United States Government Accountability Office

GAO Testimony 

Before the Special Committee on Aging, 

U.S. Senate

GUARDIANSHIPS 

Little Progress in Ensuring 

Protection for Incapacitated 

Elderly People 

Statement of Barbara D. Bovbjerg, Director 

Education, Workforce, and Income Security 

For Release on Delivery

Expected at 10:00 a.m. EDT 

Thursday, September 7, 2006 

 

GAO-06-1086T 
What GAO Found

United States Government Accountability Office

Why GAO Did This Study

Highlights

Accountability Integrity Reliability

September 7, 2006

GUARDIANSHIPS

Little Progress in Ensuring Protection for 

Highlights of GAO-06-1086T, a testimony Incapacitated Elderly People 

before the Special Committee on Aging, 

U.S. Senate 

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 Recommends

GAO is making no new 

recommendations in this 

testimony. 

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. 

www.gao.gov/cgi-bin/getrpt?GAO-06-1086T.

To view the full product, including the scope 

and methodology, click on the link above. 

For more information, contact Barbara 

Bovbjerg at (202) 512-7215 or 

bovbjergb@gao.gov. 
Mr. Chairman and Members of the Committee: 

I’m pleased to be here today to discuss guardianships for the elderly. As 

people age, some become incapable of caring for themselves and must rely 

on a guardian—a person or entity appointed by the court to make 

decisions for them.1 Despite existing safeguards, there continue to be 

instances where some guardians have taken advantage of the elderly

people they were supposed to protect. Such cases of abuse and neglect 

have prompted questions about the oversight of guardianship programs. 

In 2003, the Senate Special Committee on Aging asked GAO to study 

guardianships for the elderly, and the results of our work appeared in a 

2004 report.2 This work 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. I am here today to 

(1) provide an overview and update of the findings of this 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 do this work, we reviewed changes in guardianship statutes nationwide 

since our 2004 report, 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 

our previous report. Our work for the 2004 report involved similar 

interviews, as well as surveys of courts in the three states with the largest 

elderly populations: California, New York and Florida. For the report we 

visited courts in eight states and we interviewed federal officials 

responsible for representative payee programs. We conducted our review 

in accordance with generally accepted government auditing standards. 

In summary, our 2004 report noted that some state laws and some courts 

provide more protection for incapacitated elderly people than others. 

State laws have varied requirements for monitoring guardianships and 

 1

 For convenience, we use the term “guardian,” though some states use other terms. 

California, for example, uses the term “conservator” when the incapacitated person is an 

adult. 

2

 GAO, Guardianships: Collaboration Needed to Protect Incapacitated Elderly People, 

GAO-04-655 (Washington, D.C.: July 13, 2004). 

Page 1 GAO-06-1086T 
court practices in the states we visited also varied widely. Coordination 

among federal agencies and courts was quite limited and on a case-by-case 

basis. 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, according to guardianship

professionals, states and federal agencies have made only limited progress 

in improving guardianships. Some states, including Texas, New Jersey, and 

Wisconsin, adopted guardianship reform legislation that should help 

strengthen protections for people under guardianships in those states. 

Federal agencies administering benefit programs appoint representative 

payees to manage the benefits of incapacitated individuals. Our study 

found there is a lack of systematic coordination among the federal 

agencies and between federal agencies and the courts. In some cases, this 

may weaken protections for vulnerable incapacitated people.

Our report made recommendations to federal agencies, but to date little 

progress has been made. We recommended that the Social Security 

Administration (SSA) convene an interagency study group to increase the 

ability of representative payee programs to protect federal benefit 

payments from misuse. Although the Department of Veterans Affairs (VA), 

Department of Health and Human Services (HHS), and the Office of 

Personnel Management (OPM) indicated their willingness to participate in

such a study group, SSA disagreed with this recommendation. We checked 

with SSA recently, and its position has not changed. Second, we 

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 an 

effort to include in a survey of adult protective service agencies 

information about the extent to which guardians are the sources of reports 

about elder abuse or the alleged perpetrator. We also 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 our report, a joint conference of professional 

guardianship organizations agreed on a set of action steps to implement 

Page 2 GAO-06-1086T 
previous recommendations made at the Second National Guardianship 

conference, known as the Wingspan recommendations.3

 Although only 

modest progress has been made overall, there are a few bright spots. For 

example, the Wingspan recommendations call for the licensure, 

certification, or registration of professional guardians. Several states now 

have such programs and in the last couple of years Texas and New Jersey 

have been added to the list of states that have such requirements for some

guardians. 

The number of people age 65 and older will nearly double in the U.S. by 

the year 2030 to 71 million. Over time, some elderly adults become 

physically or mentally incapable of making or communicating important 

decisions, such as those required to handle finances or secure their 

possessions. While some incapacitated adults may have family members 

who can informally assume responsibility for their decision-making, many 

elderly incapacitated people do not. In situations such as these, additional

measures may be necessary to ensure that incapacitated people are 

protected from abuse and neglect. 

Background 

Several arrangements can be made to protect the elderly or others who 

may become incapacitated. A person may prepare a living will, write 

advance health care directives, appoint someone to assume durable power

of attorney, or establish a trust. However, such arrangements may not 

provide sufficient protection. For example, some federal agencies do not

recognize durable powers of attorney for managing federal benefits. SSA 

will assign a representative payee for an incapacitated person if it 

concludes that the interest of the incapacitated beneficiary would be 

served, whether or not the person has granted someone else power of 

attorney. In addition, many states have surrogacy healthcare decisionmaking laws, but these alternatives do not cover all cases. Additional 

measures may be needed to designate legal authority for someone to make 

decisions on the incapacitated person’s behalf. To provide further 

protection for both elderly and non-elderly incapacitated adults, state and 

local courts appoint guardians to oversee their personal welfare, their 

financial well-being, or both. The appointment of a guardian typically

means that the person loses basic rights, such as the right to vote, sign 

 3

 The second national guardianship conference, known as the “Wingspan Conference” was

held at the Stetson University College of Law in Florida on November 30 to December 1,

2001. 

Page 3 GAO-06-1086T 
contracts, buy or sell real estate, marry or divorce, or make decisions 

about medical procedures. If an incapacitated person becomes capable 

again, by recovering from a stroke, for example, he or she cannot dismiss 

the guardian but, rather, must go back to court and petition to have the 

guardianship terminated. 

The federal government does not regulate or provide any direct support 

for guardianships, but courts may decide that the appointment of a 

guardian is not necessary if a federal agency has already assigned a 

representative payee—a person or organization designated to handle 

federal benefits payments on behalf of an incapacitated person. 

Representative payees are entirely independent of court supervision 

unless they also serve their beneficiary as a court-appointed guardian. 

Guardians are supervised by state and local courts and may be removed 

for failing to fulfill their responsibilities. Representative payees are 

supervised by federal agencies, although each federal agency with 

representative payees has different forms and procedures for monitoring 

them. Each state provides its own process for initiating and evaluating 

petitions for guardianship appointment. Generally, state laws require filing 

a petition with the court and providing notice to the alleged incapacitated 

person and other people with a connection to that person. 

In many cases, both courts and federal agencies have responsibilities for 

protecting incapacitated elderly people. For federal agencies, a state court 

determination that someone is incapacitated or reports from physicians 

often provide evidence of a beneficiary’s incapacity, but agency 

procedures also allow statements from lay people to serve as a sufficient 

basis for determining that a beneficiary needs someone to handle benefit 

payments on their behalf—a representative payee. SSA, OPM, and VA ask

whether the alleged incapacitated person has been appointed a guardian

and often appoint that person or organization as the representative payee. 

In some cases, however, the agencies choose to select someone other than 

the court-appointed guardian. 

In many cases, guardians are appointed with a full range of responsibilities 

for making decisions about the incapacitated person’s health and wellbeing as well as their finances, but several states’ laws require the court to 

limit the powers granted to the guardian, if possible. The court may 

appoint a “guardian of the estate” to make decisions regarding the 

incapacitated person’s finances or a “guardian of the person” to make 

nonfinancial decisions. An incapacitated person with little income other 

than benefits from SSA for example, might not need a “guardian of the 

estate” if he or she already has a representative payee designated by SSA 

Page 4 GAO-06-1086T 
to act on their behalf in managing benefit payments. Sometimes the 

guardian is paid for their services from the assets or income of the 

incapacitated person, or from public sources if the incapacitated person is

unable to pay. In some cases, the representative payee is paid from the 

incapacitated person’s benefit payments. 

Guardians and representative payees do not always act in the best interest 

of the people they are appointed to protect. Some have conflicts of interest 

that pose risks to incapacitated people. While many people appointed as 

guardians or representative payees serve compassionately, often without 

any compensation, some will act in their own interest rather than in the 

interest of the incapacitated person. Oversight of both guardians and 

representative payees is intended to prevent abuse by the people 

designated to protect the incapacitated people. While the incidence of 

elder abuse involving persons assigned a guardian or representative payee 

is unknown, certain cases have received widespread attention. 

Our 2004 report noted that some state laws and some courts provide more 

protection for incapacitated elderly people than others. State laws have 

varied requirements for monitoring guardianships and court practices in

the states we visited also varied widely. Coordination among federal 

agencies and courts was quite limited and on a case-by-case basis. 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. 

Collaboration to 

Protect Incapacitated 

Elderly People 

Continues to Be

Limited 

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. At a 

minimum, most states’ laws require guardians to submit a periodic report 

to the court, usually at least once annually, regarding the well-being of the 

incapacitated person. Many states’ statutes also authorize measures that 

courts can use to enforce guardianship responsibilities. However, court 

procedures for implementing guardianship laws appear to vary 

considerably. For example, most courts in each of the three states 

responding to our survey require guardians to submit time and expense 

records to support petitions for compensation, but each state also has 

courts that do not require these reports. We also found that some states 

are reluctant to recognize guardianships originating in other states. Few 

have adopted procedures for accepting transfer of guardianship from 

another state or recognizing some or all of the powers of a guardian 

Page 5 GAO-06-1086T 
appointed in another state. This complicates life for an incapacitated

elderly person who needs to move from one state to another or when a 

guardian needs to transact business on his or her behalf in another state.

In addition, guardianship data are scarce. Most courts we surveyed did not 

track the number of active guardianships, let alone maintain data on abuse 

by guardians. Although this basic information is needed for effective 

oversight, no more than one-third of the responding courts tracked the 

number of active guardianships, and only a few could provide the number 

that were for elderly people specifically. 

Since issuance of our report, several states have passed new legislation 

amending their guardianship laws. During 2004, for example, 14 states 

amended their laws related to guardianships, and in 2005 at least 15 states 

did so, according to the American Bar Association’s annual compilations. 

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. Acting on legislation 

in 2004, the California court system established an education requirement 

for guardians and a 15-hour-per-year continuing education requirement for 

private professional guardians.4

 In 2004 Hawaii adopted legislation 

requiring that guardians provide the court annual accountings. Wisconsin 

also adopted a major revision of its guardianship code this year; it 

establishes a new requirement that the guardian regularly visit the 

incapacitated person to assess their condition and the treatment they are 

receiving. The new law also leaves in effect powers of attorney previously

granted by the incapacitated person unless it finds good cause to revoke 

them, and establishes procedures for recognition of guardianships 

originating in other states. 

Several states’ guardianship law amendments established or strengthened 

public guardian programs, including those in Texas, Georgia, Idaho, Iowa,

Virginia, Nevada, and New Jersey. In Georgia and New Jersey, for 

example, public guardians must now be registered. Public guardians are 

public officials or publicly funded organizations that serve as guardians for 

incapacitated people who do not have family members or friends to be 

 4

 Those who have served as guardians in California for 10 or more people during the 2000

to 2005 period are exempt from the education requirement for appointment, but are subject 

to the annual continuing education requirement. 

Page 6 GAO-06-1086T 
their guardian and cannot afford to pay for the services of a private 

guardian. 

In our 2004 report several courts were identified as having “exemplary” 

programs. As we conducted our review, we sought particular courts that 

those in the guardianship community considered to have exemplary 

practices. Each of the four courts so identified distinguished themselves 

by going well beyond minimum state requirements for guardianship 

training and oversight. For example, the court we visited in Florida 

provides comprehensive reference materials for guardians to supplement 

training. With regard to active oversight, the court in New Hampshire 

recruits volunteers, primarily retired senior citizens, to visit incapacitated 

people, their guardians, and care providers at least annually, and submit a 

report of their findings to court officials. Exemplary courts in Florida and 

California also have permanent staff to investigate allegations of fraud, 

abuse, or exploitation. The policies and practices associated with these 

courts may serve as models for those seeking to assure that guardianship 

programs serve the elderly well. 

We recently contacted officials in each of these courts and received

responses from two of them. We learned that officials in these two courts 

have worked to help strengthen statewide guardianship programs. For 

example, court officials in Fort Worth, Texas, have helped encourage 

adoption of Texas’ recent reform legislation. However, we could not 

determine whether other courts had adopted these courts’ practices. 

“Exemplary” Courts Focus 

on Training and Monitoring 

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. Federal agencies administering benefit programs 

appoint representative payees for individuals who become incapable of 

handling their own benefits. The federal government does not regulate or 

provide any direct support for guardianships, but state courts may decide 

that the appointment of a guardian is not necessary if a representative

payee has already been assigned. In our study, we found that although 

courts and federal agencies are responsible for protecting many of the 

same incapacitated elderly people, they generally work together only on a 

case-by-case basis. With few exceptions, courts and federal agencies don’t 

systematically notify other courts or agencies when they identify someone 

who is incapacitated, nor do they notify them if they discover that a 

guardian or a representative payee is abusing the person. This lack of 

coordination may leave incapacitated people without the protection of 

Page 7 GAO-06-1086T 
responsible guardians and representative payees or, worse, with an 

identified abuser in charge of their benefit payments. 

Since issuance of our report, we have not found any indication that 

coordination among the federal agencies or between federal agencies and 

the state courts has changed. SSA did, however, contract with the National 

Academies for a study of its representative payee program. The study 

committee issued a letter report including preliminary observations in 

2005, and a final report is scheduled for release in May 2007. 5

 

The committee plans to use a nationally representative survey of 

representative payees and the beneficiaries they serve in order to 

(1) assess the extent to which the representative payees are performing 

their duties in accordance with standards, (2) learn whether 

representative payment policies are practical and appropriate; (3) identify

types of representative payees that have the highest risk of misuse of 

benefits; and (4) suggest ways to reduce the risk of misuse of benefits and 

ways to better protect beneficiaries. 

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. SSA stated that its responsibility 

focuses on protecting SSA benefits, cited concern about the difficulty of 

interagency data sharing and Privacy Act restrictions, and indicated that 

leadership of the study group would not be within its purview. 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. SSA continues to provide limited information to 

the VA in cases where issues arise such as evidence of incapability or 

misuse of benefits. However, to ensure that no overpayment of VA benefits

occurs, SSA will provide appropriate VA officials requested information as 

to the amount of Social Security benefit savings reported by the 

representative payee. 

Limited Progress Has 

Been Made on 

Recommendations 

from 2004 

 5

 Committee on Social Security Representative Payees, National Research Council, 

“Assessment of the Representative Payee Program of the Social Security Administration: 

Letter Report,” The National Academies, August 4, 2005. 

Page 8 GAO-06-1086T 
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. Specifically, we recommended that

HHS support the development of cost-effective approaches for compiling 

consistent national data concerning guardianships. HHS made a step in 

this direction by supporting a study by the American Bar Association 

Commission on Law and Aging of the guardianship data practices in each 

state, which could prove helpful in efforts to move toward more consistent 

and comprehensive data on guardianships.6

 The study found that although

several states collect at least some basic data on guardianships, most still 

do not. Only about a third of states receive trial court reports on the 

number of guardianship filings. A total of 33 states responded to a question 

about whether they were interested in compiling data. Of these, 

21 expressed interest and 12 indicated that they are not interested, as the 

barriers are too high. Thus, it is still not possible to determine how many 

people in the U.S. of any age are assigned guardians each year, let alone

the number of elderly people who are currently under such protection. 

Third, we recommended that HHS support the study of options for 

compiling data from federal and state agencies concerning the incidence 

of elder abuse in cases in which the victim had granted someone the 

durable power of attorney or had been assigned a fiduciary, such as a 

guardian or representative payee, as well as cases in which the victim did 

not have a fiduciary. 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. 7

Specifically, the survey asked each state about cases in which a guardian 

was the source of a report of abuse or was the alleged perpetrator in state 

fiscal year 2003. Only 11 states provided information about the source of

reports of abuse. Similarly, 11 states indicated the relationship between 

the victims and the alleged perpetrators. Guardians were not often cited in

 6

 Erica F. Wood, “State-Level Adult Guardianship Data: An Exploratory Survey,” American

Bar Association Commission on Law and Aging for the National Center on Elder Abuse, 

August 2006. 

7

Pamela Teaster et al., The 2004 Survey of State Adult Protective Services: Abuse of Adults

60 Years of Age and Older (Boulder, Colo.: February 2006).

Page 9 GAO-06-1086T 
either case. Indeed, a recent study found that existing data cannot provide 

a clear picture of the incidence and prevalence of elder abuse.8

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 draft contains provisions that would 

allow guardianships to be formally recognized by another state or 

transferred to another state. The draft is being refined, and a NCCUSL 

committee plans to discuss it at another meeting this November. Passage 

of this draft by the NCCUSL does not, however, guarantee that states will 

follow its provisions because they must decide on their own whether to 

amend their own laws. 

While little progress has been made on several of our specific 

recommendations, other steps taken since the release of our report are 

more promising. In November of 2004, a joint conference of the National 

Academy of Elder Law Attorneys, the National Guardianship Association 

and the National College of Probate Judges convened a special session to 

develop an action plan on guardianships.9

 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

Some Developments 

Regarding 

Guardianships Appear 

Promising 

 8

 Erica F. Wood, The Availability and Utility of Interdisciplinary Data on Elder Abuse:

A White Paper for the National Center on Elder Abuse, American Bar Association 

Commission on Law and Aging for the National Center on Elder Abuse (Washington, D.C.: 

May 2006). 

9

 In addition to participants from the three organizations, representatives from the 

American Bar Association Commission on Law and Aging, the American Bar Association 

Section on Real Property, Probate and Trust Law, and the American College of Trust and 

Estate Counsel all participated in this conference. 

Page 10 GAO-06-1086T 
specialization in guardianship matters; the encouragement of the most 

appropriate and least restrictive types of guardianships; and the 

establishment of effective monitoring of guardianships. The identification

of these action steps and the work that has begun on them reflects a high

level of commitment by the professionals working in the field.

In some cases work has begun on these action steps. Both the House and

the Senate versions of bills calling for an Elder Justice Act10 would 

establish an Advisory Board on Elder Abuse, Neglect, and Exploitation 

charged with making several recommendations including some concerning 

the development of state interdisciplinary guardianship committees. As 

noted earlier, the Commission on Uniform State Law has issued a 

discussion draft of a Uniform Adult Guardianship and Protective 

Proceedings Jurisdiction Act. Wisconsin’s adoption of a reformed 

guardianship law this year emphasizes the use of the least restrictive type

of guardianship that is appropriate. Regarding the monitoring of 

guardianships, recently Texas and New Jersey joined several states that 

now have programs in place to license, certify, or register professional 

guardians. In 2005, Colorado began requiring prospective guardians (with 

some exceptions such as parents who are seeking to be guardians for their 

children) to undergo criminal background checks. 

In conclusion, as the number of elderly Americans grows dramatically, the 

need for guardianship arrangements seems likely to rise in response, and 

ensuring that such arrangements are safe and effective will become 

increasingly important. Progress on fulfilling some of our 

recommendations has been slow where it has occurred, and for some, no 

steps have been taken at all. The lack of leadership from a federal agency,

and states’ differing approaches to guardianship matters, make it difficult

to realize quick improvements. Nonetheless, many people actively 

involved in guardianship issues continue to look for ways to make 

improvements. Emulating exemplary programs such as the four we 

examined would surely help, but we believe more can also be done to 

better coordinate across states, federal agencies, and courts. 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 

Concluding 

Observations 

 10 Elder Justice Act, HR 4993, 109th Cong., 2d sess. (2006) and S 2010, 109th Cong.,

1st sess. (2005).

Page 11 GAO-06-1086T 
together in efforts to protect incapacitated elderly people. Your Committee 

has played an important role in bringing these problems to light and 

continuing to seek improvements. In the absence of more federal 

leadership, however, progress is likely to continue to be slow, particularly 

in the coordination among federal agencies and between federal agencies 

and state courts. 

- - - 

Mr. Chairman and Members of the Committee, this concludes my prepared 

statement. I’d be happy to answer any questions you may have. 

Page 12 GAO-06-1086T 
Page 13 GAO-06-1086T 

Appendix I: GAO Contact and Staff 

Acknowledgments 

Barbara D. Bovbjerg, Director, Education, Workforce, and Income 

Security Issues at (202) 512-7215. 

Alicia Puente Cackley, Assistant Director; Benjamin P. Pfeiffer; 

Scott R. Heacock; Mary E. Robison; and Daniel A. Schwimer also 

contributed to this report. 

GAO Contact 

Acknowledgments 
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