Covering Guardianship Costs in a Post-'Deanna W.' World

There is rarely enough money to go around when an Incapacitated Person (IP) with limited resources needs both a guardian to manage his finances and Medicaid to cover his medical bills.¹ In a typical low- or no-asset guardianship case brought under Article 81 of New York’s Mental Hygiene Law (MHL), the court-appointed guardian often retains the IP’s Social Security and/or pension checks to cover the expenses incurred during the course of the guardianship proceeding.

In addition to the pre-appointment fees and disbursements of the petitioner’s attorney and court appointees, the guardian must also cover expenses incurred post-appointment including the guardian’s commissions and other costs of administering the guardianship. All of this fee paying would not be a problem if the income of most Medicaid recipients did not have to be applied toward the cost of their medical care, with only very limited disregards. Disregards are the types of income that are not countable for Medicaid budgeting purposes.