 30th Senate District.