<DOC> [109 Senate Hearings] [From the U.S. Government Printing Office via GPO Access] [DOCID: f:31448.wais] S. Hrg. 109-753 EXPLOITATION OF SENIORS: AMERICA'S AILING GUARDIANSHIP SYSTEM ======================================================================= HEARING before the SPECIAL COMMITTEE ON AGING UNITED STATES SENATE ONE HUNDRED NINTH CONGRESS SECOND SESSION __________ WASHINGTON, DC __________ SEPTEMBER 7, 2006 __________ Serial No. 109-30 Printed for the use of the Special Committee on Aging U.S. GOVERNMENT PRINTING OFFICE 31-448 WASHINGTON : 2007 _____________________________________________________________________________ For Sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512-1800; (202) 512ÿ091800 Fax: (202) 512ÿ092250 Mail: Stop SSOP, Washington, DC 20402ÿ090001 SPECIAL COMMITTEE ON AGING GORDON SMITH, Oregon, Chairman RICHARD SHELBY, Alabama HERB KOHL, Wisconsin SUSAN COLLINS, Maine JAMES M. JEFFORDS, Vermont JAMES M. TALENT, Missouri RON WYDEN, Oregon ELIZABETH DOLE, North Carolina BLANCHE L. LINCOLN, Arkansas MEL MARTINEZ, Florida EVAN BAYH, Indiana LARRY E. CRAIG, Idaho THOMAS R. CARPER, Delaware RICK SANTORUM, Pennsylvania BILL NELSON, Florida CONRAD BURNS, Montana HILLARY RODHAM CLINTON, New York LAMAR ALEXANDER, Tennessee KEN SALAZAR, Colorado JIM DEMINT, South Carolina Catherine Finley, Staff Director Julie Cohen, Ranking Member Staff Director (ii) C O N T E N T S ---------- Page Opening Statement of Senator Gordon Smith........................ 1 Statement of Senator Jim Talent.................................. 16 Statement of Senator Ken Salazar................................. 41 Panel of Witnesses Ira Salzman, New York, NY........................................ 3 Carol J. Scott, Missouri Long-Term Care ombudsman, Jefferson City, MO....................................................... 16 Terry W. Hammond, executive director, National Guardianship Association, El Paso, TX....................................... 30 Barbara B. Bovbjerg, director, Education, Workforce and Income Security, U.S. Government Accountability Office, Washington, DC 47 Hon. Mel Grossman, administrative judge, Florida 17h Judicial Circuit Court, Fort Lauderdale, FL............................. 66 APPENDIX Written Testimony of Ellen J. Henningsen, J.D., Coalition of Wisconsin Aging Groups......................................... 73 Prepared Statement of Elaine Renoire............................. 81 (iii) EXPLOITATION OF SENIORS: AMERICA'S AILING GUARDIANSHIP SYSTEM ---------- -- THURSDAY, SEPTEMBER 7, 2006 U.S. Senate, Special Committee on Aging, Washington, DC. The Committee met, pursuant to notice, at 10 a.m., in room SD-562, Dirksen Senate Office Building, Hon. Gordon H. Smith, Chairman of the Committee, presiding. Present: Senators Smith, Burns, Talent, Carper and Salazar. OPENING STATEMENT OF SENATOR GORDON H. SMITH, CHAIRMAN The Chairman. Good morning, ladies and gentlemen. The hour of 10 has arrived, so take your seats, be at home. We appreciate each of you taking the time to join us in what I believe is a topic that needs both light and heat. We have entitled this hearing ``Exploitation of Seniors: America's Ailing Guardianship System.'' I recently learned of an interstate guardianship dispute that has tied up the courts, conservators, attorneys, hospitals, police, ambulances, nursing homes, adult protective services, family and friends in three different States, all because a native New Yorker fell ill while at the Connecticut home of his daughter. The ensuing year-long battle over his guardianship, which continues today, has cost thousands of dollars, torn apart the family, drained taxpayer dollars and administrative resources, and illustrates how ill-equipped the courts are to handle such disputes. Regrettably, this situation is far from unique. Horror stories abound in the press regarding the plundering of assets, physical neglect, and the indignity with which elderly wards have been treated by their guardians. As we have learned from the highly publicized Brooke Astor case, no matter your age, finances or social status, none of us in this room today are beyond potential abuse or neglect and any one of us at any time could become incapacitated and in need of assistance. We are here today because, sadly, after 20 years of congressional hearings on elder abuse, most State guardianship systems are still failing vulnerable seniors. Every State in the country requires a license to practice medicine, law, or even to drive. Unfortunately, the same cannot be said for guardians, who in most States remain largely unregulated and unsupervised. According to a recent L.A. Times series, there are approximately 500 professional conservators in California overseeing more than $1.5 billion in assets, and these conservators are subject to less regulation and oversight than a hairdresser or a guide dog trainer. Although States have made recent legislative strides to reform guardianship laws and ensure better oversight, experts feel there has been little progress when it comes to actual court practice. What has become clear is that Federal leadership is needed. Now, Senator Kohl, who is tied up in another hearing--he is our ranking member, but he and I, along with members of the Aging Committee, are cosponsors of the Elder Justice Act, a critical and necessary step in guardianship reform. The Act funds public education, data collection, and training for law enforcement and elder care professionals. So I urge my Senate colleagues and those in the House to very quickly pass this important legislation. However, States must also step forward and provide courts with the necessary staff and resources. Family law, after all, is primarily a State law issue. We are not trying to circumvent them or overtake them or preempt them, but clearly we need the States to do more when it comes to this very important area. Individuals also have a responsibility. They must plan ahead to ensure that someone they trust is in control of their financial and personal decisionmaking, should help be needed. This morning, we will hear from guardianship experts, including Ira Salzman, an attorney in the Brooke Astor case; a long-term care ombudsman, and also a probate judge has joined us, and the National Guardianship Association. I hope we all leave here today with a better understanding of the protections needed by the elderly to grow old simply, with dignity, while also keeping their fundamental freedoms intact. So let me introduce our witnesses: first, Mr. Ira Salzman. Welcome, sir. He is an elder law attorney in New York City and currently represents Philip Marshall, the grandson of Brooke Astor. Mr. Salzman will share with us the expertise he has gained in representing clients with cases involving guardianships and conservatorships. He will be followed by Ms. Barbara Bovbjerg, who is the director of Education, Workforce, and Income Security Issues for the U.S. Government Accountability Office. She will provide an update on the status of guardianships and conservatorships in the United States. Then we will hear from Mr. Terry Hammond, who is the executive director of the National Guardianship Association. Mr. Hammond's testimony will offer input and insight into the current state of guardianship in America, as well as the NGA's recommendations for guardianship standards. We will then hear from the Honorable Judge Mel Grossman. He is the administrative judge for the Florida 17th Judicial Circuit Court's Probate Division. In 2004, Judge Grossman's circuit court was recognized as one of only four exemplary guardianship programs in the Nation by the U.S. Government Accountability Office. Judge Grossman will offer this Committee insight from his years of court experience with guardianships. Finally, and certainly not least, Carol Scott, who is the Missouri Long-Term Care State Ombudsman, and has been so since 1989. From 2000 to 2004, Ms. Scott served as the president of the National Association of Long-Term Care Ombudsman Programs. Carol, you may wonder why you are seated in the middle and I read your name last. Senator Talent is between two committee meetings and wants very much to be here to hear your testimony. So when he arrives, which we estimate at about 10:20, we will just go to you next in line. So if everybody is OK with that, we will proceed in that order. So, Ira Salzman, the mike is yours. STATEMENT OF IRA SALZMAN, NEW YORK, NY Mr. Salzman. Thank you, Senator, and thank you very much for the opportunity to testify before you. As you said, I am the attorney for Philip Marshall, who is the grandson of Brooke Astor, and who has brought the petition to have a guardian appointed for his grandmother. But I think in terms of understanding where my testimony is coming from this morning, I think it is also important for you to know that I also represent a number of not-for-profit corporations in New York City that serve as guardian where there is no one else available to serve. These are publicly funded not-for-profits and are essentially New York City's equivalent of a public guardian program. Now, a lot of people have read a lot of the allegations that have been made in the Brooke Astor case in the newspapers, and many, many people have walked up to me and told me they have found these allegations to be shocking. I believe that the sense of outrage that this case has engendered is fully justified. But having said that, I think there is a really important point that needs to be made, and you made it in your opening statement, Senator. The Astor case is not unique. In the Astor case, my client is alleging that a power of attorney has been misused to misappropriate money. My firm has been involved in a lot of cases like this. This is not uncommon. Similarly, in the Astor case it is alleged that money has been misspent or not spent for needed care. Again, this is not an uncommon situation. My firm has been involved in a lot of cases where this has happened. In the Astor case, we were lucky enough to be able to document the allegations of abuse so well that the court in New York was able to determine that the immediate appointment of temporary guardians was necessary. There is an important lesson from this. Guardianship can be a powerful weapon in the battle to stop elder abuse, and when we talk about the regulation of guardianship, it is important not to lose track of the fact that it is an important tool to stop elder abuse, to prevent financial exploitation, to assist people who otherwise cannot manage for themselves. The goal should be regulation with an appropriate balance. In terms of looking at that, I think one has to look at this also from not only the point of view of the regulator, but from the point of view of the guardian because the truth of the matter is being a guardian is hard work for which you are rarely adequately compensated. Supervising the care of an incapacitated person can be very time-consuming. As I was outside, in front of this building this morning, my cell phone rang and it turned out that my mother-in-law's Lifeline alert system had gone off and it was the Lifeline people calling me to tell me there might be something wrong with my mother-in-law. Now, it turned everything was fine. There was a glitch in the phone system, but if you are a guardian, you may have a whole number of these systems. There may be a lot of Lifeline calls that you are going to get. If you get this kind of thing, you have stop what you are doing-- it doesn't matter what it is--and you have to fix it. It takes an extraordinary kind of person to be willing to do this and to do it right. You are not only managing personal affairs; you are also managing money, and you have to manage money with the knowledge that the court may come to you after the fact and says challenge you did, which means you have to be unafraid of being second-guessed by the court. Being a guardian can be difficult particularly in abuse cases because sometimes abused elderly people oppose the elimination of the abuser from their lives. Therefore, those who want to intercede in abuse cases frequently have an extraordinarily difficult decision to make. What is going to cause more harm: allowing the abuse to continue or separating the incapacitated person who is being abused from his or her loved one? If there is no one available who is willing to serve as a guardian without receiving the fair market value of the services that need to be rendered, then even the simplest of guardian cases can be expensive. Under New York law, for example, a guardian has to visit a ward at least four times a year. Let's assume that a person is in a residential care facility and in stable condition. This is the simplest of simple care plans. Let's assume a visit takes 3 hours, including transportation. Let's assume further that the guardian only has to spend an hour a month paying bills and filing insurance claims, and another 3 hours a year filing reports for the courts. That means at a minimum, in the simplest of cases, you are talking about 27 hours a year, and that assumes nothing has gone wrong. If someone is living at home, then the amount of time that a guardian has to spend is always going to be substantially more than that because especially when you are using a guardianship to manage a care plan at home, what you are doing is you are buying family, and family doesn't come cheap. This is a particular problem for lower-middle-class and poor people who are incapacitated and therefore need guardians, because guardianship for the lower middle class and the poor can be critical in order to prevent homelessness or unnecessary institutionalization. Guardianship, as time-consuming and as expensive as it may be, is often a crucial part of the equation that allows people to live out their lives at home. In the context of what I have said so far, I would like to make six points. First, guardianship is a really important tool that can be used to implement a care plan for incapacitated persons, stop elder abuse, and prevent self-neglect. Second, being a guardian and doing it right is time- consuming, hard work. Third, if there is family involved and enough money to pay for the care plan, plus legal and accounting expenses, a guardianship can work well. Fourth, even committed and caring people can be scared off by having to be involved in a legal system and being required to file what appear to them to be complicated reports when there isn't enough money to pay for legal and accounting assistance and the guardian can't afford to pay for this assistance with his or her own funds. Five, oversight is important, but oversight of guardians is expensive. The more oversight you have, the more complex the system becomes. By expensive, I don't just mean the cost of the people doing the oversight; I also mean the cost of the professionals necessary to help the guardians deal with the oversight. People don't like to go to court for a compliance conference in front of a judge without a lawyer. This is not an unreasonable position. How does that lawyer get paid? Now, I am certainly not saying there shouldn't be oversight. What I am saying is the system needs to be user- friendly. Oversight should not just mean supervision; it should also mean technical assistance to help guardians so they don't trouble with the people doing the oversight. Last, as baby-boomers age and find that their children do not live near them, there is going to be an increased need for public guardianship. Poor people needs guardians, too, and as I said, guardianship done well is expensive. But in many cases, public guardianship will be the only alternative for some people if society wants to avoid having them become homeless or being unnecessarily institutionalized. Thank you very much for the opportunity to testify before you. The Chairman. Thank you very much, Ira. As I listen to your testimony and I consider this whole category of guardianship and I think of the baby-boom generation that is going to double the size of the elder population in the next few years, I wonder if there isn't some level of increased professionalization that ought to take place in the whole category of being a guardian. We don't set fees in government for lawyers, except as to public defense and things like that, but I am just troubled by anybody can be a guardian. There is no standard, apparently. There is no schooling, there is no level of qualification that can prepare a guardian for dealing with all the things you have just cited. In your view, are there sufficient standards for guardianship in this country? Mr. Salzman. Well, I can only speak for New York, and in New York guardians are required to go through training before they are permitted to serve. I actually chair one of the training programs in New York. The Chairman. So New York is, but how about other States? Through your own knowledge, do they have such systems? Mr. Salzman. I don't know, but I think there is a further point, if I can make it, Senator. The Chairman. Yes. Mr. Salzman. You first have to distinguish between lay guardians and professional guardians. I think that there has to be a bias in the system in favor of letting family members take care of their own, and the goal there should have them not only go through training, but have available technical assistance for them. The Chairman. For lay guardians? Mr. Salzman. For lay guardians, for family members. The Chairman. Does that exist adequately, in your view? Mr. Salzman. No, it does not. We have one experimental program going on in Brooklyn, which I understand is going very well, but it is specially funded and it is only in Brooklyn. I think that in New York, we have two kinds of professional guardians. We have not-for-profits who serve as community guardian programs or their equivalent. They are not licensed, per se, but they serve under contract with government agencies and are audited by the government agencies and supervised directly by the government agencies as part of the contract process. In addition, the courts will appoint lawyers who serve as guardians from time to time or social workers who will serve as guardians from time to time. They are required to go through 6 hours of training in order to serve. In addition, they are required to file accounts which are reviewed annually. The Chairman. Do they take an examination? Do they get a license? Mr. Salzman. There is no examination, there is no license. The Chairman. You spoke about how costly it is to be a guardian. Whether you are a professional or a lay guardian, there are fiduciary responsibilities attendant to that position, and taking time costs money. Yet, I am wondering if the lack of standards doesn't incentivize some of the financial malfeasance that seems to be reported with such regularity; that someone might feel justified in raiding the corpus of an elder's estate feeling like, well, they are entitled to it. That creates all kinds of litigation, I am sure, because some would regard it as excessive or in some cases even criminal. Mr. Salzman. I have been involved in some of these cases, and you look at the financial records after the fact and you can see all kinds of different stories that pop up. I remember one of the first ones I saw was there was a guardian who was short of money. He took $200 out and then he put it back, and you could see it in the records; he put it back. Then a month later, he was short and he took another $300 and he put it back, and he repeated this half a dozen times. Then there was the first time that he didn't have the money and he couldn't put it back. When people run into hard times, then the great quote from ``Lady Windermere's Fan'' becomes applicable: ``I can resist anything except temptation.'' So, certainly, you want guardians who are financially stable. People get into trouble and they look at this pot of money and say, ``Oh, it is only going to be a loan, no one is ever going to notice, I will take it and I will put it back.'' That is a common story, that is a common story. There are some people who are just plain dishonest and do it immediately. There are lot of people who are just sloppy. There are a lot of people who think, well, it is just a little bit, nobody is going to notice. I just finished an audit of a guardianship account where they just ran up credit card bills to go out to dinner. There was a few million dollars involved and they ran up, over 3 years, $40, $50,000 worth of really odd credit card bills. They figure, you know, I am doing the work, it is really for her benefit, we are talking about here. It would be deductible in the income tax, so I am going to take it under the same rule. There are varying levels of venality. The Chairman. Should it be more formalized either in regulation or statute at the State level? Mr. Salzman. Well, I think the laws are pretty clear. The issue is what do people do about it. The Chairman. People are afraid to break the law. I mean, you are right. Mr. Salzman. Yes. The Chairman. But I guess I am just wondering if, in your view, in your experience, a lot of this goes away if someone does sufficient estate planning and provides for reasonable compensation for a guardian. Mr. Salzman. Yes. The Chairman. Yet a lot of people die intestate with no planning. You speak of the poor who need guardianship, just as someone who is wealthy, and I am just wondering if the difference between someone who is prepared--I mean, I have to believe Brooke Astor was prepared, and I don't want to ask you any details on a case. I know you have a responsibility there not to do that. But it does seem to me that such a range of financial abilities, such a range of financial planning for one's later years--maybe there ought to be some general sorts of statutes in every State, and perhaps even the Federal Government, to give some guidance, some legal structure to this relationship. Mr. Salzman. I think that in terms of cases where there are assets, when there is money around, there is always going to be somebody there who is going to complain. Ultimately it is going to pop up because ultimately the heirs are going to take a look at it and they are going to say what happened here. My concern in terms of guardianship and in terms of where guardianship is going down the road is what happens with the people who don't have money and still need guardians. My clients have had extraordinary successes in keeping people home simply by virtue of the fact that the guardianship was in place and homes were preserved. What I would hope that the Federal Government would do would be to look toward establishing best practices for guardianships, in general, and funding for public guardianship, in particular. I guess that leads me to the Elder Justice Act, which I think is an important first step by the Federal Government--should it pass, would be an important first step by the Federal Government to establish a national platform for the discussion of these issues, to establish funding for best practices, to deal with the data collection issues, because one of the things that I believe was pointed out in the GAO report is that we are really not sure as to what the nature and extent of the abuse is. I don't think we want to regulate to the point where we squeeze family members out of the system and we don't want to regulate to the point where doing the job becomes prohibitively expensive. The Chairman. Those three things you mention--data collection--well, it escapes me the other points you just made, but they are on the record. You are familiar with the Elder Justice Act? Mr. Salzman. I am. The Chairman. Do you think we have sufficiently addressed those concerns? Mr. Salzman. I do. The Chairman. So you would suggest we get it through? Mr. Salzman. Without question, without question. The Chairman. But you would add dollars for best practices to incentivize States? Mr. Salzman. Absolutely. The Chairman. Well, thank you very, very much. It has been very helpful to have your comments on the record. [The prepared statement of Mr. Salzman follows:] [GRAPHIC] [TIFF OMITTED] T1448.001 [GRAPHIC] [TIFF OMITTED] T1448.002 [GRAPHIC] [TIFF OMITTED] T1448.003 [GRAPHIC] [TIFF OMITTED] T1448.004 [GRAPHIC] [TIFF OMITTED] T1448.005 [GRAPHIC] [TIFF OMITTED] T1448.006 [GRAPHIC] [TIFF OMITTED] T1448.007 The Chairman. I see Senator Talent has just arrived. So as I mentioned in the beginning, what we will do is jump now to Carol Scott, who is from Missouri, and depending on where you are from in Missouri, you might say Missoura. How do you say it, Senator Talent? Senator Talent. Well, that is a question I never answer. [Laughter.] Either pronunciation is commonly used by fine Missourians all over our State. Am I recognized for my statement? The Chairman. Yes, you are recognized for your statement and then we will go to your witness. OPENING STATEMENT OF SENATOR JIM TALENT Senator Talent. Speaking of fine Missourians, Carol Scott is with us today. I want to thank you first, Mr. Chairman, for calling this hearing. There is just no question that we as a society need to commit ourselves, and I think we are committed, to helping our most vulnerable citizens. This certainly includes seniors who are subject to physical or financial threats, in some cases from those who ought to be close to them, who ought to be looking out the most for them. Guardianship is a great legal tool. It has benefited many, many people. It is an important tool, but if it is not carefully used and administered, it can hurt people as well. So I am glad you are holding this hearing and I am pleased that my old friend, Carol, is with us today. Carol Scott and I met when I served in the Missouri legislature. She has served as the Missouri Long-Term Care Ombudsman for almost 20 years. She is the past president of the National Association of Long- Term Care Ombudsman Programs. Her service also includes the Medicare Fraud Prevention Program and the Missouri End-of-Life Coalition. I will just say, Mr. Chairman, she really knows her stuff, so you picked a good witness. I am looking forward to hearing her testimony and the testimony of the other witnesses as well, and their recommendations about what we can do to help educate seniors and their communities about guardianship and how to use it in the right way to preserve seniors' physical and financial integrity. Thank you, Mr. Chairman. The Chairman. Thank you, Senator Talent. Carol Scott. STATEMENT OF CAROL J. SCOTT, MISSOURI STATE LONG-TERM CARE OMBUDSMAN, JEFFERSON CITY, MO Ms. Scott. Senator Smith, Senator Talent, good morning. In Jenny Joseph's poem ``Warning,'' she writes ``When I am an old woman, I shall wear purple, with a red hat which doesn't go and doesn't suit me.'' At the end, she ends with, ``But maybe I ought to start now so people who know me are not too shocked and surprised when I am suddenly old and start to wear purple.'' It seems that there is a never-ending battle to debunk stereotypic notions of older and disabled adults. Often, the labeling of an individual is tantamount to presumption of the need for guardianship. Finding yourself under a court- appointed guardian can happen quickly. There was a gentlemen in Missouri who was driving his pickup down the street and, within 2 weeks, was in a nursing home with a guardian. Within 6 weeks, all of his belongings were thrown away and all his real estate was sold. Within that time, he got better, and with the help of the ombudsman's program, the nursing home and the physician he asked the court to overturn his guardianship and the request was denied. In another Missouri case, the guardian of seven residents of one nursing home moved these individuals because the guardian was mad that the nursing home was requesting payment. One of these residents had lived in that nursing home for over 25 years. From across the country, ombudsman stories remain the same that the system is not working as it should in all cases. It is far too easy to take advantage of people. There is a lack of training and there are few standards in place to protect these vulnerable people. In Ohio, the ombudsman learned that an agency planned to move all their wards from their nursing home without even talking to them. The ombudsman visited and notified the court, but they were moved anyway. One resident died after that move. The agency then wrote a letter to the new nursing facility telling them not to allow the ombudsman to visit their residents without the guardian being present. Well, this is against Federal law, so the ombudsman program is not complying with that request. In New Jersey, a case of an attorney who was appointed guardian. The guardian applied for Medicaid when the ward had $49,000, or should have had $49,000 in the bank. This case is now under investigation. In Michigan, two cases where the wards were placed in locked Alzheimer's units in the nursing home. Neither had dementia and in both cases the facility and physicians felt the individuals did not need a guardian. While family members and friends assume the role of guardian or conservator, in Missouri there are no training requirements and only a yearly accounting of finances which is sent to the local probate court. Low-income family members face difficulties because of the cost of establishing a guardianship. In these situations, family members who are willing to be guardians should be encouraged, not discouraged and punished by the cost of becoming a guardian. The Chairman. Should they be compensated, Carol? Ms. Scott. That is a hard question. I don't know. I don't know where the money would come from. The Chairman. I just ask that question because it leads back to this whole incentive for abuse. I am sorry to interrupt you. Ms. Scott. No, that is OK. That is a tough question because I mean as Mr. Salzman says, there is a lot of time and energy put in. So I am not sure that paying is the right thing, but some incentive--in Missouri, it costs about $1,000 to get a guardianship established and that is what the beginning issue is, is just the cost of doing it. There are many best practices across the States and I think States need to look at and make appropriate changes. As far as the role of the Federal Government, I have four ideas. One is there is a need for coordination between the Social Security Administration, the VA representative payment programs and State courts handling guardianships. This issue is described in the 2004 GAO report. In the Older Americans Act, there is a need for beefing up the legal services program. In many States, this program is floundering due to lack of attention and funding. The National Conference of Commissioners on Uniform State Laws has convened a committee to address interstate issues. It would be great if Congress could somehow promote the portability of guardianships created in other States. Fourth, the Federal Government could conduct a study of the connection between guardianship and the inappropriate institutionalization of individuals in nursing homes. When guardianship works well, it is fine to have control at the local probate court level. When it is not working, there is a need for some other type of oversight. There may be a need for someone to have oversight to review the financial dealings, the living arrangements of the ward, and other quality-of-life issues. Training, education and oversight are solutions that can happen, but will take time and money. In addition to my testimony, I have submitted some other ideas for recommendations for actions. I look forward to going back to my State, and I hope everyone in this room does to their own States, to see if we can't make some changes. Thank you very much. The Chairman. Thank you, Carol. This question is not a criticism of Missouri, but just a question. Is the State legislature there taking this issue up? Ms. Scott. We are identifying State legislators that are very interested in this case. We have a situation right now where in Missouri we have public administrators that are elected within each county, and we currently have in the news one of those that is under investigation for possible financial dealings. I think that case will result in there being a lot of interest in this topic in the next legislative session. The Chairman. In Missouri, do public guardians get training? Are they licensed? Ms. Scott. No, they are not licensed. They do have a requirement to receive training, but it is less than 30 hours. I mean, they have written it themselves and so it is information that is kind of passed on. It is not any kind of a certified training. The Chairman. How about private guardians? If the public ones don't have any more than that, the private guardians have nothing? Ms. Scott. It depends on the court as to how much information is even given on what the job is. From court to court, it is very much a good old--what is that called, the buddy system, so depending on the county and the judge on how much oversight is given. It could be that the paperwork is sent in and it is just filed in a filing cabinet and not ever even reviewed. Senator Talent. Mr. Chairman, can I ask---- The Chairman. Yes, Senator Talent. Senator Talent. Thank you, Mr. Chairman, because as is often the case, as you know, we have a lot of different things going on at the same time and I am not going to be able to stay for the whole thing. I wanted to ask Carol--and with your permission, Mr. Chairman, if anybody else wants to chime in. To me, the guardian is one officer who is supposed to be looking out for seniors. The other person who is always supposed to be doing this is the judge. Now, in my limited experience, because I never practiced in this field, judges are not just supposed to accept representations that are made to them when somebody seeks guardianship. I mean, you are supposed to ask questions particularly if the person has no attorney representing them, if it is an ex parte proceeding. Is it your experience that people will falsify, say, affidavits to judges or testimony to judges about the mental state or condition of the senior in order to get guardianship rights? I am reading your anecdotes and I know this happens where people are treated as if they have Alzheimer's when they don't. Well, this is a factual question. I mean, you can't just go in to a judge and say, you know, my aunt has Alzheimer's, when she doesn't. Is anybody holding these judges accountable for their decisions, or what is fouling up at this point? Ms. Scott. Somebody else here might be able to answer. Senator Talent. I notice Mr. Grossman reacting to my question, so if he would like to add something. Ms. Scott. I will tell you that my experience in Missouri is, again, in my counties there is that good old buddy system. We see instances where the ward is not even notified that there is a court hearing. We see instances where the family member is not even notified that this is happening. We see where the judge and the guardian, whether it be public or private--I don't know what the reason is. The gentleman that was driving down the street and ended up--the only explanation we have is that he happened to own some lake property that some people wanted to get a hold of to do a development, and unfortunately this was a 70-some-year-old sailor who talked like he was still out on the sea and they absolutely took advantage of him. I have no understanding why the judge didn't do something different, other than didn't want to rock the boat, didn't look at it. We actually did some training with The Missouri Bar to get the attorneys to do something, because we have attorneys who aren't even visiting their wards before they represent them in court. Senator Talent. Does anybody else want to comment on that? Judge Grossman. If I could respond? The Chairman. Please, yes, go ahead. Judge Grossman. Florida is a little different because Florida for about 40 years has seen an influx of retirees whose children are up north, and a lot of them in Mr. Salzman's neck of the woods, and so we do have some history. In 1989, the Florida legislature enacted some comprehensive statutes on guardianship, and then just this past session, as a result of recommendations from the State legislature, created a guardianship task force, on which I served representing the circuit court of the State. We had a bunch of recommendations and they were successfully passed this last session. There is also, Senator Talent, a line of cases principally out of Maryland that takes the position--and it is a position I am comfortable with--that says that the person that we call a guardian is not really the guardian. Ultimately, the guardian is the judge and the court, and the person we appoint as a guardian is, in fact, acting as an agent for the court. We have in my circuit especially--and there are disagreements even among my colleagues in Florida, but every time there is a petition for incapacity in Florida, the first thing that happens is I enter an order appointing an attorney to represent that alleged incapacitated person and I appoint a guardianship examining committee composed of three people who go out and make a report back, and then there is an evidentiary hearing. Ms. Scott, I will be happy to give you the cites that are here so that you can put some of those together with the State of Missouri. But once you get past the appointment process, I have to tell you all that we have a requirement that professional guardians, and if they are corporate guardians, that any employee that has a fiduciary duty to a ward have a background investigation done. In my circuit, we do it annually. It has to be done every 2 years under the statute, and we check for criminal, we check for credit, and we check with our Department of Children and Families for any reports of exploitation, abuse, or neglect before anybody is appointed. Once they are appointed, there are educational requirements. We require 8 hours for family, generally, in terms of the elderly for a family member. Our bar association puts those on. For professionals, they have to be registered with the statewide public guardianship office, and if they are not on the registry, they can't be appointed and they can't get paid. Then we have codified in State legislative provisions--we have the ability to appoint court monitors. In my circuit and in one other circuit, we have actually an in-house capability. In my circuit, we have a full-time in-house court monitor with a clerical staff, and we have probably the most robust set-up of any circuit in Florida. If there is any indication that comes to a judge or a magistrate that there is something that is not quite right, or even if we get a letter in the mail and even if it is anonymous, the first thing we will do is we will send out that in-house court monitor to check. Now, 90 percent of the time---- Senator Talent. No problem. Judge Grossman [continuing]. There is no problem, but it is that troublesome 10 percent. So we decided, after some negative newspaper series--nothing gets the attention of the judiciary more than a 5-day mini-series in a major newspaper in the area that appears at the top of 1A, and above the fold, as well, are the recommendations that say Broward judges do a poor job of oversight. So we took that very seriously and basically we default to worst-case scenario in terms of our operating procedures. Now, does that cost money? Mr. Salzman, you are absolutely right; it costs money, but we have been fortunate enough to get some resources. The other thing, and it is really not directly related to this, but let me just touch on it anyway is we have an Office of Public Guardian. It is modestly funded, but what we did was I created a public-private partnership with Barry University, which is in south Florida, which has an excellent school of social work. Essentially, the university provides for our public guardian operation. So you don't have any education with that, but I do think education and I do think that there needs to be some funding. Senator Talent. Thank you, Mr. Grossman. Can I just make a final point for the record? The Chairman. Of course. Senator Talent. I am glad you mentioned, Mr. Grossman, and I am sure you probably did also, Mr. Chairman, that there are thousands and thousands of devoted children and relatives out there caring everyday. I have staff members in this situation with an aged relative, and we should say that. I mean, the love that you see in this kind of a setting is just--you just never see it repeated. We do have these abuses, and I congratulate you and Senator Kohl because this is one of the things this Committee is for. I suspect that if the Committee just issued a paper with some recommendations to some State supreme courts and some county public administrators, that publicity alone probably would light a fire under people to do what they are already supposed to be doing a little bit better. I would suggest that the Chairman consider that. The Chairman. I am encouraged, Judge. I forget the Justice of the Supreme Court that made the comment in one of his opinions that judges read newspapers, too. Senator Talent. Not that we ever do, of course. The Chairman. There is nothing like the court of public opinion to make modifications. [The prepared statement of Ms. Scott follows:] [GRAPHIC] [TIFF OMITTED] T1448.008 [GRAPHIC] [TIFF OMITTED] T1448.009 [GRAPHIC] [TIFF OMITTED] T1448.010 [GRAPHIC] [TIFF OMITTED] T1448.011 [GRAPHIC] [TIFF OMITTED] T1448.012 [GRAPHIC] [TIFF OMITTED] T1448.013 [GRAPHIC] [TIFF OMITTED] T1448.014 The Chairman. We are also joined by Senator Burns, of Montana. Senator, if you have an opening statement or a question of any of the witnesses---- Senator Burns. Well, no, and I just want to thank you. Just listening to this discussion this morning, whenever you appoint a guardian, do they also have the power of attorney? Judge Grossman. In Florida, there are different degrees in terms of guardianship. We have, pursuant to statute, a laundry list of rights and powers that an individual is free to enjoy in our society and which ones can be taken away and which can be delegated to a guardian and which cannot be delegated to a guardian. If you are talking about a durable power of attorney for financial things, a durable power of attorney, if it did exist, would cease in Florida when a guardian is appointed and the guardian would be taking over the financial aspects of the ward. I am not sure that that answers your question. Senator Burns. Is that unique to Florida or are there other States---- Judge Grossman. My understanding is it is not necessarily unique to Florida, but again more than any other State we have been out there a whole lot longer, although you are going to see the same situations as they sweep across the Sun Belt and this is just the beginning. One of the problems with this particular area is that, No. 1, nobody likes to face their own mortality. No child likes to recognize the fact that their parents are in need of assistance, and no parent relishes the idea of any kind of even limited role reversal. So this becomes a really difficult deal for families to work out. I agree with what Senator Talent said and, Senator Smith, what you said, as well as Mr. Salzman. I mean, most families really care about their families and really do everything they can to help them. Most professional guardians do the same way. But in answer specifically to your question about durable power of attorney, that would cease in Florida when a guardian was appointed. Senator Burns. Do you have the attorneys--do they sort of pull back on that? Judge Grossman. Well, you see, another difference between Missouri and many other States is every guardian, unless they are an attorney, has to be represented by an attorney. Originally, that was designed as best I can tell to provide a backup system for the court. For a good 10 years now, the general policy of the State of Florida has been that while the guardian is the representative, the attorney who has been selected by the guardian to represent the guardian has also a third-party beneficiary relationship with the ward, which brings on certain obligations. In July, the Alaska Supreme Court just ruled in a guardianship case where the attorney knew or should have known that something wrong was happening as a result of what the guardian was doing with the ward's assets that the attorney was potentially liable for the losses and the injuries incurred by the ward by virtue of his or her not stepping forward and essentially blowing the whistle. Senator Burns. Well, I can see where there would be a little conflict there. I have been through this with my parents. Of course, the toughest thing in the whole family deal is when you take the car keys away from them. That is the toughest part of managing your parents, so to speak, when everybody knows they shouldn't be driving. Now, once you make it over that hill, everything else falls in place, you know, but the toughest part is getting those car keys. Judge Grossman. You are braver than I. I told my father, may he rest in peace, that the car had been stolen. [Laughter.] Senator Burns. Well, my father was fortunate, or however you would term it. The first time he had a pain in his whole life, he was 86 and then they found there was cancer in his liver and they told him he only had 90 days to live. He looked at my mother and said, ``Now, ain't that something?'' But my mother was a very strong-willed lady and getting the car keys from her was a little bit tougher. I just want to know the difference because are we saying here--and by the way, both of those people that I was talking about are buried in Davies County, MO. You know where Davies County is? Ms. Scott. Yes. Senator Burns. This is where Frank James stood trial. Are we saying here that we are suggesting guidelines should be passed on the Federal level to unify the laws across the land, because sometimes caring children are not residents of the States in which their parents reside? Are we suggesting that? Mr. Hammond. Mr. Chair, is it my turn? I will go ahead and answer that question and make my comments, if that would be appropriate at this time, Mr. Chairman. The Chairman. Sure. STATEMENT OF TERRY W. HAMMOND, EXECUTIVE DIRECTOR, NATIONAL GUARDIANSHIP ASSOCIATION, EL PASO, TX Mr. Hammond. Thank you. My name is Terry Hammond. I am the executive director of the National Guardianship Association. I am a practicing attorney in El Paso, TX. El Paso County, TX, is one of the poorest communities in this country, and so we see a lot of indigent guardianship issues where I practice. On behalf of the National Guardianship Association, I would like to thank Chairman Smith and the Special Committee for allowing the NGA to testify on the incidence of guardianship in the aging and disabled population in America. The NGA was created in 1988 in response to a withering report by the Associated Press that exposed inadequacies in State guardianship systems. I will note that the theme of that report in 1987 was Guardians of the Elderly: An Ailing System. Today, in 2006, the theme of this hearing is Exploitation of Seniors: America's Ailing Guardianship System--almost exactly the same theme 20 years apart. NGA membership is comprised of guardians and professionals from all walks of life. The mission of the NGA is to establish and promote a recognized standard of excellence in the guardianship practice. Honored Members, I must tell you that despite the best efforts of hundreds of committed guardians, judges and attorneys, at this time we have elderly and disabled Americans suffering in their homes and in our streets. As more Americans age, Federal, State and county governments look to each other to meet the needs of a generation that has given its all and now is in need of support of governmental services to survive. The lack of a coordinated response at all levels of government too often leaves our elderly to live their final days penniless and in unspeakable pain. Simply put, we are not doing senior Americans justice. At a minimum, the Federal Government should create an environment conducive to successful judicial intervention for those in need of a guardian. This is a challenging time to be engaged in the guardianship process in America. In recent years, we have had such high-profile cases as Rosa Parks, Brooke Astor, Molly Orshansky and Lillian Glasser, the numbers of which are eclipsed by scores of Americans in each of our hometowns. The national spotlight has been directed on guardianship often in an unflattering manner. The American guardianship system is far from perfect. Americans may find themselves before a guardianship court with a loved one or third party seeking appointment as guardian. If the physician indicates there is a medical necessity for guardianship, the court may appoint a guardian even over the objection of the elderly person. Often, there is evidence of abuse, neglect or exploitation necessitating the appointment of the guardian. The courts are increasingly turning to third-party professional guardians where there are family members who are not appropriate or not available, or even where distance separated loved ones. At this time, no one knows how many guardianships there are in America. This is because guardianship is a uniquely local process governed by State law and administered on a local level, often county by county. For example, in Texas alone there are 254 counties, each of which administers guardianship slightly differently. There are no national standards for guardianship other than the standards of practice for guardians adopted by the National Guardianship Association. There is no national certification process for guardians--and this is, Senator, following up on your comments--other than the registered guardian and master guardian certification testing process adopted and promoted by the NGA's sister entity, the National Guardianship Foundation. A recent study on guardianship by the ABA Commission on Law and Aging concluded basic data on guardianship is scant, offering courts, policymakers and practitioners little guidance for improving the system. The 2004 report by the GAO confirms these findings. Only a handful of State court systems are equipped or even interested in collecting data on guardianships. Although guardianships are local in nature, there are a number of areas in which the Federal Government's policies impact on guardianship. I would like to highlight a few of these areas. First, the designations of representative payees by the Social Security Administration and the Department of Veterans Affairs often impede the administration of guardianships. It is like you have parallel tracks. You have the Federal Government's representative payee system and the guardianship system in a State and the two never cross, and so there is very little dialog or communication between the Federal agencies administering Federal funds to payees and the courts that are considering these cases. For example, in the court I practice in the probate judge has banned the Social Security representatives and the VA representatives from testifying in his court because they will typically tell him, we are the Feds, we don't have to come to your court unless you go through an extensive subpoena process, we are not going to participate. In response, our county judge has said, fine, I am never going to let you come at all. So that is the level of dialog we have in this area. Social Security and the VA routinely appoint housing providers or other persons with potential conflicts of interest as representative payees, sometimes warranting intervention by guardianship courts. Adult protective services agencies which are funded with Federal block grants are part of the guardianship continuum. When APS systems fail, immense pressure can be placed on guardianship systems to step in on an emergency basis. I have cited to you perhaps the most thorough analysis of a failed APS system which occurred in Texas in 2004 and 2005 because the guardianship process highlighted a number of cases where the elderly and disabled were left to live in squalor and to be exploited while adult protective services came in and investigated them. The report by the Texas Office of Inspector General revealed a total breakdown of that system, despite tens of millions of dollars of taxpayer money being appropriated for elderly protection. State and local governments often continue to struggle to find funding for indigent guardianship services. There may be a role for the Federal Government in this area. Courts administering guardianship cases often do not properly monitor the cases. There may be a role for Federal funding in this area. Finally, Federal funding to promote the use of alternatives to guardianship, properly drafted powers of attorney, money management services and other less restrictive alternatives to guardianship is essential. The failure of Americans to plan for incapacity is the primary cause for intervention in guardianship cases. Again, the National Guardian Association appreciates the opportunity to present testimony before the Committee today. We hope that this will be the beginning of a national dialog that will lead to the assurance that each and every elderly or disabled person subjected to a guardianship proceeding, regardless of which State or county that person may live in, will be afforded the dignity, respect and civil rights to which all Americans are entitled. [The prepared statement of Mr. Hammond follows:] [GRAPHIC] [TIFF OMITTED] T1448.015 [GRAPHIC] [TIFF OMITTED] T1448.016 [GRAPHIC] [TIFF OMITTED] T1448.017 [GRAPHIC] [TIFF OMITTED] T1448.018 [GRAPHIC] [TIFF OMITTED] T1448.019 [GRAPHIC] [TIFF OMITTED] T1448.020 [GRAPHIC] [TIFF OMITTED] T1448.021 [GRAPHIC] [TIFF OMITTED] T1448.022 The Chairman. That was excellent testimony, Terry. Thank you so much. I want to assure Barbara Bovbjerg we are not ignoring you; we are going to get to you. Judge Grossman, in your full testimony we will want to hear anything that you would like to add to your comments already. But I do want to acknowledge the presence of Senator Salazar, of Colorado, who was formerly the State attorney general and probably has a lot of insight into these types of issues. Senator, if you have an opening statement or want to make a comment or question at this point, we would welcome that. OPENING STATEMENT OF SENATOR KEN SALAZAR Senator Salazar. Thank you very much, Chairman Smith, and thank you for holding this hearing on what is a very important topic. It may not be the sexiest topic in the world when people talk about guardianships, but it certainly is one of the most important questions that faces many people across our country. During the time that I was the attorney general, one of the things that we did in Colorado was we held a summit on the financial exploitation of seniors and out of that came a number of recommendations, including a no-call telemarketing law and a whole host of other things. One of the items that was focused on also was needed changes with respect to the guardianship laws in Colorado, and as a result of that, in 2001, we in Colorado adopted the Uniform Guardianship and Protective Proceedings Act and were one of the first States to do that. I am very interested in learning some more from the panel in terms of what you think we might be able to do at the Federal level to address the issues across the Nation and perhaps try to bring some uniformity, if that is desirable. I am pleased to be a cosponsor with Senator Smith, Senator Hatch, and Senator Lincoln, as well, with respect to the Elder Justice Act which we have introduced. So your recommendations to us on this issue are very important recommendations. Mr. Chairman, I have a much longer statement for the record. The Chairman. We will include it for the record, and thank you. We have been getting some tremendous ideas on just what you are asking for, as well, on what can we do at the Federal level to shore up this growing and emerging problematic area. Thank you for your presence here, Senator. [The prepared statement of Senator Salazar follows:] Prepared Statement of Senator Ken Salazar I would like to thank Chairman Smith and Ranking Member Kohl for holding this important hearing. Abuse of senior citizens by their guardians is a problem facing many seniors today. I welcome our panel of witnesses who have come to share their knowledge and provide guidance in addressing this problem. When entering into a court appointed guardianship relationship, the financial, physical and emotional well-being of seniors is placed in the hands of an individual. Under the law, that guardian has a legal obligation to act in the best interests of their trustee. And because many fundamental rights are lost due to the guardian's appointment, significant trust is placed in our state courts and social service agencies to ensure that seniors are protected. While I am certain that many court appointed guardians act in good faith to further the best interests of the trustee, the system for monitoring these arrangements to identify guardians acting in bad faith is severely under funded, and lacks the resources necessary to appropriately monitor guardian transactions. My home state has a record of proactively addressing these problems. In 2001, Colorado became one of the first states to pass the Colorado Uniform Guardianship and Protective Proceedings Act. This law codifies procedures, background checks, and the oversight responsibility to ensure that seniors are not taken advantage of by unscrupulous guardians. This law--and other enacted in others states in recent years--is a step in the right direction to protect seniors against guardian abuse. However, unless abuse is detected and reported by the Senior or third party, who subsequently brings a complaint, there is virtually no way to monitor and prevent abuse. Oftentimes, impropriety is difficult to prove since many seniors are unaware that guardians are stealing from them and do not have family available to help them monitor their finances. In addition, in many instances, the guardian that commits the abuse is a family member or close friend of the guardian-- and seniors are reluctant to be removed from abusive environment caused by loved ones. The qualification of guardians is also an important aspect of this relationship. In Colorado, there is currently no system of training and licensing for senior guardians. However, my state and others can learn from those who have implemented annual training requirements and licensing programs. As senior citizens place their trust in the hands of court appointed guardians, they should expect that their financial matters and personal affairs are being handled by someone with a degree of competence and training. Hearing the testimony of today's panel of witnesses and experts will help to frame the problem of guardian abuse, and provide some starting points as to what we at the federal level can do to help states and senior citizens to actively address this problem. While the guardianship program is largely regulated by the state, there is one step we can take at the federal level to protect seniors from abuse. I believe that Congress should enact the Elder Justice Act. I am proud to have recently joined the bipartisan group supporting this measure--which was unanimously passed out of the Senate Finance Committee in July. As the findings in this proposal suggest, the estimated number of seniors who are abused each year greatly varies. Regardless of the figure, any abuse should not be tolerated. By creating a federally coordinated effort to prevent abuse and to support research and prevention service, passage of the Elder Justice Act would allow our federal government to take greater steps to eliminate abuse. I look forward to today's testimony, and working with the members of this Committee to bring creative and lasting solutions to this problem. The Chairman. We have also been joined by the great Senator from Delaware, former Governor of Delaware, Senator Carper. Tom, if you have a comment or an opening statement you want to make, we welcome that. Senator Carper. Just a question or two, if I could. The Chairman. Sure. Senator Carper. Thanks, Mr. Chairman. Our thanks to all of you. As my colleagues know, we are all on a multitude of different committees and we have got a bunch of different committees and subcommittees meeting this morning, so I apologize for not being here for your testimony. I tell people I am a recovering Governor. Senator Salazar is a recovering attorney general for his State. This is an issue we thought about in Delaware, in State government. But in our role as Federal legislators, let me just ask each of you to just briefly go down the line, if you will, and just share with us maybe your one best piece of advice for us at the Federal level as to what should be on the top of our to-do list as we consider these guardianship issues. Mr. Salzman, can I start with you? Mr. Salzman. I think the top of the to-do list is make sure that public guardianship throughout the country is adequately funded because that is the only way poor people who need guardians in order to prevent institutionalization and homelessness are going to get the care and treatment that they need and be able to live out their lives in their homes. Senator Carper. Thank you. Would you pronounce your name for me? Mr. Salzman. Ira Salzman. Senator Carper. No, no, I am sorry. Barbara---- Ms. Bovbjerg. Barbara Bovbjerg. Actually, Delaware is my home State. Senator Carper. You are kidding. Do you live there? Ms. Bovbjerg. I grew up in Wilmington. Senator Carper. Really? As a kid? Ms. Bovbjerg. Yes. Senator Carper. Where did you go to high school? Ms. Bovbjerg. Wilmington Friends. Senator Carper. Friends School. Great school. All right, well, it is nice to see you. Welcome. Ms. Bovbjerg. It is nice to be here. I think the most important thing the Federal Government can do--and I am from the Government Accountability Office--I think the most important thing the Federal Government can do is demonstrate leadership, which is already happening from this Committee's work, the proposal of the Elder Justice Act, some actions that have been taken in the Department of Health and Human Services in response to some of our recommendations. But I think that the idea that the Federal Government can foster and model collaboration among the States and the courts and can get the Federal agencies who have the representative payee programs to devise ways to communicate not only with each other, which is an important step, but also with the States and the courts, is very important. I think that those steps are starting in Congress, but certainly the Federal agencies need more of a push. Senator Carper. Thank you, and welcome. Ms. Scott. Ms. Scott. Carol Scott, from the State of--it is Missoura, by the way. Senator Talent was a little afraid to pick a side. I think a very important thing that the Federal Government could do is be supportive of the aging network and the Older Americans Act. There is a provision in there about having a legal services program that would be set up so that there would be opportunities for pro bono work and other networks to provide services for the elderly and disabled. So I think looking at the Older Americans Act and making sure that the Title VII elder rights section was beefed up under the legal services section. Senator Carper. Thank you. Mr. Grossman. Judge Grossman. I think that one of the recommendations that you all ought to seriously consider is something that has been touched on before, which is data collection. If you look at, for example, Senator Salazar's State of Colorado, all the probate and guardianship matters are now conducted essentially by e-filing electronically. My circuit actually is putting together a back-end system headed toward e-filing where, in addition to the document that is filed as a PDF document, there is going to be an envelope of XML data so that you can tag certain things. The beauty of the Federal Government supporting that--and I am not asking for money personally because we have dumped $500,000 in it and we will have the system and we are going to make it available to every circuit in my State. You know, most every decision in the area of guardianship tends to be done on the basis of anecdotal information. I have stories, these folks have stories, you all have stories. One of the things we are looking to do is to tag important data that will dump into a database and will provide some real quantitative, accurate information as to what is going on there. I think that that will be of great benefit to the States and to local courts. I also think it would be of great benefit to the Congress and to the Federal agencies to get a handle on what we are dealing with, because again we take anecdotal information and we extrapolate from that. But this more than any other thing that you all could do would provide a soundly based source of data that would provide us all with the information that all of us are looking to have. Senator Carper. Thank you. Mr. Hammond, the last word. Mr. Hammond. Thank you, Senator. You know, I think that there has to be a rethinking from the ground up of the way that the Federal agencies and the State agencies and the local courts are interacting and communicating and cooperating or not cooperating on guardianship issues. In Texas, I referenced the APS investigation over the last couple of years. It was found that in 71 percent of the cases where mental illness was identified, no capacity questions were asked and no clinical assessment was done of the elderly or disabled person. It seems to me that the Federal Government is devoting resources to elderly protection, but I think with the National Guardianship Association there is a question as to whether those resources are really reaching the maximum benefit to the elderly people they are designed to protect. Senator Carper. Let me just say, Mr. Chairman, thanks for pulling this hearing together and for our witnesses for being here. My mom passed away about a year ago. She had Alzheimer's disease and it progressed, as we know it does. My sister and I were able to take care of her and make sure she had the help and support that she needed. We have probably all have had folks like that in our own families and experiences like that. But as we know, too often there aren't those supportive members of the family to be there when someone needs them. I just applaud your efforts to try to make sure that in those instances there is a helping hand and someone to provide the care and attention that we all deserve. Thank you. The Chairman. Terry, you heard Judge Grossman speak about data collection and what we could do at the Federal level to enhance that and nationalize it. I am wondering, in your experience, what data we ought to be collecting. Mr. Hammond. Good question, Chairman Smith. You know, the American Bar Association just came out with this study a few months ago, and I have included it in my materials, where each State is doing it somewhat differently and many States are not doing it at all. I think that if this Committee and the appropriate entities could put together a group to work with the National Guardianship Association and other stakeholders, we could identify that information. Certainly, the age of the person, the nature of the disability that may cause them to have a guardianship, whether there is an indication of elder abuse of some kind--those are some of the very key, basic questions that need to be asked. But as the GAO report indicated and the ABA report as well, in order to even begin to address the issues, we need to know what the numbers are, and the NGA is seeking private funding. I referenced the Associated Press series earlier. The landscape in some ways has not changed in the last 20 years. One of the ways that it has changed is that you have had an increase in private efforts to shore up where the public efforts are failing. So you have the National Guardianship Association, you have 20 State guardianship organizations that have sprung up in the last 20 years. So I think privately we are doing what we can to fill in those gaps, but if the private stakeholders could work with the Federal Government and the State governments to really devote resources and develop the criteria and mandate these statistic- gathering efforts, that is going to be a prerequisite in order to taking the next step further. The Chairman. Are you familiar with the Elder Justice Act that is before the Congress? Mr. Hammond. I am, Senator. The Chairman. Do you think it does this sufficiently, or ought we to amend it and enhance it? Mr. Hammond. I think that it comes close. I think that in light of these hearings and recent public scrutiny of guardianship systems, perhaps there needs to be a bit more emphasis in this area. The Chairman. OK. You have given me some work to do and we will get on it and get that included because we want to make sure that when we pass this, it meets current needs and we are identifying a very real need. Judge, he made some comments on the data we should be collecting. Do you want to add to things that ought to be---- Judge Grossman. What I wanted to offer you is a few years back the Florida Supreme Court created a judicial applications development process, and as a result of that process we put together in guardianship, as well as probate and every other area that the trial courts deal with, a list of items that as a consensus we wanted to tag to go into the database. I would be more than happy to forward you all that information for your consideration. The Chairman. We would be very appreciative if we could receive that. It would improve the work we do with the Elder Justice Act. Yes? Mr. Hammond. Senator, if I may add, in our reform effort in Texas the past couple of years, we had put into the bill that ended up being Senate bill 6 an extensive data collection effort that would have mandated the 254 counties to report to the State information on guardianships. A significant part of that legislation was cut from the bill because it was considered to be too time-consuming, too expensive. So I think that our efforts on a State level, although well-intentioned, may not be very successful here and this may be something that has to be mandated at a higher level. Ms. Bovbjerg. May I jump in, Mr. Chairman? The Chairman. Yes, please, Barbara. Ms. Bovbjerg. When we did this work for the Committee a couple of years ago on guardianship, I was completely amazed by how little information is out there, how data are not uniformly collected. Even within a single State, there will be differences among courts when data are collected. So we couldn't tell how many guardianship arrangements there were. We couldn't tell how many of them were specifically for elderly people, and certainly we couldn't tell to what extent guardians are involved in some of these cases of abuse. I certainly agree with Mr. Salzman that we hear these high- profile cases, and there are certainly a lot more things going on under the radar. It is therefore very difficult for the Federal Government or national organizations to devise effective approaches to preventing and detecting abuse when we don't know much in any kind of comprehensive way about the circumstances of that abuse, or the incidence of that abuse. We had suggested that HHS take the leading role in looking at how you could compile data, and what kind of data you should compile. But another way to think about it is to consider some of the databases we have on the criminal justice side and look at whether there isn't some way to get the crimes that involved guardians uniquely coded. There are different ways to think about it and we were hoping that perhaps HHS could take the lead. The Chairman. Very good, and I have only one other question for you, Terry, because you related the experience with this one judge and how he doesn't involve the Federal agencies. Obviously, there are some competence issues that we ought to pursue with some of the Federal agencies, but in your experience how competent are the judges that you deal with in guardianship matters? Mr. Hammond. With all due respect to Judge Grossman, I think that by and large the judges are pretty competent to adjudicate these cases. The challenge really is when you have courts of general jurisdiction deciding guardianship cases. Those judges are not well-trained on life-and-death issues, on capacity issues. So the Wingspan report from the year 2000 where there was a national conference of guardianship practitioners and experts recommended specialization of judges who adjudicate guardianship cases. Unfortunately, sir, that is still not very often the case. I think where we have Judge Grossman here, any jurisdiction in this country would be honored and pleased to have him presiding over their cases. It is not very often we see a judge with this kind of expertise. The Chairman. Well, I think we should stipulate for the Senate record the competence of Judge Grossman. [Laughter.] Mr. Salzman. If I may say---- The Chairman. Please, Ira. Mr. Salzman. I couldn't agree with that more. We had a similar problem in New York for many years where we had guardianships in some counties being dealt with in general parts and, you know, the judges moving from a negligence case to a contracts case to a guardianship case, and it was an unmitigated disaster. The improvement that we have had since we finally persuaded the court system to set up a specialized part is astronomic. It is a really, really important point, which is why I asked to cut in here. The Chairman. That is very appreciated. I hope you see that the Aging Committee--I like to manage these sort of conversationally, and I find I and my colleagues usually get the most out of it in that way. So as I said to Barbara, we are not ignoring you. Let's go to your testimony. STATEMENT OF BARBARA D. BOVBJERG, DIRECTOR, EDUCATION, WORKFORCE, AND INCOME SECURITY, U.S. GOVERNMENT ACCOUNTABILITY OFFICE, WASHINGTON, DC Ms. Bovbjerg. I appreciate that, Mr. Chairman. I swear I won't take my whole 5 minutes because we have had an opportunity---- The Chairman. We have discussed a lot of it and we will include your full testimony in the record, but you may want to cover some points that perhaps we have not already done. Ms. Bovbjerg. Well, I appreciate that. I just wanted to remind everyone that we did this work 2 years ago, that we discovered that 50 States and the District of Columbia all have laws pertaining to guardianships, but the laws vary dramatically. Even within States, the way the courts implement these laws vary considerably. We also noticed that data are scarce on guardianships, something we already talked about today. We also talked about what we call the exemplary guardianship programs, of which Broward County and Judge Grossman's was one, not chosen by us, but chosen by organizations that we spoke to who deal with guardianship issues. We asked them, if you needed a guardian, where do you wish you lived, and they told us that Broward County was one of those places. So we reported on what we thought were good practices among courts. Then, finally, we observed that there is little cooperation between Federal agencies who have rep payee programs and between the Federal agencies and the courts. The Chairman. So the comment from Texas wasn't surprising to you that they don't even ask the Federal people to come in anymore? Ms. Bovbjerg. Actually, I was surprised by the comments about SSA and VA. I am not surprised by the variability, however. The Chairman. Just encouragement on the part of this Senator if there is something you can do to alert SSA and VA to be cooperative and not stand on their prerogatives or priorities as a Federal official. Ms. Bovbjerg. Well, I would certainly follow up with them. I know that the Social Security Administration, which has the biggest representative payee program in the Federal Government, has focused a lot of effort on that program in the last 2 years. In 2004, Congress passed the Social Security Protection Act and many of the provisions in that Act were focused on assuring that representative payees were doing what they were supposed to do and not stealing money from the people that they were supposed to represent. So Social Security is on the case to a much greater extent than in the past, but I will make them aware of what has been happening in Texas. I do want to provide a little update of our work for you, and certainly some progress has been made. About half the States in the country have amended their guardianship laws in some way since then, some in small ways, others in larger ways. New Jersey is now requiring guardians, both public and private, to be registered. California has new education requirements for guardians and continuing education requirements, which I think you were interested in, Senator. Wisconsin requires that guardians visit the incapacitated person regularly. This has increased attention to strengthening these programs, and so these are positive steps, we thought. There are other steps that have been taken. The National Conference of Commissions on Uniform State Laws recently issued a discussion draft containing provisions that would allow guardianships to be recognized across States. It is model legislation. The National Academy of Elder Law Attorneys, the National Guardianship Association and others have a joint action plan on guardianships. They have 45 steps that could be taken at the national, State and local levels to accomplish the recommendations made in 2001 at the Wingspan conference on guardianship. This was a high-level effort by the professionals in this field, and they are important groups for the Federal Government and States to collaborate with; we hope for continued progress there. We do see areas, however, where much remains to be done. I already touched on these. The Department of Health and Human Services--we recommended they develop cost-effective approaches for compiling consistent national data. They have supported a study by the ABA on guardianship practices in the States. They also supported including questions about guardians in the National Center on Elder Abuse's survey of adult protective services. Although these actions represent progress, we still, as you have heard, do not have nationwide data on guardians and those under their care. As I think I may already have stated, the cross-agency cooperation needs attention. As you may be aware, the Social Security Administration did not agree with our recommendation that they form an interagency study group with VA and OPM to look at how they might share information with each other on rep payees. The Chairman. Why? Ms. Bovbjerg. Because they don't believe that such action is within their purview and they thought it was quite complex. Now, they share data regularly with other Federal agencies within the confines of the Privacy Act. I think their primary concern, honestly, was less with VA and OPM than that we also suggested they sit down with representatives of States and the courts and try to develop some way the three agencies and these other entities could share data. They felt that this would not only be out of their purview, but that it would also be complicated, and that is true. It is complicated if you envision sharing information with the many courts there are in the United States. They felt that such action would violate the Privacy Act. We did not agree with that. We felt that nothing prevents them from considering how they might do this. There must be other ways than matching data with each individual court. They do have authority to develop what are called ``statements of routine use'' that allow them to share data with States, for example, which they do for detecting prisoners who should not be receiving Social Security payments because they are in jail, things like that. They have agreements that do that. So we felt that even though it might require some time and attention on their part, and take them away perhaps from something else, that it was worth exploring, and so we are hopeful that we can encourage them to think about it. I just wanted to say in the end that the number of elderly Americans is going to grow dramatically in the future. Clearly, guardianship arrangements for the elderly will rise dramatically in response. If we are not going to ensure now that these arrangements are safe and effective, such actions will be much more difficult in the next decade. Progress is being made in the States and the courts in part because they are emulating strong programs and developing and deploying model legislation. But we believe that more must also be done to collect meaningful data and to foster continued coordination across the States and the Federal agencies. The Chairman. Do you feel like if the Social Security Administration doesn't have the statutory authority to do this that we ought to include that in the Elder Justice Act? Ms. Bovbjerg. We believe they have the statutory authority to do it, but any encouragement you could provide would probably be helpful. The Chairman. Well, like a statute? [Laughter.] Ms. Bovbjerg. Perhaps. The Chairman. OK. Thank you so very much, Barbara. [The prepared statement of Ms. Bovbjerg follows:] [GRAPHIC] [TIFF OMITTED] T1448.023 [GRAPHIC] [TIFF OMITTED] T1448.024 [GRAPHIC] [TIFF OMITTED] T1448.025 [GRAPHIC] [TIFF OMITTED] T1448.026 [GRAPHIC] [TIFF OMITTED] T1448.027 [GRAPHIC] [TIFF OMITTED] T1448.028 [GRAPHIC] [TIFF OMITTED] T1448.029 [GRAPHIC] [TIFF OMITTED] T1448.030 [GRAPHIC] [TIFF OMITTED] T1448.031 [GRAPHIC] [TIFF OMITTED] T1448.032 [GRAPHIC] [TIFF OMITTED] T1448.033 [GRAPHIC] [TIFF OMITTED] T1448.034 [GRAPHIC] [TIFF OMITTED] T1448.035 [GRAPHIC] [TIFF OMITTED] T1448.036 [GRAPHIC] [TIFF OMITTED] T1448.037 [GRAPHIC] [TIFF OMITTED] T1448.038 The Chairman. Judge Grossman, we have probably overused you already this morning, but we never actually got to your testimony. STATEMENT OF HON. MEL GROSSMAN, ADMINISTRATIVE JUDGE, FLORIDA 17TH JUDICIAL CIRCUIT COURT, FORT LAUDERDALE, FL Judge Grossman. Well, let me just say two things. The statement that I prepared is going to be part of the record anyway. I think the only thing that I would really like to indicate is a profound belief that when the court takes away rights of an individual, the kinds of rights that all of us in this room enjoy, and appoints somebody as a guardian to make sure that that person is protected, we have got not only in Florida a statutory duty and a case law duty, but actually a moral duty to ensure that we have done the right thing and that that person is, in fact, protected. Otherwise, we should be out of the business completely. Being out of the business completely is not an option, especially as the baby-boomers hit. So the kinds of resources that are necessary both in terms of data collection and in terms of staffing and in terms of education of judges, too--the comment was made by Terry that there are some judges that it is only part of general jurisdiction and they don't understand it. Then Ira had indicated that that had changed now in New York. In Florida, 80 percent of the cases in Florida come with the 5 most populace circuits. Everywhere else, although that is now starting to change, it is only part of general jurisdiction of the court. What happens is we do an educational program twice a year at conferences, but if 90 percent of their workload is doing something else, they never show up for the education programs that involve guardianship. It is my belief that the new chief justice of the Florida Supreme Court will be remedying that. But you are absolutely right, and I am prepared to take full responsibility for the fact that judges don't always--when we did the guardianship task force, the testimony of some of the lawyers that were filling out these forms and just having the judge rubber-stamp them was, well, we know better than the judge does. In some cases, they were probably right, but there are certainly serious due process implications to the person. I mean, it is very efficient. I file a petition to determine Carol Scott's incapacity. I appoint her lawyer and I appoint the people examining her. There are some due process concerns that really need to be addressed, and I agree with these other folks here that part of it is developing specialized courts so that you have an in-house understanding of the issues and an understanding of what to look out for and provide better services than we frequently provide today. The Chairman. Very good. [The prepared statement of Judge Grossman follows:] [GRAPHIC] [TIFF OMITTED] T1448.039 [GRAPHIC] [TIFF OMITTED] T1448.040 [GRAPHIC] [TIFF OMITTED] T1448.041 [GRAPHIC] [TIFF OMITTED] T1448.042 Mr. Salzman. Senator, may I add one particular point on the specialized courts? What we are finding in New York is having a specialized court for guardianship alone may not, in fact, be enough because, for example, one of the important things you need to do in an emergency is sometimes get an order of protection. Now, in New York that is normally not done in the same court that the guardianship is done in. There may be criminal issues involved. That is another court. So under a lot of cases, even with a specialized guardianship part, you can have the same case in three different courts or two different courts. Again, we have an experimental program going on just in one county in New York now where we have one State court judge who is sitting simultaneously criminal, family, and what most other States would call superior and we call supreme, who can do all three things simultaneously. I don't practice there because it is a county that is some distance from where I am, but everybody I know is very enthusiastic about it and it is the kind of thing that I mention just because it is the kind that I think other places should be thinking about as well. The Chairman. Do you find that these different courts of jurisdiction are open to that or are there turf battles over it, because it does make a ton of sense for some consolidation? Mr. Salzman. It requires the involvement of the administrative judges. So, for example, in a case we had recently where we wanted to start a guardianship and simultaneously get an order of protection, since at least in New York you can't go in and get an order of protection for somebody else--you can only get an order of protection for yourself--we had to go into court, into the supreme court, get a temporary guardian appointed who would have the authority to apply for an order of protection, and then that temporary guardian had to go to family court to then make a separate application for the order of protection. With the experimental part in Suffolk County, that could all get done in front of one judge. The Chairman. Well, thank you all so very much. We value your time and want to assure you that your testimony today and your contribution has added immeasurably to our doing our work at the Federal level and in the U.S. Senate. I know some of you have come a long way, but whether long or short, thank you for sharing your time and your expertise with us. It has made an immeasurable contribution and we heartily thank you. With that, we adjourn this hearing with our appreciation. [Whereupon, at 11:36 a.m., the Committee was adjourned.] A P P E N D I X ---------- [GRAPHIC] [TIFF OMITTED] T1448.043 [GRAPHIC] [TIFF OMITTED] T1448.044 [GRAPHIC] [TIFF OMITTED] T1448.045 [GRAPHIC] [TIFF OMITTED] T1448.046 [GRAPHIC] [TIFF OMITTED] T1448.047 [GRAPHIC] [TIFF OMITTED] T1448.048 [GRAPHIC] [TIFF OMITTED] T1448.049 [GRAPHIC] [TIFF OMITTED] T1448.050 [GRAPHIC] [TIFF OMITTED] T1448.051 [GRAPHIC] [TIFF OMITTED] T1448.052 [GRAPHIC] [TIFF OMITTED] T1448.053 <all>