NYC Council Hearing on Access to Technology for Seniors with Limited Capacity

New York City Council Hearing

Committee on Aging, Committee on Technology,

January 22, 2021

Subject: Access to Technology for Seniors with Limited Capacity

Testimony: Beth L. Williams, Esq., Project Guardianship

I am Beth Williams, the Deputy Director of Legal Services for Project Guardianship, formerly a demonstration project of the Vera Institute of Justice.  Project Guardianship is a non-profit agency that serves as court-appointed guardian pursuant to Article 81 of the New York State Mental Hygiene Law.  In our 15 years of operation, we have served over 500 individuals in New York City for whom a judge has determined their functional limitations necessitate the assistance of a guardian of either person, property, or both. 

The overwhelming majority of our clients are seniors.  They reside across all five boroughs of New York City.  Generally, they live in one of two places – a nursing facility or at their home in the community.  Before the pandemic, we were able visit with each of our clients on a monthly basis regardless of their location.  This enabled us to visibly assess their health, affect, social relationships, and environment, and make fully informed decisions about their course of care.  With the onset of the pandemic in March 2020, the visitation restrictions in facilities have prevented us, as well as judges, court-appointed counsel, and evaluators, from having hands-on access to our senior clients with limited capacity.

It is very difficult to holistically monitor the condition of our seniors and to advocate for adjustments to their care when we are unable to see them in person.  Due to their functional limitations, many of our clients are unable to use technology to connect with us, and the nature of the communications with those who can do not lend themselves towards monitoring changes in their physical and mental condition.  Because we cannot enter a facility, we are unable to observe the environment in which care is being provided and be watchful for indicators of substandard treatment. 

It has been our experience that nursing facilities are poorly equipped to provide our clients with access to technology that would enable us to “visit” them via videoconferencing.  As such, access to our senior clients living in facilities has mostly been via telephone and, for our clients who are unable to use a telephone, the best we can do is have a conversation with care staff about their oftentimes biased perceptions of our clients’ well-being.  So long as COVID-19 continues to spread and access to nursing facilities is denied, we urgently need policies that mandate nursing facilities provide access through technology to persons under guardianship so we can ensure they receive the care they need and that we are in the best possible position to make decisions on their behalf.

For our senior clients who reside in the community, of whom many are homebound, we have limited in-person visitation to all but the most necessary of circumstances to help prevent the spread of COVID-19 to these most fragile residents of our city.  In most instances, our clients who reside in the community have either full-time or part-time home health aides.  While we have had much better success working with aides to access our clients at home via videoconferencing technology, there are still barriers such as (i) availability of inexpensive broadband and affordable mobile phones or laptops for our senior clients who are poor and live on fixed incomes, (ii) lack of training of home health aides on how to use the technology, and (iii) lack of technical support to troubleshoot issues.  We need funding for broadband and devices for low income seniors, and training for home health care providers on how to use technology like videoconferencing. 

While we understand the complexity and unprecedented nature of the present public health emergency, protecting our seniors who have disproportionately lost their lives due to COVID-19 should be made a priority.  Quick action to ensure they have meaningful access to technology will help assure that our effectiveness as their guardian will not be curtailed precisely when they need it most.

Thank you to the Councilmembers and the Committees for inviting me to testify in this hearing.