States with Standards of Practice

This article will discuss how veteran substance abuse hurts our troops when they return home. And we will discuss the way that we can help them overcome their substance use disorders.


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IRS Raises Limit For ABLE Accounts
For the first time in four years, the amount of money that people with disabilities can save without jeopardizing eligibility for government benefits is rising.

Source/More: Disability Scoop (Jan. 5, 2022 NAELA eBulletin)

Big-Ticket Drugs That Have Higher Prices in 2022
Drug companies raised the prices on hundreds of medications on Jan. 1, with most prices up 5 percent to 6 percent on average. Pharmaceutical companies increased prices on 460 drugs on Jan. 1, according to drug prices monitored by research firm 46brooklyn.

Source/More: Axios (Jan. 5, 2022 NAELA eBulletin)

Record Number of Americans Sign Up for ACA Health Insurance
A record 13.6 million Americans have signed up for health coverage for 2022 on the Affordable Care Act marketplaces, with nearly a month remaining to enroll in most states, the Biden administration announced Wednesday.

Source/More: Kaiser Health News (Jan. 5, 2022 NAELA eBulletin)


What is the purpose of Supplemental Needs Trusts? 

Supplemental Needs Trusts (also known as Special Needs Trusts) are vehicles that can hold assets for a person with a physical or behavioral health disability while still allowing that person to qualify for public benefit programs that have income and resource limitations. Examples of such public benefit programs include Medicaid and Supplemental Security Income (“SSI”). The person who establishes the trust is known as the settlor or grantor, and the person who receives trust funds is known as the beneficiary. In the case of Supplemental Needs Trusts, the beneficiary is the person with a disability. 

What are the different types of Special Needs Trusts?

There are various kinds of Supplemental Needs Trusts. A First-Party Supplemental Needs Trust, also known as a Self-Settled Trust or a d4A Trust, is one that is funded by beneficiary. For example, a person may receive monies from a lawsuit settlement, inheritance, or divorce settlement. These assets belong to the person with a disability and can be used to fund a First-Party Supplemental Needs Trust. A Third-Party Supplemental Needs Trust is one that is funded by someone other than the beneficiary. For example, a parent or grandparent may establish a Third-Party Supplemental Needs Trust for a family member. A third type of Supplemental Needs Trust, a pooled trust or d4C Trust, is one that is administered by a non-profit organization. It permits several beneficiaries to pool their trust assets together into a larger trust for investment purposes, while still allowing each beneficiary to maintain an individual trust sub-account. 

How are First-Party and Third-Party Supplemental Needs Trusts different?

Federal law governs First-Party Supplemental Needs Trusts. These types of trusts are subject to stricter rules because they hold the assets belonging to the beneficiary while still allowing that beneficiary to qualify for programs such as Medicaid or Supplemental Security Income. First-Party Supplemental Needs Trusts can only be established for a person with a disability who is under the age of sixty-five. They also can only be established by a parent, grandparent, legal guardian, court order, or the person with a disability. These types of trusts are subject to the “sole benefit” rule, meaning that distributions made from the trust cannot benefit anyone other than the beneficiary during that beneficiary’s lifetime. While the sole benefit rule may sound simple, in practice it can challenging, as many distributions can also benefit someone living with or close to the beneficiary. In addition, First-Party Supplemental Needs Trusts have a Medicaid payback provision, meaning that after the person with a disability passes away, the State will be reimbursed for the costs of medical assistance provided to that person from trust funds.  
In contrast, Third-Party Supplemental Needs can be established for someone of any age. As long as the beneficiary does not have the ability to control trust distributions or to revoke the trust, trust assets are not considered an available resource for purposes of Medicaid and Supplemental Security Income eligibility. Third-Party Supplemental Needs Trusts are not subject to the sole benefit rule and therefore these trusts can have more than one beneficiary. In addition, a significant benefit of Third-Party Supplemental Needs Trusts is that these trusts are not subject to the Medicaid payback provision. 


What is a Health Care Power of Attorney?

In a Health Care Power of Attorney, a person known as the "Principal" elects to have another person, known as the "Agent," make health care decisions on his or her behalf. The Power of Attorney becomes effective when the Principal is incapacitated and no longer able to make his or her own decisions. The documents require the certification of at least one physician that the Principal has become incapacitated. A Health Care Power of Attorney can be revoked at any time that the Principal can communicate an intent to revoke. A Health Care Power of Attorney allows the Agent to consent to, prohibit, or withdraw medical treatment. 

What is an Advance Directive?

If an individual wishes to express his or her personal decision about withholding or withdrawing extraordinary medical treatment when approaching the end of life, he or she can do so with the use of an Advance Directive. As a part of the Healthcare Power of Attorney or as a separate document, an Advance Directive (also referred to as a "Medical Directive" or "Healthcare Directive") protects the rights of a patient to refuse or to request medical treatment, thereby enabling the healthcare providers to honor the wishes of their patient. 

What is a HIPAA Authorization?

Federal law, under the Health Insurance Portability and Accountability Act (“HIPAA”) protects the confidentiality of medical records. A separate HIPAA authorization is important because it permits everyone listed on the authorization to receive information from and communicate with physicians. Thus, family members or friends can be included in the health care conversation when critical or end-of-life decisions are being made. 

What happens if I do not have a Health Care Power of Attorney?

In Missouri, a Health Care Power of Attorney is particularly important because, unlike most states, Missouri currently does not have a surrogate decision maker law. Surrogate decision maker laws provide that family members, in an order of priority, can make medical decisions for someone who has become incapacitated. Absent these statutes, medical personnel have no legal guidance on who should make decisions for an incapacitated person who lacks a Health Care Power of Attorney.

The importance of these documents cannot be overlooked. Without them, family members and friends may be forced to petition the court for a guardianship in order to make decisions on behalf of an incapacitated person. The cost and difficulty of these proceedings can be stressful, if not devastating, to all involved. An Elder Law attorney who is experienced in helping clients with these important life decisions can help families in avoiding these pitfalls.


What is an Elder Law Attorney?

Elder Law is a specialized area of legal practice that focuses on the type of client served rather than on the specific legal question involved. An Elder Law Attorney has a practice centered around the issues that impact older adults and people with disabilities. Because the Elder Law Attorney is committed to a type of client rather than a type of law, he or she implements a holistic approach.

What issues does an Elder Law Attorney handle?

An Elder Law Attorney can assist clients and families in preparing for illness and long-term care, as well as planning for the distribution of a person’s estate after he or she passes away. This can include general estate planning techniques, such as the use of wills, trusts, and powers of attorney. Elder Law Attorneys may help with probate matters such as probating the estate of a deceased person or with guardianships and conservatorships.

Elder Law Attorneys also help with planning for and accessing government programs such as Medicaid coverage for skilled nursing or home care, VA benefits, and Social Security disability benefits. They can assist clients with evaluating long-term care providers and insurance policies to help pay for long-term care. Elder Law Attorneys also help families with special needs trusts, which benefit people who are on needs-based government programs, such as Supplemental Security Income (SSI), Medicaid, or VA benefits.

Elder Law Attorneys are committed to advocating for older adults and people with disabilities, and to protecting these populations. An Elder Law Attorney can help prevent and address elder abuse, fraud, or financial exploitation. Most of all, an Elder Law Attorney is there to help families navigate complex situations and to offer legal solutions that attend to a variety of concerns, including financial, housing, familial, emotional, and health issues.

Why is it important to use an Elder Law Attorney?

An Elder Law Attorney has insight into a how different areas of law interact and can impact the client. For example, an Elder Law Attorney can anticipate how estate planning may interact with needs-based programs, such as SSI and Medicaid. Since these programs have income and/or asset limitations, an inheritance can over-resource and disqualify a recipient from these benefits. However, there are specific kinds of trusts that allow people to leave money to such family members without disqualifying them from those benefits.

What can happen if I don’t use an Elder Law Attorney?

Although the use of an Elder Law Attorney is not required, there can be unintended consequences for not using an attorney knowledgeable in this practice area.  For example, an estate planning attorney, who is unfamiliar with Elder Law but who is a skilled estate planning attorney, may not advise against an older adult gifting money to family members. While gifting may not be a bad idea from an estate planning perspective, especially if assets are below the annual estate tax exclusion amount, it may create a problem if Medicaid is needed to pay for nursing home care in the near future. This is because Medicaid imposes a penalty waiting period for gifts made within the last five years.

With so many people affected by disability in the U.S., many turn to modifying their homes as a way to maintain independence and comfort. However, the possibilities of making a home more accessible can come with a steep price tag.

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Read this article if you are a senior preparing to hit the road during the pandemic.

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Alzheimer Support is a free service that helps families who have loved ones with Alzheimer’s disease or dementia. By using our free search tool and nationwide database of Alzheimer’s care facilities, families who are in need of care for their loved ones can locate licensed care homes and communities that are properly equipped to provide care for their loved ones.

Go to Alzheimer Support website
Addiction Group is dedicated to help individuals suffering from substance abuse and prevent new cases. Medical professionals review every fact-based piece of content published to our site. Find resources on what to do if your partner is an alcoholic and more.

Visit the Addiction Group website
From The Arc: Future Planning is creating a guide for a person with an intellectual or developmental disability (I/DD) to lead a good life as independently as possible.

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This is a test story
People are living longer than ever before, and many seniors live active and healthy lives. However, as we age, our bodies and minds change. There are things you can do to stay healthy and active as you age, and it is important to understand what to expect. This category includes news on the biology of aging, demographics, continuity of care, quality of life, care needs, longevity and lifestyle.

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Pace School of Law
Pace Women’s Justice Center (PWJC) provides free legal services to victims and survivors of domestic violence, sexual assault, and elder abuse. A nonprofit legal center serving Westchester and Putnam Counties, New York, PWJC helps individuals navigate the legal system and obtain services related to divorce, custody, support, financial exploitation, public benefits, and housing. Through outreach events and training programs we raise awareness, educate the community, and train judges, police officers, attorneys, and social service providers on best practices when working with victims of abuse.

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Founded to assist students and professionals seeking social work licensure. The mission at is to provide an easy-to-navigate and more efficient way to explore social work licensure requirements in each state by pinpointing or linking directly to commonly sought social work licensure information, such as program options, concentrations, and career paths. Those interested in caring for the elderly will find information about gerontological social workers.
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The Uniform Adult Guardianship and Protective Proceedings Jurisdiction Act, approved in 2007, addresses jurisdiction over adult guardianships, conservatorships and other protective proceedings, providing a mechanism for resolving multistate jurisdctional disputes.  The goal is that only one state will have jurisdiction at any one time.
The Uniform Guardianship, Conservatorship and Other Protective Arrangements Act, approved in 2017, 
is a comprehensive guardianship statute for the twenty-first century. It promotes person-centered planning to incorporate an individual’s preferences and values into a guardianship order, and requires courts to order the least-restrictive means necessary for protection of persons who are unable to fully care for themselves.
For a current list of state WINGS in action, see the ABA Commission on Law and Aging, WINGS Court-Stakeholder Partnerships

• Seven states have WINGS funded through the Administration on Community Living grant to the ABA Commission on Law and Aging.  These states are developing strategic plans and measures of success, and engaging in specific objectives concerning guardianship reform, promotion of less restrictive options and addressing guardianship abuse.  

• Nine states were funded through the National Guardianship Network project supported by the State Justice Institute in 2013 and 2015.  Three of these states also received ACL grants in 2016 as “focus WINGS” that have special emphasis on less restrictive options and/or court oversight.  Of the remaining states, a few are currently on hold, and the remainder continue to meet.  

• Additional states have created WINGS partnerships on their own, either at court initiative or outside of the court.  These states vary in their level of activity, but all seek improved lives for individuals subject to or potentially subject to the guardianship system. 
Stiegel, L. & Wood, E., “WINGS Court-Stakeholder Partnerships Boost Guardianship Reform,” Aging Today, American Society on Aging, November-December 2017.
The report described what is known about the extent of elder abuse by guardians, and what measures federal agencies and selected state and local guardianship programs have taken to help protect older adults with guardians.  The report also identified promising practices for reducing abuse related to screening potential and existing guardians, education and support for guardians, monitoring of guardians, and enforcement.
The study found that the extent of elder abuse by guardians nationally is unknown due to limited data on key factors related to elder abuse by a guardian, such as the number of guardians serving older adults, older adults in guardianship, and cases of elder abuse by a guardian.  Some efforts are underway to try to collect better data on elder abuse and guardianship at the federal, state, and local levels to support decision-making and help prevent and address elder abuse by guardians.  The study also highlighted key state and local initiatives involving courts and organizations to address elder abuse and guardian performance.
The AARP Public Policy Institute, with the ABA Commission on Law and Aging, produced a report based on a survey on guardians about residential decision-making, entitled Choosing Home for Someone Else: Guardian Decisions on Long-Term Services and Supports.
The Administrative Conference of the United States conducted a survey of state courts on guardianship oversight and communication with the Social Security Representative Payee System, and reported the results in SSA Representative Payee: Survey of State Guardianship Laws and Court Practices.
In 2017, with support from The Greenwall Foundation and the Borchard Foundation Center on Law and Aging, the American Bar Association (ABA) Commission on Law and Aging, with Virginia Tech Center for Gerontology, published a four-state study of court termination of guardianship orders and restoration of rights, and convened a Roundtable that made recommendation for changes in law and practice.
May is National Elder Law Month when elder law attorneys across the country help educate seniors and people with disabilities about their legal options and offer pro bono services. The National Academy of Elder Law Attorneys (NAELA) is the premier U.S. association of U.S. attorneys who specialize in the legal issues of older adults and individuals with special needs. Hyman Darling, a Massachusetts elder law attorney and the president of NAELA, shares his insights to 10 common questions about elder law.

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Trustee Decanting Resolution.docx Resolution permitting trustees to move assets between irrevocable trusts
Beneficiary Decanting Consent.docx Consent form by beneficiaries to decanting transfer
Standards of Practice (updated October 2013)
Forms prepared by the ABA Commission on Law and Aging
Published by the ABA Commission on Law and Aging, this guide is for anyone serving in the role of health care decision maker for someone else.
My Directives is a free web-based service that walks you through the process of creating a Universal Advance Digital Directive which can be digitally signed. The directive is encrypted and stored in their secure database, available to you and your medical treatment providers 24/7.
The Go Wish Game is a card game for sorting out values related to end-of-life decision making, created by the Coda Alliance, a community organization in Santa Clara County, CA. An easy, entertaining way to think and talk about what's important to you if you become seriously ill.
This workbook and video were created by California advocates with developmental disabilities. 
This guide was published by Compassion and Choices.
This program from the National Hospice and Palliative Care Organization provides several online resources.
Published by the Center for Practical Bioethics, this free resource is both a workbook and advance directive.
Free resource prepared by the ABA Commission on Law and Aging.
[Logo needed] The National Adult Protective Services Association is a national non-profit 501 (c)(3) organization with members in all 50 states. Formed in 1989, the goal of NAPSA is to provide Adult Protective Services (APS) programs a forum for sharing information, solving problems, and improving the quality of services for victims of elder and vulnerable adult mistreatment.
SJI funded a Guam-WINGS, which convened an initial meeting in February 2016. Contact: Sonia Suobiron.
Legal Aid has organized a broad-based Roundtable focused on adult guardianship reform. View the 2016 West Virginia WINGS update.
Contact: Jennifer Taylor
Ombudsman Attorney
Legal Aid of West Virginia
the Supreme Court launched VA-WINGS in November 2016, with four working groups on data, monitoring resources and training. Contact: Paul DeLosh, Virginia Supreme Court.
an Interdisciplinary Guardianship Committee is a permanent subcommittee of the state Supreme Court. The Subcommittee recommended new Supreme Court Rules, which were adopted in March 2015. In addition, work has begun on pre-service and continuing education for adult guardians.
Contact: Hon. Dixie Park, Probate Judge, WINGS Chair
Stark County Probate Court
Stephanie Graubner-Nelson

Policy and Research Counsel, Children & Families Section  
The Supreme Court of Ohio 
the Rethinking Guardianship: Building a Case for Less Restrictive Alternatives initiative is in the third year of a grant awarded to the state’s Division of Aging and Adult Services by the North Carolina Council on Developmental Disabilities.  
Year 1 report
Year 2 report

The Jordan Institute for Families within the School of Social Work at the University of North Carolina, Chapel Hill is facilitating a large and diverse workgroup and using research findings and stories of those affected by guardianship to drive action.

Accomplishments, thus far, include 1) short-term and long-term strategies for change to NC legislation, policy and practice with a Guardianship Bill of Rights serving as a first step; 2) a website to provide comprehensive information and resources; and, 3) identification of training objectives and curricula for private guardians.   

In addition to the statewide effort, the initiative identified one pilot county to advance the goals of Rethinking Guardianship. The Catawba County pilot is focusing on youth transitioning into adulthood; providing supported decision making options; and raising community awareness about guardianship and alternatives.

Contact: Linda Kendall Fields
Clinical Assistant Professor
School of Social Work, UNC Chapel Hill
MO-WINGS grew out of a broadly inclusive task force convened by the Missouri Developmental Disabilities Council. It has been working on a draft revision of the state guardianship code, which is currently open for comment.
Contact: Emily Hartley
Program Coordinator
Missouri Developmental Disabilities Council
a steering committee launched Georgia WINGS in December 2015. 
Contact: Kim Grier, Coordinator
Georgia Department of Human Services
WI-WINGS held a summit on May 27, 2015. The coordinator is:
Hon. Andrew Bissonnette
Washington WINGS final report - May 2016

Shirley Bondon
Administrative Office of the Courts
Working Interdisciplinary Network of Guardianship Stakeholders (WINGS) is a multi-disciplinary problem solving body that relies on court-community partnerships to:
  • Oversee guardianship practice;
  • Address key policy issues;
  • Improve the current system of guardianship and less restrictive alternatives;
  • Engage in outreach, education;
  • Enhance the quality of care and quality of life of vulnerable adults.
In April 2013 the Utah Administrative Office of the Courts convened a large working steering committee that meets bimonthly. Agendas are posted online here.
Current WINGS Steering Committee:
  1. Carol Fletcher, Licensed caregiver, private guardian, volunteer visitor
  2. Daniel Musto, Director, Long-term Care Ombudsman
  3. David Connors, Judge, Second District Court, WINGS Chair
  4. Ellen Silver, Director, Jewish Family Services
  5. James Brady, Judge, Fourth District Court
  6. James Toledo, Program Manager, Utah Division of Indian Affairs
  7. Joseph Taylor, Crisis Intervention Team, Utah State Coordinator, SLCPD
  8. Lisa Thornton, Private attorney, activist
  9. Kent Alderman, Elder law attorney
  10. Nan Mendenhall, Director, Adult Protective Services
  11. Nels Holmgren, Director, Utah Division of Aging and Adult Services
  12. Patricia Vigo, Latino Liaison, Utah Parent Center
  13. Robert Denton, Managing Attorney, Disability Law Center
  14. Shannon Alvey, Director, Office of Public Guardian
  15. Wendy Fayles, Criminal Justice Mentor, National Alliance on Mental Illness
Court Staff:
  1. Karolina Abuzyarova, WINGS and Court Visitor Program Coordinator
  2. Nancy Sylvester, Staff Attorney, Administrative Office of the Courts
  3. Holly Kees, Court Visitor Volunteer Coordinator
  4. Julie Rigby, Team Manager, Third District Court 

Utah WINGS accomplishments are:

  1. WINGS formed in April 2013 – groundbreaking initiative with funding from the National Guardianship Network with only three other states (OR, NY, TX, UT).
  2. Held statewide guardianship summit in November 2013.
  3. Published three papers from the summit in the 2014 Utah Bar Journal:
    • “Improving Service Delivery to Protected Persons and Their Guardians”
    • “The Challenge of Submitting Competent Medical Evidence of Incapacity in Guardianship Proceedings”
    •  “Person-Centered Planning and Supported Decision-Making.”
  4. Published guardianship webpages here.
  5. Created active WINGS listserv, February 2014.
  6. Formed Executive Committee, February 2014.
  7. International profiling of the Utah guardianship monitoring program at the Third World Congress on Adult Guardianship in Virginia, May 2014. 
  8. Adopted organizational bylaws, August 2015.
  9. Started collaboration with Social Security Administration and Veteran’s Administration.
  10. Established Guardianship Signature Program that provides free and low-cost legal representation to vulnerable adults in guardianship proceedings.
  11. Featured panel consisting of Utah WINGS leaders at the 13th Rocky Mountain Geriatrics Conference, September 2015.
  12. Organized three public classes for guardians and caregivers on alternatives to guardianship, guardianship procedures, and community resources in fall 2015.
  13. Interviewed on KUED, Channel 7 on the guardianship monitoring program in December 2015.

Activities in progress:

  1. Create an online training program for the public on guardianship resources.
  2. Reach out to the minorities, disseminate information and build partnerships.
  3. Translate guardianship web pages into Spanish.
  4. Organize live public classes on guardianship in Spanish.

WINGS brings together professionals in the fields of law, social work, medicine, aging services, Veterans Administration, Social Security Administration, non-profit agencies, private guardians, healthcare associations, AARP, Alzheimer’s Association and others. Connections are established between agencies that sometimes served the same population but did not communicate with each other or provide referrals. WINGS widens the understanding of gaps in the area of guardianship and beyond, and offers a platform for a dialogue, coordination and face to face learning opportunities. Large bureaucratic structures started sharing information, and that, hopefully, will make the life of vulnerable adults and their caregivers and guardians easier. 

Contact: Hon. David Connors

WINGS chair  
Second District Court

Karolina Abuzyarova
WINGS and Court Visitor Program Administrator
Utah State Courts

The Texas Office of Court Administration convened the first meeting of TX-WINGS in November 2013 in Austin. The meeting opened with a presentation of the results of a statewide survey on adult guardianship issues, completed by close to 300 participants. Top issues considered at the meeting included support for lay guardians, alternatives to guardianship, public guardianship, and capacity assessment. WINGS  reports to the Texas Supreme Court’s Elder Law Task Force, and will continue to meet regularly.

TX-WINGS held its second meeting in June 2014; and has created three ongoing workgroups:
  • Alternatives to guardianship (including supported decision-making);
  • Support for lay guardians; and
  • Person-centered assessments.
TX-WINGS conducted a study of guardianship files and practices in 14 counties without a statutory probate court and from which fewer than 100 guardianship cases were filed in FY 2013. See Texas Guardianship Cases: Improving Court Processes and Monitoring Practices in Texas Courts.

Members of TX-WINGS have participated in key legislative advocacy. 

Contact: David Slayton
Administrative Director
Texas Office of Court Administration

Scott Griffith, JD/MPA 
Director of Research and Court Services
Office of Court Administration

Amanda Stites
Research Specialist
Texas Office of Court Administration
OR-WINGS first met in Salem in August 2013, followed by bimonthly or quarterly meetings thereafter. WINGS membership includes representatives from 28 aging, disability, legal, judicial, and mental health agencies and organizations. OR-WINGS developed a charter that states an objective to maintain interdisciplinary representation from these organizations. OR-WINGS has developed these workgroups: 
  • Training, Education & Supports for System Partners;
  • Support Services for Family, Lay & Prospective Guardians; and
  • Protected Person Advocacy and System Access.
OR-WINGS also has participated in legislative advocacy, including support for a successful bill to establish a statewide public guardianship program; and a successful bill concerning volunteer visitor programs.

Oregon WINGS Accomplishments
  • Oregon WINGS produced a brochure entitled “Guardianship in Oregon: Explained in Brief for Medical and Other Care Professionals.”
  • Oregon WINGS produced a booklet for families entitled Options in Oregon to Help Another Person Make Decisions: Guardianship, Conservatorship and Other Options in Oregon.
  • Oregon WINGS is completing a person-centered planning tool for guardians.
  • Oregon WINGS expanded key materials on an existing aging and disability site to create a consumer friendly web page on the Aging and Disability Resource Connection site that collects in one place all resources concerning decision-making options.
  • Oregon WINGS was profiled nationally at the 2014 conference of the National Adult Protective Services Association; and at the Spring 2015 conference of the National College of Probate Judges. 
Contact: Fred Steele
Legal Services Developer
State Unit on Aging
Oregon Department of Human Services
The New York State Unified Court System, Office of Court Administration, convened a WINGS Summit at White Plains in March, 2014, bringing together a broad-based group of about 60 stakeholders representing over 30 entities, including those who work with both Article 81 guardianships (general adult statute) and Article 17A (developmental disabilities) under the banner of “Setting the Agenda for Guardianship in New York: Fewer Resources, Greater Collaboration.” Based on responses to the survey, the Steering Committee assigned each summit participant to one of three workgroups: (1) pre-commencement guardianship issues; (2) models of guardianship; and (3) post-appointment guardianship issues. Each workgroup had two facilitators and a structured process for reaching recommendations. The NY-WINGS Summit built on an earlier 2011 statewide meeting on adult guardianship under Article 81 sponsored by the Cardozo School of Law.  

The New York Summit resulted in formation of three ongoing workgroups:
  • Pre-Commencement Issues;
  • Models of Guardianship; and
  • Post-Appointment Issues.
Contact: Michele Gartner
Special Counsel for Surrogate and Fiduciary Matters New York State Unified Court System
MS-WINGS final report - May 2016

The coordinator for the new MS-WINGS is:
T’Shia Gordo
Administrative Office of Courts
MN-WINGS final report - May 2016

The coordinator for the MN-WINGS is:
Anita Raymond
Volunteers of America 
Indiana WINGS final report - May 2016

Becky Pryor
Indiana Adult Guardianship State Task Force
DC-WINGS final report - May 2016

The coordinator for the new DC-WINGS is:
Anne Meister
Probate Division, Superior Court 
In July 2015, the National Center for State Courts (Richard Van Duizend and Brenda Uekert) completed an Assessment of the Impact and Efficacy of Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS).
NGN has developed an online WINGS replication guide, entitled Wings Tips: State Replication Guide for Working Interdisciplinary Networks of Guardianship Stakeholders.

View a video introduction to the WINGS Replication Guide.
Stanford Social Innovation Review, Winter 2011, which postulates that "large-scale social change comes from better cross-sector coordination rather than from the isolated intervention of individual organizations..."
Wood, E., “WINGS: Court-Community Partnerships to Improve Adult Guardianship,” National Center for State Court, Trends in State Courts, 2014, pp. 85-88. 

There are few reported cases that refer to the National Guardianship Association Standards or any other standards for guardians.  Cases referencing standards include:

  • Guardianship of Doyle, 778 N.W.2d 342 (Mn. App. 2010); and two unreported Minnesota cases that involved the same guardian, same issues and issued the same day —Guardianship of Hohenauer, 2010 Minn. App. Unpub. LEXIS 94; and Guardianship of Langa, 2010 Minn. App. Unpub. LEXIS 90.
  • Guardianship of Stamm, 2005 Wash. App. LEXIS 3030 (unpublished court of appeals decision).
  • Major v. Rowe (In re Stephens), 965 So.2d 847 (Fla. 2007).
  • Guardianship of Fowler, 198 Wash. App. 1023 (2017). In ordering a guardian to disgorge excessive fees, the court noted that the guardian had violated (unspecified) standards of practice and fiduciary duties.

In a handful of states, state-specific standards have resulted from a combination of private and public initiatives.

Some states, such as North Dakota and Alaska, have adopted the NGA Standards by statute or by rule.  NGA’s Standards also served as a template for the development of state-specific standards in California, Texas, Arizona, and Washington.  In Oregon, an optional guardianship certification process requires compliance with standards similar to NGA’s.  New Hampshire has court-adopted procedures based on NGA Standards.

Congruent with national organizational efforts, some state guardianship associations, such as the Minnesota Association of Guardianship and Conservatorship, have adopted state-specific standards of practice. The court cases listed on this page indicate how courts are applying various standards of practice.

At this time, there are study committees considering the adoption of state-specific cases in Ohio, Idaho, and Oregon.

Many states have guardianship handbooks or brochures offering guidance to guardians or potential guardians, but these do not have the force of law.

National Probate Court Standards Download
Developed by attorneys and guardianship experts with more than 120 combined years of experience, the Legal & Legislative Review summarizes the major reported court decisions and legislation impacting guardianship during the past year. It contains 180 guardianship cases, 31 guardianship bills, and much more. Available as a book or on a flash drive from NGA
The University of Kentucky, the ABA Commission on Law and Aging and Prof. Winsor Schmidt engaged in a National Study of Public Guardianship, and published a two-part report.
In phase one, the 2005 report, Wards of the State: A National Study of Public Guardianship, included the results of a national survey of public guardianship programs, as well as selected site visits and interviews.
In phase two, the 2008 report, Public Guardianship After 25 Years: In the Best Interest of Incapacitated People? included additional site visits and interviews, as well as recommendations and a model statute. 
These reports formed the basis of a book by Teaster, Schmidt, Wood, Lawrence & Mendiondo, Public Guardianship: In the Best Interests of Incapacitated People? (2010), published by Praeger.
In 2007, the AARP Public Policy Institute and the ABA Commission on Law and Aging produced Guarding the Guardians: Promising Practices for Court Monitoring, including practices drawn from site visits and telephone interviews with selected courts, and a symposium of experts.
In 2006, the AARP Public Policy Institute and the American Bar Association Commission on Law and Aging published Guardianship Monitoring: A National Survey of Court Practices, based on survey responses (through listserves, not a nationally representative sample) from close to 400 judges, court managers, guardians, elder law attorneys and legal representatives of people with disabilities.
In 1994, The Center for Social Gerontology produced a National Study of Guardianship Systems: Findings and Recommendations by Lisi, Burns & Lussenden, which examined the guardianship process intensively in ten states, gathering data from over 700 files.
In 1991, the American Bar Association Commission on the Mentally Disabled and Commission on Legal Problems of the Elderly conducted the first national study of guardianship monitoring, as reported in Hurme, Steps to Enhance Guardianship Monitoring.
In 1981, Schmidt, Miller, Bell & New published a national study on Public Guardianship and the Elderly (Ballinger Pub.).  The study reviewed existing and proposed public guardianship laws in all states and focused intensively on six state programs.
The National Guardianship Network is pleased to announce that proceedings of the 2011 Third National Guardianship Summit are now available in a special issue of the Utah Law Review. Click here to find all of the background papers commissioned for the Summit as well as the official Summit Standards and Recommendations.
The study states that monitoring court-appointed guardians’ performance can prevent financial exploitation of incapacitated adults and stop it when it occurs. Adopting promising monitoring practices could help courts improve monitoring. However, many courts have limited resources, so they may be reluctant to invest in practices that have not been proven feasible or effective. The federal government has an opportunity to lead in this area by supporting evaluation of the feasibility, cost, and effectiveness of promising monitoring practices.

The study “could not determine whether allegations of abuse by guardians are widespread.” Nevertheless, the study identified “hundreds of allegations of physical abuse, neglect and financial exploitation by guardians in 45 states and DC between 1990 and 2010.”  In 20 selected cases, the GAO found that “guardians stole or otherwise improperly obtained $5.4 million in assets from 158 incapacitated victims.” The GAO investigation also found that selected courts and guardianship certification programs failed to adequately screen potential guardians.

The study made findings on variations in guardian oversight, lack of guardianship data, problems with interstate guardianship, and lack of coordination between state courts handling guardianship, federal representative payment programs.

For the latest news on guardianship reform, please visit the NGN Public Information Portal Website.

  • In 1977, the U.S. Senate Special Committee on Aging issued a report entitled Protective Services for the Elderly: A Working Paper (86-528-0). 
  • In 1987, the U.S. House Select committee on Aging, Subcommittee on Health and Long-Term Care, convened a hearing on guardianship and issued a report entitled Abuses in Guardianship of the Elderly and Infirm: A National Disgrace, (Comm. Pub. 100-641).
  • In 1989, the U.S. House Select Committee on Aging issued a report on model standards to ensure quality guardianship and representative payeeship services, based on Guidelines for Guardianship Service Providers by The Center for Social Gerontology. 
  • In 1992, the U.S. Senate Special Committee on Aging held a Roundtable Discussion on Guardianship (Serial No. 102-22) to examine the federal role in adult guardianship reform.
  • In 2003, the U.S. Senate Special Committee on Aging held a hearing entitled Guardianship Over the Elderly: Security Provided or Freedom Denied (Serial No. 108-3). 
  • In 2007, Sen. Gordon Smith, Ranking Member, and Sen. Herb Kohl, Chairman, U.S. Senate Special Committee on Aging issued a report entitled Guardianship for the Elderly: Protecting the Rights and Welfare of Seniors with Reduced Capacity.
  • In 2011, the Subcommittee on Administrative Oversight and the Courts prepared a report for the U.S. Senate’s Committee on the Judiciary entitled Protecting Seniors and Persons with Disabilities: An Examination of Court-Appointed Guardians. 
Guardianship: Collaboration Needed to Protect Incapacitated Elderly People (2004).  The study made findings on variations in guardian oversight, lack of guardianship data, problems with interstate guardianship, and lack of coordination between state courts handling guardianship, federal representative payment programs.

Guardianships: Cases of Financial Exploitation, Neglect, and Abuse of Seniors (2010).   The study identified “hundreds of allegations of physical abuse, neglect and financial exploitation by guardians in 45 states and DC between 1990 and 2010.”  In 20 selected cases, the GAO found that “guardians stole or otherwise improperly obtained $5.4 million in assets from 158 incapacitated victims.” The GAO investigation also found that selected courts and guardianship certification programs failed to adequately screen potential guardians.  The GAO “could not determine whether allegations of abuse by guardians are widespread.”

Incapacitated Adults: Oversight of Federal Fiduciaries and Court-Appointed Guardians Needs Improvement (2011). The study states that monitoring court-appointed guardians’ performance can prevent financial exploitation of incapacitated adults and stop it when it occurs. Adopting promising monitoring practices could help courts improve monitoring. However, many courts have limited resources, so they may be reluctant to invest in practices that have not been proven feasible or effective. The federal government has an opportunity to lead in this area by supporting evaluation of the feasibility, cost, and effectiveness of promising monitoring practices.

In 1986, the Associated Press undertook a year-long investigation of adult guardianship in all 51 jurisdictions, including more than 2,200 randomly selected guardianship court files and multiple interviews with a range of informants.  The resulting national six-part series published in 1987, Guardians of the Elderly: An Ailing System, effectively triggered the modern adult guardianship reform movement. 
click here to read the report  

Since the historic AP release, additional press coverage has further highlighted problematic areas.  See for example the Los Angles Times series in November 2005, Guardians for Profit.
click here to read the report

Information and resources as part of this annual event
Chaplain Hank Dunn offers advice and answers about end-of-life issues from a spiritual point of view.
Harvard Medical School's eBook on Advance Care Planning available for purchase
Resource prepared by the ABA Commission on Law and Aging on health care decisions (2011).
National Guardianship Association (NGA)The National Guardianship Association’s mission is to advance the nationally recognized standard of excellence in guardianship. NGA represents more than 1,000 guardians, conservators and fiduciaries from across the United States who share this vision. They are professionals, volunteers and family guardians.
National College of Probate Judges (NCPJ)The National College of Probate Judges (NCPJ) is the only national organization exclusively dedicated to improving probate law and probate courts. "Probate jurisdiction" varies from state to state. However, generally, all probate courts handle cases involving the estates of deceased persons, adult guardianship and protective proceedings, and mental health and addictive disease treatment, and matters concerning developmentally disabled persons.  In some states, probate courts handle adoptions, certain juvenile matters, and/or guardianship and conservatorship of minors. 
National Center for State Courts (NCSC)The National Center for State Courts is an independent, nonprofit court improvement organization. All of NCSC's services — research, information services, education, consulting — are focused on helping courts plan, make decisions, and implement improvements that save time and money, while ensuring judicial administration that supports fair and impartial decision-making. NCSC’s work on elder issues and adult guardianships can be found at their Center for Elders and the Courts.
National Disability Rights NeworkThe National Disability Rights Network (NDRN) is the nonprofit membership organization for the federally mandated Protection and Advocacy (P&A) Systems and Client Assistance Programs (CAP) for individuals with disabilities. Collectively, the P&A/CAP network is the largest provider of legally based advocacy services to people with disabilities in the United States.
National Academy of Elder Law Attorneys (NAELA)The National Academy of Elder Law Attorneys, Inc. (NAELA) was founded as a professional association of attorneys who are dedicated to improving the quality of legal services provided to people as they age and people with special needs. The NAELA membership is comprised of attorneys in the private and public sectors who deal with legal issues affecting people as they age and people with disabilities. Members also include judges, professors of law, and students.
Center for Guardianship CertificationThe purpose of the Center for Guardianship Certification includes:
• Developing and administering a credentialing process for guardians and guardianship agencies
• Addressing issues related to renewal, suspension and revocation of credentials for guardians and guardianship agencies
• Maintaining and up-dating rules and regulations for certification of guardians
• Encouraging, supporting and fostering the work of the National Guardianship Association
The American College of Trust and Estate Counsel (ACTEC)The American College of Trust and Estate Counsel is a national organization of approximately 2,600 lawyers elected to membership by demonstrating the highest level of integrity, commitment to the profession, competence and experience as trust and estate counselors. Its members work to teach those who aspire to enter the field and to improve and reform laws, procedure and standards while working with their peers and other professional organizations.
Alzheimer's AssociationFormed in 1980, the Alzheimer's Association advances research to end Alzheimer's and dementia while enhancing care for those living with the disease.
The American Bar Association Section of Real Property, Trust and Estate LawThe Real Property, Trust and Estate Law Section is a leading national forum for lawyers, and currently has over 20,000 members. The Real Property Division focuses on legal aspects of property use, ownership, development, transfer, regulation, financing, taxation and disposal. The Trust and Estate Division focuses on all aspects of trusts, estate planning, elder law and special needs planning, employee benefits, insurance, and probate, adult guardianship, and trust litigation. 
ABA Commission on Law and AgingThe mission of the ABA Commission on Law and Aging is to strengthen and secure the legal rights, dignity, autonomy, quality of life, and quality of care of elders. It carries out this mission through research, policy development, technical assistance, advocacy, education, and training. 
AARP Real PossibilitiesThe AARP Public Policy Institute informs and stimulates public debate on the issues we face as we age. The Institute promotes development of sound, creative policies to address our common need for economic security, health care, and quality of life.
In October, special needs planning attorneys throughout the country contribute a great deal to their communities by educating those with special needs, their families, and caregivers about their legal needs.

Go to NAELA's National Special Needs Law Month page
NAELA RI Chapter Meeting - 2-21-17.pdf February 2017 Meeting Minutes
In May, elder law attorneys throughout the country contribute a great deal to their communities by educating seniors about their legal options and by providing pro bono services.

Go to NAELA's National Elder Law Month page
Read the article, "Staying Active in Your Golden Years," in the Pacific Medical Training ACLS Online Library to learn more about the importance of staying active and healthy as we age.

Go to ACLS Online Library
Working Backwards: How to Avoid a Malpractice Claim 

Presented by: Kosta Dimiris

Litigator Kosta Dimiris will provide tips to help avoid malpractice claims and litigation as well as what to do when trouble comes knocking on your door from a litigator’s perspective)
How to Maximize Public Benefits 

Presented by: Jim Huyck

Jim will be presenting on Regional Center services including Eligibility, Living Options, Day Programs and Transportation.  Also regarding In Home Support Services including eligibility, application process, and the types of supports that can be provided by IHSS including Protective Supervision.  Also will discuss an Administrative Law Judge decision regarding and SNT vs. IHSS providing services.  Also will discuss the MediCaid Waiver application process.
Top Mistakes to Avoid when Administering Special Needs Trusts-Part 2 of Kevin Urbatsch's presentation
Top Mistakes to Avoid When Drafting Special Needs Trusts, Part 1

Presented by Kevin Urbatsch.

Special needs planning has always been challenging. Small factual differences can have a huge impact on appropriate outcomes. Planning has become even more challenging with the Social Security Administration denying trusts due to a few ill-chosen words. The recent changes in our federal government will likely create even more obstacles in providing an effective plan for persons with disabilities. How do planners draft in this era of uncertainty? How can professionals advise trustees when choosing to make a disbursement or not? Our speaker will review the most common mistakes he encounters in reviewing trusts and provide practical tips on how to avoid these landmines. (Part 2 will be presented in the following session)

Elder Abuse: How to get a restraining order

Presented by: Kirsten Voyles

Legislative Update with a federal and California specific focus

Presented by: Kevin Prindiville of Justice in Aging, formerly National Senior Citizens Law Center

High Stakes for Older Adults in 2017. As the number of people age 65 and over living in America continues to rise, new leadership in Washington, DC is promising to dramatically reform and reduce the safety net upon which older adults rely. These changes – should they occur – will negatively impact all older adults, but they will cause particular harm to the millions of older adults already living in or near poverty. The health care programs upon which older adults rely - Medicare, Medicaid and the Affordable Care Act (ACA) - are under immediate threat in Congress and other important safety net programs like Social Security, SSI, the Older Americans Act and more could also soon be targeted. This presentation will outline the threats facing older adults and will provide a summary of the latest debates about the ACA, Medicaid and Medicare in Washington DC. It will also explain how emerging policies - like Medicaid block grant and per capita cap proposals - would impact low-income older adults in California.
Trust Protectors: Bodyguard or Bully? an overview of when and how to utilize them

Presented by: Ruth Phelps
Practice Management Software Low Down and Show Down (Lawyers With Purpose v. ElderCounsel v. Interactive Legal)
Elder Counsel   Lawyers With PurposeInteractive Legal

How to get your client into a Skilled Nursing Facility

Presented by Kathleen Day-Seiter

The Life Care Planning Law Firms Association is a national network of holistic law practices that offer legal services, care coordination and advocacy services to help elderly clients and their families navigate the health care and long-term care maze. In addition to providing education, networking and resources to firms that practice this unique specialty of law, the Life Care Planning Law Firms Association is a national advocate for quality care for elders, dedicated to raising public awareness about the physical, financial, and legal implications resulting from aging.

Go to LCPLFA website

NELF was founded by NAELA's Board of Directors in 1993. This non-profit organization is dedicated to the development and improvement of the professional competence of lawyers in the area of elder law, and provides certification for elder law attorneys.

Go to NELF website
NaCCRA is dedicated to the promotion of continuing care resident communities as a humane, cost-effective long-term care model for elderly individuals. NaCCRA encourages the development of minimum federal standards for provider performance, allowing ample opportunity for each state to utilize policies, which contribute to the welfare and financial security of their residents.

Go to NaCCRA website
LLS is the world's largest voluntary health agency dedicated to blood cancer. LLS funds lifesaving blood cancer research around the world and provides free information and support services.

Go to LLS website
Developed by the Elder Law Clinic of Wake Forest University
This site offers a wide array of links to organizations and articles, for scholars and practitioners interested in global developments on law and aging (or law and ageing, as its written in the U.K.). Links include legal organizations, NGOs, academic resource centers, governmental bodies, and issue-specific organizations.

Go to International and Comparative Elder Law website
This website includes extensive information about nursing home costs, medical decision-making and other topics.

Go to H.E.L.P. website
Bet Tzedek Legal Services is a non-profit public interest law firm which provides free legal services to the elderly and indigent of Los Angeles County.

Go to Bet Tzedek Legal Services website is a premier informational resource about annuities and structured settlements.

Go to website
The American Association for Homecare (AAHomecare) works to preserve and strengthen access to care for the millions of Americans who require medical care in their homes. AAHomecare represents health care providers, equipment manufacturers, and other organizations in the homecare community.

Go to AAHomecare website
The Mesothelioma Center is dedicated to providing those who suffer from the asbestos-related cancer malignant mesothelioma—also known as asbestos cancer—or from asbestos-related lung cancer, or who know someone who does, with the most up to date information and support.

Go to Mesothelioma Center website
Since 1983, California Advocates for Nursing Home Reform (CANHR), a statewide nonprofit 501(c)(3) advocacy organization, has been dedicated to improving the choices, care and quality of life for California’s long-term care consumers.

Go to CANHR website
This website includes information on how to request military service records, locate pre-WWI records, replace lost medals and awards, and more.

Go to Veterans' Service Records website
All Americans—including people with disabilities and older adults—should be able to live at home with the supports they need, participating in communities that value their contributions. To help meet these needs, the U.S. Department of Health and Human Services (HHS) created a new organization, the Administration for Community Living (ACL).

Go to ACL website
Free access to legislative information that anyone can search for and read.

Go to website
ABA (2-11 Military Survivor Benefit Res).pdf American Bar Association Military Survivor Benefit Resolution - November 2013
CCD Letter of Support Moran (FINAL).pdf Consortium for Citizens with Disabilities Letter to Congressman Moran - July 2013
CCD Letter of Support Hagan (FINAL) (2).pdf Consortium for Citizens with Disabilities Letter to Congressman Hagan - July 2013
Easter Seals Thank You Letter Moran.pdf Easter Seals Thank You Letter to Congressman Moran - June 2013
Easter Seals Thank You Letter Hagan.pdf Easter Seals Thank You Letter to Congressman Hagan - June 2013
LetterofSupport-RepMoran (1).pdf NAELA Letter of Support to Congressman Moran - June 2013
LetterofSupport-SenHagan.pdf NAELA Letter of Support to Sen. Hagan - July 2013
LetterofSupport-SenGillibrand.pdf NAELA Letter of Support to Sen. Gillibrand - July 2013
BILLS-113hr2249ih.pdf House Bill Language - June 2013
BILLS-113s1076is.pdf Senate Bill Language - June 2013
LetterofSupport-RepMoran.pdf Press Release - NAELA Commends Congressman Moran and Sen. Hagan for Their Dedication to Improving the Lives of Military Families with Disabled Children - June 2013
DMCPA LeaveBehind 060214.pdf NAELA Leave Behind Document - June 2014
NAELAS748LeaveBehind.pdf Leave Behind Document: NAELA Proposed Changes to S.748 and H.R. 2341 - July 2013
NAELASenateCommittee-VATestimony.pdf NAELA Senate Committee on Veterans' Affairs Testimony - May 2013
Public Policy - VA Pensions Hearing.pdf NAELA Staff Summary: Senate Special Committee on Aging Hearing - June 2012
BILLS-112s3270is.pdf Full Text of Senate Bill S.3270 - June 6, 2012
summarygao.pdf Summary of GAO Report - May 15, 2012
fullreportgao.pdf Full GAO Report - May 15, 2012
VA-2015-VBA-0003-0003.pdf VA's Impact Analysis
ABR-Pension-FY13-09262014.pdf VBA Benefits Report FY 2013 on Veterans Pension
Comment_on_AP24-Toomey,_Patrick_(US_Sentor)_(Unredacted).pdf Letter from Sen. Toomey (Feb. 16, 2015)
Comment_on_AO73-Proposed_Rule-_Ron_Wyden(U_S_Senate).pdf Letter from Sen. Wyden (Mar. 23, 2015)
ManagersAmendment2013.pdf Manager's Amendment - September 30, 2013
BILLS-113s1562is.pdf Bill Text: S. 1562 Older Americans Act Reauthorization Act of 2013 - October 17, 2013
BILLS-113s1028is.pdf Bill Text: S. 1028 Older Americans Act Reauthorization Bill - May 23, 2013
Press Release - OAA Reauthorization Bill.pdf NAELA Commends Sen. Bernie Sanders’ (I-VT) Dedication to Strengthening and Improving the Older Americans Act -
LetterofSupportSanders-June2013.pdf NAELA Letter of Support to Sen. Sanders - May 22, 2013
OlderAmericansActGuidelinesJan2015.pdf OAA NAELA Public Policy Guidelines Jan 2015
HELPOAASummary093013.pdf Senate HELP Subcommittee on Primary Health and Aging OAA Summary - September 30, 2013
FINAL-LCAO-Letter-on-OAA-June-19-2013.pdf LCAO Letter to Senate and House Subcommittees on Labor/HHS/Education - June 19, 2013
LCAO-Letter-to-Senate-re-OAA-Reauthorization-042213.pdf LCAO Letter to Senate on OAA Reauthorization - April 22, 2013
LCAO-Letter-to-House-re-OAA-Reauthorization-042213.pdf LCAO Letter to House of Representatives on OAA Reauthorization - April 22, 2013
TortReformGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Tort Reform
LegalServicesGuidelinesJan2015.pdf Legal Services- NAELA Public Policy Guidelines
NAELA Seeks Clarificatio IRC.pdf NAELA Seeks Clarification Regarding IRC Section 1022 - March 31, 2010
2012 Letter to Congress - Sequestration.pdf Letter to Congress – Protect NDD Programs (August 13, 2012)
Medicaid Coalition - Medicaid Funding.pdf Medicaid Coalition - Medicaid Funding Letter
LCAO-Federal-Budget-Principles-Dec2012.pdf LCAO Federal Budget Principles
Ltr-to-Congress-re-Budget-Principles-121312.pdf LCAO Budget Letter to Congress
Ltr-to-Senate-re-Sequester-022613.pdf Letter to Senate from LCAO on Sequestration - February 26, 2013
NNDltr.pdf Letter to Congress from NDD United on Nondefense Discretionary (NDD) Programs - February 11, 2013
NDD Programs - Sequestration.pdf NAELA Press Release - NAELA Urges Congress to Protect Elderly and People with Disabilities by Preventing Sequestration
R42050.pdf Congressional Research Service - Budget "Sequestration" and Selected Program Exemptions and Special Rules
LCAO-Sequestration-Issue-Brief-Oct2012.pdf Leadership Council on Aging Organizations - NDD Sequestration Hurts Vulnerable Seniors
Pre-Existing Conditions and Sale of Medigap Policies.pdf ISSUE BACKGROUND Pre-Existing Conditions and Sale of Medigap Policies
MMCO response to advocate letter.pdf Letter from Melanie Bella in Response to June 2013 Dual Eligible Stakeholders' Letter - August 9, 2013
Dual-Eligible-stakeholder-letter-June-19.pdf Letter to Melanie Bella - Dual Eligible Stakeholders - June 19, 2013
Sign on Letter Dual Eligible Ombudsman Office.pdf Sign on Letter Dual Eligible - Ombudsman Office - October 25, 2012
LCAO Dual Eligible Fact Sheet.pdf LCAO Dual Eligible Fact Sheet - October 25, 2012
LettertoMelanieBella_NewMexico.pdf Letter to Melanie Bella - Withdrawing New Mexico's Demonstration Proposal - August 17, 2012
Dual Eligibles.pdf NAELA Press Release - NAELA and 32 Other Organizations to CMS: Protect the Vulnerable Elderly - August 14, 2012
LCAO_Letter_to_CMS_on_FL_Medicaid_Waiver_Request_121511.pdf LCAO Letter to CMS on FL Medicaid Waiver Request - December 15, 2011
NAELA CMS letter.pdf NAELA CMS Letter
NAELA CMS letter (1).pdf Cover Letter to Melanie Bella - Dual Eligible Issues and Recommendations
FMAP_BACKGROUND.pdf ISSUE BACKGROUND Extension of temporary increase in Federal Medical Assistance Percentage (Medicaid matching rate) (FMAP)
HealthCareAccessGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Health Care Access Jan 2015
HealthCareDecision-MakingGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Health Care Decision-Making Jan 2015
ManagedCareGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Managed Care Jan 2015
MedicareGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Medicare Jan 2015
MedicaidGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Medicaid Jan 2015
NAELASupportsAPCCodes-09-01-2015.pdf NAELA Comments Supporting CMS Proposal to Pay Doctors for Advance Care Planning- September 2015
Letter to Congress - Support S 569.pdf Letter to Congress April 2013
BILLS-113s569is.pdf S.569 A BILL To amend title XVIII of the Social Security Act
BILLS-113hr1179ih.pdf H. R. 1179 To amend title XVIII of the Social Security Act
SenateFinanceHearing-CMAStatement-July2013-2.pdf PROGRAM INTEGRITY: OVERSIGHT OF RECOVERY AUDIT CONTRACTORS United States Senate Committee on Finance Hearing June 25, 2013
NPRM observation status AB rebilling 05 2013 (00028228) (1).pdf CMA to CMS - Letter on Medicare Program; Part B Inpatient Billing in Hospitals - (May 17, 2013)
LCAO-Observation-Status-Letter-2013.pdf LCAO - Letter to Senator and Representatives on Observation Status - (March 28, 2013)
ABLE_Comments_NAELA_09-21-14.pdf Comments on Proposed Rule, Qualified ABLE Programs RIN 1545-BM68, IRS REG—102837—15
PensionsGuidelinesJan2015.pdf NAELA Public Policy Guidelines: Pensions Jan 2015
SSI-SSDIGuidelinesJan2015.pdf NAELA's Public Policy Guidelines for Supplemental Security Disability Insurance Jan 2015
Chained CPI Listserv 2013.pdf The Chained Consumer Price Index: Left out of December’s Fiscal Cliff Deal but Still in the Mix February 2013
SSA - FY 2014 - Funding Letter.pdf Letter to SSA Requesting 2014 Funding
SocialSecurityGuidelinesJan2015.pdf NAELA's Public Policy Guidelines for Social Security January 2015
ElderJusticeGuidelinesJan2015.pdf NAELA's Public Policy Guidelines for Elder Justice Jan 2015
CFPB Elder Financial Exploitation Summary 2012.pdf Recommendations to the Consumer Financial Protection Bureau on Elder Financial Exploitation
Elder Financial Abuse - 2012 Report.pdf Response to Request for Information Regarding Senior Financial Exploitation Docket Number: CFPB-2012-0018
NAELA_Comments_RIN 2900-AO73_March-17-2015.pdf NAELA's Comments on Proposed Rule NAELA submitted a 27 page commentary to Acting Director William F. Russo on March 17, 2015
NAELA-VA Pensions NPRM-1pager.pdf One-pager for Congress Senior Public Policy Manager David Goldfarb prepared a one-page memo of talking points when meeting with your Congressional Representatives
NAELAPositionVARule.pdf Position Statement on Proposed Rule
UPL Opinion 53 Medicaid Advisors 5 16 16.pdf Letter Supporting Congressional Efforts to Maintain Spousal Protections in MN HCBS Waiver
NAELA Ltr SFC Chronic Care 06-22-15.pdf Letter to Senate Finance Committee Working Group on Chronic Conditions
Long-TermCareGuidelinesJan2015.pdf LTC NAELA Public Policy guidelines
NAELA_Ltr_LTC_Facility_Requirements_NPRM_10-8-15.pdf CMS Proposed Rule on Requirement for Long-Term Care Facilities NAELA Comments to Ban Forced Arbitration (Oct 8, 2015)
NAELA_Ltr_CMS-2390-P_July-27-2015.pdf Comments on CMS Medicaid Managed Care Proposed Rule (July 27, 2015)
Protecting Spouses of the Chronically Ill One-Pager 10-13-2015.pdf Limitations to Community Spouse Annuities Protecting the Spouses of Those With a Chronic Illness
LTCCommAppointees-June2013-2.pdf Long-Term Care Commission Appointees
LTCCommNAELA.pdf Long-Term Care Commission Guiding Principles
NAELA Response to NSMD.pdf NAELA Response to NASMD Request to Revisit Treatment of Community Spouse Annuities
LCAO-Commission-for-Long-Term-Care-Principles-for-an-LTSS.pdf LCAO and CCD Principles for Long-Term Services and Supports - June 2013
LCAO-CCD-Letter-to-LTC-Commissioners.pdf Leadership Council of Aging Organizations (LCAO) and Consortium for Citizens with Disabilities (CCD)
This nonprofit member organization lobbies for individuals over 50 through legislative and regulatory advocacy. AARP also provides products, services, and special discounts for individuals over 50. Go to AARP
NAELA RI Chapter Meeting - 9-20-2016.pdf September 2016 Meeting Notes
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This section works to develop and improve the laws that affect the elderly, and promotes high standards of ethical performance and technical expertise for those who practice in the area. The section sponsors CLE programs at State Bar conventions, monitors proposed state legislation and publishes a newsletter.

Go to Wisconsin Bar Association's Elder Law Section website
The Center on Aging (Center) is a new university-wide, interdisciplinary center specializing in aging education, research and community service. Its academic home is the University of Maine School of Social Work in the College of Business, Public Policy, and Health.

The mission of the Center is to serve the state by maximizing the quality of life of Maine's older citizens and their families. Through its state-of-the art training, research and service initiatives, the Center, in direct partnership with elders and community agencies, works to prepare professionals and the lay community in "best practice" approaches to serving older adults and better appreciating the resources that elders bring to their communities.

Go to University of Maine Center on Aging website

Created by the state legislature in 1927, the State Bar is a public corporation within the judicial branch of government, serving as an arm of the California Supreme Court. All State Bar members are officers of the court.

Membership in The State Bar of California affords attorneys the right and privilege of practicing law in this state. The bar's integrated network of functions and services — many of them mandated by law — protects the public and assists attorneys in meeting their professional obligations.

Go to State Bar of CA website
The New York State Coalition on Elder Abuse is a multidisciplinary, statewide group of individuals, private organizations and public agencies working together to protect elders from abuse, neglect and financial exploitation. The Coalition was formed to implement the Action Agenda created by the 2004 New York State Elder Abuse Summit.

Go to New York State Coalition website
This website features a wealth of government information and links.

Go to the White House website
Resources are available in English and Spanish, such as recent legislation, the Social Security Handbook, links to federal regulations, and information on legal employment with the Administration.

Go to SSA website
BDHAP is the component of the U.S. Department of Health and Human Services charged with developing, analyzing, evaluating, and coordinating HHS policies and programs which support the independence, productivity, health, and long-term care needs of children, working age adults, and older persons with disabilities. 

Go to BDHAP website
Directed by the U.S. Administration on Aging, NCEA is committed to helping national, state, and local partners in the field be fully prepared to ensure that older Americans will live with dignity, integrity, independence, and without abuse, neglect, and exploitation.

Go to NCEA website
The Official U.S. Government Site for Medicare contains information on health and drug plans, facilities and doctors, and benefits and eligibility information.

Go to Medicare website
The Library's website provides information about its programs, services, online collections of American historical materials, legislative information, and guides to special collections.

Go to Library of Congress website
Fannie Mae is a government-sponsored enterprise chartered by Congress to keep money flowing to mortgage lenders, to help strengthen the U.S. housing and mortgage markets, and to support affordable homeownership.

Go to Fannie Mae website
FDsys provides free online access to official publications from all three branches of the Federal Government.

Go to FDsys website
The U.S. Department of Justice Elder Justice Initiative provides resources to victims and family members who have dealt with or are currently dealing with elder abuse, and will also serve as a forum of information for practitioners; researchers; law enforcement agencies; victim service providers; and federal, state, and local prosecutors.

Go to Elder Justice Initiative website
The central mission of the CFPB is to make markets for consumer financial products and services work for Americans—whether they are applying for a mortgage, choosing among credit cards, or using any number of other consumer financial products.

Go to CFPB website
This U.S. Federal agency which administers Medicare, Medicaid and the Children's Health Insurance Program. Learn more about the proposed rule that makes changes to both Medicare Part C and D.

Go to CMS website
This U.S. Department of Justice site includes information and numerous links relating to the Americans with Disabilities Act and enforcement.

Go to ADA website

These sites offer a variety of Special Needs resources.

Go to website  -  Ten organizations and resources for individuals with special needs 

Go to CHC website  -  100 Best Disability Blogs and Websites

The Consumer Affairs site article discussing the different types of senior living options.

Go to Consumer Affairs website is a complete online resource for getting smart about caring for your aging parents, with hundreds of articles, experts on demand and a store with over 4,500 of the most often needed home care products and medical supplies.

Go to website
Founded in 2007, is the leading online destination for those seeking information and support as they care for aging parents, spouses, and other loved ones.

Go to website
A guide for counsel to elderly clients, this publication includes forms, checklists and practice tips for healthcare, retirement, tax and financial decisions. By Michael Gilfix, David M. English, and Rebecca C. Morgan; Published by LexisNexis

Go to Tax, Estate & Financial Planning guide website
Designed to assist anyone who has regular contract with older persons, including lawyers, law students, social workers, health care personnel, retirement planners and gerontologists or anyone who wishes a better insight into the world of elder law. By Lawrence A. Frolik and Richard L. Kaplan; Published by West Publishing

Go to Elder Law in a Nutshell website

The Synergy Summit is a nonprofit collaboration among the leadership of the major accounting, legal, and financial service organizations in the United States. Together, these groups represent more than 200,000 lawyers, accountants, financial advisors, philanthropic gift planners, and insurance and other professionals. Synergy Summit helps bring quality estate, financial, and charitable planning information and services to the public through multidisciplinary partnerships and projects.

Go to Synergy Summit website

Locate pro bono legal services by state.

Go to State Bar Associations website
Parkinson's Resource Organization is a non-profit, charitable organization that provides group and individual support to those making the journey through Parkinson's.

Go to Parkinson's Resource Organization website
The National Partnership hosts a special section on caregiving which has information on important federal laws that can help caregivers; helpful articles on a range of caregiving issues, from how to prepare for the possibility of caregiving to what to do when the job suddenly falls on your shoulders; links to research on caregiving; and a resource section that highlights other sites.

Go to National Partnership website
This website is a useful resource for patients, caregivers, and professionals. 

Go to National Parkinson Foundation website
NOSSCR is the national support organization for attorneys specializing in Social Security disability law. The site features basic information on the law and the organization. Some materials are available only to members.

Go to NOSSCR website
The National MS Society is a collective of passionate individuals who want to do something about MS now—to move together toward a world free of multiple sclerosis. The Society helps people affected by MS by funding cutting-edge research, driving change through advocacy, facilitating professional education, and providing programs and services that help people with MS and their families move their lives forward.

Go to National MS Society website
The Alzheimer's Foundation of America initiated National Memory Screening Program as part of its mission to provide "optimal care and services to individuals confronting dementia, and to their caregivers and families"…and as part of its focus on “Caring for the Nation.”

Go to National Memory Screening Program website
NHeLP is a national organization providing health care advocacy for low-income people. It provides litigation support, training and consulting services, and detailed analysis of current and proposed legislation.

Go to NHeLP website
The mission of the National Guardianship Association is to provide educational training and networking opportunities for guardians; to promote the highest levels of values, standards and ethics; and to ensure a nationally recognized standard of excellence.

Go to NGA website
Caregiver Action Network (formerly National Family Caregivers Association) is the nation’s leading family caregiver organization working to improve the quality of life for the more than 90 million Americans who care for loved ones with chronic conditions, disabilities, disease, or the frailties of old age.

Go to Caregiver Action Network website
The organization was formed as NCCNHR (National Citizens' Coalition for Nursing Home Reform) in 1975 because of public concern about substandard care in nursing homes. The Consumer Voice's mission is to represent consumers at the national level for quality long-term care, services, and supports.

Go to the National Consumer Voice website
The National Committee for the Prevention of Elder Abuse (NCPEA) is an association of researchers, practitioners, educators, and advocates dedicated to protecting the safety, security, and dignity of America's most vulnerable citizens.

Go to NCPEA website
The U.S. Department of Health and Human Services developed this website to provide information and resources to help you and your family plan for future long-term care (LTC) needs.

Go to National Clearinghouse for LTC Information website
This association is an established group of professionals who specialize in facilitating a smooth transition for seniors moving from the home into a senior housing community.

Go to National Association of Senior Move Managers website
With more than 210,000 members, NAMI is the nation's leading grassroots advocacy organization solely dedicated to improving the lives of persons with severe mental illnesses including schizophrenia, bipolar disorder (manic-depressive illness), major depression, obsessive-compulsive disorder, and severe anxiety disorders.

Go to NAMI website
This not-for-profit organization is dedicated to ensuring that older adults and people with disabilities receive quality, affordable health care. The website offers helpful and reliable Medicare information for professionals in the health care field.

Go to the Medicare Rights Center website
Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center (NSCLC), since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency. 

Go to Justice in Aging website
HPA is a private non-profit charitable corporation dedicated to serving the general public, hospice patients, their families/caregivers, the bereaved and hospice staff. HPA promotes quality hospice services whether a patient is enrolled in a licensed hospice, residing at home, or in a facility.

Go to HPA website
The Hartford Institute seeks to shape the quality of health care older Americans receive by promoting the highest level of geriatric competence in all nurses. By raising the standards of nursing care, the Hartford Institute aims to ensure that people age with optimal function, comfort and dignity.

Go to Hartford Institute website
The official geriatric nursing Web site of the American Nurses Association (ANA) - It was developed through the Nurse Competence in Aging initiative to provide information regarding nursing care of older adults.

Go to GeroNursesOnline website
Families USA Foundation is a national non-profit organization dedicated to the achievement of high-quality, affordable health and long-term care for all Americans. This is a valuable site for those involved in advocacy at the legislative and regulatory levels and for those with legal problems with managed care or Medicaid.

Go to Families USA Foundation website
The Elder Justice Coalition was formally launched on February 10, 2003, to coincide with the introduction of the Elder Justice Act (S. 333), which was introduced by Sens. John Breaux and Orrin Hatch. The Coalition has five founding organizational members: the National Committee for the Prevention of Elder Abuse (NCPEA), the National Academy of Elder Law Attorneys, Inc. (NAELA), the National Association of State Units on Aging (NASUA), the National Association of Adult Protective Service Administrators (NAAPSA), and the National Association of State Long-Term Care Ombudsman Programs (NASOP).

Go to EJC website
CJPF is a private, non-profit educational organization that promotes solutions to problems facing the criminal justice system. The organization assists policy makers, criminal justice professionals, and the public by disseminating information about preventing crime and improving the quality of justice through education programs, publications, and the media.

Go to CJPF website

The Consumer Financial Protection Bureau (CFPB) Office for Older Americans released four easy-to-understand booklets to help financial caregivers. The Managing Someone Else’s Money guides are for agents under powers of attorney, court-appointed guardians, trustees, and government benefit fiduciaries (Social Security representative payees and VA fiduciaries).

The guides help people acting as fiduciaries in three ways:

  • They walk them through their duties.
  • They tell them how to watch out for scams and financial exploitation, and what to do if their loved one is a victim.
  • They tell them where to go for help.
Go to CFPB website; also view the CFPB Managing Someone Else's Money guides.
CMA is a private, not-for-profit organization that produces a wide array of written materials to assist Medicare beneficiaries and their advocates including self-help packets, brochures, and a quarterly newsletter. Additionally, CMA is involved in education, policy making, and litigation impacting Medicare beneficiaries throughout the country.

Go to CMA website
The purpose of ASBH is to promote the exchange of ideas and foster scholarship, research, teaching, policy development, professional development, and collegiality among people engaged in all endeavors related to clinical and academic bioethics and the health-related humanities.

Go to ASBH website
This organization provides information and supports programs for terminally ill and grieving individuals, their families, and the professionals who care for them. AHF closed its doors in June 2014. This website has tools and materials they produced over the years.

Go to American Hospice Foundation website
ACTEC is a professional association consisting of approximately 2,700 lawyers from throughout the United States. Members are invited to join based upon their professional reputation and ability in the fields of trusts and estates.

Go to ACTEC website
Since its founding in 1980, the association has provided nearly $140 million to support research into the prevention, treatment and eventual cure for Alzheimer's. Its nationwide network of chapters offer frontline support to individuals affected by Alzheimer's through 24/7 information and referral services, and education and support groups. Check out their Dementia and Driving Resource Center for signs of unsafe driving, tips on having the conversation, and video vignettes illustrating supportive conversations taking place in four different situations.

Go to Alzheimer's Association website
This website contains text of many ABA publications and information on the activities of the ABA's Commission on Legal Problems of the Elderly. Browse the Senior Lawyers DivisionABA Section of Real Property, Trust, and Estate LawABA Commission on Law and Aging pages for more resources.

Go to ABA website
Formerly known as the National Association of Professional Geriatric Care Managers, ALCA is an organization dedicated to the development, advancement, and promotion of humane and dignified social, psychological, and health care for the elderly and their families through counseling, treatment, and the delivery of concrete services by qualified, certified providers. The site features a Find an Aging Life Care Expert search to locate a professional.

Go to ALCA website
The AARP's website covers the organization's advocacy positions on a variety of elder topics including Social Security and Medicare. Helpful features include information on comparing Medigap insurance policies and information on Medicare.

Go to AARP website
Presented by: Professor Roberta K. Flowers, Stetson University College of Law, and A. Frank Johns, LLM, CELA, CAP


Presented by: Kimberly Dodson Gilbey, MBA, Ph.D.
BO1_AshkarMurphy_SupDoc.pdf Workshop Document
BO1_AshkarMurphy_SupDoc.pdf Supporting Document
Saturday 10:45am – 12:00pm
Trust Protectors for the Aging Beneficiary and Special Needs Trust
Speakers: Bernard Krooks, CELA, Fellow; and Lawrence Frolik, CAP, Fellow
Although trust protectors are increasingly being employed, their use has not yet become standard practice. They should almost certainly be appointed, however, for trusts that anticipate having very old beneficiaries or for Special Needs Trusts because of the need to provide someone to monitor the trust and protect the interest of beneficiaries who may not be able to advocate on their own behalf.
In this session we will discuss the nature of trust protectors, when to use them, what powers to grant them, what they can be expected to do, and what is their standard of care. In particular, we will examine whether a protector should be a fiduciary and what degree of oversight and action can be required of the protector.
Room: Sundance
Trust Protectors .pdf Download Document
Saturday 9:15am – 10:30am
Use of Computer Cloud & Other Tech Concerns
Speaker: Sharon Rivenson Mark, CELA, CAP, Fellow; and Stephen Silverberg, CELA, CAP, Fellow
Lucy in the Sky with Diamonds: Options, trials and tribulations of cloud computer systems
This practical technology session will review and demonstrate working in the cloud. Applications and programs covered will include Google Apps, Office 360, Clio and other programs, as well as integration with other cloud applications. The session will also discuss the pluses and minuses of some programs. This will be a visual presentation.
Room: Sundance