‘Emptying the reservoir, one teaspoon at a time:’ new C.O. Guardian Assistance Program sees success in first six months

(Update: adding video and comments by executive director)

BEND, Ore. (KTVZ) -- The Central Oregon Guardian Assistance Program (COGAP) was established as a nonprofit organization last August in Bend to provide guardianship services to indigent and low-income incapacitated individuals in the Central Oregon area. And it's already having a positive impact.

The nonprofit was formed in response to the rapid increase of indigent and low-income incapacitated adults having no family or other legal decision-making support cycling through the hospital and jails or unhoused in our communities, and without care and housing appropriate to their needs.

Executive Director Lisa Bertalan spoke with us about the program's early success: "We're emptying the reservoir, one teaspoon at a time, so I hope it's more like a tablespoon."

Bertalan practiced law in Central Oregon for more than 30 years as an elder law and estate attorney and retired in 2022 from the firm of Brinich & Bertalan, LLP, of Bend, of which she was a founding partner.

The program was formed following input from the Council on Aging of Central Oregon, the state Department of Human Services, adult behavioral health agencies and mental health agencies, elder law attorneys, judges, trial court administrators, the probate commissioner, law enforcement, professional guardians and medical professionals.

COGAP provides pro bono and low-cost guardianship services to Central Oregonians with limited means who are incapacitated and unable to make medical, housing, and financial decisions for themselves. They offer a variety of services including access to basic needs and direction into placement programs.

They help people who are unable to make decisions regarding medical treatment, housing, and nutrition due to a lack of capacity by providing pro bono guardianship services to those in need.  Often these individuals may be unhoused, dealing with learning or cognitive disabilities, mental illness, acute medical needs, dementia, or Alzheimer’s Disease and/or substance abuse disorders. 

“Someone who might be older and experiencing dementia or Alzheimer's type dementia, somebody who suffers from a mental illness such as some sort of schizophrenia. normally somebody might have a child or a spouse or somebody that could step in and assist with those decisions," Bertalan said. So they are helping "a segment of the population that really have no family or no support system in place that can step in and do that."

When individuals enter the program, Bertalan said, “usually they require some sort of placement, sets up appropriate primary care physician, puts together a long-term care plan, nutritional plan, medication plan, so that these people can continue to to lead a stable, safe life."

The referral process for the program is through multiple avenues, often involving city and county agencies. COGAP participates in high-risk team meetings with representatives from Behavioral Health, Adult Protective Services and the hospital that refer individuals.

Bertalan said you can also "go to our website and send me an email. We've received a referral a week. We get a lot of referrals from Deschutes County Behavioral Health."

COGAP's goal for this year is to help a total of 25 individuals and to get additional funding.

"I feel like every every victory we have where we help somebody, where we're either putting somebody in a better situation than they were the day before," Bertalan said. "And that makes my heart grow when we do that."

The guardian program is also beginning a volunteer campaign open to the community. They're accepting applications via their website. The nonprofit is also seeking to partner with COCC to start a guardian training program.

While serving on the Elder Abuse Task Force, Bertalan drafted several bills that are now law to protect Oregon seniors from financial and physical abuse. She also created and co-chaired the Central Oregon Elder Law Council and was a frequent presenter and author in areas of guardianship conservatorship law, bioethics, elder abuse, estate planning, elder law, and probate administration. 

Emily Coxey serves as COGAP’s staff guardian. She received her Bachelor of Arts degree in Liberal Arts with a social science option from Oregon State University.

Coxey has worked as a partner and office administrator in a certified public accounting firm for over 21 years. In 2010, the firm added conservator, fiduciary and guardianship services to the practice which shey manages and serves as a Certified Guardian and Conservator.

Coxey is a National Certified Guardian and Conservatorship as certified by the Center for Guardianship Certification.  She also serves as a mentor to apprentices who are interested in learning more about elder care and becoming a Professional Guardian and Conservator. And she is a member of the Guardian/Conservator Association of Oregon and serves on the membership committee. 

COGAP operates with a five-person working Board of Directors who bring legal, financial, and medical expertise to the table in advising the organization. COGAP also uses the expertise of a five-person Advisory Committee that reviews all program applications.  In doing so, COGAP is steadfast in maintaining confidentiality and HIPAA compliance with all referrals to the program.   

Since the program’s inception only six months ago, COGAP has assisted 20 incapacitated individuals. Referrals to the program are from Deschutes County Behavioral Health, St. Charles Bend, Adult Protective Services and Deschutes County Court.

A recent case COGAP staffed arose out of a referral from Deschutes County Circuit Court regarding an elderly gentleman who had suffered a series of strokes and with severe dementia (most probably Alzheimer’s Disease) who had been housed inappropriately at the Deschutes County jail on for almost two years.

The criminal charges in this case were due to his dementia, paranoia and confusion, all symptoms of advanced Alzheimer’s Disease. The man was deemed never able to aid and assist his defense because of his severe and progressive cognitive impairment. In such cases, by law, the case is dismissed, and the person is released to the community.

This gentleman is a Veteran and a decorated Search and Rescue body recovery specialist with no criminal history. 

Upon a referral from Judge Allison Emerson, County Counsel, and the District Attorney’s office, COGAP became his guardian, and within a week of such referrals, he was released from jail and transported directly to a memory care facility, which continues to provide him with appropriate care and a safe and secure living environment.

COGAP says it will continue to provide this gentleman with support throughout his lifetime. Without COGAP’s intervention, he would have been released to the community without a care plan, support, or the means to ensure his safety and well-being.  

COGAP is currently supported by St. Charles Health System, Deschutes County, Horner Law, LLP, and the Central Oregon Health Council.  COGAP’s initial funding came from Deschutes County, St. Charles Medical Center Foundation, and the Central Oregon Health Council. All three organizations gave $100,000 to COGAP.

Future grants from Oregon Health authority are pending, while initial funding remains consistent.

For more information about the Central Oregon Guardian Assistance Program, visit www.co-gap.com.