Elder Law Prof Blog

Mark Your Calendars for Two New Webinars!

I received several notices recently about upcoming webinars, so I thought I'd let you know about them so you can register. Both happen to be on the same day, but luckily not at the same time. Block off the time on your calendar, register and plan to eat at your desk!

1.  NAPSA Research-to-Practice (R2P) Webinar on July 17, 2019 at 1:30 edt. Topic: The Role of Social Support in the Lives of Elder Abuse Victims. Register, click here.

2. National Center of Law & Elder Rights, on July 17, 2019 at n0on edt. Topic: Protecting Older Adults Against Abusive Telemarketing Scams. Register: click here.

Report on Unreported Abuse & Neglect at SNFs

The Office of Inspector General for Health & Human Services issued a report this month, Incidents of Potential Abuse and Neglect at Skilled Nursing Facilities Were Not Always Reported and Investigated.

Here's a summary of their findings

We determined that an estimated one in five high-risk hospital ER Medicare claims for treatment provided in calendar year 2016werethe result of potential abuse or neglect, including injury of unknown source, of beneficiaries residing in a SNF.We determined that SNFs failed to report many of these incidents to the Survey Agencies in accordance with applicable Federal requirements. We also determined that several Survey Agencies failed to report some findings of substantiated abuse to local law enforcement. Lastly, we determined that CMS does not require all incidents of potential abuse or neglect and related referrals made to law enforcement and other agencies to be recorded and tracked in the Automated Survey Processing Environment Complaints/Incidents Tracking System. Preventing, detecting, and combating elder abuse requires CMS, Survey Agencies, and SNFs to meet their responsibilities.

OIG's recommendations include

• work with the Survey Agencies to improve training for staff of SNFs on how to identify and report incidents of potential abuse or neglect of Medicare beneficiaries,
• clarify guidance to clearly define and provide examples of incidents of potential abuse or neglect,
• require the Survey Agencies to record and track all incidents of potential abuse or neglect in SNFs and referrals made to local law enforcement and other agencies, and
• monitor the Survey Agencies’ reporting of findings of substantiated abuse to local law enforcement.

The OIG full report is available here.

HHS Releases Final Conscience Rule

Health & Human Services in a press release, explains that HHS Announces Final Conscience Rule Protecting Health Care Entities and Individuals."that protects individuals and health care entities from discrimination on the basis of their exercise of conscience in HHS-funded programs. Just as OCR enforces other civil rights, the rule implements full and robust enforcement of approximately 25 provisions passed by Congress protecting longstanding conscience rights in healthcare. "

The final rule is available here. A fact sheet from HHS on this rule is available here.

The Role of Older People in Climate Change

A colleague and dear friend of mine is doing amazing work to combat climate change.  I have on several occasions told him he should look at the impact of climate change on elders but never have I thought about the role of elders in contributing to climate change.... until now. Last month the New York Times ran an article, Older People Are Contributing to Climate Change, and Suffering From It.

Not only have elders seen climate change happening, according to the article, "Older  Americans ...  are significant contributors to climate change. A just-published study has found that residential energy consumption rises as a resident’s age increases."  The article examines the why of this  and although "[t]he study could not provide explanations, but“there might be more need for air-conditioning,” ... [o]r older people may not be able to maintain their homes as well to conserve energy....."  Living in one of those southern states where air conditioning is a must and on extremely hot days we get warnings about certain folks needing to stay in air conditioning, I can say the researcher was right on that reason.

The article notes that there is a vicious cycle occurring-"There will be more warm days in most areas because of climate change... [and]  more energy use by the older group... [with] the population aging, there will be more people in that age group.'"

The article goes on to discuss how older people are disproportionately affected by climate extremes and disasters. Fighting climate change should be one of our top priorities because we are all affected by it-but clearly our older folks are affected more than most.

Thank you Roy for all of your work.

At What Age Are You Old?

That's the age-old (pun intended) question, isn't it? I know my students perceive me as old, but I know in my mind I'm not as old as my chronological age would denote. So the Washington Post tackled the "how old is old?" question in a recent story, An ageless question: When is someone ‘old’?

Typically, people decide who is “old” based on how many years someone has already lived, not how many more years they can expect to live, or even how physically or cognitively healthy they are. I will soon turn 62. What does that actually tell you? Not very much, which is why, like many of my sexagenarian friends, I’m apt to claim, “Yes, age is just a number.”

So what does “old” really mean these days?

All of us who teach elder law know that asking how old is old is valid and important. It impacts eligibility for programs and benefits, for example. It's also important for the purpose of policymakers who have to make plans for aging populations, the article explains. In the U.S. we still see the use of 60 or 65 as a threshold to "old."

The United Nations historically has defined older persons as people 60 years or over (sometimes 65). It didn’t matter whether you lived in the United States, China or Senegal, even though life expectancy is drastically different in each of those countries. Nor did it depend on an individual’s functional or cognitive abilities, which can also be widely divergent. Everyone became old at 60. It was as though you walked through a door at midnight on the last day of 59, emerging a completely different person the next morning: an old person.

Two experts quoted in the article, demographers, discuss the different between chronological age and prospective age, that is "'chronological age 'tells us how long we’ve lived so far. In contrast, prospective age is concerned about the future. Everyone with the same prospective age has the same expected remaining years of life.'” One of them is quoted as saying you are old when you have a "specific life expectancy is 15 years or less. That ..  is when most people will start to exhibit the signs of aging, which is to say when quality of life takes a turn for the worse."  By this measure I'm not old yet but by golly I'm close.

The expert when on to elaborate

[For] ... folks in the United States... When are we considered old? For women, the old age threshold is about 73; for men, 70.... [The expert] layers his concept of prospective age with another quality, which he calls “characteristic aging.”... “It depends upon the characteristics of people, in which sense they are old,” he says. “Are they cognitively old? Are they physically old? Are they old in terms of their disabilities? It depends.”

Old is not a one-size fits all and not only are there variations within the U.S. there are by country.  The article is really fascinating-read it and figure out how long before you are "old."

Thanks to Professor Naomi Cahn for sending the article.

10 Tips for Guardians

The National Center on Law & Elder Rights recently published 10 Tips for Guardians of Older Adults.  Here are the tips

1. Maintain separate financial accounts...
2.  Keep detailed records»Save receipts for everything you can, and write every expenditure or decision down....
3. Only use the persons’ money and property for their benefit....
4. File timely reports...
5. Regularly talk with the person....
6. Spend time together....
7. Provide social contact....
8. Remember the dignity in choice....
9. Safeguard the person’s rights....
10. Reassess the Need to Continue the Guardianship....

The explanations for the tips and additional resources are available here.

Doctors Giving--Or Not Giving--Bad News

Kaiser Health News ran an interesting story that doctors aren't always the best at breaking bad news. Never Say ‘Die’: Why So Many Doctors Won’t Break Bad News relates the experiences of one doctor who as a patient, found his doctor unable to give him his terminal diagnosis. With the time he has left, he is teaching med students on how to have the conversation.

Robust research shows that doctors are notoriously bad at delivering life-altering news, said Dr. Anthony Back, an oncologist and palliative care expert at the University of Washington in Seattle....

....

Up to three-quarters of all patients with serious illness receive news in what researchers call a “suboptimal way,” Back estimated.... “’Suboptimal’ is the term that is least offensive to practicing doctors,” he added.

This lack of information seems puzzling given that patients need info in order to make an informed decision. Why is this happening? For one, "many doctors, especially those who treat cancer and other challenging diseases,'“death is viewed as a failure,'” said one expert quoted in the article. The article covers the needed skills, how they might be taught, and what is being done to help with this issue.

In-Depth Story on Reverse Morgages

USA Today, ran this story, Seniors were sold a risk-free retirement with reverse mortgages. Now they face foreclosure. This is not a happy story.

Alarming reports from federal investigators five years ago led the Department of Housing and Urban Development to initiate a series of changes to protect seniors. USA TODAY’s review of government foreclosure data found a generation of families fell through the cracks and continue to suffer from reverse mortgage loans written a decade ago.

These elderly homeowners were wooed into borrowing money through the special program by attractive sales pitches or a dire need for cash – or both. When they missed a paperwork deadline or fell behind on taxes or insurance, lenders moved swiftly to foreclose on the home. Those foreclosures wiped out hard-earned generational wealth built in the decades since the Fair Housing Act of 1968 ¹

  . . .        

Borrowers living near the poverty line in pockets of Chicago, Baltimore, Miami, Detroit, Philadelphia and Jacksonville, Florida, are among the hardest hit, according to a first-of-its-kind analysis of more than 1.3 million loan records. USA TODAY worked in partnership with with Grand Valley State University, with support from the McGraw Center for Business Journalism.

The article looks at some examples of individuals who are in trouble and examines the situation that led us to this point.

Federal regulators and industry leaders cautioned that numbers alone tell only part of the story, since many foreclosures result from the natural end of reverse mortgages: the homeowner’s death. The average term of a reverse mortgage is about seven years, and if a family member is not willing or able to repay the loan, lenders push the property through foreclosure.

Regulators said actual evictions of seniors are rare. There’s no way to verify that, though, since HUD, the top government regulator of Home Equity Conversion Mortgage ⁴ loans, does not sign off on evictions – or even count them.

The article is lengthy but full of important information. Read it yourself, and then assign it to your students.

Thanks to my colleague and dear friend, Professor Bauer, for sending me the article.

Maine Passes Medical Aid in Dying

Maine has paased a law legalizing medical aid in dying.  Maine Becomes 8th State to Legalize Assisted Suicide notes that the governor signed the law last week,  The votes in both the Maine House and Senate were close. The Maine law is similar to that in effect in several other states.

 

The Maine Governor "issued an executive order ...  calling for the state to swiftly put the law’s protections into place and analyze the law’s impact." As she explained

For all of these concerns as well however, I have also issued Executive Order Number Nine, which requires the Department of Health and Human Services to engage in Emergency Substantive Rulemaking within the next few months.

The broad purposes of this Executive Order will be to provide a high level of protection for those in care and those who shall be in care; to track trends in the utilization of the law; to pursue our responsibility for end of life care; and to avoid the moral and social consequences of a law that in some way might facilitate the taking of life without the full authority of the individual.

DOJ Transnational Elder Fraud Strike Force

DOJ announced the creation of a multi-agency strike force to fight elder fraud. Justice Department Announces New Transnational Elder Fraud Strike Force. Law Enforcement Effort Will Coordinate Action Against Foreign Fraud Schemes that Target American Seniors announces

the establishment of the Transnational Elder Fraud Strike Force, a joint law enforcement effort that brings together the resources and expertise of the Department of Justice’s Consumer Protection Branch, the U.S. Attorneys’ Offices for six federal districts, the FBI, the U.S. Postal Inspection Service, and other organizations. The Strike Force will focus on investigating and prosecuting individuals and entities associated with foreign-based fraud schemes that disproportionately affect American seniors. These include telemarketing, mass-mailing, and tech-support fraud schemes.

The Transnational Elder Fraud Strike Force will be comprised of prosecutors and data analysts from the Consumer Protection Branch, prosecutors with six U.S. Attorneys’ Offices (Central District of California, Middle and Southern Districts of Florida, Northern District of Georgia, Eastern District of New York, Southern District of Texas), FBI special agents, Postal Inspectors, and numerous other law enforcement personnel. The Strike Force will also collaborate with the Federal Trade Commission and industry partners, who have pledged to engage with the Department to help end the scourge of elder fraud. It will further benefit from the help of the Elder Justice Coordinators now assigned in every U.S. Attorney’s Office.

Paying for Aging in Place with Payroll Tax: State's Ideas

Kaiser Health News recently ran a story, Payroll Tax Is One State’s Bold Solution To Help Seniors Age At Home. According to the article,

[T]wo states — Washington and Hawaii — are experimenting with taxpayer-funded plans to help older residents remain in their homes.

Washington state’s ambitious plan, signed into law in May, will employ a new 0.58% payroll tax (or “premium,” as policymakers prefer to call it) to fund a $36,500 benefit for individuals to pay for home health care, as well as other services — from installing grab bars in the shower to respite care for family caregivers.

Hawaii’s Kupuna Caregivers Program, which was initiated in 2017, is also publicly funded, but state budget allocations limit enrollment and benefits. It provides up to $210 a week for services when family caregivers work outside the home at least 30 hours a week.

As the article notes, there is a growing need for caregivers. 

The number of Americans 65 and older will double to 98 million by 2050, and studies show few have the financial resources to pay for care in old age. More than half of adults 65 and up will require long-term assistance at some point with everyday activities, for an average duration of about two years, according to a 2015 study by the Department of Health and Human Services. Finding a way to help people stay in their homes — and not move to nursing homes — can keep them happier and save them and the state money. Medicaid programs help cover the costs of 62% of nursing home residents.

The article notes that other states are watching the results of these two innovative programs, but it will take some time to see the results. In Washington state, "[t]he state will begin collecting the payroll tax in 2022, and starting in 2025 residents can collect benefits if they have paid into the system for at least three of the previous six years or five consecutive years within a decade. The details will be set over the next few years, but to qualify for a benefit of up to $100 a day, which will be adjusted for inflation, a person must show they need help with at least three activities of daily living."  The program is projected to be a money-saver, to the tune of "$3.9 billion in state Medicaid costs by 2052."

Other states are exploring other solutions:

Minnesota is considering allowing people to convert life insurance plans to long-term care insurance.

...

Maine voters rejected a ballot proposal to provide free long-term care to residents, funded by a 3.8% income tax on residents making more than $128,400 a year. Instead, the state government is educating people about the need to buy long-term care insurance, including an awareness campaign in high schools.

The California Aging and Disability Alliance, an advocacy group, is considering a ballot initiative for a state program to provide long-term services and support.... Michigan and Illinois are also studying proposals.

New York lawmakers have debated a graduated income tax to pay for comprehensive long-term care for its citizens. The Assembly has passed such a bill repeatedly, but the state’s Senate has refused to approve it.

GAO Report on Elder Justice

The Government Accounting Office released a new report on Elder Justice.  Elder Justice: Goals and Outcome Measures Would Provide DOJ with Clear Direction and a Means to Assess Its Efforts explains the reason for this report

Why GAO Did This Study

Researchers estimate that as many as 1 in 10 older adults in the United States—age 60 or older—experience abuse each year. Elder abuse may involve physical, sexual, emotional, or financial abuse or neglect. It can occur by family, guardians, or caregivers as well as by strangers and international criminal enterprises, which operate schemes for monetary gain or to facilitate other criminal activities. According to media reports and congressional testimony, some older U.S. citizens who have traveled abroad have unwittingly participated in illicit activities, and in some cases, have been arrested in foreign countries.

EAPPA included a provision for GAO to review elder justice efforts in the federal criminal justice system. This report examines (1) the ways DOJ works to address crimes against older adults, and to what extent DOJ is planning for and assessing its efforts; and (2) how the Departments of State and Homeland Security address the arrest of older U.S. citizens abroad, including arrests involving international criminal enterprises. GAO reviewed agency policy documents, and interviewed agency officials, as well as a nongeneralizable sample of elder abuse stakeholders and state and local officials selected for their experience in this area.

Along with offering examples of scams and frauds targeting elders, the GAO report included a recommendation for DOJ "that DOJ develop and document elder justice goals and outcome measures to better guide its elder justice efforts."

The full report is available here.

 

 

Ageism in Medicine? One Doctor's Thoughts

Kaiser Health News (KHN) ran a story last month, A Doctor Speaks Out About Ageism In Medicine.

Society gives short shrift to older age. This distinct phase of life doesn’t get the same attention that’s devoted to childhood. And the special characteristics of people in their 60s, 70s, 80s and beyond are poorly understood.

Medicine reflects this narrow-mindedness. In medical school, physicians learn that people in the prime of life are “normal” and scant time is spent studying aging. In practice, doctors too often fail to appreciate older adults’ unique needs or to tailor treatments appropriately.

The story focuses on a new book by a doctor, “Elderhood"  which is "an in-depth, unusually frank exploration of biases that distort society’s view of old age and that shape dysfunctional health policies and medical practices." The rest of the article is a Q&A interview with the author focusing on her idea of "elderhood", how she sees her concepts working, and ageism.  Using an anecdote, the author offers it as an example of "ageism: dismissing an older person’s concerns simply because the person is old. It happens all the time."  Here is another example the author offers

Recently, a distressed geriatrician colleague told me a story about grand rounds at a major medical center where the case of a very complex older patient brought in from a nursing home was presented. [Grand rounds are meetings where doctors discuss interesting or difficult cases.]

When it was time for comments, one of the leaders of the medical service stood up and said, “I have a solution to this case. We just need to have nursing homes be 100 miles away from our hospitals.” And the crowd laughed.

The interview does have some optimistic insights, including "the age-friendly health system movement, which is unquestionably a step in the right direction. And a whole host of startups that could make various types of care more convenient and that could, if they succeed, end up benefiting older people."

Update on Litigation of Medicare's 2 Midnight Rule

The Center for Medicare Advocacy (CMA-full disclosure, I'm on their board) has been litigating with CMS on the observation status issue. The latest litigation on the observation status, Alexander v. Azar, has a new opinion decided on June 4, 2019.  On a motion for clarification and reconsideration filed by CMS, as well as a motion to seal, the Court in the June 4 order grants in part and denies in part the motion to seal and denies the motion for reconsideration and clarification.

Stay tuned.  This case is going to trial in the fall!

GAO Report on Disaster Assistance for Individuals With Disabilities and Elders

GAO has issued a new report, Disaster Assistance: FEMA Action Needed to Better Support Individuals Who Are Older or Have Disabilities. According to the GAO findings,

A range of officials from entities that partner with the Federal Emergency Management Agency (FEMA)—including states, territories, localities, and nonprofits)—reported challenges providing assistance to individuals who are older or have disabilities following the 2017 hurricanes. For example, officials said that many of these individuals required specialized assistance obtaining food, water, medicine, and oxygen, but aid was sometimes difficult to provide.Officials in Puerto Rico and the U.S. Virgin Islands cited particular difficultiesproviding this assistance due to damaged roads and communication systems, as well as a lack of documentation of nursing home locations. Based on GAO’s analysis of FEMA data and interviews with FEMA officials and stakeholders, aspects of the process to apply for assistance from FEMA after the 2017 hurricanes were challenging for older individuals and those with disabilities. According to stakeholders and FEMA officials, disability-related questions in the registration materials are confusing and easily misinterpreted. For example, FEMA’s registration process does not include an initial question that directly asks individuals if they have a disability or if they would like to request an accommodation for completing the application process (see figure below). While FEMA has made efforts to help registrants interpret the questions, it has not yet changed the language of the questions to improve clarity. As a result, individuals with disabilities may not have requested accommodations or reported having disabilities, which may have hindered FEMA’s ability to identify and assist them.

. . .

FEMA did not establish objectives before implementing its new approach to disability integration, which includes adding new disability integration staff in the regions and decreasing the number of disability integration advisors deployed to disaster sites. Without documented objectives for the new approach, regional leadership across the nation may implement changes inconsistently. In addition, the new approach shifts the responsibility for directly assisting individuals with disabilities to all FEMA staff. FEMA has taken some initial steps to provide training on the changes; however, it has not established a plan for delivering comprehensive disability-related training to all staff who will be directly interacting with individuals with disabilities. Developing a plan to train all staff would better position FEMA to achieve its intended goals and better equip deployed staff to identify and assist these survivors.

The full report is available here as a pdf.

Maine May Pass MAD

Maine may be the latest state to pass medical aid-in-dying according to the Washington Post. The article explains the Maine House passed the bill by a one vote margin, Maine could allow terminally ill to get life-ending meds. Two days later, CNN reported that the bill has been sent to the Maine governor, Maine legislature sends bill effectively legalizing assisted suicide to governor. "The legislation, called the "Maine Death with Dignity Act," would allow mentally-competent patients over the age of 18 'to make a request for medication prescribed for the purpose of ending the person's life.'"  The vote in the Maine Senate was also close, but not quite as close as in the Maine House, passing the Senate 19-16.  The article notes that the bill "states that it does not legalize medically-assisted suicide, though if enacted, it would effectively do so."

Dementia & the Ethics of Choosing to Die

The Hastings Center has announced a new and very important research project. Dementia and the Ethics of Choosing When to Die will focus on basic issues surrounding an individual's ability to exercise end of life choices when suffering from dementia. As the announcement explains

As the American population ages and dementia is on the rise, The Hastings Center is embarking on pathbreaking research to explore foundational questions associated with the dementia trajectory and the concerns of persons facing this terminal condition. This new research is made possible by a major grant to The Hastings Center from The Robert W. Wilson Charitable Trust as part of its visionary support for the Center’s research and public engagement on ethical challenges facing aging societies.

...

During the dementia trajectory, a person experiences progressive impairment of cognitive abilities – including memory, problem-solving, and language – as well as changes in behavior and physiological functions. As cognition deteriorates, a person with dementia will need daily assistance and eventually total care, often in an institutional setting, for several years before physical deterioration progresses to death from pneumonia or another condition associated with severe dementia. There are no effective treatments to cure or halt the progression of dementia. Alzheimer’s disease, the most common form, is the sixth leading cause of death in the U.S.  Vascular dementia, the second most common form, may develop following stroke.

In 2018, 5.7 million Americans were living with dementia. An estimated 12 million others will be at high risk for developing dementia over the next 30 years as the baby boom generation lives into their 80s and 90s.

In the U.S., the basic legal right to be free of unwanted treatment is long established. People with decision-making capacity have the right to forgo life-sustaining treatment they do not want. People who lack decision-making capacity have the same right through the use of an advance directive or a surrogate decision-maker. However, this longstanding legal framework and ethical consensus does not fully reflect the situation of a person facing dementia if this person has no medical treatments to refuse. Also, the timeframe in which a terminally ill person with decision-making capacity can request and use medical aid-in-dying (MAID), now legal in nine U.S. jurisdictions, does not correspond to the dementia trajectory.

...

Through literature review and workshops, a Hastings Center work group will conduct an ethical analysis of end-of-life choices in the context of dementia, identifying areas where further research or policymaking is needed. In exploring these emerging issues, the work group will also consider how the field of bioethics should contribute to research, policy solutions, and public understanding to improve the experiences of living with dementia and caring for people with the condition. Products will include a special report, to be published in 2021.

“Population aging raises profound questions about how a society values the experiences of aging and caregiving,” says Berlinger. A separate Wilson Trust grant will build on a recent Hastings Center special report to support events and publications on how policymakers, practitioners, and the public can promote inclusion and equity for older adults and caregivers. Learn more about the dementia project and the aging societies project.

Elder Justice Resources Hub from ACL

The Administration for Community Living (ACL) unveiled the Elder Justice Resources Hub which incorporates the work of several agencies, including NCEA (National Center on Elder Abuse),  NCLER, (National Center on Law & Elder Rights), NAMRS,(National Adult Maltreatment Resource Center),  NORC (National Long-Term Care Ombudsman Resource Center), PHA (Pension Help America), NRCWRP (National Resources Center on Women & Retirement Planning) and APS-TARC (APS Technical Assistance Resource Center) The website explains

No matter how old we are, justice requires that all people are equal and full members of our communities, and the safety and dignity of all its members are preserved, including older adults and people with disabilities. Unfortunately, we do not always live up to this ideal. Committed to developing systems and programs that encourage justice, prevent abuse, and provide protection and support to those in need, the Administration of Community Living (ACL) seeks to change how our society thinks of older people and those with disabilities and what we can do to enable their participation. Just like a stable building requires a strong set of support beams, we need a solid social structure so that older people and those with disabilities can live their lives to the fullest, participate in our communities, and live free from abuse and neglect.

Don't forget as well, the DOJ Elder Justice Initiative, which also has a lot of research and resources!

This website highlights some of ACL’s efforts to build public and professional understanding about elder abuse and strengthen the social supports needed to prevent it. Strong, stable communities with structures to support people of all ages and abilities not only ensure justice and dignity for older people and adults with disabilities, but also secure the wellbeing and quality of life for us all.

Good News Out of Alabama for SNT Beneficiaries

One piece of good news from Alabama that caught my eye was the passage of a new law regarding pensions and Special Needs Trusts.   Here is the press release from the firm of one of the attorneys integrally involved in this legislative effort:

A new act has been passed by the Alabama Legislature and signed into law by the Governor that will allow participants in the Retirement Systems of Alabama (“RSA”) pension plan to direct proceeds to pass to a special needs trust for a beneficiary with a disability who receives government benefits.  Sirote & Permutt shareholder, Katherine N. Barr, a member of the firm’s Private Clients Trusts and Estates Group, recognized the need for this important statutory change when doing estate planning for RSA employees and retirees who wanted to leave their RSA pensions to children with disabilities receiving SSI and Medicaid.  The RSA provisions required the pension payment to be paid directly to the child, which caused a loss of these critical government benefits in most cases.  With input from RSA, Ms. Barr prepared legislation to correct this problem.  State Senator Cam Ward from Alabaster, Alabama introduced the legislation as SB 57 this session and State Representative Matt Fridy from Montevallo, Alabama introduced to it the House.  Both the House and Senate passed it unanimously. Governor Ivey signed the legislation on May 22, 2019.  The Act covers all RSA retirement plan participants and will become effective August 1, 2019.  Ms. Barr states that it took more than three years to obtain this result.  This legislation will benefit individuals with disabilities for years to come by allowing them to receive the pension payments in a manner that will not affect their Medicaid and SSI payments. The pension can now be directed to a certain type of special needs trust upon the death of the plan participant.  The trust can be set up in advance or following the participant’s death.  The Alabama Family Trust can be designated to receive the benefit, as can a private trust. 

Well done Katherine!

Stan Lee-Another Victim of Elder Abuse?

Stan Lee may have created a superhero universe, but he had no superhero to protect him from alleged elder abuse, according to a recent article in the Washington Post. As Stan Lee’s ex-caregiver is arrested, last year’s videos provide an illuminating lens on his elder-abuse case explains that Mr. Lee's "adviser and confidant" had  been arrested and "appeared in [an Arizona court] on a charge of being a fugitive of justice,  ... accused of 'fleeing California charges of fiduciary elder abuse....'”   According to the article, the charges filed in California include "theft, embezzlement, forgery/fraud against an elder and false imprisonment of an elder."  One twist in this case is a video made by Mr. Lee some time ago in which he claimed he was not a victim of elder abuse.  Now there are claims that the video wasn't done of his own free will.  You can view the video in the article.

All I can say is stay tuned....