Thursday, April 15, 2021
Kaiser Health News ran an interesting story about aid in dying in Montana. Getting a Prescription to Die Remains Tricky Even as Aid-in-Dying Bills Gain Momentum
[I]n 2009, the Montana Supreme Court had, in theory, cracked open the door to sanctioned medically assisted death. The court ruled physicians could use a dying patient’s consent as a defense if charged with homicide for prescribing life-ending medication.
However, the ruling sidestepped whether terminally ill patients have a constitutional right to that aid. Whether that case made aid in dying legal in Montana has been debated ever since. “There is just no right to medical aid in dying in Montana, at least no right a patient can rely on, like in the other states,” said former state Supreme Court Justice Jim Nelson. “Every time a physician does it, the physician rolls the dice.”
The article discusses the legislative efforts on both sides of the issue. Fascinating story!
The elder justice legislation found in this document was elicited and finalized from the National
Center on Elder Abuse (NCEA) Listserv and independent websites in February 2021. The
compilation is intended to reflect highlights across the nation and does not include all legislation related to elder justice. However, updates will be sent biannually and states are encouraged to send updates on significant legislative action to Ageless Alliance. This document reflects activity in 15 states and highlights at the federal level.
In addition to summaries by state, the highlights include links to the individual legislation.
Oh and btw, mark your calendars now for the 2021 World Elder Abuse Awareness Day, June 15, 2021.
Wednesday, April 7, 2021
Published recently in the Washington Post, Diane Rehm tackles ‘death with dignity’ again, this time in a new documentary. "In 2016, Diane retired from NPR station WAMU after working there for more than 30 years. Since then, she has championed what she and other advocates call “death with dignity.” On Wednesday, PBS will broadcast her new documentary, 'When My Time Comes.'" The article is a Q&A with the author about her book and the resulting documentary. Check it out!
Friday, March 26, 2021
Published a few days ago in the New York Times, Fully Vaccinated and Time to Party: If You Are 70, notes "[o]der people, who represent the vast majority of Americans who are fully vaccinated against the coronavirus, are emerging this spring with the daffodils, tilting their faces to the sunlight outdoors. They are filling restaurants, hugging grandchildren and booking flights." The article features a number of elders who are resuming their pre-COVID lives now that they have been vaccinated. Or, as the author describes it, "[f]or now, about two-thirds of Americans over 65 have started the vaccination process and nearly 38 percent are fully vaccinated, compared with 12 percent of the overall population, giving the rest of the nation a glimpse into the after times."
The stories will make you smile.
Sunday, March 21, 2021
Kaiser Health News recently published a story, Texas Winter Storm Exposes Gaps in Senior Living Oversight. The storm
brought power failure and burst water pipes to millions of homes and businesses throughout Texas. But the impact, as is often the case in emergencies, was most profound on the state’s most vulnerable — including residents of senior living facilities.
Of the state’s 1,200 nursing facilities, about 50% lost power or had burst pipes or water issues, and 23 had to be evacuated, said [the] long-term care ombudsman for Texas. Of 2,000 assisted living facilities, about 25% had storm-related issues and 47 were evacuated. Some facilities reported building temperatures in the 50s.
The article discusses revisions to the regulations regarding emergency preparedness and the industry's responses, as well as the issues with other types of supportive housing. The article also highlights how these "disasters of a century" are actually occurring more frequently, and the focus on disaster preparedness includes a conversation about requiring facilities to have generators. "In Texas, assisted living facilities are required to have emergency plans but not generators. The legislation introduced in the wake of [the recent] winter storm ... seeks to change that. Independent living facilities ... might not be covered, though; they already have even fewer state guidelines to follow."
Thursday, March 18, 2021
California has released its Master Plan FOR Aging. Here's the rationale for having a master plan:
Aging is changing and it’s changing California. California’s over-6o population is projected to diversify and grow faster than any other age group. By 2030, 10.8 million Californians will be an older adult, making up one-quarter of the state’s population.
The Master Plan for Aging outlines five bold goals and twenty-three strategies to build a California for All Ages by 2030. It also includes a Data Dashboard on Aging to measure our progress and a Local Playbook to drive partnerships that help us meet these goals together.
This is not a plan simply for today’s older adults. Instead, the Master Plan is a blueprint for aging across the lifespan. The Master Plan calls on all California communities to build a California for All Ages: for older Californians currently living through the many different stages of the second half of life; for younger generations who can expect to live longer lives than their elders; for communities of all ages – family, friends, neighbors, coworkers, and caregivers – surrounding older adults. As Californians, we can create communities where people of all ages and abilities are engaged, valued, and afforded equitable opportunities to thrive as we age, how and where we choose.
The five goals address health, housing, equity and inclusion, affordable aging, and caregiving. The plan is available here.
PHI issued a report regarding the direct care workers and the California Master Plan For Aging. Quality Jobs Are Essential: California’s Direct Care Workforce and the Master Plan for Aging
[P]rovides a detailed overview of the state’s direct care workforce and examines how California’s Master Plan for Aging can improve jobs for this rapidly growing workforce. It describes how the Master Plan supports this workforce, highlights where it incorporated the LTSS Subcommittee’s recommendations, and proposes where and how the Master Plan can be strengthened. This report also includes various stories from direct care workers in the state.
The report is available here for download.
Monday, March 1, 2021
The End of Life Options Act has been reintroduced in Massachusetts. This article notes an overwhelming support by U.S. adults for aid-in-dying. The article also includes a short podcast of the story. If this bill passes, Massachusetts will join a handful of other states where aid-in-dying is legal Stay tuned.
Monday, February 22, 2021
Despite projects to vaccinate those elders who are homebound or lack internet access, we are still lagging behind on reaching them, according to a story today in Kaiser Health News. Countless Homebound Patients Still Wait for Covid Vaccine Despite Seniors’ Priority starts with the good news-recognizing the unique outreach efforts by hospitals, health systems, and paramedics, for example. These folks are home are highly vulnerable. Described by one expert in the article as a "hidden group", they are at great risk, "[b]y virtue of their age and medical status, these seniors are at extremely high risk of becoming seriously ill and dying if they get covid-19. Yet, unlike similarly frail nursing home patients, they haven’t been recognized as a priority group for vaccines, and the Centers for Disease Control and Prevention only recently offered guidance on serving them." The article notes that those professionals whoa are regularly in contact with them are not those with access to vaccines. Medicare's reimbursement rates for time-consuming house calls doesn't allow the health care professionals to recoup their costs, notes the article. Not only that, knowing the storage requirements for the vaccines doesn't mean a health care professional can just hop into their car and drive around with the vials in a cooler.
So this brings us to this story, a new hero for all of us! Last week in the New York Times, Woman, 90, Walked Six Miles in the Snow for a Vaccine
explained how after that recent snow storm, driving was out for her, but given all her previous failed efforts to get the vaccine, she wasn't going to miss this opportunity.
Where's Rosie the Riveter when we need her?? Surely "we can do it" or at least do better?
Thursday, February 18, 2021
Register now for two upcoming webinars.
1. Webinar: Financial Protection for Older Adults During the COVID-19 Pandemic set for Feb 23, 2021 at 1 eastern.
Join experts from the Consumer Financial Protection Bureau (CFPB), the Federal Communications Commission (FCC), and ACL on Tuesday, February 23 at 1 pm ET for a free webinar on financial protection of older adults during the COVID pandemic. The FCC will begin the program with an overview of coronavirus-related phone scams targeting older adults. The CFPB will share resources to help older adults address the financial impact of the pandemic. HHS will conclude the webinar with a discussion of the role of the aging services network.
Click on FCC live link to join the webinar on Feb 23 at 1 eastern.
2. A series of 3 webinars from the DOJ Elder Justice Initiative;
- March 4th 2pm EST | Programs for Older Adults Who Have Experienced Financial Exploitation. Learn about three distinct programs designed specifically for older adults who have experienced financial exploitation. Register here.
March 23rd 2pm EST | The Path Forward: One MDT’s Journey to Address the Impact of Racial Injustice on Their Work. The Hennepin County Minnesota Adult Protection/Law Enforcement Multi-Disciplinary Team “MDT” provides a model case study of the impact of racial injustice on their work as an elder abuse MDT in Minneapolis. Register here.
April 13th 2pm EST | Tackling Transnational Robocall Scams: The Importance of State and Federal Partnerships Features a Federal and State partnership that successfully fought against computerized autodialing “robocall” scammers. Register here
February 18, 2021 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Programs/CLEs, State Cases, State Statutes/Regulations, Webinars | Permalink | Comments (0)
Wednesday, February 17, 2021
First, good news from California. Recognizing the issue with elders who may not be able to get to vaccine sites (or sign up online....), Kaiser Health News reports on one solution in California. Vaccines Go Mobile to Keep Seniors From Slipping Through the Cracks
The team of county nurses and nonprofit workers is targeting Contra Costa County residents who are eligible for covid vaccines but have been left out: residents of small assisted-living facilities that haven’t yet been visited by CVS or Walgreens, and occasionally people who live in low-income senior housing. The retail pharmacy giants have a federal government contract to administer vaccines in most long-term care facilities.
Launched a few weeks ago, the strike team moves through each vaccination clinic with practiced choreography. At a small group home in Antioch recently, a nurse filled syringes while another person readied vaccine cards and laid them on a table. An administrative assistant — hired specifically for these clinics — checked everyone’s paperwork and screened them for symptoms and allergies before their shots, logging them into the state’s database afterward. After the shots, a strike team member told each person when their 15 minutes of observation was up.
The endeavor is going to take time because there are so many of these facilities, many of which have just a handful of residents. It may be slow-going, but it's going!!!!
So that was the good news. Now for the not-so-good, but not surprising news from this article also published in Kaiser Health News: Family Caregivers, Routinely Left Off Vaccine Lists, Worry What Would Happen ‘If I Get Sick’.
Tens of thousands of middle-aged sons and daughters caring for older relatives with serious ailments but too young to qualify for a vaccine themselves are ... terrified of becoming ill and wondering when they can get protected against the coronavirus.
Like aides and other workers in nursing homes, these family caregivers routinely administer medications, monitor blood pressure, cook, clean and help relatives wash, get dressed and use the toilet, among many other responsibilities. But they do so in apartments and houses, not in long-term care institutions — and they’re not paid.
““In all but name, they’re essential health care workers, taking care of patients who are very sick, many of whom are completely reliant upon them, some of whom are dying... Yet, we don’t recognize or support them as such, and that’s a tragedy.”
If the caregiver is older and meets the age-threshold for the caregiver's particular state, then the caregiver is eligible for vaccination that way. But the younger caregivers are out of luck right now. This is an important article. Read it!
Monday, February 15, 2021
Read these three articles, to get a full picture of what happened. First, the AP story: AP: Over 9,000 virus patients sent into NY nursing homes. Next, the CNN story: New York governor's top aide apologizes and says administration 'froze' after inquiries on Covid-19 deaths at long-term care facilities. Finally, Politico's story: Top Republicans call for Cuomo's ouster following nursing home revelation.
Wednesday, February 10, 2021
Periodically I will see items about businesses seeking protection against liability for injuries to others that occurred during the pandemic. It's not just SNFs seeking protection. Here are a couple of updates on the topic.
First, a Florida-specific article, Brandes bill shielding business from coronavirus suits gets backing in Senate.
The Senate Judiciary Committee on Monday approved a proposal that would give Florida businesses that “substantially” comply with public-health guidelines broad protection from coronavirus-related lawsuits filed by customers and employees.
The bill (SB 72) would not apply to health-care providers such as hospitals, nursing homes and physicians, who have been clamoring for protections since spring. Instead, the bill would help shield other types of businesses and educational and religious institutions from claims for damages, injuries or deaths.
Then, an article from NPR, Why Nursing Homes' COVID-19 Legal Shields May Interfere With Other Cases. Here is a summary: "[o]ver the course of the pandemic, 27 states have granted legal immunity to nursing homes. Some advocates worry this temporary reprieve is being used to hide misconduct not related to the coronavirus." The link includes the podcast as well as a transcript.
Monday, February 8, 2021
A couple of weeks ago the New York Times ran this article, Filing Suit for ‘Wrongful Life’, which asks this question: "More Americans are writing end-of-life instructions as the pandemic renders such decisions less abstract. But are medical providers listening?" The article features one case in litigation where the surviving spouse claimed that the health care providers failed to honor the patient's directive claiming the health care providers "disregarded a New York State MOLST — medical orders for life-sustaining treatment — form and his spouse’s explicit instructions to a doctor who called to seek her guidance." The article gives a good explanation of the issues and a review of prior cases on similar topics. This is an important issue and I'm going to have my students read the article.
Thursday, February 4, 2021
A couple of recent articles about NY SNFs will make you stop and think.... hmmmm.. First, Politico noted a recent NY AG report New York undercounted nursing home deaths by as much 50 percent, report finds.. Nursing Home Response to COVID-19 Pandemic report includes preliminary findings
OAG’s preliminary findings are:
» A larger number of nursing home residents died from COVID-19 than DOH data reflected.
» Lack of compliance with infection control protocols put residents at increased risk of harm during the COVID-19 pandemic in some facilities.
» Nursing homes that entered the pandemic with low U.S. Centers for Medicaid and Medicare Services (CMS) Staffing ratings4 had higher COVID-19 fatality rates than facilities with higher CMS Staffing ratings.
» Insufficient personal protective equipment (PPE) for nursing home staff put residents at increased risk of harm during the COVID-19 pandemic in some facilities.
» Insufficient COVID-19 testing for residents and staff in the early stages of the pandemic put residents at increased risk of harm in some facilities.
» The current state reimbursement model for nursing homes gives a financial incentive to owners of for-profit nursing homes to transfer funds to related parties (ultimately increasing their own profit) instead of investing in higher levels of staffing and PPE.
» Lack of nursing home compliance with the executive order requiring communication with family members caused avoidable pain and distress; and,
» Government guidance requiring the admission of COVID-19 patients into nursing homes may have put residents at increased risk of harm in some facilities and may have obscured the data available to assess that risk.
Then consider this article in the Washington Post. Andrew Cuomo’s bad ‘who cares’ answer on coronavirus nursing home data
Facing a brutal report from his own party’s state attorney general that said the state had undercounted nursing home deaths from the virus, Cuomo essentially argued that it’s neither here nor there.
“Look, whether a person died in a hospital or died in a nursing home, it’s — the people died,” Cuomo said. “People died. ‘I was in a hospital, I got transferred to a nursing home, and my father died.' ‘My father was in a nursing home, got transferred to a hospital, my father died.’ People died.”
It does matter. As the article notes "there are major and very valid questions about whether nursing home policies led to unnecessary ones. To the extent that more deaths occurred in or came from that setting, it allows us to evaluate how significant that problem was and how much corrective action is needed."
Wednesday, February 3, 2021
Mark your calendars now for this important webinar, Advancing Guardianship Reform through Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) on Feb. 9, 2021 at 2 eastern.
Improvements to state adult guardianship systems can include the promotion of less restrictive options, strengthening rights, and ensuring accountability. To make real changes in law and practice requires the collaboration of courts with stakeholders in the legal, aging, and disability communities. Working Interdisciplinary Networks of Guardianship Stakeholders (WINGS) or similar collaborative entities in many states have begun to forge positive changes.
The 2020 American Bar Association Commission on Law and Aging WINGS Briefing Paper makes key findings and recommendations about the effectiveness of WINGS and the need for their long-term, systemic support. This webinar will highlight the WINGS Briefing Paper findings and recommendations, and summarize guardianship reform obstacles and efforts and the development of WINGS. Presenters will also offer tips to establish or enhance WINGS in your state.
Click here to register.
Monday, February 1, 2021
Well at least there is some good news on the vaccination front. Last week the New York Times reported Nursing Homes, Once Hotspots, Far Outpace U.S. in Covid Declines.
Throughout the pandemic, there has been perhaps nowhere more dangerous than a nursing home. The coronavirus has raced through some 31,000 long-term care facilities in the United States, killing more than 163,000 residents and employees and accounting for more than a third of all virus deaths since the late spring.
But for the first time since the American outbreak began roughly a year ago — at a nursing care center in Kirkland, Wash. — the threat inside nursing homes may have finally reached a turning point.
The article explains
Experts attribute the improvements in large part to the distribution of vaccines. About 4.5 million residents and employees in long-term care facilities have received at least one dose of the vaccine, according to the Centers for Disease Control and Prevention, including about 2.1 million who have been fully vaccinated.
Other factors, including the steep drop in new infections nationwide in recent weeks, may have contributed as well.
Just good news....finally, for this important group of our population.
Thursday, January 28, 2021
A new GAO report was released last week. ELDER JUSTICE: HHS Could Do More to Encourage State Reporting on the Costs of Financial Exploitation offers fast facts, highlights and the report, all available for download or access via the links. Here are the fast facts:
Financial exploitation of elders—illegal use of their funds or property—affects the victims, their families, and society. Estimated financial costs to victims are in the billions.
Most state-run adult protective services agencies have provided some data on financial exploitation of elders to the Department of Health and Human Services. But it's hard to collect the data because
not all incidents of exploitation are reported to state agencies
victims can be reluctant to implicate family members or caregivers
HHS and state data systems may not align
We recommended that HHS work with state agencies to improve the data on financial exploitation.
Consider this from the report:
Studies estimate some of the costs of financial exploitation to be in the billions,
but comprehensive data on total costs do not exist and NAMRS [National Adult Mistreatment Reporting System] does not currently collect cost data from APS agencies. The Consumer Financial Protection Bureau found actual losses and attempts at elder financial exploitation
reported by financial institutions nationwide were $1.7 billion in 2017. Also, studies published from 2016 to 2020 from three states—New York, Pennsylvania, and Virginia—estimated the costs of financial exploitation could be more than $1 billion in each state alone. HHS does not currently ask states to submit cost data from APS casefiles to NAMRS, though officials said they have begun to reevaluate NAMRS with state APS agencies and other interested parties, including researchers, and may consider asking states to submit cost
data moving forward. Adding cost data to NAMRS could make a valuable contribution to the national picture of the cost of financial exploitation. Recognizing the importance of these data, some APS officials GAO interviewed said their states have developed new data fields or other tools to help caseworkers collect and track cost data more systematically. HHS officials said they plan to share this information with other states to make them aware of practices that could help them collect cost data, but they have not established a timeframe for doing so.
January 28, 2021 in Consumer Information, Crimes, Current Affairs, Elder Abuse/Guardianship/Conservatorship, Federal Statutes/Regulations, Health Care/Long Term Care, State Statutes/Regulations | Permalink | Comments (1)
Tuesday, January 26, 2021
There have been some stories about the impact COVID is having on the prison population. A news station in Denver, CO ran this story a while back, Broncos players join campaign to release medically-vulnerable inmates during pandemic. The ACLU in Colorado has an effort underway to get the Colorado governor to grant clemency to low-risk prisoners. The sidebar on the ACLU page gives examples of folks in prison who are medically-compromised but likely low risk if released. The Marshall Project has a state by state list of COVID in prisons, concluding about 20% of prisoners have COVID. The Federal Bureau of Prisons also has information covering COVID in prisons, which includes their modified operations plans. Although in person visits were suspended, a November update indicated those would be resumed, with safeguards. With the latest surges, I expect those will again be suspended.
And although prisons are "COVID hotspots," prisoners may not be high in priority for the COVID vaccine per a recent article in the Washington Post, Prisons are covid hot spots. But few countries are prioritizing vaccines for inmates.
Since this is the elderlawprof blog, are you wondering what this has to do with Elder Law? Just google "elderly prisoners and covid" and look at the results. Here are a few:
- Supreme Court denies request from geriatric prisoners seeking Covid relief
- COVID-19 and the Compassionate Release of the Elderly, Infirm or High Risk
- Sick, elderly prisoners are at risk for covid-19. A new D.C. law makes it easier for them to seek early release.
- Pandemic underscores need to release more elderly prisoners | COMMENTARY
January 26, 2021 in Consumer Information, Crimes, Current Affairs, Federal Cases, Federal Statutes/Regulations, Health Care/Long Term Care, State Cases, State Statutes/Regulations | Permalink | Comments (0)
Monday, January 18, 2021
There are so many stories being published about COVID and the impact on elders, I'm just going to include a few in this post.
I had mentioned a few weeks back that some states were circumventing the CDC recommendation on the second priority tier for vaccination. Florida is among those states, choosing to vaccinate those 65 and older. In case you weren't aware, Florida has a lot of folks 65 and older. And not enough vaccine doses for everyone. When the second batch of vaccines arrived, stories appeared regarding confusion and inefficiencies regarding signing up to receive the vaccine. (I and several of my friends can tell you first-hand accounts of this). As the New York Times described it, ‘It Became Sort of Lawless’: Florida Vaccine Rollout Turns Into a Free-for-All. It's not just Florida having this problem, as noted in Online Sign-Ups Complicate COVID-19 Vaccine Rollout For Older People.
We need to remember that not everyone has access to a computer or reliable internet-so are we leaving out an entire group in that 65 and over category eligible for the vaccine? With states left to administer the programs, Vaccination Disarray Leaves Seniors Confused About When They Can Get a Shot.
It seems to me that COVID news has been pushed off the news as the #1 story, replaced by the insurgency (rightfully so) but we shouldn't lose focus on the increasing spread of the pandemic. So we know things are going to get worse, before they get better---we haven't seen the surge from the Christmas holidays, but it's coming and very soon. Just look at what happened at Thanksgiving: COVID Kills Over 12,000 Nursing Home Residents in Weeks Surrounding Thanksgiving.
Finally, if you don't read any of these articles, read this one. COVID-19 And Congress Have Left The Senior Citizen Safety Net In Tatters explains the impact the pandemic and the economy is having on senior centers.
Monday, January 11, 2021
The American Bar Association Commission on Law & Aging has released its 2020 summary of guardianship legislation. The summary, Directions of Reform: 2020 Adult Guardianship Legislation Summary, American Bar Association Commission on Law and Aging is available .here.
The summary is divided into the following: pre-adjudication issues, multi-jurisdictional issues, guardian selection, guardian actions, fees, rights of the individual, capacity matters, guardian & fiduciary misconduct, and post-adjudication/monitoring matters. The summary includes a chart at the end for a quick reference. The link to the archives for prior year summaries is available here.