Project Guardianship

Most individuals in New York State’s guardianship system are low-income older adults with severe mental, physical, or cognitive disabilities.

When a person has limitations or diminishing capacity, an individual or entity can petition a court to have a guardian appointed. In many cases a family member, friend, or hired private guardian is appointed. However, for individuals with no family or friends able to serve, and no money to pay, it is extremely difficult to find a high-quality guardian. New York State does not offer a public guardian program for low-income people, instead relying on a web of services from Adult Protective Services, community guardian programs, nonprofits, and attorneys. This fragmented system is not working for vulnerable patients. Project Guardianship was launched as a pilot program in New York City to fill this gap in the safety net for limited-capacity New Yorkers. In 2021, NYHealth awarded Project Guardianship a grant to create a framework for an improved and better-coordinated statewide guardianship program.

Under this grant, Project Guardianship leveraged its service model and partnerships to design and advocate for a statewide guardianship system that ensured equal access to high-quality guardianship, regardless of an individual’s ability to pay or the complexity of the case. It gathered data regarding the scope and scale of guardianship services and needs across New York State, as well as information on best-practice models implemented across the country. It hosted a series of virtual sessions to gain input from rural and urban partners and patients. Project Guardianship also worked with New York State’s health information exchanges to access health outcomes data, which was used to identify gaps and opportunities for a statewide system. Project Guardianship also expanded its current services for low-income New Yorkers to serve more clients statewide. It convened partners to create a coordinated provider network, including courts, government agencies, nonprofits, professional guardians, and health care systems. New partnership arrangements and less-restrictive alternatives to guardianship was explored and tested as well. With lessons learned, Project Guardianship engaged with New York State policymakers, advocating for the establishment of an improved and coordinated guardianship program.