Incapacitated, Indigent and Alone: Meeting Guardianship and Decision Support Needs in New York
We commissioned a report — Incapacitated, Indigent, and Alone: Meeting Guardianship and Decision Support Needs in New York (“Guardian Report”) — to review the current state of guardianship in New York and to find ways to meet the growing demand for guardianship, working with representatives (past and present) from the Center for Gerontology, Virginia Tech, and the American Bar Association Commission on Law and Aging.
The report, published in Fall 2019, confirmed an urgent, escalating need for guardianship, along with many alarming gaps. It recommended many systemic improvements — better data; more supportive services; and increased oversight, accountability, and coordination across systems.
It also recommended more adequate payment mechanisms for better guardian care, and the utilization of different models of guardianship care (e.g., the use of geriatric care managers), which may provide cost savings to public systems such as Medicaid.
The report described an alarming mix of Medicaid, housing, mental health, long-term care, and social services issues, as well as the need for alternative options to prevent guardianship.