Oversight of professional guardians—people who make decisions for others who are incapacitated—is rigorous, and a certification process that has been beefed up over the last few years has brought greater credibility to the profession, say those in the field here.

Certified professional guardians are appointed by courts to make decisions for people who are deemed not able to make such decisions themselves due to illness, disability, or dementia. Often the duties entail making not only medical decisions, but also legal and financial decisions on behalf of the clients, says Lynda Clark, a Spokane-based certified professional guardian. Guardians can be hired by the client's family members, or referred by social service agencies, she says.

Richard Sayre, a partner in the Spokane law firm Sayre & Sayre PS, says training required for guardians to become certified has increased greatly in the last several years. Sayre was a charter member of the Washington state Certified Professional Guardian Board, which oversees professionals who provide guardianship for incapacitated clients, and served on the board for 10 years.

He says the oversight is important, because guardianship is seldom reversed by the court.

"Guardianship is more complex than going to jail, because at least when you go to jail you get out, but if I become your guardian, I'm likely to be your guardian forever," Sayre says.

People who are under guardianship have no legal right to work, marry, or own property, which makes both the responsibility and potential for problems for guardians huge, he says.

Clark says that at the heart of guardianship is the goal to do what a client would have wanted if he or she were able to make their own decisions.

"There are ways to figure out what a person's prior wishes were, through documents and their prior choices," she says.

Clark says she currently is the medical and financial guardian for four clients. In such a situation, the client's Social Security check or other income is sent directly to Clark, and she uses it to pay the client's bills and to make sure his or her needs are met.

For example, Clark says, "I have a client who needs a pair of shoes, so I go out and buy her shoes and take them to her."

Clark operates her business, Safe Haven Guardianship & Advocacy Services LLC, part time. Others operate their guardianship businesses full time, and might have case managers and others helping them, Sayre says.

Even though Clark considers herself to be a part-time guardian, she says she's on call 24 hours a day for her clients, because she never knows when they might need her assistance.

In 1998, a group of guardians asked the Washington Legislature to set professional standards for their roles to reduce what they perceived to be rampant fraud and poor management of the care of vulnerable populations.

"Once you were appointed a guardian, you disappeared," and the courts didn't monitor how a person's decisions were being handled by an appointed guardian, Sayre says. That led to unaddressed abuse, theft, or neglected needs in some cases, he asserts.

The Legislature concurred, and created a set of guidelines that require any guardian with more than three clients to be certified. It also created the board to regulate the certification of guardians who have more than three clients. The state doesn't, however, regulate nonprofessional guardians or guardians ad litem, who are appointed by the courts to represent a person's interests regarding a single legal matter.

The Certified Professional Guardian Board certifies and monitors licensed professional certified guardians. If a complaint is filed against a guardian, the board investigates and has the power to revoke the guardian's license, Sayre says.

The legislation also gave the courts more power to monitor guardians, so they are overseen not only by the board, but also by judges. In Spokane County, a volunteer group of AARP members, many of whom are retired certified public accountants, assist the courts by reviewing financial records guardians must keep for their clients, a layer of oversight that many counties lack, Sayre says.

"They have caught a lot of thieves," and have saved people millions of dollars, Sayre says. Spokane County Superior Court Commissioner Joseph Valente currently serves on the Certified Professional Guardian Board, and there are about 30 active certified professional guardians in Spokane County.

The board created a three-day training program soon after its inception in order to get people certified to do the work, but soon determined that more training was needed to ensure that guardians were versed in their responsibilities and able to respond appropriately in the variety of situations that could arise for their clients. The board contracted with the University of Washington to develop a certification program, which began offering it in 2008.

Most professional guardians are social workers or counselors, Sayre says. They must have an advanced degree to qualify for certification, and now also must go through a 90-hour training program offered by the UW. Sayre says that if family members are at odds, attorneys may suggest a professional guardian be appointed instead of a family member.

"This 90-hour course is the most comprehensive in the country, so we feel it's a model that other states can follow. They want to improve the care of elderly and disabled people, and help their loved ones know they are well taken care of," says university spokeswoman Alison Koop.

Family members of incapacitated people don't have to be licensed to be their guardians, but still must attend a lay guardian training program offered by the court before they can serve in that role.

People have to apply to the UW program. Clark says she had a long career as a patient representative and advocate before becoming a certified professional guardian.

The training includes online classes, as well as a number of long weekend training sessions. Currently the courses are offered mainly in Bellevue, Sayre says, but the UW also offers the sessions periodically in Spokane or the Tri-Cities. A certified professional guardian training manual, which also is used in the coursework, is available online.

In addition to the certification, guardians are required to receive 12 hours of instruction each year, offered as workshops or other training sessions.

Sayre says he sees the limited locations as a drawback to the certification program, in that it's difficult for rural-based guardians to attend the training, and he hopes it will be expanded in the future to make it easier to obtain.

"We don't have any certified guardians in Omak," he says.