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Clients who are unable to manage their own affairs and cannot afford needed medical care must balance the ongoing costs of the administration of the guardianship program with the financial eligibility rules of the Medicaid program. They will face greater difficulty in light of a recent Appellate Division, Second Department, opinion1 that reversed an order of the Supreme Court against a Medicaid agency. In the reported case the Supreme Court had ordered Nassau County Medicaid to disregard certain expenses in the calculation of the eligibility of Deanna W. so that there would be sufficient funds to pay for the administration of her guardianship. The Department of Social Services objected and successfully appealed that portion of the order. Medicaid recognizes a distinction in this regard between the initial expenses to bring the proceeding and the cost of maintaining it.

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