albany elder law

Dental Care and Old Age

Published on: April 13, 2017 | by Ettinger Law Firm

As we continue to age, there are a number of ailments that develop and health issues that we are forced to address and adapt to. While we anticipate problems such as achy joints and the occasional stiff legs, we do often forget about the continued upkeep associated with dental hygiene. Dental checkups are easy to forget about and avoid, especially when you do not feel like anything is wrong, however, as soon as something starts to ache, the check up can turn into a very expensive visit. Many elderly individuals avoid going to the dentist due to the associated fear of costs and lack of coverage.

Medicare does not provide dental care coverage for their insured beneficiaries, which leads many to either go without coverage or to retain an independent plan that could cost them more than they can afford in their budget. Millions of elderly Americans rely on Social Security and Medicaid or Medicare to support them in their old age, however, these programs continue to shrink in size and will not be able to provide for all of those soon to be retirees. Medicare does provide dental care for some chronic medical conditions such as reconstruction following an accidental injury, or extraction due to radiation exposure for neoplastic diseases of the jaw, a very specific list. Even with those exceptions, the reimbursement rate is so low that some doctors will not accept Medicare coverage in their offices because they know how difficult it becomes to get paid.
The National Center for Health Statistics has found that 20% of Americans over 65 years old have cavities that are currently going untreated, with the numbers steadily increasing with old age. With teeth becoming more brittle and procedures performed decades earlier needing maintenance, many elders find themselves in the Emergency Room due to the pain. There are a number of nonprofits however across the nation that offer free or discounted dental cleanings for elderly patients that do not have dental coverage and cannot afford it. Additionally, many universities offer discounted cleanings as well as procedures by having elderly patients be seen by their class of graduating dentists. They will offer up front costs of services as well as payment plans in an effort to avoid having the individual rack up debt.

Meals on Wheels Funding Gets Threatened

Published on: April 11, 2017 | by Ettinger Law Firm

Meals on Wheels is a government program that started in the 1950s that has assisted elderly citizens by delivering food to them when in need, either by providing the meals in the elderly individual’s home or in a community senior center. They not only provide the meal but also provide safety checks and visit with the senior, critical actions that have been shown to help elders live longer. There are over 5,000 independent organizations across America that help administer the program, and it has for decades, had much success. In order to receive funding local communities as well as the Older Americans Act help to keep the program afloat.

As the new budget is proposed, many programs are in jeopardy of being cut. One program that is may see a threat to funding is Meals on Wheels, due to the program not providing results. However, the nature of the program is not a results oriented initiative. The program services 2.4 million Americans, a number that will undoubtedly grow in the coming decades due to the large number of baby boomers beginning the retirement age. These cuts are the result of discretionary spending decisions related to the Community Development Block Grant that allocates a portion of the block grant money to elderly through Meals on Wheels. There have been numerous studies conducted that have showed the effectiveness of Meals on Wheels decreasing loneliness scores and also decreasing reliance on traditional care, while allowing elderly individuals to remain in their homes longer.

However, there are conflicting opinions about how much influence this will actually have on the institution. From financial statements released last year, only about 3% of the total funding was made from the block grant. On a local level, there is much more monetary influence, with federal funds accounting for 30% of the expenses relating to the home delivered meals. While the program’s costs and returns are currently being debated, it is evident that although it may not be the most lucrative on it’s face, Meals on Wheels can provide a number of benefits. One study even found that if there was a 1% increase in elderly individuals receiving Meals on Wheels, states would saved over $109 million, due to reductions in need for nursing home care.

The Future of Medicaid

Published on: April 7, 2017 | by Ettinger Law Firm

One of the biggest promises in the Trump candidacy was repealing Obamacare, a promise he attempted to follow through on within the first few months into his presidency. Speaker of the House, Paul Ryan, was a widely known proponent, who worked to rally votes and repeal Obamacare in order to get The American Health Care Act implemented in it’s place. While the vote was called off before a final count was made, the American Health Care Act still has some changes to make before there will be bi-partisan agreement. It is not a surprise that this program was one of the first to be reconsidered for funding, the program covers 74 million people alone.

Lawmakers were drastically divided on the topic, with those focused on public health benefits contesting the bill due to the cut in benefits that those most in need would experience, Once Obamacare was fully implemented, Medicaid programs across the nation greatly expanded, giving coverage to 11 million Americans opting for coverage under the federal program, which in turn assisted states who were not able to pay for the health care expansion for their citizens on their own. Medicaid was able to expand coverage to so many Americans by qualifying low income individuals for the program and paying through state and federal funding. Governors in Alaska, Arkansas, Colorado, Michigan, New Hampshire, Nevada, and Ohio all oppose any kind of restructuring for their Medicaid programs. Kansas and North Carolina are currently attempting to expand their Medicaid in light of the recent bill failure.

On the other side of the debate, critics of the mandatory health care system feel that it has left states and citizens ‘hooked’ on the federal government supplying funds for health care now. The states that receive federal assistance with Medicaid cannot sustain losing the funding while still providing coverage to all their citizens. While some states are starting to cover some costs associated with their Medicaid expansions, the federal government in 2017 is still covering at least 90% of the costs associated with the expansion, which is projected to continue through 2020. Critics continue to note the declining insurance provider participation in Medicaid and Obamacare services which fails to provide medical specialists.

Family Members Acting as Paid Caregivers

Published on: April 4, 2017 | by Ettinger Law Firm

The demand for caregivers will begin to far exceed the amount of elderly individuals who need caring for in the United States, as our elderly population will grow substantially in size by the year. As the caregiver network continues to dwindle, there have been efforts made throughout the country to retain those caregivers leaving the field for other opportunities, regulate the field more to better advocate for caregivers rights, and to consider alternatives for care and treatment for the elderly community. This job of being a professional caregiver can be physically and emotionally taxing and for those who cannot afford assistance, these responsibilities can begin to fall on the loved ones that surround them.

The role of caregiver has been assumed by more than 65 million people who provide care for a chronically ill, disabled or aging family member in United States. Many of these family member caregivers care for their loved ones upwards of 20 hours a week, without compensation. This role can take a toll on their personal lives and impact their ability to perform at a full time job throughout the week. As a response to this, lawmakers in some states have begun to offer family members who act as caregivers compensation for their time spent with their elderly loved one. Compensating the family member helps offset the time set aside as well as the expenses incurred by traveling or giving time to other areas.

While the name varies between the states, programs that compensation family members include consumer directed care, cash and counseling, and family member caregivers. The regulations differ between the states as to who will qualify as a caregiver, what they are compensated, how much and what benefits they may possibly have. Those who have a loved one who is also a veteran may qualify for aid and the attendance pension benefits through the Veteran’s Administration. If you are in a state without these benefits or would like to form a private agreement, many families draw up a personal care agreement.

The Role of the Executor

Published on: February 26, 2017 | by Ettinger Law Firm

There are plenty of fancy words in law that actually have very basic definitions. Estate planning law is no different, with plenty of legal terms that can often be hard to unpack and understand. One such term that gets thrown around a great deal in the field of estate planning is “executor.” Who is an executor? What is their role? The following information may help you understand more about an executor and their role in your estate planning.

What is an executor?

The person creating a Will, known as the testator, will name someone that will be responsible for administering the provisions of the will in compliance with the law known as the executor. Basically, an executor oversees making sure that debts are paid and remaining assets are distributed per the testator’s wishes. Depending on the characteristics of your estate, some of the executor’s jobs may include:

Elderly Abandonment: An Issue Around the World

Published on: February 17, 2017 | by Ettinger Law Firm

Aging comes with a wide variety of issues and relying on the care of your family is not a resource available to all. Whether it is due to lack of accessibility, estranged familial relationships, or advanced care requirements, many elderly find themselves alone in their older age.

This is not a phenomenon specific to America, it is an issue experienced by countries across the world. Certain cultures are more focused on caring for their elders, much like those elders helped raise them, while others have a less integrated idea of family including care for their elders.

In fact, the issue of elderly abandonment was such a large problem in Japan it was deemed “granny dumping”. While this practice, where senile senior citizens were taken up to the top of mountains and left there by loved ones due to the inability to care for them, is a very old practice, the modern version of abandonment is once against becoming a problem. Today, elderly individuals are being taken to local hospitals, churches and charities, and being left like they used to in the mountains.

Fiduciary Duties & The New Rule for Financial Advisors

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

The New Rule

When consulting a financial advisor, we all assume that they would have our best interest in mind when determining where our portfolio should be invested and what investments best suit our interests, however, this has not always been the case. This year, the Labor Department issued new regulations that require industry professionals dealing with individual retirement accounts and 401k accounts to act on the best behalf of their clients.

Before this new standard was issued, financial advisors only needed to meet a suitability standard, meaning that the financial advisor only has to choose what is suitable for the portfolio, which is not always what is in the client’s best interest. A financial advisor under this standard could invest in a fund he found suitable, but may be more risky or expensive, although a similar option is available with a different fund. This suitability standard led to many advisors investing in funds they were personally interested in, sparking a need for change.

The Right to Die: New York’s Medical Aid in Dying Act

Published on: July 12, 2016 | by Ettinger Law Firm

Nationwide

The Death with Dignity Act gained national attention when it Brittany Maynard, a 29 year old woman suffering from an incurable brain tumor, chose to end her life with the help of a lethal dose of medication. Since then, a national debate has resurfaced about terminally ill patient’s ability to decide when, not if, they are going to die. Currently, the Death with Dignity Act has been passed in California, Oregon, Vermont and Washington, with proposals in many more states, including New York.

New York

ADULT GUARDIANSHIPS, RESTORING RIGHTS

Published on: February 9, 2016 | by Ettinger Law Firm

GUARDIANSHIP CAN BE VACATED

As this blog has discussed in some detail in the past, Adult Guardianship is a complicated area of the law, dealing with many sensitive issues of personal power, ability and basic competence. On a very basic level, guardianship is a judgment that is entered by a Court, which allows one person the the legal right to exercise decision making over another. The basic medical reality is that once competency is gone, an individual often does not regain that capacity back.

As such, when a Judgment of Guardianship is entered is often permanent. There are plenty of cases to show that this is indeed not so common so as to consider it an inalterable rule. The law recognizes this fact and allows for a judgment of guardianship to be vacated if and when a person regains their facilities. Under current New York law, a guardianship Judgment may be entered upon the consent of the ward (protected party), or, if not by consent, then by clear and convincing evidence that someone (either the potential ward or a third party) will likely suffer harm because :

FAIR HOUSING ACT IN SENIOR HOUSING

Published on: November 22, 2015 | by Ettinger Law Firm

CIVIL RIGHT ACTS DEALING WITH ELDER LAW MATTERS

The Fair Housing Act of 1968 was one of the raft of civil rights acts promulgated to help make the promises of Civil Rights Era real. In its current, amended form, it prohibits discrimination in the sale, rental and financing of housing based on, among other things, disability status. The Age Discrimination Act of 1975 is another enactment that speaks to the issue of senior housing, as it bars age discrimination in any program or activity that receives federal financial assistance. While there is a “housing for older person exemption” that is beneficial for seniors who need the special services found in many communities, the right to restrict housing is limited to only certain delineated situations. Indeed, the protections for senior housing are broad and robust.

HIDDEN FAIR HOUSING VIOLATIONS ISSUES IN SENIOR HOUSING