Tuesday, May 14, 2019

California ALF Resident Evicted for Not Paying Rent

That headline may have elicited a shoulder shrug from you and a fleeting thought as to why I thought this was newsworthy enough to be the subject of a blog post.  So how about if I add some info for you?  What if the story's title is this? Medi-Cal recipient, 101, evicted from Santa Rosa assisted living facility for being unable to pay. This is a situation where the elder outlived her savings. As the story explains

[The resident] like most people, probably never thought she’d live to be 101, and she clearly did not expect to be paying nearly $7,000 a month to be living in a senior residential care facility.

The expense drained her of all the money she had after selling her modest home in Santa Rosa’s Holland Heights neighborhood in 2013. By November of last year, all [the resident] could afford to give ...  the assisted living facility, was her monthly Social Security check of about $1,300 — it wasn’t enough. ...

On April 18, [the resident], who suffers from dementia, was wheeled into Sonoma County eviction court on Cleveland Avenue. With her bank account drained, the former real estate agent was now receiving Medi-Cal, the state’s version of Medicaid health insurance, which the private-pay [ALF] le did not accept.

The story ultimately has an ending-a Medi-Cal bed was located for the resident. The story goes on to focus on the lack of beds in the area, the cost of long-term care, and the problem for folks like the elder in this story who outlives her savings.

Thanks to Julie Kitzmiller for alerting me to this story.

May 14, 2019 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, Medicaid, State Cases | Permalink | Comments (0)

Sunday, April 28, 2019

PA Supreme Court's Choice of Law Ruling Obligates New Jersey Family Members to Provide Filial Support For Disabled Adult Son In Pennsylvania

In what appears likely to be the final chapter in a long-running "reverse" filial support case in Pennsylvania, a unanimous Pennsylvania Supreme Court ruled on April 26, 2019 that Pennsylvania statutory law applies to determine the liability of older New Jersey parents on the issue of whether they must pay for the long-term care costs for their son in a private institution in Pennsylvania.  New Jersey law, unlike Pennsylvania law, expressly exempts any person "55 years of age or over" from a support obligation for an adult child.  

I've been following the case of Melmark v. Schutt since at least 2016, and you can review some of the history of the case here, here and here.  Until this ruling, the parents had successfully argued that New Jersey's law controlled the case.   From the Supreme Court's opening footnote, however, where it outlined evidence of the parent's annual income, it was apparent the Court was outraged that parents who could be characterized as wealthy could refuse to pay a nonprofit care provider.  The Court ruled that there was a "true conflict" between the laws of New Jersey and Pennsylvania, and recognized that while many factors such as the domicile of the parents and the stipulated 'residency" of the son  pointed to the application of New Jersey law, the most significant contact factor was the "harm" of nonpayment, occuring in Pennsylvania.  The Court concluded:

"[A]lthough New Jersey's welfare laws apparently provide for Alex's support at public expense, there is no reason to suppose that New Jersey has adopted a public policy favoring imposition of the ongoing cost of care for indigent adults on an unwilling private third party [i.e., Melmark].... [T]he exemption in New Jersey's statutory support law for parents over 55 years of age cannot justifiably override Pennsylvania's governing statute -- at least for the period between April 1, 2012 to May 1, 2013 -- so that the financial burden of Alex's care falls upon Melmark." 

I have long thought the case has uniquely "tough facts," and Pennsylvania has a history of using Pennsylvania's law to obligate families to cover certain costs of care for indigent family members.  Further, the Court also ruled that the institution had a viable related theory of recovery under Pennsylvania common law, sounding in quantum meruit or unjust enrichment.  

The opinion has potential implications for cross border claims of filial support in the more typical Pennsylvania fact pattern, where adult children are asked to pay the costs of care for an aging parent who fails to qualify for Medicaid.   E.g., Health Care & Retirement Corp. of America v. Pittas.  I can see the potential for out-of-state children to be subject to a claim for reimbursement, especially if they have any role in choosing a Pennsylvania facility where Medicaid is unavailable to pay, facts that might also give the Pennsylvania court personal jurisdiction over the out-of-state children. 

April 28, 2019 in Current Affairs, Ethical Issues, Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, April 1, 2019

New Article on Planning for Beneficiaries with Special Needs

Kristen Lewis has published a really great article in the March 2019 issue of Estate Planning Magazine.  Planning Challenges for Beneficiaries With Special Needs. To accommodate adequately the particular circumstances of beneficiaries with special needs, multiple trusts may be required provides a comprehensive discussion of 10 challenges faced by estate planners when a beneficiary has special needs.

Consider the opening of this article

Disabilities do not discriminate based on a family’s socio-economic status. Families of great wealth have children or other beneficiaries with disabilities at the same rate as families of modest means. Estate planning attorneys, and the other allied professionals who serve these families, are no longer able to take the position that “We don’t do special needs planning,” or worse yet, recommend that the child or other beneficiary with a disability simply be disinherited (which is likely grounds for malpractice). A recent study by the Centers for Disease Control and Prevention concluded that the prevalence of Autism Spectrum Disorder (ASD) has risen to one in every 68 births in the U.S. A more recent study concluded that the estimated prevalence of children in the U.S. with a “parent-reported” diagnosis of ASD is now one in 40. The 2010 U.S. Census reported that almost 20% of the U.S. civilian non-institutionalized population claimed to have a disability.  With statistics like these, estate planners and allied professionals must become, and remain, educated about the tools and techniques available to help clients secure the future of beneficiaries with disabilities within the broader context of estate planning. A critical first step is recognizing, and knowing how to overcome, the most common challenges to effective special needs planning. (citations omitted)

Read this article, then save it to your library as a resource.  You will be glad you did!

PS-shameless plug: Mark your calendars for Stetson Law's 2019 Special Needs Planning Institute for October 16-18, 2019. Registration opens July 1. #StetsonSNT2019

 

April 1, 2019 in Cognitive Impairment, Current Affairs, Dementia/Alzheimer’s, Estates and Trusts, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, March 18, 2019

Florida AG Creates Senior Protection Team

Florida Attorney General Ashley Moody announced last week the creation of the Senior Protection Team "an intra-agency group of experts working together to fight fraud and abuse. The team is comprised of leading members from the Attorney General’s Office of Statewide Prosecution, Consumer Protection Division and Medicaid Fraud Control Unit. Seniors v. Crime and the Florida Department of Law Enforcement will also actively assist the team with investigations and outreach efforts." The team is being led by Statewide Prosecutor, Nick Cox, a long-time advocate for the protection of elders from scams and frauds.

Kudos to General Moody!

March 18, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Florida AG Creates Senior Protection Team

Florida Attorney General Ashley Moody announced last week the creation of the Senior Protection Team "an intra-agency group of experts working together to fight fraud and abuse. The team is comprised of leading members from the Attorney General’s Office of Statewide Prosecution, Consumer Protection Division and Medicaid Fraud Control Unit. Seniors v. Crime and the Florida Department of Law Enforcement will also actively assist the team with investigations and outreach efforts." The team is being led by Statewide Prosecutor, Nick Cox, a long-time advocate for the protection of elders from scams and frauds.

Kudos to General Moody!

March 18, 2019 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Wednesday, February 27, 2019

Nursing Home Employees Indicted

McKnight's Long Term Care News reported that Nursing home employees indicted for involuntary manslaughter after patient’s death from bedsores. "The Ohio attorney general has indicted seven former Columbus nursing facility workers on dozens of charges following a patient’s 2017 death from bedsores ... against six employees and a contracted nurse practitioner at the Whetstone Gardens and Care Center. All told, the seven individuals have been hit with 34 charges, including involuntary manslaughter, with some stemming from alleged neglectful care of a second patient." One of the patients died of septic shock and the second received insufficient care.  The SNF takes a different view of the incidents.

Stay tuned....

 

February 27, 2019 in Consumer Information, Crimes, Current Affairs, Health Care/Long Term Care, State Cases | Permalink | Comments (0)

Tuesday, December 18, 2018

ALFs Too Popular for Resident Safety?

Kaiser Health News recently ran a story about ALFs that focuses on resident safety. Assisted Living’s Breakneck Growth Leaves Patient Safety Behind opens with a story about one resident and then points out

Assisted living facilities were originally designed for people who were largely independent but required help bathing, eating or with other daily tasks. Unlike nursing homes, the facilities generally do not provide skilled medical care or therapy, and stays are not paid for by Medicare or Medicaid.

Dementia care is the fastest-growing segment of assisted living. As these residences market themselves to people with Alzheimer’s and other types of dementia, facilities across the country are straining to deliver on their promises of security and attentive care, according to a Kaiser Health News analysis of inspection records in the three most populous states.

We know that ALFs are regulated at the state level and thus regulations from one state may vary from another. We also know that residents of ALFs are going to need assistance with ADLs. What more do we know?

[Residents] are older and frailer than assisted living residents were a generation ago. Within a year, 1 in 5 experience a fall, 1 in 8 visit an emergency room and 1 in 12 have an overnight hospital stay, according to the Centers for Disease Control and Prevention. Half are 85 or older.

“Assisted living was created to be an alternative to nursing homes, but if you walk into some of the big assisted living facilities, they sure feel like a nursing home,” said [one expert who is] director for mission partnerships with the Alzheimer’s Association.

There is a tension between viewpoints-regulation vs. the environment the facilities market for residents. Residents with dementia may pose a challenge for the ALFs.

Nearly a quarter of the nation’s 30,000 assisted living facilities either house only people with dementia or have special areas known as memory care units. These wings have locked doors and other safeguards to prevent residents from leaving. The facilities often train staff members in techniques to manage behavior related to these diseases and provide activities to keep the residents engaged and stimulated.

These units usually are more expensive, with monthly costs averaging $6,472, compared with $4,835 for regular assisted living, according to a survey by the National Investment Center for Seniors Housing & Care, a group that analyzes elder care market trends. Senior housing investors earned nearly 15 percent in annual returns over the past five years, higher than for apartment, hotel, office and retail properties, according to the center. Beth Burnham Mace, chief economist at the center, said memory care unit construction was outpacing all other types of senior housing.

Aggressive behavior, a hallmark of dementia, is a major problem in assisted living facilities. One national study, published in 2016, found that 8 percent of assisted living residents were physically aggressive or abusive toward residents or staff.

As noted earlier, regulation varies amongst the states. According to one study cited in the article, "only seven states required facilities to have a registered nurse. States required anywhere from two to 30 hours of training for dementia unit workers. A handful of states required no specialized training ... [and]  19 states set minimum staff-to-resident ratios for dementia units, while the others left it to the facilities."

December 18, 2018 in Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Webinar-Recognizing Elder Abuse

Mark your calendars now for a free webinar from the National Center on Law & Elder Rights on Signs of Elder Abuse, Neglect, and Exploitation. The webcast is scheduled for 2 p.m. on January 16, 2019.  Here is a description of the webinar

Lawyers and others who work with older adults should be aware of potential signs of abuse, neglect, and exploitation. This awareness requires an understanding of abuse signs, as well as the questions to ask when abuse is suspected. As the first part in the forthcoming National Center on Law and Elder Rights (NCLER) Elder Justice Toolkit, this webinar will help lawyers tune in to potential warning signals and train the audience on key questions to ask when elder abuse is suspected. The fast paced one-hour program will include checklists of physical, behavioral, and emotional signs of abuse, sexual abuse, self-neglect, caregiver neglect, and exploitation. 

To register, click here.

December 18, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, Programs/CLEs, State Cases, State Statutes/Regulations, Webinars | Permalink | Comments (0)

Monday, December 17, 2018

Ohio Supreme Court Addresses Liability of a Surviving Spouse for Nursing Home Debt

University of Cincinnati College of Law Professor of Practice Emerita Marianna Brown Bettman has a very interesting and well-written Blog report on the Ohio Supreme Court's December 12th decision in Embassy Healthcare v. Bell.  The issue is under what circumstances a surviving spouse can be held liable for her deceased husband's nursing home costs under a statutory theory of "necessaries." Lots to unpack here.   

December 17, 2018 in Consumer Information, Current Affairs, Estates and Trusts, Ethical Issues, Health Care/Long Term Care, Property Management, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, December 10, 2018

Thinking about New York Time's Article on Guardianships and One Woman's Personal Story

For anyone working in legal fields where adult guardianships may be an option, for anyone teaching elder law, health care law, constitutional law or even landlord-tenant law, a recent New York Times article, "I'm Petitioning . . . for the Return of My Life," is an important read.

On a threshold level, this is a well-told tale of one woman, Ms. Funke, who becomes subject to an intervention under New York adult protective services law, and, eventually, to a full-blown guardianship proceeding.   It can be easy to become enraged on behalf of Ms. Funke as you read details about her past life as a freelance journalist and world traveler, and compare it to the limitations placed on her essential existence under a guardianship. 

The article is a rather classic example of using one tragic story, a human story, to paint a picture of a government process gone wrong.  At several points in the article, the writer, John Leland, offers questions that suggest some conclusions about how unfair the process has been to Ms. Funke.  The writer asks, for example, 

"If you were Ms. Funke, shouldn't you be allowed to withdraw into the covers [of your bed] if you wanted to?  And the clutter in your apartment -- couldn't people understand that a writer needs materials around?  Even if she were evicted, she had money to start somewhere else.  Courts evict people with lots less [than she appears to have]. " 

It's implied that the answers to those questions may outweigh the fact that the protective services intervention prevented the landlord from completing an eviction of Ms. Funke, an eviction that would have forced her out of her apartment of 40+ years.    

Other, less dramatic details in the article suggest that for every Ms. Funke, there may be other people -- an unknown number of people in New York -- who are also very alone and who have also lost control over their lives because of physical frailty, mental decline, depression or other facts, and who are rescued with the help of a protective services intervention. Sometimes the intervention interrupts the decline, usually with the help of family member or friend who volunteers to help, sometimes acting with a measure of authority under a power of attorney, making a guardianship unnecessary. 

The challenge, of course, is knowing when to help (and how far to go), and when to preserve the  individual's right  to make choices that appear unsafe.  Some of the most complex cases involve people who have spent a lifetime on a unique and often solo path, and now have few family members or friends to help them as that path becomes rockier with age or illness, especially when they have no plan for the future.  In the face of such facts, as one person interviewed in the article observes, guardianships are a "blunt instrument."

Something I wrote about last week also figures into the New York situation -- the apparent absence of a guardianship case tracking or monitoring system.  

But another issue I'm concerned with is also suggested.  At one point, an interview with one of Ms. Funke's guardians, a so-called professional (in other words, not a family member or a public guardian) discloses he does not know how far his authority as guardian extends.  For example, would he be allowed to prevent her from marrying?  He responded, he did not know.

It would seem that guardians and other agents, alleged incapacitated persons, -- and family members -- could all benefit from greater information, and to ongoing education on their rights, duties and options.  That was also a theme emerging from article asking the question  "Where's Grandma?" that I linked to last week and that I link to again here.    

My thanks to the several folks who suggested this New York Times article for discussion on our Blog, including my Dickinson Law colleague, international human rights expert, Dermot Groome.    

December 10, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink | Comments (2)

Thursday, December 6, 2018

Kansas Disciplinary Case on Fees

The Kansas Supreme Court released a lengthy disciplinary opinion on November 30, 2018  that concerns, among other things, excessive fees. The case, In re: Crandall, resulted in a 6 month suspension.  The opinion is available here.   The Kansas Supreme Court addressed several procedural issues in its opinion. As far as fees, the court found that "testimony provides clear and convincing evidence and establishes that the representation of [clients] was straightforward and did not require the time and labor needed to justify the amount ... charged." The opinion goes step-by-step through the  provisions of Rule 1.5(a) criteria to determine reasonableness of a fee. The Court found that there was clear and convincing evidence that the attorney had violated Rule 1.5.  The opinion also examines other issues and concludes "that the fees in two cases were unreasonable in violation of KRPC 1.5(a) and that [the attorney] violated KRPC 1.1 (competence), 1.3 (diligence), 1.4(b) (communication), 1.7(a) (concurrent conflict of interest), and 8.4(d) (conduct prejudicial to the administration of justice)."

December 6, 2018 in Consumer Information, Current Affairs, Legal Practice/Practice Management, State Cases | Permalink

Wednesday, December 5, 2018

The Importance of Guardianship Tracking Systems (and a related CLE Program!)

I've been a bit busier than usual lately and haven't felt I could take the time to Blog regularly even though I'm constantly seeing intriguing topics to discuss.  I'm buried in a manuscript with a looming deadline!  Fortunately, I'm seeing that Becky Morgan is keeping everyone updated and I've been benefiting from her regular reports.  I hope to get back to daily posts of my own by January.  

In the meantime, I can report on a smaller, interim task of  serving as a co-presenter for a half-day Continuing Legal Education program at the Pennsylvania Bar Institute on  new developments in Guardianship Practice and Procedure on Friday, December 7.   Among the important developments, the Pennsylvania Courts is nearing completion on its statewide implementation of a Guardian Tracking System or GTS.  In 2014, the Supreme Court's Elder Law Task Force strongly recommended adoption of such a system, having determined just how little was actually known across the state about open guardian cases.  Implementation of the new system began with a pilot in Allegheny County in July 2018.  As of today, 60 counties are "live" in the system.  The remaining 7 counties are scheduled to be included by the end of this month.

With the help of the new tracking system, I learned that we currently have more than 14,000 active guardianships in Pennsylvania.

Key features of the GTS system include:

  • Automation:  a means of automatically running a process to check specific aspects of guardianship reports for missing information or other concerns;
  • Flagging:  when a concern is detected, the item is automatically flagged, allowing court personnel to review and respond to the potential problem;
  • State-wide Court Communications: providing the court system with a means of immediate and cost-effective state-wide communications whenever a judge in one case is alerted to suspicion of neglect or other improper conduct by a guardian; and
  • Alerts on Specific Guardians:  when an "alert" is triggered on a specific guardian in one case, the system will generate notices to all of the other courts in the state, alerting them to the potential need for action on that individual in their cases.  

Such a system required entirely new software, new reporting forms, and new court rules to make implementation effective.  We will be talking extensively about the new rules and forms on Friday.  The migration  from the older system of record-keeping imposes a huge learning curve on many involved in guardianship matters, including lawyers.

The need for better systems in Pennsylvania has been highlighted during the last year of controversies surrounding appointment of one particular individual as guardian for alleged incapacitated persons in three Pennsylvania counties.  She is accused of mismanaging cases, plus it turned out she had a criminal history for fraud in another state. 

See also the recent news reports about another Pennsylvania guardianship matter that asks the troubling question "Where's Grandma?" The  reporter on this case, Cherri Gregg, who also happens to be a lawyer, opines that everyone in the case, including the lawyer appointed as guardian, and the family members of the person subject to the guardianship, needed better education about their roles after the grandmother's own children passed away, as the grandmother became more vulnerable, and especially when it became necessary to place her in a nursing home.  

My special thanks to Karen Buck, Executive Director of the SeniorLAW Center in Philadelphia, and the good folks at Pennsylvania Courts' Office of Elder Justice for helping me with my part of the presentation for Friday!

December 5, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Ethical Issues, Health Care/Long Term Care, Legal Practice/Practice Management, Programs/CLEs, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (0)

Tuesday, December 4, 2018

SNF Silver Tsunami Hitting Texas?

A recent article mentioned that the number of elders in Texas who will need SNF care is going to be a "silver tsunami."  The Houston Chronicle published this article, Silver Tsunami set to hit Texas nursing homes where the article acknowledges "[m]ore than 12 percent of the Texas population is over 65, and that number is growing. According to the Texas Demographic Center, the over-65 population across the state is projected to increase by more than 262 percent by 2050." But it is more than the numbers creating this "silver tsunami: the impact is magnified "by the increasingly complex medical conditions — such as Parkinson’s and Alzheimer’s — of aging Texans needing nursing home care. According to data from the Alzheimer’s Association “2018 Texas Facts and Figures,” more than 380,000 of the state’s residents have already developed Alzheimer’s disease or other dementia. In Texas, Alzheimer’s is the sixth leading cause of death, and its prevalence is expected to increase by almost 30 percent by 2025."

The article also highlights the fact that in many instances the caregivers themselves will be elders.

We all need to be planning ahead.....

December 4, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Health Care/Long Term Care, Housing, State Cases, State Statutes/Regulations | Permalink

Monday, December 3, 2018

Decline in US Life Expectancy

U.S. life expectancy has declined. What's up with that? According to an article in the Washington Post, this is not good news for us. U.S. life expectancy declines again, a dismal trend not seen since World War I emphasizes the impact of the opioid and suicide crises.

The data continued the longest sustained decline in expected life span at birth in a century, an appalling performance not seen in the United States since 1915 through 1918. That four-year period included World War I and a flu pandemic that killed 675,000 people in the United States and perhaps 50 million worldwide.

The U.S. trend seems to be opposite of what is happening in other countries, and although the decline may not seem very large, it is still part of an overall concerning trend. The numbers re: opioid deaths cited in the article are shocking. Read the article to absorb the data and look at the geographical info detailing where opioid deaths are highest and lowest.  It's just not drug deaths attributing to the decline. "Other factors in the life expectancy decline include a spike in deaths from flu last winter and increases in deaths from chronic lower respiratory diseases, Alz­heimer’s disease, strokes and suicide. Deaths from heart disease, the No. 1 killer of Americans, which had been declining until 2011, continued to level off. Deaths from cancer continued their long, steady, downward trend."

December 3, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care, Other, State Cases, Statistics | Permalink

Friday, November 30, 2018

Senate Special Committee on Aging-Guardianship Hearing

Earlier I had blogged about the upcoming hearing on guardianships scheduled for the Senate Special Committee on Aging The hearing was held on November 28, 2018, and a report as well as the video of the hearing are now available.  You can also access the witness statements here.

November 30, 2018 in Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Elder Abuse/Guardianship/Conservatorship, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink

Thursday, November 8, 2018

Call for Proposals-National Center for Victims of Crime

The National Center for Victims of Crime has released a call for proposals for its 2019 training institute. The website announcing the call for proposals explains:

The National Center is pleased to present the National Center for Victims of Crime 2019 National Training Institute. As in past years, this training will emphasize a multidisciplinary approach to sharing promising practices, current research, and effective programs and policies that are victim-centered, practice-based, and research-informed. Our National Training is a forum for law enforcement, victim service professionals, allied practitioners, policymakers, and researchers to share current developments and build new collaborations. Conference sessions will highlight practical information to better support services for the wide range of persons victimized by crimes of all types.

 Call for Workshop Proposals

The National Center for Victims of Crime is seeking presenters for its National Training Institute, to be held September 4-6, 2019, in Denver, Colorado. Workshops will address a wide range of topics organized into separate conference tracks. Workshops are scheduled for 90 minutes (1.5 hours) in length, unless otherwise specified in the proposal. Accepted presenters will be assigned day and presentation time by the Institute planning committee.

Click here  to submit a proposal.

November 8, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Programs/CLEs, State Cases, State Statutes/Regulations | Permalink | Comments (0)

8 Briefs-Financial Exploitation by Conservators

The National Center for State Courts project on  Elders & Courts, with other organizations have published  a series of 8 research briefs on Financial Exploitation by Conservators.  The topics include

  • Examples of Conservator Exploitation: An Overview
  • Conservator Exploitation in Minnesota: An Analysis of Judicial Response
  • Detecting Exploitation by Conservators – Court Monitoring
  • Detecting Exploitation by Conservators – Systemic Approach
  • Court Actions Upon Detection of Exploitation
  • Innovative Programs that Address Financial Exploitation by Conservators
  • Data Quality Undermines Accountability in Conservatorship Cases
  • Supporting Victims of Conservator Exploitation

as well as key resources for these cases.

The introduction explains the impetus for the work, the 8 briefs, definitions of common terms and the reason for the project

NCSC in 2016 estimated, based on projections, that there are approximately 1.3 million active adult guardianship or conservatorship cases in the United States and at least $50 billion in assets under conservatorships (see Data Quality Brief). Also in 2016, the U.S. Government Accountability Office (GAO) found that “the extent of elder abuse by guardians nationally is unknown due to limited data . . .” While many conservators are trustworthy, dedicated, and provide critically needed services, multiple media accounts over many years profile instances in which conservators have breached their fiduciary duty – taking advantage of those they were charged with protecting. (citations omitted)

 

November 8, 2018 in Cognitive Impairment, Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Monday, November 5, 2018

A 22 Year Retrospective of Elder Abuse Prosecutions

Paul Greenwood, a rock star prosecutor known widely for his successes in elder abuse prosecution recently retired (huge loss for all of us).  He authored The Changing Landscape of Elder Abuse Prosecutions: A 22-Year Journey. He writes about the changes

Today prosecutors and law enforcement have an abundance of materials at their disposal to assist in the investigation and prosecution of criminal elder abuse cases. One such outstanding example is the newly released Elder Abuse Guide for Law Enforcement [EAGLE] operated by the National Center on Elder Abuse. Another great tool is the Elder Justice Initiative created by the Department of Justice.

The quandary that we face is not where to find the information but rather whether to make elder abuse prosecution a priority.

It is no exaggeration to say that elder justice is fast becoming a critical national issue. Demographics, availability of technology to seniors, the opioid epidemic, and the expanding number of dementia patients are just a few factors that have combined to create the perfect climate for predators. Elder abuse has been called the “crime of the 21st century”.

He writes about the upcoming challenges and steps prosecutors are taking to face them. Those preparations include trainings for prosecutors, in-state collaborations between prosecutors and state attorney generals, and multi-disciplinary teams.  Paul writes that two areas present hurdles:

  1. "Financial elder abuse is exploding and many of the perpetrators are able to hide in anonymity thanks to the proliferation of such internet ruses as romance, IRS, sweepstakes and grandma scams. Moreover, many exploiters are using nontraditional methods to steal from their elderly victim and then claiming that the transaction represents either a gift or a loan. We are having to find new ways to argue lack of consent aggressively and effectively and also educate ourselves as to the ways in which undue influence impacts this crime."
  2. "Secondly, we are still figuring out how to uncover, investigate and prosecute crimes – particularly sexual abuse – that occur in long term care facilities. Prosecutors need to reach out to the various state agencies that oversee the issuance and revocation of facility licenses along with the Long Term Care Ombudsman programs."

Paul Greenwood has done amazing things in advancing the prosecution of elder abuse cases. We all should thank him and wish him well as he moves to his retirement. Thank you Paul!

 

November 5, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, State Cases, State Statutes/Regulations | Permalink | Comments (0)

Friday, October 26, 2018

Filial Friday: "Elternunterhalt" -- An Update on Germany's Approach to Filial Support Law

GermanyMy first close look at filial support law in Germany arose in 2015, when I met a German-born, naturalized U.S. citizen living in Pennsylvania who had received a series of demand letters from Germany authorities asking her to submit detailed financial information for the authorities to analyze in order to determine how much she would be compelled to pay towards care for her biological father in German.  Her father had become seriously ill and did not have inadequate financial resources of his own.  As I've come to learn, the name for Germany's applicable legal theory is elternunterhalt, which translates into English as "parental maintenance."   

Since 2015, I've heard from other adult children living in the U.S.,  but also in Canada and England, about additional cross-border claims originating in Germany.  They write in hopes of getting objective information and to share their own stories, which I appreciate. In some instances, such as the first case I saw in Pennsylvania, a statutory defense becomes relevant because of past "serious misconduct" on the part of  the indigent parent towards the child.  The misconduct has to be more than mere alienation or gaps in communication. Sometimes misconduct such as abuse or neglect is the very reason the child left Germany, searching for a safer place.  

Most of the adult children who reach out to me report they had never heard of elternunterhalt.  Their years of estrangement are often not just from the parent but from the country of their birth.  Even those who still have a relationship with the parent in Germany often learn of the potential support obligation only after their parent is admitted to a nursing home or other form of care.  They face unexpected demands for foreign payments, while they are often still looking to fund college for children or their own retirement needs.  

National German authorities began to mandate enforcement of elternunterhalt in 2010 in response to increasing public welfare costs for their "boomer" generation of aging citizens.  Enforcement seems to have been phased in slowly among the 16 states in the country.  I've read news stories from Germany about confusion and anger in entirely domestic cases.

A claim typically begins with letters from a social welfare agency in the area where the needy parent is living.  The first letters usually do not state the amount of any requested maintenance payment, but enclose forms that seek detailed, documented information about the "obligated child's" income and certain personal expenses or obligations (such as care for minor children). The authorities also seeks information about any marital property and for income for any spouse of "life partner." 

Whether or not the information is supplied, at some point in a wholly domestic German case the social welfare office may initiate a request for a specific amount of  back pay as well as current "maintenance." Such a request cannot be enforced unless the child either agrees to pay or a court of law decrees that payment must be made.  The latter requires a formal suit to be initiated by the agency and litigated in the family divisions of the German courts.  The amount of any compelled payment is determined by a host of factors, including the amount of the parent's pension, savings, and any long-term care insurance, and the child's own financial circumstances.

Cross border cases have been pursued within the EU with some reported results.  As for parental maintenance claims presented to U.S. children, enforceability is less clear.  According to some of the letters sent by German authorities, Germany takes the position that a German court ruling in a cross border elternunterhalt claim can be enforced in the United States under "international law."  The letters do not explain what legal authorities are the basis for such enforcement. 

The Hague Convention on International Recovery of Child Support and Other Forms of Family Maintenance was approved by the European Union, thereby affecting Germany, in 2014.  The treaty is mostly directed to the mechanics of international child support claims and is built on past international agreements on child support; however the treaty also provides that the Convention shall apply to any contracting state that has declared that it will extend the application "in whole or in part" to "any maintenance obligation arising from a family relationship, parentage, marriage or affinity, including in particular obligations in respect of vulnerable persons."  See Article 2(3). 

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October 26, 2018 in Consumer Information, Current Affairs, Ethical Issues, Federal Statutes/Regulations, Health Care/Long Term Care, International, Legal Practice/Practice Management, Property Management, State Cases, State Statutes/Regulations, Statistics | Permalink | Comments (1)

Tuesday, October 23, 2018

The Need for Fiduciary Service Organizations

In a perfect world, everyone will be able to handle all of their own affairs, right until the day they die.  In a perfect world, even if that was not possible (or even desirable), there is always some trustworthy family member or friend to step in to help.  

Alas, it isn't a perfect world.  For a number of years, when I was supervising an Elder Law Clinic, our clients sometimes needed the assistance of a professional agent or guardian, someone who was experienced in providing fiduciary management services for people of modest means, and who had a track record and references to demonstrate competence.  We also wanted to see their certificate of insurance or bonding.

Recently I was looking for a guest speaker for a Nonprofit Organization Law class and I reached out to a company in my address book.  I learned it had ceased doing business.  In contrast to the dramatic stories from locations such as New Mexico, where nonprofit entities failed to carryout their fiduciary duties, Neighborhood Services, based in Lancaster, Pennsylvania found it necessary to close their doors for 300 vulnerable clients because of gaps in charitable funding.

Some clients had behavioral health needs. Approximately 150 of the clients were incapacitated people living in nursing and personal care homes in a multiple county region.  New representatives were needed for all of them.  A 2017 news story explained:  

Founded in 1964, nonprofit Neighborhood Services fell over $400,000 in debt after losing most of its United Way funding a couple of years ago and failing to secure key federal grants, said Stanley, who joined the agency in October 2015 as its woes were mounting.

 

The agency, which never prioritized fund-raising, has lost several staff members in recent months and currently employs five.

 

Neighborhood Services’ most visible role has been serving as the representative payee for more than 150 clients with intellectual disabilities, mental illness or addiction issues. The agency received the clients’ monthly disability checks and prioritized the payment of their rent and other basic needs.

 

"I'll miss all the staff," said Nathan Wilson, 57, who relied on Neighborhood Services to manage his finances.  "Whenever I need extra, they always get it for me."  

This history is a reminder that more than good intentions are needed to run a successful nonprofit organization.   

October 23, 2018 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Estates and Trusts, Ethical Issues, State Cases, State Statutes/Regulations | Permalink | Comments (0)