Illinois House Passes Private Guardianship Bill With Safeguards After Hospital Opposition

New Bill Aims to Strengthen Oversight of Private Guardianship for Vulnerable Adults

SPRINGFIELD — Legislation that would strengthen court oversight of private guardianship appointments for vulnerable adults has advanced from the Illinois House after months of debate and negotiations with hospital opponents.

State Rep. Marti Deuter, an Elmhurst Democrat, worked with AARP Illinois on the latest bill, which picked up 14 other sponsors in the House before the April 16 vote. The measure passed on an 81-28 vote and has now moved to the Senate.

The bill comes in the wake of a Chicago Tribune investigation published in November that revealed hospitals had initiated hundreds of guardianship petitions in an 18-month period. The Tribune found that when patients owned property or financial assets, hospitals typically recommended private guardianship organizations rather than county public guardians.

"That's scandalous in my mind, and that's what happens when guardians accept appointments with people who they have never met," said Cook County Public Guardian Charles Golbert.

The amended bill would allow private guardianship appointments but enact requirements aimed at giving probate court judges more authority to hold entities accountable.

Key Safeguards In The Bill

The legislation includes several requirements for private guardians:

• Employees of private guardians must undergo criminal background checks every five years
• Private guardians must receive education necessary for national certification
• Private guardian corporations managing more than $1 million in assets must submit to annual independent audits
• Private guardians cannot have financial ties to other for-profit entities involved in the person's case
• Courts would receive annual budgets and fee schedules from private guardians

Earlier versions of the bill would have banned private professional guardians when a hospital, nursing home or similar institution had asked a judge to rule that a person needed court-ordered oversight. But the proposal to bar private guardians completely drew objections from hospitals and others who argued it would force some patients to remain hospitalized beyond medical necessity.

Compromise on Meeting Requirements

One point of contention was whether prospective private guardians must meet with patients before accepting appointments. The hospital association, which still objects to the bill, cited concerns that such a requirement may slow the process as well as timing issues concerning medical consent.

To address the possibility that a person may be too incapacitated to meet with the guardian or be unwilling to meet, supporters changed the bill to specify that if the meeting is "not reasonably possible" the prospective private guardian must certify in court that "they will meet with the respondent as soon as feasible after the appointment."

"IHA supports the goal of strengthening existing protections in the guardianship statute and is committed to working through any remaining unintended consequences of the proposed legislation on patients, like the previously mentioned delays in obtaining timely consent for treatment that directly impacts patient outcomes," Paris Ervin said in a statement from the Illinois Health and Hospital Association.

The Catholic Conference of Illinois, which runs a private guardianship program for elderly people that receives hospital referrals, initially opposed the bill but dropped its opposition after the bill recognized a place for private guardianships.

Fee Collection Changes

Supporters deleted language that would have temporarily prevented private guardians from collecting court-approved fees if it meant the person had to sell their home for nonmedical reasons. Lawmakers recognized that private entities do not have taxpayer funding like public counterparts and need to be paid for their services.

Under the latest version, fees may be collected but the private guardian must notify the court as soon as it estimates the estate of the person with a disability can no longer afford the services, or if the sale of the person's residence would be required for continued services within 36 months.

The hope is the court would step in at that point to either reduce fees or appoint a public guardian.

Public Guardian Perspective

Cook County Public Guardian Charles Golbert has supported legislation to change state laws regarding the appointment of private guardians. His staff oversees cases of more than 600 adults under guardianship.

"Face-to-face meetings are standard practice in my office prior to appointment and are crucial to properly assessing the person's needs," Golbert said.

In the Tribune's 18-month review, only seven of the hospital-initiated guardianships, or roughly 2%, were limited rather than full guardianships. Golbert noted that more than 20% of all cases in his office involve people under a limited guardianship that allows the person some control over their life.

The Illinois Guardianship and Advocacy Commission, which operates the state guardian's office, initially opposed the bill because of a provision that would have required the office to receive notice if a facility determines that someone may need a guardian.

The measure has yet to gain the approval of the Illinois Health and Hospital Association, but supporters say it represents progress after turning several past opponents into supporters through months of discussions.