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Testimony: 

Before the Special Committee on Aging, U.S. Senate: 

United States Government Accountability Office: 

GAO: 

For Release on Delivery Expected at 10:00 a.m. EDT: 

Thursday, September 7, 2006: 

Guardianships: 

Little Progress in Ensuring Protection for Incapacitated Elderly 
People: 

Statement of Barbara D. Bovbjerg, Director Education, Workforce, and 
Income Security: 

GAO-06-1086T: 

GAO Highlights: 

Highlights of GAO-06-1086T, a testimony before the Special Committee on 
Aging, U.S. Senate 

Why GAO Did This Study: 

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 Found: 

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. 

What GAO Recommends: 

GAO is making no new recommendations in this testimony. 

[Hyperlink, http://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. 

[End of Section] 

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.[Footnote 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.[Footnote 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 
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 
previous recommendations made at the Second National Guardianship 
conference, known as the Wingspan recommendations.[Footnote 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. 

Background: 

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. 

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 decision- 
making 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 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 well-being 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 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. 

Collaboration to Protect Incapacitated Elderly People Continues to Be 
Limited: 

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. 

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 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.[Footnote 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 their guardian and cannot afford to pay for the services 
of a private guardian. 

"Exemplary" Courts Focus on Training and Monitoring: 

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. 

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 
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.[Footnote 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. 

Limited Progress Has Been Made on Recommendations from 2004: 

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. 

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.[Footnote 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.[Footnote 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 either 
case. Indeed, a recent study found that existing data cannot provide a 
clear picture of the incidence and prevalence of elder abuse.[Footnote 
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. 

Some Developments Regarding Guardianships Appear Promising: 

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.[Footnote 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 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 Act[Footnote 
10] 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. 

Concluding Observations: 

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 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. 

[End of section] 

Appendix I: GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Barbara D. Bovbjerg, Director, Education, Workforce, and Income 
Security Issues at (202) 512-7215. 

Acknowledgments: 

Alicia Puente Cackley, Assistant Director; Benjamin P. Pfeiffer; Scott 
R. Heacock; Mary E. Robison; and Daniel A. Schwimer also contributed to 
this report. 

FOOTNOTES 

[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). 

[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. 

[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. 

[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. 

[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). 

[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. 

[10] Elder Justice Act, HR 4993, 109TH Cong., 2d sess. (2006) and S 
2010, 109TH Cong., 1ST sess. (2005). 

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