Incapacitated Adults
Improving Oversight of Federal Fiduciaries and Court-appointed Guardians
Gao ID: GAO-11-949T September 22, 2011
Today's hearing is on the appointment and oversight of guardians. As people age, they often reach a point when they are no longer capable of handling their own finances or have difficulty making other decisions for themselves. To ensure that federal cash payments received by incapacitated adults are used in their best interest, the Social Security Administration (SSA), Department of Veterans Affairs (VA), and other federal agencies assign a responsible third party or fiduciary to oversee these benefits. SSA and VA can designate spouses, other family members, friends, and organizations to serve as fiduciaries. Similarly, when state courts determine that adults are incapacitated, they have the authority to grant other persons or entities--guardians--the authority and responsibility to make financial and other decisions for them. Incapacitated adults are vulnerable to financial exploitation by fiduciaries and guardians, so these arrangements are not without risk. In 2010, we identified hundreds of allegations of abuse, neglect, and exploitation by guardians in 45 states and the District of Columbia between 1990 and 2010. At that time, we reviewed 20 of these cases and found that guardians had stolen or otherwise improperly obtained $5.4 million from 158 incapacitated victims, many of whom were older adults. To protect against financial exploitation, state courts as well as federal agencies are responsible for screening prospective guardians and federal fiduciaries, respectively, to make sure suitable individuals are appointed. They are also responsible for monitoring the performance of those they appoint. This statement today is based on our recent report on this topic. It will cover (1) SSA and VA procedures for screening prospective federal fiduciaries, and state court procedures for screening prospective guardians; (2) SSA and VA monitoring of federal fiduciary performance, and state court monitoring of guardian performance; (3) information sharing between SSA and VA fiduciary programs and between each of these programs and state courts; and (4) federal support for improving state courts' oversight of guardianships.
In summary, we found that SSA and VA are required to and have procedures for screening prospective fiduciaries and are also required to monitor fiduciary performance. Most states, as well, have laws requiring courts to follow certain screening procedures for prospective guardians and to obtain annual reports from them, but there is evidence that courts often find monitoring guardian performance challenging. SSA and VA do not systematically share with one another the identities of beneficiaries determined to be incapacitated or the identities of fiduciaries who have misused an incapacitated adult's benefit payments, and there is evidence that state courts have difficulty obtaining similar information from SSA about SSA beneficiaries the courts have determined to be incapacitated and in need of a guardian. Finally, the federal government has a history of supporting technical assistance and training for state courts related to guardianship, primarily with funding from the Administration on Aging (AoA) in the Department of Health and Human Services (HHS).
GAO-11-949T, Incapacitated Adults: Improving Oversight of Federal Fiduciaries and Court-appointed Guardians
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United States Government Accountability Office:
GAO:
Incapacitated Adults:
Testimony:
Before the Committee on the Judiciary, Subcommittee on Administrative
Oversight and the Courts, U.S. Senate:
For Release on Delivery:
Expected at 2:30 p.m. EDT:
Thursday, September 22, 2011:
Improving Oversight of Federal Fiduciaries and Court-appointed
Guardians:
Statement of Kay E. Brown, Director: Education, Workforce, and Income
Security:
GAO-11-949T:
Chairman Klobuchar, Ranking Member Sessions, and Members of the
Subcommittee:
I am pleased to participate in today's hearing on the appointment and
oversight of guardians. As people age, they often reach a point when
they are no longer capable of handling their own finances or have
difficulty making other decisions for themselves. To ensure that
federal cash payments received by incapacitated adults[Footnote 1] are
used in their best interest, the Social Security Administration (SSA),
Department of Veterans Affairs (VA), and other federal agencies assign
a responsible third party or fiduciary[Footnote 2] to oversee these
benefits. SSA and VA can designate spouses, other family members,
friends, and organizations to serve as fiduciaries. Similarly, when
state courts determine that adults are incapacitated, they have the
authority to grant other persons or entities--guardians[Footnote 3]--
the authority and responsibility to make financial and other decisions
for them.[Footnote 4]
Incapacitated adults are vulnerable to financial exploitation by
fiduciaries and guardians, so these arrangements are not without risk.
In 2010, we identified hundreds of allegations of abuse, neglect, and
exploitation by guardians in 45 states and the District of Columbia
between 1990 and 2010. At that time, we reviewed 20 of these cases and
found that guardians had stolen or otherwise improperly obtained $5.4
million from 158 incapacitated victims, many of whom were older
adults.[Footnote 5] To protect against financial exploitation, state
courts as well as federal agencies are responsible for screening
prospective guardians and federal fiduciaries, respectively, to make
sure suitable individuals are appointed. They are also responsible for
monitoring the performance of those they appoint.
My remarks today are based on our recent report on this topic.
[Footnote 6] They will cover (1) SSA and VA procedures for screening
prospective federal fiduciaries, and state court procedures for
screening prospective guardians; (2) SSA and VA monitoring of federal
fiduciary performance, and state court monitoring of guardian
performance; (3) information sharing between SSA and VA fiduciary
programs and between each of these programs and state courts; and (4)
federal support for improving state courts' oversight of guardianships.
Findings in the report are based on interviews with federal officials
and state court officials and experts in this area. We also reviewed
relevant federal laws, regulations, policies and procedures, as well
as summaries of state guardianship laws compiled by other
organizations. We did not independently review implementation of the
laws, regulations, or policies referred to in the report. We also
incorporated findings from prior work in which we proactively tested
state guardian certification processes in four states: Illinois,
Nevada, New York, and North Carolina.[Footnote 7]
We conducted our previous work from June 2010 to June 2011 in
accordance with generally accepted government auditing standards.
These standards require that we plan and perform the audit to obtain
sufficient, appropriate evidence to provide a reasonable basis for our
findings and conclusions based on our audit objectives. We believe
that the evidence obtained provided a reasonable basis for our
findings and conclusions based on our audit objectives.
In summary, we found that SSA and VA are required to and have
procedures for screening prospective fiduciaries and are also required
to monitor fiduciary performance. Most states, as well, have laws
requiring courts to follow certain screening procedures for
prospective guardians and to obtain annual reports from them, but
there is evidence that courts often find monitoring guardian
performance challenging. SSA and VA do not systematically share with
one another the identities of beneficiaries determined to be
incapacitated or the identities of fiduciaries who have misused an
incapacitated adult's benefit payments, and there is evidence that
state courts have difficulty obtaining similar information from SSA
about SSA beneficiaries the courts have determined to be incapacitated
and in need of a guardian. Finally, the federal government has a
history of supporting technical assistance and training for state
courts related to guardianship, primarily with funding from the
Administration on Aging (AoA) in the Department of Health and Human
Services (HHS).
SSA, VA, and Most State Courts Are Required to Screen Fiduciaries or
Guardians:
SSA, VA, and most state courts are required to follow screening
procedures for ensuring that prospective fiduciaries and guardians are
suitable to serve. SSA and VA strive to prevent individuals who have
misused beneficiaries' payments from serving again, and each agency is
currently developing an automated system that will enhance its ability
to compile and maintain information about fiduciaries who have misused
cash benefits.
Similarly, according to the AARP Public Policy Institute, most states
require courts to follow certain procedures for screening prospective
guardians and restrict who can be a guardian.[Footnote 8] Thirteen
states require prospective guardians to undergo an independent
criminal background check before being appointed. Nine prohibit
convicted felons, and two prohibit convicted criminals from serving.
However, these screening procedures are not always effective. Using
two fictitious identities--one with bad credit and one with the Social
Security number of a deceased person--GAO obtained guardianship
certification or met certification requirements in the four test
states where we applied.
SSA and VA Have Procedures for Monitoring Fiduciaries, but Monitoring
Guardians Can Be Challenging for Many Courts:
SSA and VA have similar procedures for monitoring fiduciary
performance. SSA is required to establish a system of accountability
monitoring that includes periodic reports from fiduciaries.[Footnote
9] Certain organizational fiduciaries and individuals serving as an
SSA fiduciary for 15 or more beneficiaries are also subject to
periodic on-site review.[Footnote 10] VA requires its fiduciaries to
submit a two-page accounting report but asks those who are also court-
appointed guardians to submit the same accountings that they submit to
the court. Similar to SSA, VA is required to conduct periodic on-site
reviews of certain organizational fiduciaries, as well,[Footnote 11]
and also conducts periodic site visits with incapacitated
beneficiaries to reevaluate their condition and determine if their
fiduciaries are properly using their payments.
Most states require court-appointed guardians to be monitored in some
way, but according to an AARP Public Policy Institute report, in many
states there are only limited resources to do so.[Footnote 12] The
American Bar Association (ABA) Commission on Law and Aging[Footnote
13] has found that most states require courts to obtain annual reports
from guardians on their incapacitated adult's condition, among other
things.[Footnote 14] In some states, court investigators may visit
guardians and their wards either regularly or on an as-needed basis.
Monitoring court-appointed guardians' performance can prevent
financial exploitation of incapacitated adults and stop it when it
occurs. In our 2004 survey of state courts, most indicated they did
not have sufficient funds to oversee guardianships.[Footnote 15] In
its 2007 report, the AARP Public Policy Institute indicated that
sufficient resources were not available to fund the staff, technology,
training, and materials needed to effectively monitor guardians even
though, according to Institute officials, judges and court
administrators would like to improve guardianship monitoring. AARP has
identified a number of promising practices to strengthen court
monitoring or guardianship.[Footnote 16] It has also noted that some
state courts have begun to adopt these practices, but progress appears
to be slow. Given limited resources for monitoring, courts may be
reluctant to invest in these practices without evidence of their
feasibility and effectiveness. The federal government has an
opportunity to lead in this area by supporting evaluations of the
feasibility, cost, or effectiveness of promising monitoring practices.
Information Sharing Between SSA, VA, and State Courts Could Improve
Protection of Incapacitated Adults:
Sharing certain information about beneficiaries and fiduciaries
between SSA and VA enhances their ability to protect the interests of
incapacitated beneficiaries by better ensuring that suitable
fiduciaries are appointed. Although the Privacy Act generally
prohibits a federal agency from disclosing personal information from a
system of records without the consent of the individual to whom the
record pertains, an agency may disclose such information without
consent if there is a published statement of routine use that permits
this disclosure.[Footnote 17] According to SSA officials, there is a
routine use provision that allows SSA to disclose certain information
about its beneficiaries to VA, and there is a current data exchange
agreement between SSA and VA that allows VA to directly query an SSA
automated system on a case-by-case basis. Through these queries, VA
can learn key information such as whether or not SSA has appointed a
fiduciary for a beneficiary and the identity of the SSA fiduciary. On
the other hand, SSA officials indicated that obtaining similar
information from VA may not be cost-effective given the relatively
small proportion of SSA beneficiaries who also collect VA benefits.
With regard to state courts' access to SSA information about its
incapacitated beneficiaries and their fiduciaries, this information
could provide courts with potential candidates for guardians when
there are no others available. Further, when SSA's automated system
that will track fiduciaries who have misused benefits is complete,
this information could help state courts avoid appointing individuals
who, while serving as SSA fiduciaries, misused beneficiaries' SSA
payments. Although the National Research Council has emphasized the
importance of information sharing between SSA and the courts,[Footnote
18] officials from organizations representing elder law attorneys, and
advocating for elder rights, told us it is difficult for state courts
to obtain information from SSA when it is needed. SSA officials do not
believe their agency is permitted to provide information to state
courts about an SSA beneficiary, or that beneficiary's SSA fiduciary,
without the beneficiary's consent because there is no statement of
routine use under the Privacy Act allowing it to do so. Moreover,
officials said the agency has not considered establishing a routine
use statement because SSA believes that sharing this information with
state courts would not be compatible with the purpose for which the
information was collected. Furthermore, agency officials told us that
since disclosure of information to state courts is outside its
mission, it could not use appropriated funds for this purpose and
would have to charge courts for this information.
Regarding information sharing between VA and state courts, according
to a VA official, the agency has no written policy on how requests for
information about VA beneficiaries from state courts that appoint
guardians should be handled. However, in guardianship proceedings
involving VA beneficiaries, the agency does share its information
about these beneficiaries with a court when a court requests this
information. VA also has data-sharing agreements with courts in two
counties and has reached out to organizations representing elder law
attorneys and guardians to promote VA and state court information
sharing.
The Administration on Aging Has Taken Some Steps That Could Help State
Courts Improve Guardianship Oversight:
In 2008, AoA established the National Legal Resource Center (NLRC), in
part to support demonstration projects designed to improve the
delivery of legal assistance and enhance elder rights protections for
older adults with social or economic needs.[Footnote 19] AoA funding
enabled NLRC partners to provide training, case consultation, and
technical assistance related to guardianship, including:
* assistance drafting and promoting adoption of a model state law that
would resolve long-standing issues with interstate transfer and
recognition of guardianship appointments,[Footnote 20]
* evaluation of Utah's public guardian program, and:
* revision of guardianship provisions in South Carolina's probate code.
According to AoA officials, the agency has also supported development
of guardianship training modules[Footnote 21] for elder law attorneys
and a guardianship webinar. AoA has not, however, recently supported
any demonstrations or pilots to help evaluate guardian monitoring
practices. Because of its activities in the guardianship area, the
federal government is well-positioned and has an opportunity to lead
in protecting the rights of incapacitated adults with court-appointed
guardians, in particular by supporting evaluations of promising court
guardianship monitoring practices.
We made two recommendations in our report. Our first calls for SSA to
take whatever measures necessary to allow it to disclose certain
information about SSA beneficiaries and fiduciaries to state courts,
upon their request, including proposing legislative changes to address
the impediments it identified. SSA has not identified what steps, if
any, it will take to address this recommendation.
We also recommend that HHS direct AoA to consider supporting the
development, implementation, and dissemination of a limited number of
pilot projects to evaluate the feasibility, cost, and effectiveness of
one or more generally accepted promising practices for monitoring
guardians. In response, HHS agreed that AoA has the authority to take
such action.
This concludes my statement. I would be pleased to respond to any
questions you or other members of the Subcommittee may have.
GAO Contacts and Acknowledgments:
For questions about this testimony, please contact Kay E. Brown at
(202) 512-7215 or brownke@gao.gov. Contact points for our Offices of
Congressional Relations and Public Affairs may be found on the last
page of this statement. Individuals who made key contributions to this
testimony include Clarita Mrena, Jaime Allentuck, David Perkins,
Jessica A. Botsford, and Sheila R. McCoy.
[End of section]
Footnotes:
[1] Here the term "incapacitated" is used recognizing that federal
agencies and states use a variety of terms and somewhat different
definitions to assess whether someone is in need of a guardian. SSA,
for example, assigns a fiduciary to people it has determined are
incapable of managing or directing the management of benefit payments.
VA uses the term "incompetent" instead of incapacitated. Most states
use a term such as "incapacitated," but others use such terms as
"incompetent," "mentally incompetent," "disabled," or "mentally
disabled."
[2] VA refers to these responsible parties as fiduciaries. SSA refers
to them as representative payees. Here the term "fiduciary" is used to
refer to both VA fiduciaries and SSA representative payees.
[3] As used here, the term "guardian" also includes conservators.
[4] The responsibilities of federal fiduciaries and court-appointed
guardians differ in a number of ways. Federal fiduciaries oversee only
federal cash payments while guardians typically manage all of an
incapacitated adult's property. Moreover, guardianship is usually a
legal relationship under which the incapacitated adult typically
forfeits some or all civil liberties. This is not the case under
federal fiduciary programs.
[5] GAO, Guardianships: Cases of Financial Exploitation, Neglect, and
Abuse of Seniors, [hyperlink, http://www.gao.gov/products/GAO-10-1046]
(Washington, D.C.: Sept. 30, 2010). These case studies reflect varied
guardianship arrangements, and their findings cannot be projected to
the overall population of guardians.
[6] GAO, Incapacitated Adults: Oversight of Federal Fiduciaries and
Court-Appointed Guardians Needs Improvement, [hyperlink,
http://www.gao.gov/products/GAO-11-678] (Washington, D.C.: July 22,
2011).
[7] [hyperlink, http://www.gao.gov/products/GAO-10-1046].
[8] The AARP Public Policy Institute was created to inform and
stimulate public debate on the issues related to aging and to promote
development of sound, creative policies to address the common need for
economic security, health care, and quality of life. This information
is from a compilation of state guardianship laws provided to us by
AARP.
[9] 42 U.S.C. §§ 405(j)(3)(A) and 1383(a)(2)(C).
[10] 42 U.S.C. §§ 405(j)(6)(A) and 1383(a)(2)(G)(i).
[11] 38 U.S.C. § 5508.
[12] AARP Public Policy Institute. Guarding the Guardians: Promising
Practices for Court Monitoring (Washington, D.C.: 2007).
[13] The ABA Commission on Law and Aging was created to strengthen and
secure the legal rights, dignity, autonomy, quality of life, and
quality of care of elders. It carries out this mission through
research, policy development, technical assistance, advocacy,
education, and training.
[14] See "Monitoring Following Guardianship Proceedings (as of
December 31st, 2009)" at [hyperlink,
http://www.americanbar.org/groups/law_aging/resources/guardianship_law_p
ractice.html].
[15] GAO, Guardianships: Collaboration Needed to Protect Incapacitated
Elderly People, [hyperlink, http://www.gao.gov/products/GAO-04-655]
(Washington, D.C.: July 13, 2004). We surveyed California superior
courts in each of California's 58 counties, circuit courts in each of
Florida's 67 counties, and courts in each of New York's 12 judicial
districts. We received usable survey responses from 42 California
courts, 55 Florida courts, and 9 of New York's judicial districts for
response rates of 72 percent, 82 percent, and 75 percent, respectively.
[16] AARP Public Policy Institute. Guarding the Guardians: Promising
Practices for Court Monitoring (Washington, D.C.: 2007).
[17] The Privacy Act applies to personal information under the control
of an agency that is maintained in a system of records, which is any
group of personal information that is retrieved by the name of the
individual or other identifier. Under the Privacy Act, each agency
that maintains a system of records must publish a notice describing
that system and include a statement of routine uses of those records,
including the categories of the uses and the purpose of use. A routine
use of a system of records must be compatible with the purpose for
which the record was collected. 5 U.S.C. § 552a.
[18] National Research Council, Improving the Social Security
Representative Payee Program: Serving Beneficiaries and Minimizing
Misuse, Committee on Social Security Representative Payees, Division
of Behavioral and Social Sciences and Education (Washington, D.C.: The
National Academies Press, 2007).
[19] NLRC partners include the American Bar Association Commission on
Law and Aging, the Center for Elder Rights Advocacy, the Center for
Social Gerontology, the National Consumer Law Center, and the National
Senior Citizens Law Center.
[20] See [hyperlink, http://www.gao.gov/products/GAO-04-655] ,12, 30-
32.
[21] National Consumer Law Center. Nuts and Bolts on Guardianship as
Last Resort: The Basics on When to File and How to Maximize Autonomy.
[End of section]
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