Elder Law

HOME CARE SERVICES IN NEW YORK STATE

Published on: March 29, 2016 | by Ettinger Law Firm

IN HOME PERSONAL ASSISTANTS

If you already have New York Medicaid you may be eligible for managed long term care or in home care by a licensed Managed Long Term Care Agency (often simply referred to as MLTC). The animating thought is to ensure that older adults can remain in their home and community rather than in a nursing home. The menu of options available to eligible New York state residents is actually quite extensive. In fact, there is even the option of hiring and training your own personal assistant, know as Consumer Directed Personal Assistance Program.

Traditionally, they could not live with you and you cannot hire your own spouse, parent, son-in-law, son, daughter-in-law or daughter, although they can be grandchildren, neices or nephews or any other relative for that matter. That requirement is changing in April, 2016. There is an exception that allows your personal assistant to live in your home if the amount of care required by the patient makes it necessary. That means that parents (usually of a disabled child), children, grandchildren or sons and daughters in law may reside in the home and care for the patient and get paid for it. You are also required to hire and train an alternate for when the primary care assistant is unable to come to your home because of vacation or need for sick time.

MEDICARE AND HOSPICE CARE

Published on: March 25, 2016 | by Ettinger Law Firm

FOCUS ON COMFORT

Hospice care is intended to ensure that those who are in the final stages of a terminal illness are cared for and comfortable. It is not to cure a current disease process. Instead it is to help provide a more holistic or all encompassing level of care. The patient’s medical, emotional, mental, social and religious needs are addressed. Prior to entry into a Medicare hospice program you and your family will meet with your hospice team to address the families needs, obviously with primary focus on the patient. Included within that plan, there could be social workers, dietary consultants, nurses, physicians, speech pathologists or any other medical professional that is Medicare eligible.

There are times when a hospice care plan will include bereavement counselors and priests or chaplains. Care can even be provided in home, unless your hospice team determines that the level of needed care can only be provided in an inpatient facility. If the care is in home and one of the primary caretakers needs a break, Medicare authorizes respite care for up to five days each time respite care is authorized. Respite care may be available more than once it is not authorized more than once very often.

PARENTAL VISITATION LAWS – RIGHT TO VISIT PARENT OF ADULT CHILDREN

Published on: March 22, 2016 | by Ettinger Law Firm

ANOTHER CELEBRITY CASE MAKING CHANGES

In the last few months that Casey Kasem had on this earth, he was the center of a brouhaha between his daughter, Kerri Kasem, and her stepmother, Jean Kasem, Mr. Kasem’s second wife. More specifically, Kerri Kasem alleged that at the end of the Mr. Kasem’s life she tried to visit with him but was not allowed until she forced the issue via a court Order. Kerri obviously cared deeply for her father and was clearly distraught over how everything played out during Ms. Kasem’s last few months as almost anyone would. She decided to do something about it and created the Kasem Cares Foundation to advocate for parental visitation laws.

It is not surprising that Kerri Kasem sound to advocate for change, as Mr. Kasem was well known for his advocacy against things such as factory farming and his refusal to engage in movies as a voice actor that portrayed Arabs in a negative light; the Kasem’s are of Lebanese heritage. Kerri Kasem also followed her father into the radio industry. Mr. Kasem passed away on June 15, 2014 and in the last two years, the foundation can justifiably claim some modest success.

NURSING HOME EVICTIONS

Published on: March 17, 2016 | by Ettinger Law Firm

LEADING COMPLAINT ABOUT NURSING HOME IS EVICTIONS

On February 25, 2016 National Public Radio (NPR) ran a story about what is looking to become like a national epidemic: nursing home evictions. According to statistics between 8,000 and 9,000 nursing home residents complain each year about nursing home evictions. The problem with this statistic is that it only measures the complaints, not the actual evictions. As if not being able to measure the full extent of the actual problem is not enough, there is a larger, more grievous issue wrapped up in the issue of nursing home evictions. According to the ombudsman to the Federal Department of Health and Human Services, Administration on Aging, it is the number one complaint regarding nursing facilities. In many cases the nursing home wrongfully evicted the resident(s) but will not honor rulings that find that the nursing home wrongfully evicted the resident. The entity that decides if a facility wrongfully evicts a resident is not the same entity to enforce its own decision. Without a sister state agency to enforce its decision (much like one state honoring a sister state’s money judgment on full faith and credit), such legal endeavors by residents are simply an exercise in futility. The rulings are not worth the paper they are printed on. It is a prime example of a bureaucracy run amok; without teeth to enforce its own ruling. One can and should rightfully ask, why do the agencies even bother to engage in a hearing to only allow the offending party to blithely ignore its ruling?

FEDERAL CASE TO FORCE CALIFORNIA TO ACT

MAJOR NURSING HOME CASE TESTING MANDATORY ARBITRATION CLAUSE

Published on: March 15, 2016 | by Ettinger Law Firm

CASE OF POTENTIALLY NATIONAL IMPORTANCE REPORTED IN NEW YORK TIMES

On August 21, 2009 a tragic event occurred at a nursing home in the quaint coastal town of South Dartmouth, Massachusetts. Elizabeth Barrow was over 100 years old at the time of the tragedy, but told her son on her birthday when she turned 100 that she wanted to live to be 104. The New York Times article describes her as a sweet, compassionate woman full of verve and love even in her advanced age. She was known around the nursing home as offering people hugs. It is no surprise that she made friends quickly and was quite popular amongst the fellow residents. Mrs. Barrow entered the nursing him in 2006 with her husband, with whom she shared a room. She felt fortunate just the same because her room gave her a terrific southern exposure, which helped her grow her beloved african violets. Then in 2008 Ms. Barrow’s new roommate moved in with her, after the new roommate had an argument with her previous roommate.

The exact nature of the relationship between Ms. Barrow and her roommate and very much in dispute. What is known is that soon after Ms. Barrow’s death the local District Attorney filed second degree murder charges against the 98 year old roommate. Soon after the charges were filed, the Defendant was found incompetent to stand trial. As of the time of the writing of the New York Times article, the Defendant was still alive at 104 in a local state hospital. Given her advanced age it is unlikely she will ever stand trial.

LONG TERM CARE THROUGH LIFE INSURANCE POLICY

Published on: March 10, 2016 | by Ettinger Law Firm

CONVERSION OF LIFE INSURANCE DURING LIFE OF COVERED INDIVIDUAL

As this blog discussed in the past, long term planning insurance is something that many consumers are reluctant to purchase for a number of reasons One of the main reasons for this reluctance is the long term cost may not financially justify its utilization. Life insurance companies recognized this problem and started to allow for a hybrid financial product in their life insurance policies. The life insurance company allows for the conversion of a life insurance policy to pay for the long term care services.

The animating philosophy is that there will be a pay out regardless of whether or not it happens during the insured’s lifetime, so the life insurance company could just as easily pay out on the policy during the insured’s life. Every day over 10,000 baby boomers turn 65, so the population base that could potentially utilize such as a product is growing larger every day. It is estimated that at least 70 percent of the baby boomer population will need some sort of long term care during their lifetime, with 40 percent in need of nursing home treatment.

TOOLKIT TO HELP PREVENT SENIORS FROM FALLING

Published on: March 8, 2016 | by Ettinger Law Firm

SIMPLE GUIDELINES, EASY TO UNDERSTAND AND FOLLOW

The Center for Disease Control (CDC) released guidelines to help prevent and mitigate falls among senior citizens in 2012. The CDC program is called STEADI, an acronym coming from the full title Stopping Elderly Accidents, Deaths and Injuries. Research shows that falls are the leading cause of injuries, death and emergency room visits for trauma. If a senior citizen falls it can literally be a traumatic, life altering event or even a deadly one. The silver lining is that many falls are preventable. Last year the Obama Administration announced that that the White House Conference on Aging, the Administration on Aging awarded $4 million in various grants to help expand STEADI. It is estimated that the increased funding will help reach an additional 18,000 at risk senior citizens. It is further hoped that the funding will increase participation in evidence based community programs and improve the overall programs long term viability. The CDC developed these guidelines in conjunction with British and American Geriatric Societies.

The American and British Geriatric Societies already had clinical practice guidelines in place to better define the various risk factors in falls by senior citizens. The CDC guidelines contain basic information about falls, methods to begin conversations with seniors, balance assessment tests, gait assessment tests along with instructional videos for the gait and balance tests and even case studies of the the fall risks for different senior citizens. The program and recommendations are all inclusive in that the STEADI program at the CDC website has a testing protocol for professional medical care providers, to information about webinars and other instructional videos, material for senior citizens themselves, important facts about falls, referral forms, posters for professional establishments, with posters also available in Spanish and Chinese and most importantly, it has a toolkit for medical professionals.

OPERATION COCOON: FEDERAL EFFORT TO CURB UNWITTING SENIORS FROM ACTING AS DRUG MULES

Published on: March 4, 2016 | by Ettinger Law Firm

On February 10, 2016 the United States Immigration and Customs Enforcement (‘ICE’) announced in a policy document that appears to coincide with ranking ICE officials testimony before the United States Senate Special Committee on Aging that it recently launched ‘Operation Cocoon‘ to help curtail the use of “elderly citizens” unknowingly acting as drug couriers, or drug mules as couriers are sometimes referred to as, from foreign countries to the United States or to other foreign countries. While not part of the policy document released, typical of the victims of such scams is J. Byron Martin a 77 year old retired minister from Maine, who thought he was helping a fellow soul by transporting what he believed to be books from Peru to London via Spain.

It turned out that the books in issue had drugs secreted away in them. Mr. Martin’s son, Andy Martin of Henderson, Nevada testified that his father was never arrested in his 70 plus years on this planet prior to this episode. Mr. Martin is now serving a seven year sentence of incarceration in Spain. Senator Susan Collins presided over the hearing and indicated that the ensnared seniors are duped into transporting the drugs, those with the requisite criminal intent secret the drugs away in “chocolates, picture frames, tea, markers, canned goods, shampoo bootles, soap and wooden hangers.” The hearings were an effort to get the word out about this very serious danger. Both the Senate Committee on Aging and ICE operate a toll free number to report suspected scams. That number for ICE is (866) DHS-2-ICE; (866) 347-2423. The phone number for the Senate Committee on aging is (855) 303-9470.

RAW NUMBERS

PERSONAL INJURY AND MEDICAID: WHY WOULD STATE GET INVOLVED IN PERSONAL INJURY SETTLEMENT?

Published on: March 1, 2016 | by Ettinger Law Firm

It is a fortunate state of affairs that it is happening less and less, with the requirement for every American obtain health insurance under the Affordable Care Act (often called Obamacare), that some people do not have proper health insurance coverage for a catastrophic injury. It is still unfortunate that is happens often enough. As such, either a loved one or when you are well enough retain an attorney in a personal injury suit against the offending party or entity for your past pain and suffering, future anticipated pain and suffering and future medical bills.

Most personal injury attorneys know that any settlement or jury (or even judge if the matter proceeded to trial without a jury) award should earmark or indicate the amount of the award or settlement for your future medical expenses because the government will get involved and assert a lien over any financial award for medical expenses. This overall schema enables you to effectuate a meaningful change in your life, by satisfying the state’s obligation to recoup its medical costs and leaves some money to you to live at a level above the basic minimum that medicaid insures.

It must be asked, however, what of the cases where there is no designation of the settlement or verdict that speaks to the amount awarded for medical expenses and what is pain and suffering or other line awards. Both Congress and the Federal Supreme Court dealt with these issues. Congress enacted 42 U.S.C. § 1396p(a)(1) as part of the Social Security Act that prohibits the government from asserting a medicaid lien against the property of a medicaid recipient, except under certain clearly delineated circumstances. One of those delineated circumstances is when the state may seek recovery for “any medical assistance correctly paid”. The Supreme Court dealt with this issue in 2013, in the case of Wos v. E.M.A. when it ruled that a state may only asset a medicaid lien against that portion of a personal injury settlement or verdict that is specifically designated for medical expenses.

PRE-PAID FUNERAL S IN NEW YORK

Published on: February 26, 2016 | by Ettinger Law Firm

NEW YORK PROTECTIONS

Many people are leary about purchasing a pre-paid funeral. This blog discussed some of the issues common to prepaid funerals. In 2002, the American Association of Retired People (AARP) issued a consumer “scam alert” warning people to preplan but not prepay for their funerals. Indeed, often this is good advice. What really should be discussed and should be planned for and paid for is an irrevocable prepaid funeral fund.

It will not render a person ineligible for Medicaid, as Medicaid treats irrevocable trusts as an exempt asset. Some prepaid funeral plans incur account maintenance fees or various other unforeseen problems could result from prepaying for a funeral. It is important to note, however, that New York has some of the strongest consumer protection laws in place for prepaid funerals. Most specifically, the law requires that the money be put into an individual account – as opposed to an account for all of the individuals who prepay for their funeral through a particular funeral director or funeral home – that is both interest bearing and insured, which remains the property of the consumer. If the funds are in a revocable account, the consumer may request a full refund at any time. The funeral home or funeral director also ensures that the consumer receives a notice of what bank the funds are held in and as well as a statement of any interested earned.