Friday, May 15, 2015
On May 12, the U.S. Department of Justice announced resolution of a disabilities discrimination complaint initiated by residents of a Continuing Care Retirement Community (CCRC) in Virginia.
The resolution includes filing of a complaint and consent order that resolves allegations that Fort Norfolk Retirement Community Inc. (Fort Norfolk) violated the Fair Housing Act by instituting policies that discriminated against residents with disabilities at Harbor’s Edge, a CCRC in Norfolk, Virginia:
The consent order, which still needs to be approved by the court . . . along with a complaint, in the U.S. District Court of the Eastern District of Virginia. The complaint alleges that beginning in May 2011, Fort Norfolk instituted a series of policies that prohibited, and then limited, residents in the assisted living, nursing and memory support units at Harbor’s Edge from dining in dining rooms or attending community events with independent living residents. The complaint also alleges that when residents and family members complained about these policies, Fort Norfolk retaliated against them. In addition, the complaint alleges that Fort Norfolk had polices that discriminated against residents who used motorized wheelchairs by requiring those residents to pay a non-refundable fee, obtain liability insurance and obtain Fort Norfolk’s permission.
Under the consent order, Fort Norfolk will pay $350,000 into a settlement fund to compensate residents and family members who were harmed by these policies. Fort Norfolk will also pay a $40,000 civil penalty to the United States. In addition, Fort Norfolk will appoint a Fair Housing Act compliance officer and will implement a new dining and events policy, a new reasonable accommodation policy and a new motorized wheelchair policy.
There is a history of similar issues arising in other CCRCs. For example, in 2008, in California, CCRC resident Lillian Hyatt initiated, and eventually resolved to her satisfaction, a discrimination claim based on a ban on "walkers" in the dining rooms of her community.
As the average age of residents in CCRCs has increased in recent years, the "appearance" issues are sometimes raised as a marketing or image concern, contrasting sharply with the expectations of individual residents as they age and seek continued access to the full range of services in their community.
Our thanks to Karen Miller, Esq., of Florida, for bringing the recent Virginia case to our attention.
Thursday, May 14, 2015
PBS is premiering a powerful documentary special, Caring for Mom & Dad, during the month of May, with Meryl Streep as the narrator. A sample? Many of us might find resonance with one adult's "bad daughter" (or "bad son") feelings of guilt, candidly admitted here.
Even more important than the video itself will be the conversations that follow viewing. Check your local public t.v. schedule to see when the program will air in your area. (You can check here, to see if the documentary is scheduled yet in your viewing area -- go to the drop down menu for "Schedule.") Plus, in some markets, the documentary will be combined with a live call-in opportunity for individuals and families to explore health care, social care, financial topics and legal issues with a panel of experts.
My own university, Penn State, is hosting the special on Thursday, May 28, 2015 at 8:00 p.m. (Eastern time), followed by Conversations Live at 9:00 p.m. That is two weeks from today on WPSU-TV, a station that reaches a viewing area of 29 counties in central Pennsylvania. In addition, the Conversations Live program will be broadcast on WPSU-FM radio and can be viewed "on-line" at WPSU.org.
As a result of an invitation to be part of the WPSU studio panel, I've had the opportunity to watch the documentary -- several times (it's that interesting!) -- in preparation to help in responding to audience comments, emails and call-in questions. Additional Conversations Live guests include:
Ai-jen Poo, co-director of Caring Across Generations and director of National Domestic Workers Alliance, will be joining via satellite from D.C. Ai-jen Poo is featured in the documentary, and she also has a particular interest in enactment of a Domestic Workers' Bill of Rights, to deal realistically and fairly with the work force that will be necessary to meet the boomer generation's care needs.
Dr. Gwen McGhan, Hartford Center for Geriatric Nursing Excellence at Penn State, with a research background on informal family caregiving.
Jane McDowell, Hartford Center for Geriatric Nursing Excellence at Penn State, and a geriatric nurse practitioner.
The documentary was produced by WGBH-Boston, with funding assistance from AARP and Pfizer.
Please join us and share your stories and observations. The documentary starts with personal stories, but the public policy messages that emerge are ones that need to be heard at state and federal levels -- and heard clearly -- for there to be hope for realistic, necessary and timely solutions.
May 14, 2015 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Federal Statutes/Regulations, Film, Health Care/Long Term Care, Medicaid, Medicare, Social Security, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Wednesday, May 13, 2015
The recent issue of Bifocal, the bi-monthly Journal of the ABA Commission on Law and Aging has a great line-up of articles, including a piece by Social Security Administration (SSA) specialist Janet Truhe on Social Security Seeks Pro Bono Lawyers to Meet Need for Representative Payees. She notes that many disabled individuals do not have family members or other trusted persons who can serve as their agents for receipt and management of Social Security benefits. Anticipating the need for "rep payees" will continue to grow as boomers age, SSA is recruiting attorneys to serve:
Recently, the agency announced the implementation of a pro bono pilot in the State of Maryland (where SSA is headquartered), which is aimed at expanding the pool of suitable representative payee candidates statewide. SSA believes that partnership with the legal community for this purpose is a natural fit....
One particular advantage of this pro bono opportunity is that any attorney, regardless of his or her specialty, can serve as a representative payee with SSA providing any needed assistance. SSA has created a web site for attorney volunteers with training and other information about the role of a representative payee. Any licensed attorney in Maryland, or in neighboring jurisdictions, who would like to volunteer as a representative payee for a beneficiary residing in Maryland can go to http://www.socialsecurity.gov/payee/probonopilot.htm and complete an online registration form. SSA will send the volunteer attorney’s contact information to the servicing local field office. When SSA needs a representative payee for a particular beneficiary, that field office will contact one of the volunteer attorneys and make an appointment for the attorney to come in for an interview and meet the beneficiary.
Hat tip to ElderLawGuy Jeff Marshall for pointing out this SSA recruitment effort.
One option for seniors needing more income late in life is using the equity in their homes, and "reverse mortgages" may make it possible for the older homeowner to stay in the home longer. The Washington Post recently explored the option of having family members serve as the source of reverse mortgage funding. When the Kids Provide a Reverse Mortgage for Mom and Dad outlines potential pros and cons of family-based financing, starting with the mechanics of the loan:
Here’s a simplified example: Say you and two siblings want to help Mom and Dad, who are in their late 70s. You and your siblings are all doing well enough that you have at least some cash to spare. Ultimately, you want to retain your parents’ house for the estate once your parents pass away, keep costs to a minimum and sell the property only when you, not a faraway bank, choose to do so.
So you sit down with Mom and Dad and determine that, at least for the foreseeable future, they will need about $1,500 in additional income a month. You and your siblings agree to apportion the payments among yourselves in some way, maybe a commitment of $500 a month each for a period of years. You also pick an interest rate that achieves a win-win result for you and your parents — say, 3 percent annually. That’s much lower than a commercial lender would charge but higher than what you’ve been earning on your bank deposits or money market funds. There are no required fees upfront — hey, it’s Mom and Dad.
Thanks to Maryland elder law attorney Morris Klein for the pointer to this article.
Tuesday, May 12, 2015
We've written on this blog several times about successful prosecutions connected to so-called "off label" drug use, including the use of antipsychotics for agitation in dementia patients. See here and here, for example. Now, courtesy of a New York Times article, there is news of a pharmaceutical company's lawsuit to preempt such prosecutions, raising First Amendment free speech rights as grounds for off-label advocacy:
On Thursday, Amarin Pharma took the unusual step of suing the Food and Drug Administration, arguing that it has a constitutional right to share certain information about its product with doctors, even though the agency did not permit the company to do so. Lawyers for the company said that they believed their case was the first time a manufacturer had pre-emptively sued the agency over the free-speech issue, before it had been accused of any wrongdoing. Other companies have sued the agency only after they have gotten into trouble....
Lawyers for Amarin say the company is not proposing to market Vascepa to a wider population of patients, merely to share with doctors the results of a 2011 company-sponsored clinical trial that showed the drug lowered triglycerides in patients with “persistently high” levels....
More details about the suit available here.
Monday, May 11, 2015
Last week I was visiting in Ireland, and specifically in Belfast, Northern Ireland, where I was giving a workshop on comparative contract law for students at Queen's University Belfast in its new J.D program. When I visit the city, I always try to save a day for a "dander" around the town, which is wonderfully walkable.
St. George's Market is a favorite spot -- and in fact last year while I was visiting, Queen Elizabeth was there too, a definite surprise, if you know the history of politics in this city.
There is an interesting collection of stalls, that change a bit with the season and the day.
Tuesday, May 5, 2015
Yesterday I posted about a new report on Americans' views of the "retirement crisis". Another report from the same organization, National Institute for Retirement Security ,focuses on Americans saving for retirement. The Continuing Retirement Savings Crisis is a 30 page report that offers 4 key findings:
- Account ownership rates are closely correlated with income and wealth…
- The average working household has virtually no retirement savings. When all households are included— not just households with retirement accounts—the median retirement account balance is $2,500 for all working-age households and $14,500 for near-retirement households…
- Even after counting households’ entire net worth—a generous measure of retirement savings—two thirds (66 percent) of working families fall short of conservative retirement savings targets for their age and income based on working until age 67...
- Public policy can play a critical role in putting all Americans on a path toward a secure retirement by strengthening Social Security, expanding access to low cost, high quality retirement plans, and helping low income workers and families save…
Here we go again. Another hard look at why a significant percentage of the public has not signed some form of advanced directive. In April 2015, GAO issued Advance Directives: Information on Federal Oversight, Provider Implementation, and Prevalence, its response to requests made by Senators Bill Nelson (D-Fla), Johnny Isakson (R-Ga), and Mark Warner (D-Va) who were inquiring into the role of the Centers for Medicare and Medicaid Services (CMS) in overseeing providers, including hospitals and nursing homes, that are mandated by law to maintain written procedures and provide information about advance directives.
Perhaps it is just me, but whenever legislators raise this topic, it seems to me the not-so-subtle underlying message is "why aren't people agreeing in writing to forego aggressive health care as they near the end of life so that we can save more money on health care?"
In any event, the report:
- documents current practices for offering living wills, health care powers of attorney, and various alternatives such as DNR and POLST forms (including the potential for some confusion among staff members of health care providers about "who" should be handling the education and signing process),
- refers to a major Institute on Medicine study (Dying in America, 2015) on a similar topic, and
- concludes that there is no "single" point of entry for execution of advanced directives.
As the GAO team observes, "[t]herefore, a comprehensive approach to end-of-life care, rather than any one document, such as an advance directive, helps to ensure that medical treatment given at the end of life is consistent with an individual’s preferences."
Hat tip to Karen Miller, Esq., in Florida for the link to the latest study and report.
May 5, 2015 in Advance Directives/End-of-Life, Consumer Information, Current Affairs, Estates and Trusts, Federal Statutes/Regulations, Health Care/Long Term Care, Medicaid, Medicare | Permalink | Comments (1) | TrackBack (0)
Monday, May 4, 2015
The National Institute on Retirement Security has issued a new report, Retirement Security 2015: Roadmap for Policy Makers. Americans' Views of the Retirement Crisis. The 36 page report offers 7 key findings
- An overwhelming majority of Americans believe there is a retirement crisis...
- Three in four Americans remain highly anxious about their retirement outlook, but the concern has dissipated slightly as the economy has recovered…
- Even though Americans feel slightly less stressed about their retirement prospects, support for steady and reliable retirement income from a pension is high and growing…
- Americans continue to feel that leaders in Washington do not understand their struggle to save for retirement, and they strongly support efforts by states to set up retirement plans for those workers without access to an employer sponsored plan…
- Americans see retirement benefits as a job feature that is almost as important as salary...
- Americans express strong support for pensions for public employees…
- Protecting Social Security benefits is increasingly important…
The nationwide poll is conducted every two years and "is intended to serve as a tool for policymakers, thought leaders and retirement service providers as they work to stem the retirement crisis and re-fortify the U.S. retirement infrastructure." The full report is available here.
Sunday, May 3, 2015
My Retirement Paycheck is an interactive website from the National Endowment for Financial Education. The website offers 8 icons on which the user clicks to learn more about the topic. The 8 topics include home & mortgage, insurance, retirement plans, savings & investments, debt, fraud, work and Social Security. Each topic offers information in an easy to understand format and links for additional readings.
Friday, May 1, 2015
I strongly suspect that my Blogging colleague Becky Morgan, who embraces new technology, will approve. As detailed in the New York Time's business section, Japan's leadership position in a surprising market sector-- as the nation with the highest percentage of older citizens -- has inspired innovation:
Japan is an incubator of aging.... Twenty-five percent of its population, or 33 million people, are age 65 or older, more than double the global average.
IBM, Apple and Japan Post Group, a giant postal service, bank and insurer, declared on Thursday that they were joining to deliver a new technology service to the fast-growing market of older Japanese adults. The service involves equipping Japan’s silver generation with iPads loaded with software apps to help them communicate with family and friends, monitor their health, and buy goods and services.
Wednesday, April 29, 2015
The Insured Retirement Institute (IRI) has issued its 5th annual report on Boomer Retirement Preparedness. Boomer Expectations for Retirement 2015 Fifth Annual Update on the Retirement Preparedness of the Boomer Generation is a 24 page report, and offers the following "key observations":
- Overall economic satisfaction among Boomers dropped precipitously in 2015, to 48% from 65% in 2014 and further down from 76% in 2011.
- The decline in overall satisfaction was more pronounced among retirees, plunging to 45% from 72% in 2014, versus 53% of working Boomers feeling satisfied compared to 60% in 2014....
- Only six in 10 Boomers report having money saved for retirement, down sharply from prior years when approximately eight in 10 had retirement savings.
- A significant number of Boomers continue to struggle financially; in the past 12 months:
- Almost one-quarter of Boomers reported that they have had difficulty in paying their mortgage or rent.
- 19% of working Boomers stopped contributing to a retirement account such as a 401(k) or IRA.
- 24% of Boomers postponed plans to retire.
- The percentage of Boomers feeling extremely or very confident they will have enough money to last throughout retirement has declined significantly, to 27% of Boomers in 2015 from almost four in 10 in 2011.
The report discusses a number of topics including annuity ownership, economic life satisfaction, short term and long term financial outlook, retirement expectations, retirement planning, planning for negative results, and the advantages to using financial advisors.
The report concludes
As a group, the Baby Boomer generation is feeling less confident in their prospects and preparations for a secure retirement, and are more concerned about specific aspects of retirement such as medical expenses, children’s educations, and long term care. Paradoxically, however, many believe they will enjoy a more secure retirement than their parents did, and even those with relatively little saved for retirement and no pensions expect to enjoy travel and leisure activities in retirement in addition to paying for their basic needs and medical costs. While this may be unrealistic for many, the study finds that Boomers who work with financial advisors, and those who own annuities, are far more likely to have set goals, to have saved (and saved more) for retirement, and to feel both more economically satisfied currently and better prepared for retirement.
After my blog piece earlier this week about "elder guardianship" concerns in Florida, I've received communications about similar concerns in other states, including Nevada.
According to a report by Contact 13 (ABC affiliate), on April 21 Commissioners in Clark County (Las Vegas area) conducted a "first-of-its-kind" hearing on alleged guardianship abuses that were described by some as "appalling, frightening and plagued by problems." At the heart of the complaints by individuals and family members was frequent court appointment of "private guardians" rather than family members, and an alleged absence of notice to family members about court hearings. A "blue ribbon" panel or expert may be appointed to audit Clark County's court-supervised guardianships. A recent statement by the Chief Judge for the district court, set forth in full on the Contact 13 website, pledges the court's commitment to "ensuring clarity and instilling public trust in the process of handling guardianship cases.
According to the Las Vegas Review-Journal, the Chief Judge's response follows a series of stories by the Review-Journal about "thousands of elderly and mentally ill in Clark County open to exploitation."
As reported by the Las Vegas media, the problems reported in Nevada are not unique to one county or even to one state, as demonstrated by an Associated Press series of articles in 1987 titled "Guardianships of the Elderly: An Ailing System." See also the national Center for Elders and the Courts for more information on guardianship reforms in state courts.
April 29, 2015 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Legal Practice/Practice Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0) | TrackBack (0)
Tuesday, April 28, 2015
Another change from the Medicare Access and CHIP Reauthorization Act of 2015 is that Medicare will stop using beneficiary Social Security numbers on the Medicare cards. Section 501 of the new law provides that
The Secretary of Health and Human Services, in consultation with the Commissioner of Social Security, shall establish cost-effective procedures to ensure that a Social Security account number (or derivative thereof) is not displayed, coded, or embedded on the Medicare card issued to an individual who is entitled to benefits under part A of title XVIII or enrolled under part B of title XVIII and that any other identifier displayed on such card is not identifiable as a Social Security account number (or derivative thereof).
This will appear in 42 U.S.C. 405(c)(2)(C)(xiii). The changes won't necessarily occur immediately and "shall apply with respect to Medicare cards issued on and after an effective date specified by the Secretary of Health and Human Services, but in no case shall such effective date be later
than the date that is four years after the date of the enactment of this Act." The same holds true with reissuing cards; HHS has up to 4 years from the date the Secretary picks for the new cards.
This is a critically important step, what with the rise of identity theft. It has been a long time coming.
Monday, April 27, 2015
On April 15, 2015 the SEC and FINRA issued a report, National Senior Investor Initiative. Together the SEC Office of Compliance Inspections & Examinations and FINRA conducted a review of 44 broker-dealers to look at "how firms conduct business with senior investors [65 and older] as they prepare for and enter into retirement." The examinations looked a long list of items in broker-dealer interactions with clients 65 and older, including "how firms address issues relating to aging (e.g., diminished capacity and elder financial abuse or exploitation)..."
This report highlights recent industry trends that have impacted the investment landscape and prior regulatory initiatives that have concentrated on senior investors and industry practices related to senior investors. Additionally, the report discusses key observations and practices identified during the recent series of examinations.
The 42 page report, after providing background on the initiative, discusses 9 topics, including documentation, disclosures, complaints, training, supervision, suitability, marketing, "senior designations" and securities purchased. Each section contains a conclusion as well as "notable practices." The overall conclusion includes this excerpt
The current environment, where traditional savings accounts and other conservative investments are earning historically low yields, may prompt firms to recommend and senior investors to purchase more non-traditional securities, such as variable annuities, non-traded REITs, structured products, and other alternative products. OCIE and FINRA staff are concerned that broker-dealers may be recommending unsuitable securities to senior investors or failing to adequately disclose the related risks. It is imperative that senior investors receive proper and understandable disclosures regarding the terms and risks related to securities recommended to them, particularly non-traditional investments.
Occasionally I feel a little "push-pull" from the different directions that writing about "laws and policies of aging" takes me. One minute I'm writing about hunger for seniors in our nation's capitol, a dynamic driven by poverty, and then there is today's story from NPR on Drop-In Chefs Help Seniors Stay in Their Own Homes.
"Part of the business plan is keeping the service affordable. In addition to the cost of the food, the client pays $30 an hour for the chef's time. That's usually a couple of hours a week of cooking and cleaning up the kitchen. There's also a $15 charge for grocery shopping. So clients pay on average $45 to $75 a week.
And while there are lots of personal chefs out there and services that deliver meals for seniors there are few services specifically for older adults that prepare food in their homes."
All part of the big, complex picture of "aging."
Sunday, April 26, 2015
Curious Behaviors That Can Ruin Your Retirement is an interactive program on behavioral impediments to retirement planning. A host leads users through exercises designed to create an “Aha!” moment as they relate to the behaviors. The host then explains how the behavior can hinder retirement planning and how to cope with it. Users can then go to a “Learn More” page with additional information in various media formats.
The link to the tool is available here. It takes about 10 minutes to work through it. Check it out and have your students check it out as well!
Sunday's New York Times has a feature article on aging and financial skills, and the message is not "just" for individuals with dementia:
"Studies show that the ability to perform simple math problems, as well as handling financial matters, are typically one of the first set of skills to decline in diseases of the mind, like Alzheimer’s, and Ms. Clark’s father-in-law, who suffered from mild dementia, was no exception. Research has also shown that even cognitively normal people may reach a point where financial decision-making becomes more challenging."
The article gives several example of individuals who were vulnerable to exploitation, because of their reduced interest in or understanding of financial decisions. David Laibson, an economics professor at Harvard, one of the researchers cited in the article said "he believed that crystallized intelligence tended to plateau when people reached their 70s." Further, "he wishes all 65-year-olds would start by simplifying their financial lives, reducing the money clutter to just a few mutual funds at a reputable institution."
The article, As Cognition Slips, Financial Skills Are Often the First to Go, offers several links to recent reports and studies, as well as examples of "early signs."
Hat tip to Penn State's Dickinson Law 1L student Spencer Flohr for sharing the link to this article -- and noting the probable relevance to law students' studies of trusts and estates law. Good catch!
April 26, 2015 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Property Management | Permalink | Comments (1) | TrackBack (0)
Friday, April 24, 2015
Are you an inventor? Ever have a good idea for an invention? There is a renaissance of sorts in American ingenuity with an increasing number of older Americans becoming inventors. The NY Times ran a story about older inventors on April 17, 2015. More Older Adults Are Becoming Inventors notes this renaissance
Whether as volunteers or for profit, older inventors ... are riding a rising tide of American innovation. They are teaming up, joining inventors clubs and getting their products into the marketplace. And older inventors bring valuable skills to their work, many experts say, like worldly wisdom and problem-solving abilities that can give them an advantage over younger inventors.
According to the article, the Baby Boomers are at least part of the catalysts for this surge of older inventors, as the boomers look for products to assist them as they get older. According to one expert quoted in the article, older inventors may have an edge over younger ones, since "[a]n aging brain can see patterns better.” Before you get out the proverbial drawing board, the article notes that inventions don't necessarily lead to wealth with less than 5% of inventions making money, not to mention the prototype and startup costs
Thursday, April 23, 2015
As outlined by The Washington Post, AARP Public Policy Institute has a new "Livability Index" offered as a way to evaluate factors such as safety, security, ease of getting around, access to health care, and housing affordability.
More intangible factors are also assessed, such as WiFi, farmers' markets and "public policies that promote successful aging."
(After following the trauma of the trial in Iowa, I wonder whether "criminal laws on sexual relations between husband and wives if one has dementia" should be added as an express factor?)