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I want to start my answer by saying that it’s complicated. I am often asked about this, though. I will only be able to give very simplistic answer in this post, so if you have additional questions, please contact me at mindi@bridgebldrs.com.

Certified Professional Guardians have a variety of ways that we get paid depending on the assets of the vulnerable adult who is under guardianship.

Pro Bono – Many Certified Professional Guardians take some Pro Bono guardianships. This means that the guardian does not get paid. Often, the vulnerable adult has only SSI to live on and there are no funds allowed to be used to pay the guardian.

DDA – Many vulnerable adults in the DDA program do not have funds to pay for a Certified Professional Guardian. The exception is if the vulnerable adult has a special needs trust that allow the Certified Professional Guardian to be paid. Sometimes, there are some funds (figured out through a very complicated algorithm) that will allow the Certified Professional Guardian to be paid a small sum month.

Medicaid – There are sometimes funds to pay a Certified Professional Guardian by Vulnerable adults who are receiving Medicaid benefits and have enough income where they have to pay a “participation” toward their care. This has to be approved by the DSHS financial worker and is capped at $235 per month.

Public Guardianship Program – The Public Guardianship Program is currently funded for only 75 vulnerable adults statewide. A Certified Professional Guardian has to have a contract with the Public Guardianship Program in order to accept guardianship clients who qualify for this program. The initial rate for the first three months is $535 per month. After the first three months the fee changes to $325 per month.

Private Pay – Each Certified Professional Guardian has an established hourly rate for private pay vulnerable adults. In order to pay themselves, each Certified Professional Guardian or Certified Professional Guardian Agency needs a court order allowing them to pay themselves. At each reporting period where the guardian submits a report to the court, the judge has to determine if the fees are reasonable and approve them.

With very few exceptions, Certified Professional Guardians are not allowed to petition a guardianship and recommend themselves as the court appointed guardian. A Certified Professional Guardian has to wait until a Guardian ad Litem (court investigator) contacts him/her and asks if they would take the guardianship.

There is a lot of negative publicity about professional guardians these days. Unfortunately, the media tends to focus on guardians who have “gone bad.”

Professional guardians have to protect their clients’ privacy so the success stories don’t get heard. So, did you know:

• Professional, or third party, guardians are the guardians of last resort? The Court always looks for the least restrictive solution when a guardianship petition is filed. First, the Guardian ad Litem (GAL), who investigates the guardianship petition for the Court, will try to find a family member or friend who is willing to be Power of Attorney. Yes, Power of Attorney. A Power of Attorney is less restrictive than a guardianship because the individual does not lose any civil rights. If a guardian is determined to be needed, the GAL will look for a family member or friend who may be willing to do it. Only when no other less restrictive alternative is found is a professional guardian appointed.
• A Professional guardian is to be an advocate for the incapacitated person. This is a requirement in the Certified Professional Guardian Standards of Practice. This job can be a challenge for a professional guardian because sometimes what the client wants isn’t a safe situation. A professional guardian works hard to tactfully explain the options available and, even when the client has his/her own option that may be worrisome, as long as it isn’t unsafe and the client can afford it the professional guardian needs to help the client give it a try.
• There is a grievance process if a Professional Guardian behaves badly. Sometimes a professional guardian may not be doing his or her job properly. Concerned people can file a grievance with the Certified Professional Guardian Board, who will research the matter. Prior to the development of a grievance process, filing a petition or motion with the Court was the only way to try to change the situation.
• Most guardianships where a professional guardian is appointed are due to the financial exploitation and/or abuse of the client. This is unfortunate but true. Other situations where a professional guardian is appointed may include individuals who have no family or friends to act as guardian; when family intervention has failed due to the individual(s) being fiercely independent and unwilling to entertain any options even though their current living situation is unsafe; individuals who have mental health issues or brain injuries that require a knowledge of behavior management techniques.

Eleanor raised a family and lived among them for many years. Unfortunately, most of her family and friends had alcohol and drug issues. Eleanor managed reasonably well until she started developing some dementia. When she started becoming forgetful, money would go missing; sometimes so much money went missing that she couldn’t pay her bills. She started drinking too much herself to try to deaden the fear and anxiety that growing within her. There was no one she could count on to look out for her. One day she had a medical crisis and ended up in the hospital.

Once the hospital stabilized her, Eleanor was moved into a long term care facility. Because she hadn’t regained her ability to make medical decisions for herself, the facility petitioned a guardianship and a professional guardian was appointed. The professional guardian monitored Eleanor’s continued improvement and after several years, Eleanor expressed a wish to live independently again. The professional guardian felt that moving into an assisted living facility would be the best alternative. Eleanor visited some assisted living facilities but didn’t feel that they would allow the level of independence that she wanted. Eleanor wanted the total independence of living in an apartment by herself. The professional guardian was reluctant to do so because of the history and when Eleanor continued to be adamant, the professional guardian resigned and the Court appointed a different professional guardian.

The second professional guardian assisted Eleanor in finding a place to live. The area Eleanor chose was not in a neighborhood that the professional guardian would have chosen for her but Eleanor gave a reasonable explanation regarding her choice and the professional guardian made the arrangements. At first Eleanor needed caregivers for additional emotional support as the transition to living independently after so many years in long term care was quite a dramatic change but over time she felt more comfortable with her independence and the professional guardian discontinued the caregivers.

Eleanor also found that she liked having a professional guardian managing most of her money. She and the professional guardian worked out a monthly budget so Eleanor had weekly discretionary money. If she needed more money for a special purchase she just called the professional guardian, who would supply it. Eleanor found that when family or friends tried to “borrow” money from her, she could let the professional guardian be the person saying “no” allowing Eleanor to shrug her shoulders and say “sorry!”

After more time elapsed, Eleanor had improved so much that the professional guardian asked the Court to reinstate Eleanor’s ability to make her own medical decisions. She continues to do well with minimal assistance from the professional guardian and emotionally healthy family and friends. Should Eleanor have a medical emergency, the professional guardian will be there to assist Eleanor according to her stated preferences.

Bridge Builders, Ltd. celebrated their 10^th Anniversary in 2013. We would like to share some of our accomplishments:

• Provided peace of mind to our members by being available 24/7 for urgent needs.
• Provided ten years of continuing education for Certified Professional Guardians.
• Mindi Blanchard, Founder, was a finalist for the 2011 Small Business Association’s Small Business Person of the Year Award.
• Legal, medical and social service professional seek out our advice.
• Enabled clients to stay safely in their homes and helped to transition them to supported living when they decided they wanted to move.
• Successfully assisted incapacitated individuals in their journey of regaining capacity and independence.
• Provided support services to lay guardians.
• We are a community resource for information on care management and guardianship.
• In 2013, started The Guardian Institute to address the issue of low income guardianships and provide support services to lay and professional guardians.