3. Social Services-Guardian and Protective Serv funding

o ~ '. Turnover of staff was, reportedly surprisingly low. The predominant weakness of programs was the lack of funding. The most consistent opportunity for public guardian programs appeared to be education of the public, which usually took a back seat to providing guardianship services. Websites giving information about the programs were, as a rule, underdeveloped. Another opportunity for some programs, used exceptionally effectively in Cook County, Illinois. was the use of lawsuits to provide needed services for clients. Not surprisingly, and, regrettably, similar to the 1981 study was the assertion, by nearly every program in every state of a critical lack of funding, which translated into circumscribed services for wards and inadequate staffing to meet ward needs. This is more significant now than in the past, as the demographic imperative portends more and more individuals needing guardianship services. Case Studies of States with In-Depth Interviews The study included in-depth interviews with key contacts in four states - Indiana, Iowa, Missouri and Wisconsin. The resulting case profiles show the diversity of state programs and the significant gaps remaining. Indiana. The state's 16-year-old public guardianship program is coordinated by the state unit on aging with regional programs through area agencies on aging and mental health associations. The program is state funded. Some of the regional programs use Medicaid funding to pay for guardianship services. The program served approximately 289 individuals in FY 2004. The local programs petition for guardianship. A rough estimate of time spent on each case is five hours. Case loads per individual guardian ranged from 25-44 wards, Wards are visited at least monthly, but for wards in nursing homes, every 90 days. While a statewide needs assessment is underway, the unmet need is perceived as substantial, and the funding limited. The programs are at "maximum capacity" at current case loads, and the program does not serve as guardian of last resort with unlimited intake. Iowa. Currently public guardianship needs in Iowa are met in piecemeal fashion and in many areas not at all. State legislation creating a system of volunteer guardianship programs was enacted but not funded, and currently only one county has such a program. An additional county operates an independent staff-based program that provides guardianship, conservatorship, and representative payee services. Also, under a state law, seven counties have established substitute medical decision-making boards of last resort for individuals without the capacity to give informed consent, if there is no one else to do so, This leaves much of the state without public guardianship. Practitioners and advocates are acutely aware of the' gap and are assessing unmet need and developing legislative proposals to create a'statewide public guardianship program. Missouri. Missouri law provides for an elected county public administrator to serve as guardian of last resort in each of the state's 115 jurisdictions. There is wide variability throughout the state in: the background and experience of the public 5