Monday, July 21, 2014

What Should You Look For In An Elder Law Attorney?

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.  

July 21, 2014 in Consumer Information, Ethical Issues, Legal Practice/Practice Management, Weblogs | Permalink | Comments (0) | TrackBack (0)

Sunday, July 20, 2014

17th Annual Elder Law Institute in Pennsylvania: Packed Program on July 24-25

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

Talking about China, Ageing, Families and Law

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? 

July 16, 2014 in Ethical Issues, Housing, Legal Practice/Practice Management, Social Security | Permalink | Comments (0) | TrackBack (0)

Wednesday, June 18, 2014

Pennsylvania Legislature Sends New POA Law Reform Measures to Governor

On June 18, the Pennsylvania House of Representatives approved  House Bill 1429 (Printer's No. 3708), thus sending the long-debated bill's new provisions on Powers of Attorney to the Governor for signing.  If, as anticipated, the bill is signed by the Governor, the new rules would be effective for POAs created on or after January 1, 2015. 

Pennsylvania pracitioners?  That means the Elder Law Institute offered by the Pennsylvania Bar Institute on July 25-26 in Philadelphia will have new relevance to your practice to prepare for the changes.  The opening session of the Institute is the always valuable "Year in Review" by elder law and estate planning specialists Marielle Hazen and Rob Clofine.

A detailed summary of the history and key provisions in H.B. 1429 is provided by Pennsylvania Attorney Neil Hendersthot on his blog. 

June 18, 2014 in Ethical Issues, Legal Practice/Practice Management, Property Management, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Monday, June 16, 2014

May-June 2014 Issue of Clearinghouse Review Focuses on Advocating for Persons with Disabilities

 

A United Nations treaty, civil rights, guardianship, protection from school bullies, free appropriate public education, and emotional-support animals are topics covered in this disability-themed May-June 2014 Clearinghouse Review issue. Also covered: making the most of current resources to increase legal services.

June 16, 2014 in Discrimination, Elder Abuse/Guardianship/Conservatorship, Legal Practice/Practice Management | Permalink | TrackBack (0)

Tuesday, May 20, 2014

Justice Dep't Announces ADA Title II Settlement with LSAC

The Justice Department filed a joint motion today for entry of a landmark consent decree to resolve allegations that the Law School Admission Council (LSAC) engaged in widespread and systemic discrimination in violation of the Americans with Disabilities Act (ADA). Under the proposed consent decree, LSAC will pay $7.73 million in penalties and damages to compensate well over 6,000 individuals nationwide who applied for testing accommodations on the Law School Admission Test (LSAT) over the past five years. The decree also requires comprehensive reforms to LSAC’s policies and ends its practice of “flagging,” or annotating, LSAT score reports for test takers with disabilities who receive extended time as an accommodation. These reforms will impact tens of thousands of test takers with disabilities for years to come.

More here.

May 20, 2014 in Discrimination, Federal Statutes/Regulations, Legal Practice/Practice Management | Permalink | TrackBack (0)

Monday, May 12, 2014

Elder Law Attorneys Get "Props" During Fresh Air Interview with Cartoonist

Roz Chast, well known for her cartoons in The New Yorker, has been getting well deserved coverage of her new graphic book, "Can't We Talk About Something More Pleasant?"   She brings her light, dark touch to bear on a tough topic, a daughter's relationship with her increasingly frail and sometimes stubborn parents. Roz Chast Memoir

Despite the obvious relevance of her book to this Blog, I was nonetheless pleasantly surprised when I heard Chast interviewed recently on the radio by Terry Gross for Fresh Air.  Roz Chast recounts how a lawyer specializing in "elder care law" (the phrase I increasingly hear used by lay people, displacing "elder law") helped her and her parents get to the heart of some very tough issues they'd been avoiding, as suggested by the title of her memoir.  As captured on the NPR website report, in describing the lawyer during the interview, Chast said:

"This person was really good.  And I think he was able to ... somehow make them trust him enough that they could open up a little bit about things that they really never wanted to open up about, like money and talking about the future.  I was there with them when he came over and we talked about things like health care proxy forms.  Things I had never thought about, things I had never heard of.  It was very, very helpful."

Reading between those few lines, I see the type of caring, tactful attorney -- and someone who makes home visits -- that I often have the pleasure of working with in Elder Law.

Chaz also talks humorously -- and with great candor -- about the dollars and "sense" of long-term care, and how she as a daughter felt about her parents' money going to pay for assisted living. 

Refreshing Fresh Air! 

 

May 12, 2014 in Health Care/Long Term Care, Legal Practice/Practice Management | Permalink | Comments (0) | TrackBack (0)

Wednesday, May 7, 2014

Planning Ahead: Extend Malpractice Insurance for Retiring Lawyers?

In part 6 of the ABA Journal's series on retirement issues, retiring lawyers are reminded that one important option is to purchase "extended reporting endorsements" (ERE) or "tail coverage" for existing professional liability insurance policies.  Such an endorsement permits a longer period to report  claims for coverage.  Mark Bassingthwaighte, an attorney and risk manager for Attorneys Liability Protection Society (ALPS) explains, "Tail coverage ... [is] not a new policy."  Rather, the existing policy explains the terms of any ERE coverage option, with the cost set as a fixed percentage of the expiring policy's premium. 

"'I recommend that the retiring partner talk with other partners and request to be kept in the loop within the applicable state statute of limitations for malpractice should the firm dissolve; even formalize an agreement that works best to protect all parties involved,' says Matt Lubaroff, ALPS director of client services. 'The firm's ERE can only be purchased at the time of dissolution, and for certain firms the best answer would be upon the first retirement.'"

Additional planning topics for retiring lawyers appear in "Retirement Reset" by Susan Berson in the May issue of the ABA Journal.

May 7, 2014 in Consumer Information, Legal Practice/Practice Management, Retirement | Permalink | Comments (0) | TrackBack (0)

Tuesday, May 6, 2014

Updated Federal Courts App available for Android and IPhone

An updated Federal Courts app is for Android, iPhone, iPad is now available.  The app provides access to PACER, the federal rules of civil, criminal, bankruptcy, and appellate procedure, federal rules of evidence, local rules for EVERY federal court in the country, and more.  It's a must have for all practitioners. And it's only 3 bucks!!!

To download search the relevant app store for Fed Courts, or go here:

Android

IPhone

May 6, 2014 in Legal Practice/Practice Management, Web/Tech | Permalink | TrackBack (0)

Thursday, May 1, 2014

New Yorker: Have You Read "Have You Lost Your Mind?"?

In the April 28 issue of The New Yorker magazine, Michael Kinsley offers a great piece, entitled "Have You Lost Your Mind?"  At first I thought the article was just a well written but not very surprising prediction about the looming "tsunami" of aging baby boomers.  Good research, interesting tidbits of medical fact, sharp-edged moments of social commentary and nice touches of humor.  Kinsley writes, for example: 

"I predicted [a few years ago] that the ultimate boomer rat race would be the competition to live the longest.... But, on further reflection, I think I underrated the penultimate boomer competition: competitive cognition.  The rules are simple:  the winner is whoever dies with more of his or her marbles."

But then the article gets serious, and seriously interesting.  The author reveals he was diagnosed twenty years ago with Parkinson's disease (PD) at the age of 43. That's when I, as a reader, noticed that the article was subtitled "Personal History."  For the last twenty years, Kinsley has had time and reason to think about the potential consequences of PD, not just for his body, but his mind.  He thoughtfully explores cognitive defects that can accompany PD, and which can be progressive. 

With facts, anecdotes and his own worry-driven research, Kinsley explains that not all dementias are about loss of memory:  

"[A] difference between Alzheimer's and Parkinson's is that Alzheimer's tends to starts its destruction in the parts of the brain affecting memory, whereas Parkinson's starts with what they call the executive function: analyzing a situation and your options and making a decision."

Ultimately, even though he isn't having any symptoms he can identify as PD-related cognition problems, Kinsley bites the bullet and decides, as he puts it, to have his "brain tested." Bottom line (and, really, his entire article is absolutely worth reading so I'm being unfair in skipping to the bottom line), although he scored exceptionally well on intelligence and "cognitive reserve" (meaning memory), in fact the test identified very real deficits in executive function. 

Now remember, the article is funny and, in many ways, brilliant.  This guy is functioning at a very high level.  But there's a message here, including a possible message for families and lawyers. 

As I read the article, I was remembering a conversation with someone who was asking me about alternatives under the law because he was worried about a family member.  In his explanation, at first he focused on the possibility of a memory problem, then instances of unexplainable mood changes, and then, finally, he gave me specific examples of what could be described as impairments in the loved one's "executive function."    

At what point -- especially if Kinsley and others are right about the looming tsunami of baby boomers with dementia -- do lawyers need to be much more sensitive to and skilled in the subtleties of impaired "executive function?"  Does our tendency to focus on the presence or absence of "memory problems" gloss over the biological explanations for a client's odd gifting decision?  I wonder how many lawyers would think to ask about Parkinson's disease, even if they witnessed a tremor or shake?  Do they therefore fail to ask appropriate questions of the "intelligent" client with the "clear" memory about the reasons for trusting a new "befriender" while becoming estranged from long-standing family or friends? Admittedly, I'm taking Kinsley's analysis one or two steps further.

As he winds to a close in his piece, Kinsley suggests the need for greater appreciation of age-related neurological disorders, observing:  "[W]eaknesses can be overcome, to some extent, by strengths somewhere else.... We are comfortable with the idea that physical health is not just a single number but a multiplicity of factors.  That's where we need to arrive about mental problems.  As we get older, we're all going to lose a few of our marbles."    

May 1, 2014 in Cognitive Impairment, Ethical Issues, Legal Practice/Practice Management | Permalink | Comments (0) | TrackBack (0)

Wednesday, April 23, 2014

Dementia Diagnosis and the Law

On April 24, I have the good fortune to be working with a neuropsychologist from the neurology department at Penn State Hershey Medical Center in presenting a program on "Dementia Diagnosis and the Law," for a meeting of the Estate Planning Council in York, Pennsylvania.  Professor Claire Flaherty and I have "traded" presentations in the past, with her speaking at the law school and me speaking at the medical school, but this will be our first time presenting together.  We're excited. 

One of the important lessons that I've learned in working with Claire is the clear potential for cognitive impairment to exist without the "usual" symptoms associated with "Alzheimer's."  For example, much of Claire's work is with patients and families coping with early onset dementias.  Because Frontotemporal Dementia or FTD (sometimes also referred to as Frontotemporal Lobar Degeneration or FTLD) can begin to manifest in persons aged 45 to 64 years, the onset may be overlooked or misunderstood. Plus, as Claire reminds me, "FTD is primarily a disease of behavior and language dysfunction, while the hallmark of Alzheimer's Disease is loss of memory."

For legal professionals, including those asked to prepare deed transfers, wills or estate planning documents, the potential for subtle presentations of cognitive impairment can be especially significant.  Making sure the client is oriented as to "time, place and person" may not be enough to address the potential for loss of judgment, thus opening the door for unusual gifts, risky financial decisions or even of adamant rejection of once trusted family members. 

A good place to turn for information about early onset forms of dementia, including FTD, is the Association for Frontotemporal Degeneration or AFTD -- or join us for the York Estate Planning Council meeting this week.  

April 23, 2014 in Cognitive Impairment, Dementia/Alzheimer’s, Estates and Trusts, Ethical Issues, Legal Practice/Practice Management | Permalink | Comments (0) | TrackBack (0)

Thursday, March 27, 2014

ProPublica publishes road map for patients injured while getting health care

ProPublica’s patient safety guide iss a viable resource for those who don’t know where to turn for answers and accountability after suffering a preventable injury, infection or medical error.  Reporter Marshall Allen explains what readers should do after suffering patient harm, based on advice from Helen Haskell, founder of Mothers Against Medical Error.
 
Some of the key steps include:
  • Get a copy of medical records, which every patient has a right to under federal law. These records can provide important information about what happened -- and what might have gone wrong.
  • If the patient has died, order a forensic autopsy, which includes toxicology tests. Autopsies -- though not always 100 percent accurate -- are the most reliable means of finding out what happened in an unexpected death. Hospitals do not routinely conduct autopsies, but the family has the right to get one.
  • Consider calling an attorney. Be aware that the standards for proving medical malpractice are much higher than most patients expect. Attorneys take few cases because they're expensive to pursue and difficult to win.

Read more at ProPublica.

March 27, 2014 in Health Care/Long Term Care, Legal Practice/Practice Management | Permalink | TrackBack (0)

Monday, March 24, 2014

ABA Webinar on Retirement Issues for Lawyers, Especially Young Lawyers

From January through March, the ABA Journal has run an interesting series of articles on retirement planning for lawyers, with clear messages for all age groups. Following that series, the ABA is hosting a live Webinar on "Retirement Expectations and Trends for 2014" on Wednesday, March 26.  The program is scheduled to begin at noon Eastern time.  The faculty, including Sally Hurme from AARP, Dean Deanell Reece Tacha from Pepperdine School of Law, and financial planning consultants, will

"...go beyond the basics of retirement and financnial planning to discuss other factors that can make your retirement what you want, including goal-setting; making the actual transition to retirement; determining whether a second or part-time post-retiremetn career is right for you; and dealing with the emotions of being retired.  Faculty will also provide guidance on the ethics of transitioning out of your practice, transitioning your clients, and selling your practice."

The 90 minute program is free for ABA members and $50 for the general public; no CLE credits are attached to the program.  Registration is here. 

March 24, 2014 in Current Affairs, Legal Practice/Practice Management, Retirement | Permalink | Comments (0) | TrackBack (0)

Tuesday, March 11, 2014

Aging with Dignity Offers Free Resources for National Healthcare Decisions Day Events

National Healthcare Decisions Day (NHDD) is April 16th, the date set aside each year to encourage everybody over age 18 to discuss and plan ahead of a serious illness. Five Wishes makes it easy because it is written in everyday language and deals with the things people care about most: their comfort, maintaining their dignity and other personal, spiritual and family matters.
  
Interested in $25 worth of free resources?

If you send us a photo and short account of your NHDD event or family gathering we'll give you a $25 credit for Five Wishes resources. Use this credit for a free DVD or to get copies of the 26 language translations of Five Wishes, pediatric documents, discussion guides, presenters guides, or access to Five Wishes Online. Get more information and tell us about your event here. Submit before May 15 to receive your credit.

NHDD button

NHDD buttons and stickers = more visibility for your good efforts:
If you're thinking about doing a community event, we want to help ensure it is a success, so we're again offering you a limited number of free "Five Wishes - Have You Signed Yours?" buttons and stickers. Just send us a message here, and we'll get the buttons and stickers to you.
 
NHDD Five Wishes

Five Wishes can deliver your message.  Don't miss the chance to customize the back cover of Five Wishes with your organization's logo and message. To receive your customized documents in time for NHDD, please complete your request by March 14 (that's the end of next week!).

More Info Here

March 11, 2014 in Advance Directives/End-of-Life, Health Care/Long Term Care, Legal Practice/Practice Management | Permalink | TrackBack (0)

Wednesday, February 26, 2014

Follow up--CRS Reports on Medicaid, Medicare, and Related Issues

Following up on Becky's post of Feb. 25 regarding some recent CRS Reports--I'm using a number of CRS reports in a class I am designing for Valparaiso's new health management and policy master's program.  These include:

Medicare, A Primer  Download Medicare Primer CRS

Medigap: A Primer Download Medigap CRS

Medicaid, An Overview (referenced by Becky) Download CRS Medicaid an Overview

Medicaid Coverage of Long Term Services and Supports Download Medicaid LTC CRS

Health Care Fraud and Abuse Laws AffectingMedicare and Medicaid: An Overview Download Fraud and Abuse CRS

Medicare Secondary Payer:Coordination of Benefits Download Fraud and Abuse CRS

Overview of Private Health Insurance Provisions in the Patient Protection and Affordable Care Act (ACA) Download Private Health Insurance ACA CRS

CRS reports aren't generally made available to the public, but I have had great luck over the years in obtaining them simply by contactiing one of the authors and requesting a copy.

February 26, 2014 in Legal Practice/Practice Management, Medicaid, Medicare | Permalink | TrackBack (0)

Monday, February 17, 2014

DOJ says state bar committees may be violating ADA with mental-health inquiries

Via the ABA Journal:

Asking would-be lawyers standard questions about their mental health, including their history of diagnosis and treatment, could violate the Americans with Disabilities Act, according to the civil rights division of the U.S. Department of Justice.  In a lengthy Feb. 5 letter (PDF) to the Louisiana Supreme Court, its committee on bar admissions and the state attorney disciplinary board that is likely to reverberate throughout the country, the division says some, but not all, of the questions asked in a standard National Conference of Bar Examiners questionnaire are unduly broad and violate the ADA. The DOJ also found that the state violates the ADA in evaluating bar applications from individuals with a history of mental health issues and admitting them to practice conditionally.

Read more.

 

February 17, 2014 in Discrimination, Federal Statutes/Regulations, Legal Practice/Practice Management | Permalink | TrackBack (0)

Tuesday, February 11, 2014

Career Development: Fellowship Applications Due to Borchard April 15

The Borchard Foundation Center for Law and Aging reminds us that the application window is now open to apply for 2014-15 Borchard fellowship funding.  The program provides three law school graduates the opportunity to pursue their research and professional interests for a year in law and aging. 

The fellowship is $42,500 and is intended as a full-time position only. The fellowship period runs from July 1 to June 30 each year, or for the calendar year beginning the month after the fellow’s completion of a state bar examination. 

Examples of activities and projects by Borchard Fellows: 

·     Working with an established legal services program to enable vulnerable, isolated, low-income seniors to age-in-place by addressing their unmet legal needs; 

·     Providing holistic services to older clients facing consumer debt and foreclosure-related concerns; 

·     Implementation of a courthouse project to help elderly pro se tenants achieve long-term housing stabilization through the interdisciplinary use of legal representation and social services, allowing more elderly tenants to “age in place” at home; 

·     Development of a non-profit senior law resource center providing direct legal services and public education; 

·     Development of an interdisciplinary elder law clinical program at a major public university law school; 

·     Development of a mediation component for a legal services program elder law hotline; 

·     Development of an interdisciplinary project for graduate students in law, medicine, and health advocacy to foster understanding and collaboration between professions.

For more details on how to apply before April 15, 2014 deadline, see details here

February 11, 2014 in Consumer Information, Grant Deadlines/Awards, Legal Practice/Practice Management | Permalink | TrackBack (0)

Thursday, February 6, 2014

Elder Law & the Future: What Role for "Limited License Legal Technicians?"

What are "limited license legal technicians" or LLLTs?  As defined by the Supreme Court of Washington in an order issued in June of 2012, LLLTs are individuals who achieve certification through a new state program, authorizing them to provide specific legal services within specific substantive areas of law and law-related practice. 

Why create the LLLT alternative, especially in a country and during an economy where there are, arguably, more than enough underemployed lawyers?  As the Washington Supreme Court carefully details, the current civil legal system "is unaffordable not only to low income people but, as a [2003 state study] documented, moderate income people as well...."  For low income people, the "underfunded civil legal system is inadequate" to meet their very real needs.  For many who are moderate in income, "existing market rates for legal services are cost-prohibitive."  A new means of meeting public need is warranted, says the Court. 

Why is a system of licensing LLLTs in the State of Washington potentially very significant to the practice of Elder Law?  Washington has identified four areas of unmet civil law needs: Family Law, Immigration, Landlord/Tenant, and... yes, Elder Law. 

Very interesting!  The first practice area to be certified in Washington will be "Domestic Relations," with the Limited License Legal Technician Board expecting to begin accepting applications for a licensing examination in late summer or early fall of 2014.  No indication yet on when "Elder Law" LLLTs might be certified. In the roll-out design, applicants must first satisfy threshold educational standards, including holding at least an associate level degree, plus 45 credit hours at an ABA-approved program (which, for the moment at least, means an ABA approved law school). Details on the certification process are available on the Washington State Bar Association's website, here.   The University of Washington's School of Law has announced its "inaugural program" for LLLTs in family law to begin in the winter quarter of 2014. 

While I suspect this movement might make existing Elder Law attorneys a bit nervous, my own research points to the very real need for more widely available, trustworthy legal advice.  For example, Penn State Dickinson law students, with financial support of the Borchard Foundation's Center on Law and Aging, helped me to conduct focus groups drawn from a wide range of income, race, ethnicity and gender orientation, from locations all across Pennsylvania. In English and in Spanish, in inner cities and rural senior centers, we asked about their views and experiences with accessing legal assistance with Social Security, Medicare, Medicaid, insurance and other legal questions of concern to older persons.  As summarized here, fear of the cost of seeing a lawyer, and the difficulty in finding free or affordable attorneys who were "trustworthy," were  concerns clearly raised in each of the focus group sessions. That study pointed to the need for elder law specialists -- but not necessarily to a need for "just" Elder Law attorneys

Big thanks go to Penn State Dickinson Professor Laurel Terry, our in-house guru on all things cutting edge in the practice of law, for sharing with me the latest materials on Washington's LLLT program.  

February 6, 2014 in Consumer Information, Ethical Issues, Legal Practice/Practice Management, State Statutes/Regulations | Permalink | Comments (0) | TrackBack (0)

Wednesday, January 22, 2014

Should We Teach Law Students "How to Sell Law," Including Elder Law?

Recently, a long-time friend, a successful business person, sent me a link to an Inc. article about an interesting course at the University of Chicago called "Entrepreneurial Selling." The course was taught in the Business School and the Inc. article included the course syllabus.  My friend asked "should lawyers -- and by extension law students -- be taking this kind of course?"  Reading the first line of the article made me shudder just a little, because it made the distinction between learning "how to sell," versus mere "marketing," especially for small businesses.  But, the more I read, the more I was intrigued.  My friend (a non-lawyer) argued that selling is the art of effective communication and lawyers are or should be all about effective communication. 

That got me thinking, and I realized that some of the most effective "sellers" of law are Elder Law attorneys, who regularly engage with the public in social and business contexts, always with their eyes open for new relationships and new clients.  As examples, I've witnessed (and participated in) an interesting variety of educational seminars for the public or other professionals that were sponsored by Elder Law firms or Elder Law attorneys. 

Elder Law is still a relatively young (and evolving) field.  Most members of the public have little understanding of what might be covered by the term.  Indeed, two summers ago, a group of law students and I were sharply reminded of that fact while doing a state-wide research project with focus groups of older adults and their families, asking them to talk about access to trustworthy legal advice and information. We frequently encountered people who thought of Elder Law as "writing wills for old people," or similar amusing, if worrisome, definitions. Thus, "selling" the field is perhaps especially important and necessary. 

But, of course, that leads to more questions. Is there an ethical model for "selling" a particular field of law, particularly a field that may not be well understood by the potential client base?  Is so, what are the elements of that model? 

What is necessary, for example, to avoid the Consumer Financial Protection Bureau's concerns about manipulation of potential clients, as addressed in an earlier post on this blog about investment products marketed to seniors?  I'm tempted to say that one possible element of an ethical model would be to de-couple the educational programming from the client-retention meetings, but perhaps I'm being very naive, trapped in my ivory tower.

Silvia Hodges, who runs a blog subtitled The Legal Firm as a Business,  recently published "I Didn't Go to Law School to Become a Salesperson -- The Development of Marketing in Law Firms."  in the Georgetown Journal of Legal Ethics.   She argues that "lawyers [often] mature in their professions without marketing training and therefore are ... ill-prepared to handle both the business and the professional part of their profession simultaneously."  She refers to the problem as "market disorientation," where lawyers "consistently underrate the importance of clients' selection clues and criteria."  She concludes that law firms "need to aspire to have marketing embedded in their firm culture, independent of whether the firm is a professional partnership or a managed professional business." 

Perhaps the first step to that culture change should occur in law school, and thus "selling law" should also be addressed specifically in Elder Law classes. 

January 22, 2014 in Current Affairs, Ethical Issues, Legal Practice/Practice Management | Permalink | Comments (0) | TrackBack (0)

Tuesday, January 21, 2014

Geriatric Care Management and Boomers

Recently, a Pennsylvania friend was describing her aging father's situation in one of the sunshine states.  When her father, a widower, began to show signs of diminishing capacity, the adult children discussed options, including moving Dad closer to one of them. But, he liked his retirement spot in the sunshine, had friends, and, in fact, there were more care options where he was living.

Eventually, my friend hired a local geriatric care manager in the sunshine state, with the cost shared by her and two siblings.  In our most recent conversation, my friend described that decision as perhaps the best move the family made.  She said that at first she had a hard time getting her father's facility to accept the fact that they should call the care manager first.  But having an informed person -- an experienced advocate for her father -- in the community has often been essential, as questions arose over insurance, level of care, medications, transfers between facilities, nutrition and whether to hospitalize. My friend still makes regular trips to visit her father, but the local manager meant there were fewer emergency trips.

Geriatric care managers, sometimes called care coordinators, elder care coordinators, or professional care managers, could -- and perhaps should -- be an increasingly important part of planning.  One of the questions about this emerging profession is credentials.  At least two national trade groups exist, including the National Association for Professional Geriatric Care Managers (NAPGCM) and the National Academy of Certified Care Managers (NACCM).

In addition, law firms specializing in elder law frequently offer care management services, often employing non-lawyer professionals as part of the team.

Geriatric care management may be very important to "elder boomers," both as they become seniors caring for their even-more-senior-aged parents, and as future care-needing individuals themselves.  Unfortunately, a big question may be cost.  Medicare and Medicaid -- and most insurance -- does not cover the cost of care management.  As reported by the New York Times a few years ago in "Care Coordination: Too Expensive for Medicare?," attempts to secure public funding for care managers has been stymied by studies that show care management does not necessarily reduce the costs of care. 

Nonetheless, such coordination may be particularly important in a nation where family members often live far apart.  In my friend's situation, she expected the need to last for a couple of years, but in fact, her father is approaching age 98, and the "healthy" relationship between the children, their father and his care coordinator has lasted for more than 10 years. 

January 21, 2014 in Cognitive Impairment, Consumer Information, Dementia/Alzheimer’s, Ethical Issues, Health Care/Long Term Care, Legal Practice/Practice Management, Medicare | Permalink | Comments (0) | TrackBack (0)