Monday, August 25, 2014
Thomas Jefferson School of Law Professor Susan Bisom-Rapp and Middlesex University (UK) Business School Professor Malcolm Sargeant, both with deep expertise in employment and labor law, have joined forces to examine the long-range impact of discrimination against women during the course of their working lives. Based on experiences in the U.S. and the U.K., they recommend a comprehensive strategy to remedy identified problems. Their article, "It's Complicated: Age, Gender, and Lifetime Discrimination Against Working Women - The U.S. and U.K. as Examples," was published in 2014 in theUniversity of Illinois' Elder Law Journal. Here's a tantalizing introduction:
"This article considers the effect on women of a lifetime of discrimination using material from both the U.S. and the U.K. Government reports in both countries make clear that women workers suffer from multiple disadvantages during their working lives, which result in significantly poorer outcomes in old age when compared to men. Indeed, the numbers are stark. In the U.S., for example, the poverty rate of women 65 years old and up is nearly double that of their male counterparts. Older women of color are especially disadvantaged. The situation in the U.K. is comparable.
To capture the phenomenon, the article develops a model of Lifetime Disadvantage, which considers the major factors that on average produce unequal outcomes for working women at the end of their careers. One set of factors falls under the heading “Gender-based factors.” This category concerns phenomena directly connected to social or psychological aspects of gender, such as gender stereotyping and women’s traditionally greater roles in family caring activities. A second set of factors is titled “Incremental disadvantage factors.” While these factors are connected to gender, that connection is less overt, and the disadvantage they produce increases incrementally over time. The role of law and policy, in ameliorating or exacerbating women’s disadvantages, is considered in conjunction with each factor, revealing considerable incoherence and regulatory gaps. Notably, the U.K.’s more protective legal stance toward women in comparison with the U.S. fails to change outcomes appreciably for women in that country.
An effective, comprehensive regulatory framework could help compensate for these disadvantages, which accumulate over a lifetime. Using the examples of the U.S. and the U.K., however, the article demonstrates that regulatory schemes created by “disjointed incrementalism” – in other words, policies that tinker along the margins without considering women’s full life course – are unlikely to vanquish systemic inequality on the scale of gender-based lifetime discrimination."
Professor Bisom-Rapp is also a co-author of The Global Workplace: Internatioanl and Comparative Employment Law - Cases and Materials, now in its second edition.
Sunday, August 24, 2014
We've reported several times, including here and here, on recent academic and professional publications that address the sensitive topic of "consent" to sexual relations for individuals residing in nursing homes.
The Huffington Post and other media reports now bring the topic into the general public realm with coverage of a complicated case emerging in Iowa, where a husband has been arrested on charges connected to sexual relations with his wife, a resident with Alzheimer's, in her nursing home room.
Two items that may be critical to the outcome of the case: Alleged "notice" to the husband by the facility that his wife was no longer legally able to give consent to sexual relations, and the identity of the husband as a public figure. The fact that the husband is a state legislator is a reason why the case may get wide news coverage. But that wider coverage could also generate important discussion and debate about the deeper legal, personal and public issues. From one article:
"An Iowa legislator who allegedly had sex with his mentally incapacitated late wife has been charged with sexual abuse. Henry Rayhons, 78, a Republican state representative from Iowa House District 8, was told by medical staff on May 15 that his wife, 78-year-old Donna Rayhons, no longer had the mental ability to consent to sexual activity, according to a criminal complaint obtained by WHO-TV. Donna Rayhons, who suffered from Alzheimer's disease, had been living in Concord Care Center in Garner, Iowa, since March, according to the Des Moines Register....
In an interview with law enforcement in June,Rayhons allegedly confessed to 'having sexual contact' with his wife, according to KCCI. He also allegedly admitted that he had a copy of the document that stated his wife did not have the cognitive ability to give consent. Rayhons was charged with third-degree sexual abuse on Friday.
Elizabeth Barnhill, executive director of the Iowa Coalition Against Sexual Assault, told the Des Moines Register that even though spousal rape has been illegal in Iowa for about 25 years, arrests for the crime are rare and 'convictions are even rarer.' Barnhill also noted that sexual assault between spouses is not considered a 'forcible felony' in Iowa."
According to new sources, the family has also made a statement.
August 24, 2014 in Cognitive Impairment, Crimes, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Friday, August 22, 2014
Articles recently posted by U.S. law school academics on the Social Science Research Network's (SSRN's) Elder Law Studies network:
- "Rethinking ERISA's Promise of Income Security in a World of 401(k) Plans," by Prof. Larry Frolik (Pitt Law), to be published in the Connecticut Insurance Law Journal (2014)
- "Making Mediation Work in Guardianship Proceedings: Protecting and Enhancing the Voices, Rights and Well-being of Elders," by Prof. Jennifer L. Wright (St. Thomas Law), for the Journal of International Aging, Law and Policy (2014)
- "Storm Surges, Disaster Planning and Vulnerable Populations at the Urban Periphery: Imagining a Resilient New York after Superstorm Sandy," by Prof. Andrea McCardle (CUNY Law) to be published in the Idaho Law Review (2014)
- "Letters Non-Testamentary," by Deborah Gordon (Drexel Law), to be published in Kansas Law Review (2014)
- "Complex Decision-Making and Cognitive Aging Call for Enhanced Protection of Seniors Contemplating Reverse Mortgages," by Profs. Debra Stark (John Marshall Law), Jessica Choplin (Depaul), Joseph Mikels (Depaul), and Amber McDonnell (John Marshall Law), for the Arizona State Law Journal (2014)
Thursday, August 21, 2014
Recent Duke Law graduate Whitney Bosworth Blazek is the author of a timely, interesting note, "Combating Privatization: Modifying Veterans Administration Fiduciary Program to Protect Incompetent Veterans" in a recent issue of the Duke Law Journal. The abstract explains:
"Created to supervise the distribution of Veterans Administration benefits, the Veterans Benefit Administration Fiduciary Program was designed to help thousands of incompetent veterans handle their finances. Rather than directly managing each veteran's funds, the Fiduciary Program employs a privatization model whereby a private individual or institution is appointed to manage a veteran's assets. The Fiduciary Program then monitors these fiduciaries to ensure the veteran's funds are properly expended.
This Note argues that in practice this privatization model is seriously flawed and that it exposes some of the most vulnerable portions of the veteran population's funds to misuse. In support of this conclusion, this Note compares the federal statutes, regulations, and internal directives that govern the Fiduciary Program--paying special attention to the Fiduciary Program Manual-- with audits performed by the Veterans Affairs Office of Audits and Evaluations and the U.S. Government Accountability Office. Relying on these audits, this inquiry rejects total reliance on substantive statutory reform in light of legislative and judicial barriers. Instead, this Note advocates for critical internal reforms designed to improve the Program's efficiency and functionality, the adoption of a state enforcement mechanism, and reliance on principles of cooperative federalism and interagency cooperation."
Friday, August 15, 2014
"According to [Joshua Slocum, executive director for the nonprofit Funeral Consumers Alliance], most states regulate the funeral business with boards that are packed with established funeral directors. As a result, regulations tend to suppress legitimate complaints and smother new competitors. That's one of the complaints behind Heffner v. Murphy... that may end up before the U.S. Supreme Court. Plaintiff Ernest Heffner, a licensed funeral director from York [Pennsylvania] claimed that the Pennsylvania Funeral Directors Law imposes 'arbitrary, burdensome and unreasonable' restrictions on funeral businesses, including who may own funeral homes and requirement for on-site embalming rooms."
According to the ABA Journal, "the libertarian-leaning Institute for Justice has stepped in and petitioned the U.S. Supreme Court for certiorari. IJ senior attorney Jeff Rowes says the case raises legal issues central to a core mission for the institute: stopping unreasonable regulations on small businesses." The petition for certiorai was filed July 15, 2014.
For more, read "Regulated to Death: Consumer Activitists Seek Certiorari for Challenge to 'Protectionist' Funeral Laws," by Lorelei Laird.
Thursday, August 14, 2014
University of Memphis Law Professor Andrew Jay McClurg's article, "Preying on the Graying: A Statutory Presumption to Prosecute Elder Financial Exploitation," appears in May 2014 issue of the Hastings Law Journal. Professor McClurg proposes that states adopt "state criminal statutes that create a permissive presumption of exploitation with regard to certain financial transfers from elders." In correspondence, Professor McClurg points to the fact that on the surface it may appear that older persons -- victims -- are "voluntarily" parting with assets, when "in fact [the transactions] occur because of undue influence, psychological manipulation and misrepresentation."
Professor McClurg stresses the need for a statutory presumption to give prosecutors an effective tool to hold offenders accountable. His proposal has already had direct impact, in the form of Florida legislation, Fla. Stat. 825.103(2) signed into law June 20, 2014 and effective on October 1, 2014. Key language from the provision includes:
"Any inter vivos transfer of money or property valued in excess of $10,000 at the time of the transfer, whether in a single transfer or multiple transactions, by a person age 65 or older to a nonrelative whom the transferor knew for fewer than 2 years before the first transfer and for which the transferor did not receive the reasonably equivalent financial value in goods or services creates a permissive presumption that the transfer was the result of exploitation."
The Florida provision applies "regardless of whether the transfer or transfers are denoted by the parties as a gift or loan, except that it does not apply to a valid loan evidenced in writing that includes definite repayment dates...." Further, the new Florida provision does not apply to "persons who are in the business of making loans" or "bona fide charitable donations to nonprofit organizations that qualify for tax exempt status."
In cases tried to a jury under the Florida statute, the law provides that jurors "shall be instructed that they may, but are not required to, draw an inference of exploitation upon proof beyond a reasonable doubt of the facts listed in this subsection." The law's presumption "imposes no burden of proof on the defendant."
UPDATE: Professor McClurg wrote again to explain that he worked directly with the Florida Elder Exploitation Task Force and with Florida Representative Kathleen Passidomo to secure passage of the new law. Professor McClurg's presumption proposal was introduced as part of H.B. 409, which passed unanimously through the two houses of the state legislature. According to Professor McClurg, the statute is the only one of its type in the nation. Thanks for the clarification, Andrew!
Wednesday, August 6, 2014
In recent Formal Ethics Opinion 2014-F-158, the Board of Professional Responsibility for the Supreme Court of Tennessee addressed the following interesting question:
"Can a lawyer who represented a testator refuse to honor a court order or subpoena to disclose, prior to the client's death, a Will or other testamenatry document executed when the testator was competent on the basis that the document is protected against disclosure by the attorney-client privilege or confidentiality."
The Board's opinion indicates that not only "may" the lawyer refuse to disclose the will, but where circumstances indicate the client is no longer able to give informed consent because of intervening dementia, the lawyer may have a duty to raise all "nonfrivolous grounds" to protect the will from disclosure, including privileges under Tennessee statutes, citing Rule of Professional Conduct 1.6(c)(2).
In opening its analysis, the Board noted that it has become "increasingly common for courts to appoint attorneys in a representative capacity to represent individuals suffering from dementia and/or Alzheimer's who are the subject of a dispute or litigation regarding management of the individual's funds and/or person." During the course of the dispute, parties may attempt to seek review of the will prior to the death of the testator, citing reasons such as the need to "engage in estate planning."
The Board acknowledged the potential for facts that would permit the lawyer to disclose the contents of the disabled client's will, such as when a "lawyer believes the disclosure of the contents ... would be in furtherance of client's interest."
In commentary on the Tennessee Board Ethics Opinion, the ABA/BNA Manual on Professsional Conduct, in Vol. 30, No. 15, observed that "a 2010 law review article cites demographic patterns that have increased the likelihood of such scenarios," pointing to "A Common Thread to Weave a Patchwork: Advocating for Testatmentary Exception Rules," 3 Phoenix L. Rev. 729, 734-35 (2010) by then law student Andrew B. Mazoff, now an attorney in Phoenix.
Thanks to my colleague and ethics guru, Laurel Terry, for sharing this ethics opinion.
Tuesday, August 5, 2014
The Law and Ethics of Dementia, co-edited by Israel Doron, Charles Foster and Jonathan Herring, recently released in hardback by Hart Publishing and available for e-readers in September, is definitely on my "must read" list. Followers of this Blog will certainly recognize Issi Doron, from the University of Haifa, who has long exercised an international, comparative perspective on issues in ageing. Professor Foster is a practicing barrister and a fellow at Green Templeton College, University of Oxford, which is also the working home of prolific writer and Law Professor Herring.
The book is organized into five parts, Medical Fundamentals, Ethical Perspectives, Legal Perspectives, Social Aspects, and Patient and Carer Perspectives. As part of the first section, physicians and researchers Amos Korczyn and Veronika Vakhapova co-author "Can Dementia be Prevented?" a question we all hope will be answered in the affirmative. Not surprisingly, given the title of the book, the section on ethical perspectives promises to be especially fascinating, offering multiple views on ethical components of decision making and care. To suggest the scope, Andrew McGee's chapter is on "Best Interest Determinations and Substituted Judgement," while Leah Rand and Mark Sheehan tackle the challenge of "Resource Allocation Issues in Dementia."
In the Social Aspects section, I notice that Syracuse Law Professor Nina Kohn has a chapter on "Voting and Political Participation," while Chinese (and University of Pennsylvania) health care scholar Ruijia Chen and colleagues address "Physical, Financial and Other Abuse."
With more than forty individual chapters and dozens of international writers, this book promises to be a key guide for the future.
Thursday, July 31, 2014
At the 2014 International Elder Law and Policy Conference hosted by John Marshall Law School in Chicago on July 10 and 11, many weeks of hard work culminated in adoption of a "Chicago Declaration on the Rights of Older Person." The 11th draft -- of what is to be a working document for the future -- will be presented at the Fifth Working Session of the United Nations Open-Ended Working Group on Ageing to be held in New York City this week.
In addition, the Chicago Declaration was submitted by United States Representative Janice Schakowsky (Illinois) to the Congressional Record on July 25.
Congratulations to all who worked on this, with the leadership of many, including Associate Dean Ralph Rubner and Amy Taylor, Head Research Coordinator at John Marshall Law School. More work for everyone is ahead on this exciting task of seeking wider recognition of the human rights of older persons.
Speakers at the "Side Event" for the Chicago Declaration, to be held on August 1 at the U.N., include William Pope, Commissioner of the American Bar Association Commission on Law and Aging, and Ebbe Johansen, Vice President, AGE Platform Europe from Brussels.
As readers of this Blog may recall, back in April 2008 NBC's Dateline program aired a segment called "Tricks of the Trade" that incorporated use of hidden cameras to record portions of seminars that allegedly showed insurance salesmen trained to market certain types of deferred payment annuities. The NBC program alleged that the sales techniques specifically and improperly targeted or misled older consumers.
Tyrone M. Clark and his company, Brokers' Choice of America (BCA), brought suit against NBC and certain employees in federal court in Colorado, claiming the Dateline program violated state law, including allegations of defamation. Clark and BCA also alleged constitutional violations. The federal district court dismissed the complaint in 2011.
On July 9, 2014 the Tenth Circuit affirmed the dismissal of the alleged 4th Amendment violations, but remanded for further proceedings on the allegations of defamation. At the heart of Clark's claim was the argument that a full, unedited viewing of his seminar for insurance salesmen would reveal that students were properly counseled that such "annuities were not for everyone" and that salespeople must give "full disclosure of various advantages and disadvantages of the annuity products." In other words, Clark claimed Dateline's excerpts were misleading, and therefore defamatory.
The Tenth Circuit's ruling on defamation stressed that it was reviewing the district court's ruling on NBC's motion to dismiss and thus must view the facts alleged in the complaint "as true and in the light most favorable to the nonmoving party," i.e., Clark and BCA. The 10th Circuit concluded, "Whether these allegations will survive summary judgment remains to be seen. The factual basis of the complaint ... is sufficient to state a plausible claim."
Further, the Tenth Circuit upheld the request by Clark and BCA to discovery of the full, unedited tapes surreptitiously recorded by NBC, production that NBC has resisted:
"BCA would be greatly prejudiced in its ability to prove the defamation claim without access to the unedited film. Dateline's First Amendment interests do not involve the disclosure of confidential information or confidential sources. The fact-finder is entitled to the best evidence available, particularly in a case like this, which asks whether the media's zeal to report and perhaps sensationalize should be tempered by its responsibility not to defame. For all of those reasons, BCA's factual allegations are sufficient to warrant discovery of the unedited film. The Colorado statue [on newsperson's privilege] is a shield, not a sword."
For additional details, see the 10th Circuit's ruling on Broker's Choice of America, Inc. v. NBC Universal, Inc. and commentary from the Colorado Bar Association's Legal Connection news.
Tuesday, July 29, 2014
As we reported previously, Congress passed the "Reverse Mortgage Stablization Act" in August of 2013. In both state and federal legislatures, a new law's title may over-promise and under-deliver. With respect to reverse mortgages, Public 113-29 gave authority to the Secretary of Housing and Urban Development (HUD) to establish, by "notice or mortgagee letter, or any alternative requirements" deemed ncessary "to improve the fiscal safety and soundness of the program," and the latest in a series of HUD requirements takes place, as detailed below, on August 1.
From a consumer perspective, one concern has been reported attempts by mortgage companies to "foreclose" on mortgages where the "borrowing spouse" has died but his or her "non-borrowing, surviving spouse" was still in the home. Other concerns have focused on "defaults" triggered by failure of a borrower to pay real estate taxes or utilities, thus suggesting continuing vulnerability of the elderly borrower to financial insolvency despite receiving cash from the reverse mortgage. Taking out a reverse mortgage without careful planning for necessary home-related payments means the borrower can lose the equity in the home, equity that could have been put to better use by selling the home. As reported here, suits have challenged application of payment due status in such fact patterns.
In June, the Department used its "Mortgagee Letter" authority to issue its latest in guidelines intended to better protect prospective borrowers of the risks of reverse morgages, including requirement that the mortgage companies make clear to borrowers the following:
- FHA insures fixed interest rate mortgages, as well as annual and monthly adjustable interest rate mortgages;
- The borrower has the ability to change the method of payment under the reverse mortgage ARM products at any time provided funds are available;
- Fixed interest rate mortgages are limited to the Single Disbursement Lump Sum payment option where there is a one-time draw at loan closing and no future draws post loan closing;
- Adjustable interest rate mortgages provide for five, flexible payment options, and allow future draws;
- The amount of funds available to the mortgagor is currently determined by the age of the youngest mortgagor, and
- The disbursement of mortgage proceeds during the first twelve-month disbursement period is subject to an initial disbursement limit as determined by requirements set by the Secretary.
In April, the Department issued "Mortgagee Letter 2014-07" to establish, effective August 1, that "the due and payable status will be deferred for as long as a Non-Borrowing Spouse continues to meet all the qualifying attributes...." The nonborrowing spouse has 90 days after the death of the borrowing spouse to "establish legal ownership" or other legal right to remain in the home.
Monday, July 28, 2014
Recently a former law student who is considering a career change asked me about elder law, wanting to meet with me to discuss what is involved. I'm happy to chat any time with current and former students, especially about elder law, but this time my advice was simple: "Drop everything and go to Pennsylvania's 2014 Elder Law Institute." Indeed, this year saw some 400 individuals attend.
Important to my advice was the fact that ELI is organized well for both "newbies" and more experienced practitioners. After the first two-hour joint session, over the course of two days there are four sessions offered every hour. One entire track is devoted to "Just the Basics" and is perfect for the aspiring elder law attorney. Indeed, I usually sponsor two Penn State law students to attend. As in most specializations, in elder law there will is a steep learning curve just to understand the basic jargon, and the more exposure the better.
One of my favorite sessions is the first, "The Year in Review," a long tradition at ELI and currently presented by Marielle Hazen and Rob Clofine. Marielle reviews new legislation and regulations, both at the state and federal level, while Rob does a "Top Ten Cases" review. Both speakers focus not just on what happened in the last 12 months, but what could or should happen in the future. They frequently pose important policy perspectives, based on recent events.
Among the highlights from the year in review session:
- Analysis of the GAO Report on "Medicaid: Financial Characteristics of Approved Applicants and Methods Used to Reduce Assets to Qualify for Nursing Home Coverage" released in late June 2014. Data collection efforts focused on four states and reportedly included "under cover" individuals posing as potential applicants. The report summarizes techniques used to reduce countable resources, most occuring well within the rules and thus triggering no question of penalty periods. Whether Congress uses the report in any way to confirm or change existing rules remains to be seen.
- A GAO Report on Medicaid Managed Care programs, also released in June, concluding that additional oversight efforts are needed to ensure the integrity of programs in the states, which are already reporting higher increases in outgoing funds than fee-for-service programs.
- The need to keep an eye open for Pennsylvania's Long Term Care Comission report, expected by December 2014. Will it take issue with the Governor's rejection of the Affordable Care Act's funding for expansion of Medicaid?
- Report on a number of lower court decisions involving nursing home payment issues, including a report on a troubling case, Estate of Parker, 4 Pa. Fiduciary Reporter 3d 183 (Orphans' Court, Montgomery County, PA 2014), in which a court-appointed guardian of the estate of an elderly nursing home patient "agreed" to entry of a judgment, not just for nursing home charges, but also for pre- and post-judgment interest, plus attorneys' fees for the nursing home's lawyer of almost 20% of the stipulated judgment, in what was an uncontested guardianship.
In light of the number of nursing home payment cases in Rob's review, perhaps it wasn't a surprise that my co-presenter, Stanley Vasiliadis, and I had a full house for our session on "Why Am I Being Sued for My Parents' Nursing Home Bill?" We examined how adult children (and sometimes elderly parents of adult children in care) are finding themselves the target of collection efforts by nursing homes, including actions based on theories of breach of promise (contract, quatum meruit, and promissory estoppel), fault (common law fraud or statutory claims of "fraudulent transfers), or family status, such as statutory filial support.
The extensive course materials from all of the presenters, both in hard copy and electronic formats, are available for purchase directly from the Pennsylvania Bar Institute.
July 28, 2014 in Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Cases, Health Care/Long Term Care, Housing, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Wednesday, July 23, 2014
Atlanta attorney Kristen M. Lewis has a very interesting article in the July/August issue of the ABA's publication Probate & Property. In "The Crime of the 21st Century: Financial Abuse of Elders," Lewis brings to bear her experience in estate planning and wealth protection, including use of special needs trusts, to examine examples of elder financial abuse, for which she coins the acronym "EFA."
While I wish Lewis had included more citations of authority to support observations regarding prevalence of financial abuse, what I find unique about the article is the discussion of "defensive use" of powers of attorney and revocable living trusts. She advocates careful drafting of powers for individuals serving in these fiduciary roles and to consider the use of co-agents or co-trustees. Their roles may be limited but can expressly include "oversight."
On a related concern, in my experience POAs are often silent on the issue of compensation for agents, thus opening a door to confusion or worse about an agent's "self-payment." In contrast, Lewis recommends that POAs
"... should outline whether and how the agent is to be compensated for services while acting as agent (for example, hourly at a specified rate or a fee based on the value of the assets under management). Fairly compensating an agent can encourage him to be more honest, attentive, and diligent in the exercise of his duties."
For revocable living trusts (RLTs), she advises "it is imperative to identify a lineup of disinterested trustees, persons who have no interest in the assets remaining in the RLT on the elder's death." Further, she observes that increasingly, "attorneys specializing in estate planning or elder law are agreeing to serve as trustee for their clients' RLTs, or as co-trustee with a corporate fiduciary. Such professionals are typically compensated based on the regular hourly rate they would otherwise charge their clients." I suspect Lewis is thinking about trusts with substantial assets.
The full article is currently available only in hard copy, but American Bar Association magazines are usually eventually posted at the ABA website, and the website for the Real Property, Trust and Estate Law Section of the ABA is here.
Tuesday, July 22, 2014
Mexico and countries in the Caribbean, Central and South America have been working very hard on the question of whether laws are needed to recognize and promote the human rights of older persons. This commitment was demonstrated during the 2014 International Elder Law and Policy Conference in Chicago, by Rosa Bella Caceres Mongelos from Paraguay, as one of the speakers on the panel focused on "Dignity, Equality and Anti-Ageism Rights of Older Persons."
Professor Caceres Mongelos is the current president of the Central Association of Retired Public Servants and Teachers in Paraguay, and has experience as a master teacher, educational administrator, and vocational counselor. She has also taught classes at the university level on leadership. When I asked whether her organization is comparable to AARP in the U.S., which was started by a retired teacher, she laughed and said "maybe some day." I think she would not mind me saying that she's tiny but powerful -- and certainly she is an articulate spokesperson for the issues her country, with a total popularion of 6.8 million, is facing.
Professor Caceras Mongelos has served as a spokesperson for her civil society organization during regional meetings for Latin America and the Caribbean in 2012 and 2013 that led to endorsment of a formal international convention on the rights of older persons.
The participation of Paraguay in international discussions of aging is forward-thinking, as it is actually a comparatively young country in terms of its overall population. Persons aged 60 and over comprise approximately 8% of the population. Recent news reports indicate that more than 66% of its population is less than 30 years old. At the same time, with their citizens already experiencing relatively long-life spans, especially on a comparative basis (average life span is now 75 according to some reports), the country will begin to see the impact of aging as a nation starting in 2038.
The organization headed by Caceres Mongelos has adopted advocacy goals for its members, including health related goals, such as securing free health care (including mobile clinics) for retirees for critical matters such as vision and dental care, and for treatment of cancer and chronic diabetes, all issues recognized as important for the self-esteem of older persons. Her Central Association has a project called "Hogares de Jubliados" or "Homes for the Elderly," with a goal of providing space for as many as 200 persons deemed vulnerable and unprotected. Her organization seeks to "monitor and insure safekeeping of social security funds under control of the treasury" during the current fiscal crisis. A better system of public transportation is another key goal.
She described her Central Association's recent Yellow Ribbon Campaign to re-enforce recognition of the rights of civil services and retirees to be free from pay discrimination under the Constitution of Paraguay. She described the yellow ribbons as symbols for the "struggle to claim solidarity, love, better living and the light of hope for a bearable and dignified old age." Despite the small proportion of Paraguayans currently deemed older -- in their "third age" -- she said "fragility" often characterizes their life conditions, with more than a quarter of the population of older adults illiterate and with only 19% currently receiving any form of income from pension or retirement benefits. In addition, her association stresses that real attention must be paid to the needs of older persons in indigenous communities and Afro-descendants.
In closing, Professor Caceres Mongelos called for an end to procrastination on international recognition of the rights of older persons. She said, "Declaring and implementing the regulations calling for dignity, equality and non-discrimination ... for older persons needs to be achieved as quickly as possible [toward] the goal of improving quality of life and respecting the human rights of older persons."
Monday, July 21, 2014
ElderLawGuy (and good friend) Jeff Marshall has a great blog post on "How to Find A Good Attorney for Older Adult Issues" He knows whereof he speaks and starts off by explaining the important reasons for asking the right questions:
"Planning for senior issues like incapacity and long term care is an important aspect of the services provided by what have become known as “elder law attorneys.” Unfortunately, in most states any lawyer can say he or she practices elder law or hold themselves out as being an “elder law attorney” even if the lawyer has little or no experience with the issues that are especially important to older adults. This means seniors must be particularly cautious in choosing a lawyer and carefully investigate the lawyer before hiring."
Jeff explains the significance of "certification" as a specialist and how to assess "ratings" or particular approaches to planning, such as "life care planning." The post is useful both for consumers and young attorneys thinking about how to build a respected career.
Sunday, July 20, 2014
The growing significance and scope of "elder law" is demonstrated by the program for the upcoming 2014 Elder Law Institute in Philadelphia, Pennsylvania, to be held on July 24-25. In addition to key updates on Medicare, Medicaid, Veterans and Social Security law, plus updates on the very recent changes to Pennsylvania law affecting powers of attorney, here are a few highlights from the multi-track sessions (48 in number!):
- Nationally recognized elder law practitioner, Nell Graham Sale (from one of my other "home" states, New Mexico!) will present on planning and tax implications of trusts, including special needs trusts;
- North Carolina elder law expert Bob Mason will offer limited enrollment sessions on drafting irrevocable trusts;
- We'll hear the latest on representing same-sex couples following Pennsylvania's recent court decision that struck down the state's ban on same-sex marriages;
- Julian Gray, Pittsburgh attorney and outgoing chair of the Pennsylvania Bar's Elder Law Section will present on "firearm laws and gun trusts." By coincidence, I've had two people this week ask me about what happens when you "inherit" guns.
Be there or be square! (Who said that first, anyway?)
July 20, 2014 in Advance Directives/End-of-Life, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, Housing, Legal Practice/Practice Management, Medicaid, Medicare, Programs/CLEs, Property Management, Retirement, Social Security, State Cases, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)
Wednesday, July 16, 2014
An interesting moment for me at the 2014 Internatonal Elder Law and Policy Conference at John Marshall Law School in early July occurred when I asked several speakers from China to comment on recent reports suggesting "filial support" or "family support" is attracting interest of legislators, courts and older persons in China. For example, I shared with them the text, in English and Chinese, from Chinese Law Prof Blog on "Controversy Over Elder Law in China," that included news reports on consideration of laws in Shandong province in northeastern coastal China. If passed the laws would appear to require adult children to maintain "their parents' standard of living at a level at least equal to their own."
My question sparked a vigorous debate among the Chinese participants and quite a few chuckles from the audience as we tried to keep up with the translators. Over the course of the next two days Professor Lihong Tang from the law school at Fuzhou University in Fujian Province, Professor Chey-Nan Hsieh from Chinese Culture University in Taiwan, and Professor Xianri Zhou of South China Normal University School of Law in Shanghai attempted to help me understand. Here is my understanding of several points made during our discussion, a conversation we have agreed to continue via email:
- The population of individuals aged 65 and older in China is already 119 million. From my separate research I know that the older population is projected to continue to grow at a rate of 3.2 percent per year. The percentage of the population deemed older is also increasing, and according to some reports, it is projected to hit 1/6th of the total population by 2018 and possible as high as 1/5th of the total population by 2035. In other words, as Professor Tang explained, at some point in the relatively near future the total number of elderly in China could exceed the total population -- young, middle-aged and old -- of the U.S.
- With these population statistics in mind, they advised caution in making any judgments or predictions about trends based on a single case decision or from news stories reporting about any single family controversy involving support. And of course, this point is valuable to remember in all legal research, but the importance (and challenge) of having an adequate empirical base in China may be even more significant.
- Court actions to mandate younger family members to care for their elders are not a major trend in China. Rather, they emphasized that most families voluntarily provide the majority of care and financial assistance needed by their elders.
- There are efforts to create a stronger public system of income support where necessary to meet basic needs.
- Recent news reports (that received high profile attention in the U.S., such as this 2013 report on CNN) about a Chinese law that would mandate that adult children also "visit" their elderly parents were focusing on a "proposed" law, not one that was enacted.
In addition to my on-going discussion with the law professors at the conference, Yihan Wang, Senior Judge in the People's Court of the Jing'an District in Shanghai, gave a fascinating presentation on "The Path of Judicial Protection of the Rights and Interests of the Elderly in China." He has served for many years as a judge, and is currently in charge of "civil trials, commercial trials, finance trials and elderly trials" in his judicial district in Shanghai. He explained that an "elderly judicial tribunal" was established in 1994, for civil cases in which one or both parties is aged 60 or more. His court recognizes that older adults may have unique needs for legal assistance in disputes, including a potential need for free legal representation or guidance.
After the presentation of his paper via a translator, Judge Yihan Wang provided me with a copy of the English language translation of his paper. Thus, I was able to both hear and read about his examples of cases that have occurred in the Shanghai court:
"For one example, in the disputes of sale contracts of real estate, some adult children sell their parents' apartment and violate their parents' residency by stealing their parents' identification -- or make them sign the contract with the older person is unconscious. In [some] cases, the judge will judge the contract as valid to protect the third-parties' legal rights according to the Property Law. However, in cases involving the older [person], judges will consider more about the buyer's duty of care and the residency rights of the senior. They will be more cautious and much more strict to confirm the effectiveness of the contract. Mainly to protect the older people's residency right."
In contrast to my on-going discussion with the three Chinese law professors who emphasized the voluntary nature of assistance provided by families to their elders, Judge Yihan Wang's paper suggested that some level of litigation or claims review does occur over the issue of "family support," including what he described as efforts to "remind the adult children of their duty." His paper reported that "statistics show that 56% of the claiming alimony cases are closed by conciliation. In most of these cases, after the trials, children go to visit their parents automatically and the family relationship is improved." He emphasized that for older adults, "conciliation not only protects their legal rights and interests, but also maintains their family relationship and brings their children home."
Judge Yihan Wang's paper, in translation, concludes with these words: "China's 5,000-year-old culture emphasizes respect for the elderly, pension, help age virtues, which [are] absorbed by Chinese law and policy concerning the elderly, reflected in the Chinese judicial practice and become the judicial characteristics on protection of the rights and interests of the elderly in China."
Thus, I can see that my efforts to understand the role of "filial support" or "family support" laws in China will continue, especially as it appears that there may be regional differences in how any such laws are used or needed. In most countries I have studied, voluntary assistance, both practical and financial, flowing from adult children to elderly parents, is the norm. What I find interesting is the question of to what extent is "voluntary" filial assistance also encouraged, mandated, or subject to enforcement by laws. Is the 5,000 year tradition of filial piety under sufficient pressure in the 21st century that law is necessary?
Monday, July 14, 2014
Professional guardians have become important players in the world of adult and elder care. As the need has grown, so have efforts to establish standards or oversight mechanisms. The Center for Guardianship Certification (CGC), for example, offers a national certification process that requires applicants to pass a test, meet minimum eligibility requirements, pay a fee, and make attestations about their background. As reported recently by Sally Hurme for the ABA's Commission on Law and Aging, "as of April 2013, CGC had approved over 1,600 National Certified Guardians and 65 National Master Guardians throughout the country."
Some states have required professional guardians (as opposed to family member or similar one-time guardians) to obtain CGC certification or have adopted state-specific certification standards. In some states, such as Texas and Washington, certification combines with a state entity to receive and evaluate complaints about professional guardians, combined with a disciplinary process. Such disciplinary boards are usually treated as a supplemental option, rather than as a substitution for court reviews, where parties seek review of a guardian's performance.
Having the power to affect the career of a guardian, disciplinary boards for professional guardians have generated questions about procedural fairness. In a recent decision by the Washington Supreme Court, the court was called upon to review the procedural fairness of anctions imposed by the Washington's Certified Professional Guardian Board. At the heart of the challenge was the defendant's allegations of bias against her by an influential member of the Board, someone with whom she had previously served on the Board, and further asserting that the hearing officer had a financial interest in the outcome of the disciplinary proceedings, because of desire to continue his paid role for the Board.
The allegations against the defendant, who had more than 10 years of experience as a certified guardian and who maintained an active caseload of more than 60 guardianships, focused on her role as guardian for an elderly woman and for a disabled younger adult. She was alleged to have failed to assist in timely purchase of new glasses for the elderly woman with dementia, and to consult regarding movement of the younger adult to a hospice facility. The defendant contended that all actions taken by her were appropriate and consistent with the discretion accorded her under a "substitute judgment" standard.
In its July 3, 2014 decision in The Matter of Disciplinary Proceedings against Lori A. Petersen, the Washington Supreme Court, sitting en banc, rejected the defendant's arguments about a "personal vendetta" against her, upheld the findings and conclusions regarding defendant's alleged violation of state guardianship standards in serving the two wards, and rejected the defendant's arguments about procedural unfairness.
Nonetheless, the Washington Supreme Court ruled that "[b]ecause this is a case of first impression and the Board aspires to consistency with disciplinary sanctions, we remand to the Board to consider whether the sanctions sought against [the defendant], including the monetary fees, are consistent with those imposed in other cases." The Court questioned the imposition of a one year suspension from practice and more than $30,000 in costs and fees, stating its belief that the "circumstances of this case and the severity of the sanctions and fees in light of the charges brought by Petersen warrant an explicit proportionality inquiry."
In 2010, a Seattle Times news article raised questions about the oversight role of the Washington board, reporting that in "five years, the board has taken action against seven guardians or guardian companies. One lost certification. The others negotiated deals in which they promised not to break the rules. Some agreed to additional monitoring."
In the Petersen case, the Washington Academy of Elder Law Attorneys (through Rajiv Nagaich, Esq.) submitted an amicus brief, challenging the procedural fairness of proceedings against professional guardians in Washington.
For additional thoughts about oversight of guardians, see "A Call for Standards: An Overview of the Current Status and Need for Guardian Standards of Conduct and Codes of Ethics," by University of Washington Law Professor Karen Boxx and Texas attorney and former executive director for the National Guardianship Association, Terry W. Hammond.
Saturday, July 12, 2014
University of Missouri Law Professor David English, who is the current Chair of the ABA Commission on Law and Aging, provides a succinct outline of key legal challenges connected to aging in the U.S., an outline he also uses to organize his law school's Elder Law course. The essay appears in the May/June issue of Bifocal, capturing a lecture Professor English gave to the Institute of Gerontology at the University of Tokyo, Japan and the Beiing Administrative College in China.
In addition to the impact of demography, Professor English points to the following "challenges:"
- Employer Pensions: "In many countries, pensions provided by employers are closely coordinated with government Social Security payments. In the US, the two systems are independent...."
- Social Security: "It is predicted that the [Social Security] Trust Fund will run out of money in 2033. The program will thereupon have to cut benefits by about 25% in order to match payments to current Social Security taxes. To avoid such a sudden cut, Congress should act well in advance of the 2033 deadline to either increase Social Security taxes or modify benefits. Each year that the US Congress waits to act, the necessary adjustments will become more severe...."
- Health Care Finances: "...Medicare already has many gaps in coverage, requiring that elderly persons purchase private supplemental policies. Medicaid for the poor isn't necessarily in better financial shape, and because of low fees paid by Medicaid, many doctors refuse to accept Medicaid patients. Nor are Medicaid benefits coordinated well with Medicare...."
- Consumer Fraud: "The elderly are frequent targets of fraud. Federal and state regulation is incomplete and inconsistent.... Examples include: mortgage fraud; fraudulent sales of private health insurance; theft by court-appointed guardians; theft by agents under powers of attorneys; funeral fraud; telemarketing, home repair, and sweepstakes fraud."
- Guardianships: "Over the past 30 years, there have been major reforms in US guardianship laws. The court is encouraged to explore alternatives to guardianship before making an appointment. In making an appointment, the court is encouraged to give the guardian only such powers as are necessary, a goal which is achieved by appointing what is known as a limited guardian. But there is a big gap between the statute and the actual practice."
- Planning for Incapacity: "Most people will lack adequate mental capacity to make their own decisions sometime during their lives. Yet, most adults fail to plan in advance. There is a need for better education on the options and encouragement for people to plan."
- Health Care Decisions: "[S]igning a health care power of attorney or health care directive may not be effective to assure that health care decisions are made in accordance with the individual's wishes.... POLST [Physician Orders of Life Sustaining Treatment] shows great promise of creating a pathway whereby a patient's wishes will more likely be honored."
- Elder Abuse: "Similar to guardianship, good data on the prevalence of elder abuse does not exist but the increases in the number of elderly suggest a corresponding increase in the incidence of abuse."
Professor English was also one of the participants at the 2014 Elder Law and Policy Conference recently held at John Marshall Law School in Chicago, serving as a moderator, with JML's Barry Kozak, for the panel on "social security, pensions, and economic rights of older persons."
Thursday, July 10, 2014
One of the effects of "devolution" in the United Kingdom has been opportunities for Northern Ireland, Wales and Scotland to consider afresh their domestic laws and policy guidelines, separate from the mandates of Parliament in London. As those following recent UK news will know, Scotland this has gone beyond mere "home rule." A referendum vote on full independence is scheduled in Scotland for September 18, 2014.
Northern Ireland has not moved as quickly on adoption of domestic laws and policies. In part because of interruptions in efforts to fully establish home rule following disruptions of violence and the "Troubles," the process of enacting NI domestic laws has been slower paced than in Wales or Scotland, even after the Good Friday Agreement of 1998.
Nonetheless, high on the domestic agenda in NI have been laws and policies related to older people. One of the first modern era laws passed by Stormont was domestic legislation that established an independent Commissioner of Older People for NI. The discussions on that law overlapped with my Fulbright year and sabbatical in NI in 2009-10, and resulted in passage in January 2011.
The first Commissioner, Claire Keatinge, was appointed to a four year term in November of 2011. In my observation, Claire is a force of nature and if anyone can create a clear path to establish ageing as a priority matter for action in NI, it will be this dynamo.
On June 25, Commissioner Keatinge presented her call for fresh adult safeguarding legislation in NI. With emerging data suggesting significant increases in the number of cases of alleged abuse of older people, Commissioner Keatinge commissioned an evaluation of existing laws and comparative approaches in other nations. She asked whether and how NI can better protect adults from abuse, including physical, emotional, sexual and financial abuse. After receipt of the academics' report, her in-house legal team responded, helping her present a clear written call for action, a template for legislation.
As explained in her launch on June 25, the Commissioner advocates for:
- Clear definition of "adult at risk," the target term for safeguarding measures and not limited to older adults, as well as enhanced definitions of abuse or harm, and especially of financial abuse;
- Establishment of an adult safeguarding board, with statutory powers;
- Specific duties for relevant bodies and organizations within NI to report, investigate, provide services and cooperate with other agencies to order to better protect "adults at risk;"
- Specific powers of access to an individual believed to be at risk of harm or abuse, to defuse the potential for the abuser to influence the investigation process; and
- Protection from civil liability for those making reports of suspected abuse.
Further, Commissioner Keatinge recommends additional consideration be given to whether an Adult Safeguarding Bill -- as a single piece of legislation -- should grant specific powers to authorities to remove an individual at risk or ban a suspected abuse from contact. Her call for action recommends consideration of a specific grant of power to access financial records, often deemed crucial to investigation of financial risk and proof of abuse. Also on the Commissioner's radar screen is the potential adoption of specific criminal charges for "elder abuse" or "corporate neglect."
It has been exciting for me to see the evolution of the Commissioner's role and her use of the Queens University Belfast and University of Ulster academic reviews (on which I consulted). Professor John Williams (depicted on the far left, next to Claire Keatinge in yellow), head of the department of law and criminology at Aberystwyth University in Wales provided forceful support for the proposed legislation in Northern Ireland during his commentary at the launch, saying the status quo cannot be justified.
I'd like to say I see an easy path for a comprehensive Adult Safeguarding Law to emerge in the near future for Northern Ireland, thus serving as a role model for other jurisdictions facing similar issue.
I have to admit, however, that I was discouraged by what sounded -- at least to me -- like vacillation coming from key government leaders. The Minister of Health, Social Services and Public Safety in the Northern Ireland Executive, Edwin Poots (above, in the blue tie). spoke at the Commissioner's launch, expressing his own concern for older people as victims of abuse, especially financial abuse; however, I was disappointed when Minister Poots predicted that it would not be possible for Stormont to reach the issue of safeguarding legislation in the next 21 months. (Of course, coming from the political gridlock of Congress in the U.S., and as a witness to the snail's pace for protective legislation in my home state of Pennsylvania, I guess I should not be too surprised.)
Still, the good news is that the first major steps have been taken by Commissioner Keatinge and her capable staff including Catherine Hewitt and Emer Boyle, with strong support at the launch from social and health care professionals who have seen first hand the potential for subtle and not-so-subtle abuse of elder, disabled or frail adults in Northern Ireland.
And by the way, Professor Williams from Wales will be one of the presenters at the 2014 International Elder Law and Policy Conference at John Marshall Law in Chicago, speaking on older persons' access to justice as a key component of international human rights on Friday, July 11. It is a small world at times and one with a growing commitment to tackle key topics in ageing.