Private Organization Accreditation

CSS Healthcare Services provides Community based health services to the young, the elderly and to Individuals with Developmental Disability. Founded in 1997, we have the ability to offer a variety of quality community-based services to our clients, which has greatly contributed to our growth and success.


Nicole Deprez-Garrity, M.Ed.

Volunteer Roles: Endorser, Lead Endorser

Nicole Deprez-Garrity is a lead After School Endorser based in Germany.
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Individuals who receive guardianship services maintain a level of independence and self-determination appropriate to their functional capacity, and are at minimized risk of abuse, neglect, or exploitation.

AG 9: Guardian of the Estate

The individual’s estate is managed in an open and transparent manner that:

  1. is consistent with service goals and the individual’s values;
  2. encourages the individual’s involvement to the greatest extent possible;
  3. protects the individual’s assets; and
  4. maintains or improves the individual’s financial standing as appropriate.

Note: The terminology used may vary; however, any organization court-ordered to manage an individual’s finances is expected to meet the standards outlined in this section. That includes guardians of the destitute who may only be responsible for managing the individual’s public benefits. Guardian of the estate may also be responsible for managing the individual’s stocks and bonds, paying bills, income and property taxes, real estate, insurance, and maintaining eligibility for public benefits.

NA The organization only acts as guardian of the person.

Rating Indicators
All elements or requirements outlined in the standard are evident in practice, as indicated by full implementation of the practices outlined in the Practice standards.
Practices are basically sound but there is room for improvement, as noted in the ratings for the Practice standards; e.g.,
  • Minor inconsistencies and not yet fully developed practices are noted, however, these do not significantly impact service quality; or
  • Procedures need strengthening; or
  • With few exceptions procedures are understood by staff and are being used; or
  • For the most part, established timeframes are met; or
  • Proper documentation is the norm and any issues with individual staff members are being addressed through performance evaluations (HR 6.02) and training (TS 2.03); or
  • Active client participation occurs to a considerable extent.
Practice requires significant improvement, as noted in the ratings for the Practice standards. Service quality or program functioning may be compromised; e.g.,
  • Procedures and/or case record documentation need significant strengthening; or
  • Procedures are not well-understood or used appropriately; or
  • Timeframes are often missed; or
  • A number of client records are missing important information  or
  • Client participation is inconsistent; or
  • One of the Fundamental Practice Standards received a rating of 3 or 4.
Implementation of the standard is minimal or there is no evidence of implementation at all, as noted in the ratings for the Practice standards; e.g.,
  • No written procedures, or procedures are clearly inadequate or not being used; or
  • Documentation is routinely incomplete and/or missing; or  
  • Two or more Fundamental Practice Standards received a rating of 3 or 4.

Table of Evidence

Self-Study Evidence On-Site Evidence On-Site Activities
    • A description of services
    • Procedures for conducting inventory of client assets
    • Procedures for sharing financial information with service recipient
    • Guardian of the Estate financial management procedures
    • Documentation of coordination with Guardian of the Person as applicable
    • Informational material on maintaining eligibility for public benefits
    • Interview:
      1. Program director
      2. Relevant personnel
    • Review case records

  • AG 9.01

    The individual participates in estate planning and financial decision-making to the greatest extent possible given his or her assessed capacity for decision-making and subject to state law and court order.

  • AG 9.02

    Upon initiation of guardianship, a thorough inventory of the individual’s assets is conducted to determine:

    1. the type and value of the individual’s assets;
    2. how assets are held, owned or managed;
    3. areas of risk or potential loss; and
    4. what assets should be maintained.

    Interpretation: Assets include real estate such as residential or commercial property and personal properties such as investments, insurance, vehicles and other valuables.

  • AG 9.03

    The guardian of the estate communicates regularly with the guardian of the person, or any other health care decision-maker, to ensure the financial plan is consistent with service goals.

    Interpretation: This may include communication within the organization or with outside providers. Some organizations have successfully implemented a checklist system, or similar protocol, for ensuring everyone involved with a particular case is aware of decisions made or work done on behalf of the individual.

  • AG 9.04

    Financial information is available to the individual upon request, as appropriate to their assessed capacity to handle such information and in accordance with state law or the court order.

  • AG 9.05

    The individual’s income is used to meet his or her identified needs and can include:

    1. food, clothing, shelter, and utilities;
    2. health care and prescriptions;
    3. home care, aide services, and housekeeping;
    4. transportation;
    5. insurance;
    6. legal or other professional fees, with court approval;
    7. pre-paid burial arrangements;
    8. social and recreational needs; and
    9. savings.

  • FP
    AG 9.06

    The organization has procedures governing the management of funds that protect the assets of individuals, including:

    1. an accounting system that accurately tracks all transactions;
    2. authorization and processing of disbursements;
    3. regular, internal audit of client accounts;
    4. an external audit of client accounts conducted at least once every three years;
    5. segregation of duties regarding cash disbursements;
    6. tracking system to notify guardians of key due dates;
    7. separate accounts for each service recipient; and
    8. managing funds in accordance with the Prudent Investor Rule.

    Interpretation: Key due dates can include billing due dates, tax deadlines, legal notifications, contractual deadlines or expirations, expiration dates for public benefits; and due dates for submitting accounting reports to regulatory bodies and oversight entities, including the court.

    Interpretation: Money can be pooled into one bank account when accounting software has the capacity to manage each account separately, provide adequate documentation of income and expenditures, protect the holdings of each individual, and complies with all applicable laws and contractual obligations.

    Interpretation: Authorities that may require regular accounting reports include the courts, the Department of Veterans Affairs, and the Social Security Administration when the guardian has been appointed by the Social Security Administration to serve as a representative payee who manages the individual’s Social Security payments. A growing number of social service organizations are being appointed by the Social Security Administration to serve as representative payees for beneficiaries who lack the capacity to make financial decisions.

    Research Note: The Social Security Administration recommends that a record for all disbursements be retained for at least two years as documentation of how money is being spent.

  • AG 9.07

    Guardianship workers are familiar with state and federal regulations governing eligibility for public benefits, and take appropriate steps to maintain the individual’s eligibility.

    Interpretation: Guardianship workers should be aware of income and resource limitations and transactions or assistance from family members that may disqualify the individual from continuing to receive public benefits. They should also be aware of tools that can be used to spend down assets to within limits, such as the establishment of a special needs trust, or pre-payment of funeral or burial plans. Examples of assistance from family members that may disqualify beneficiaries from continuing to receive benefits can include rent payment, groceries, or cash. However, family members may be able to provide payments directly to vendors for items other than food or housing such as phone or cable. Specific allowances will vary by state.

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