Public Testimony: New York City Council Committee on Aging Preliminary Budget Hearing

Thank you, Chair Hudson and Committee Members, for the opportunity to present today. My name is Kimberly George and I’m the President and CEO of Project Guardianship. 

Project Guardianship is a NYC-based nonprofit that provides legal guardianship services to New Yorkers in need of a surrogate decision-maker. We also provide a range of preventative services to help New Yorkers access critical health and social services prior to guardianship. Doing so helps to ensure that guardianship remains a tool of last resort, as it is intended to be. Because of our varied boots-on-the-ground expertise, we inform guardianship reform policies and practices throughout our state. 

The people for whom we provide guardianship services have a few things in common. First, they have experienced an event in their lives that caused them to lose decision-making capacity. That event could be the onset of disability, dementia, serious mental illness, substance misuse, Traumatic Brain Injury, and other conditions that impact their ability to manage daily activities and potentially put them in harm’s way. In some cases, we are appointed guardian simply to make end-of-life decisions for someone who has nobody in their lives to do so. 

This brings me to the second thing our clients have in common, which is an absence of family members or friends willing or able to serve as their guardian. The overwhelming majority of our clients are older adults who are aging alone. This reflects a national trend; according to US Census Bureau data, today, one third of older adults live alone. Finally, our clients have no funds to pay for a private guardian, with 96 percent of them living under 80 percent of the area median income. These three factors—loss of capacity, social isolation, and a lack of financial resources—make our clients among the most vulnerable residents of our city. As such, it is essential that they have advocates looking out for their health, safety, and dignity. 

These are our priorities at Project Guardianship, and we achieve them by deploying multidisciplinary teams of social workers, lawyers, finance associates, and housing and benefits coordinators to serve each client. We keep our client-to-staff ratio low, because the work that we do on behalf of our clients is intense and time-consuming. We make every effort to keep our clients aging in their homes and communities and out of institutional care, and to transition clients out of facilities as soon as is safe to do so. We visit our clients regularly and maximize their involvement in decision-making processes. We get to know them and their values and wishes so that if the time comes to make end-of-life decisions on their behalf, we can do so as they would have wanted. And if, after we have helped a client stabilize, they no longer require a guardian, we swiftly terminate the guardianship and restore their rights, freeing up space for another older New Yorker waiting for a guardian to be appointed. 

What I’m describing is not only challenging work for our staff; it is also expensive. On average, our per-client cost is $10,000. And that’s for good reason. When we become someone’s guardian we manage all aspects of their lives, often for the remainder of their lives, from scheduling and accompanying them to appointments, to paying all of their bills, to stocking their refrigerators, to overseeing home repairs and accessibility modifications, to assisting in legal matters. Our funding allows us to serve up to 200 clients at any given time. 

When our docket is full as it is today, we have to tell the appointing judges in the guardianship parts that we cannot take their appointments because we are at capacity. I recently heard that—in New York City—judges cannot find guardians for half of cases where guardians are needed on any given day. This crisis—a lack of funding that has led to a shortage of guardians—is, in part, responsible for the case of Judith Zbiegniewicz, which ProPublica investigated and published yesterday. If you haven’t read the story, it’s a harrowing account of what can happen when we don’t invest in good guardianship; namely the erosion of human rights, dignity, health, and safety at the hands of unscrupulous guardians, in this case a guardian posing as a nonprofit organization. 

To be clear, nonprofits are exceptionally fit to do this work. They have deep ties to their communities and diverse skills and knowledge to navigate complex situations. They often surpass the court’s minimum care requirements for guardians. And, critically, their success is measured not by their ability to turn a profit but rather by their ability to improve outcomes for the people in their care: to enroll people in public benefits programs so that they may obtain critical health and social services, to help them age in their homes and communities and avoid institutional care, and to terminate guardianship arrangements when they are no longer necessary. 

With New York City’s older adult population booming, expected to surpass that of school-aged children by 2030, we cannot look away from this crisis any longer. Good guardianship must be prioritized; it must be funded. We call on this committee to remember Judith’s case during budget negotiations and to fund good guardianship.