Elder Law Prof Blog

How SSA Hold Harmless Works

Concomitant with the announcement of the Medicare premiums for 2021 comes a blog post from SSA explaining how the hold harmless provision works. How the Hold Harmless Provision Protects Your Benefits explains that with some exceptions,  "the “hold harmless provision” protects ... Social Security benefit payment from decreasing due to an increase in the Medicare Part B premium... To qualify for the hold harmless provision, [the recipient] must: .... Receive Social Security benefits or be entitled to Social Security benefits for November and December of the current year [and the recipient's] Medicare Part B premiums for December and January [are] deducted from [the SSA] monthly benefits."

Read the blog here.

AALS Call for Papers/Presenters on Intersectionality, Aging and the Law

The AALS Section on Law and Aging is joining forces with the Sections on Civil Rights, Disability Law, Family and Juvenile Law, Minority Groups. Poverty, Sexual Orientation, Gender-Identity Issues, Trusts & Estates and Women in Legal Education to host a program for the 2021 Annual Meeting, scheduled to take place in San Francisco in January.  The theme for the program is appropriately broad -- "Intersectionality, Aging and the Law."  

I like this definition of "intersectionality": 

The interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage.  Example:  "Through an awareness of intersectionality, we can better acknowledge and ground the differences among us."

We need great presenters!  

From Naomi Cahn at George Washington Law:

We are interested in participants who will address this subject from numerous perspectives. Potential topics include gray divorce, incarceration, elder abuse (physical or financial), disparities in wealth, health, housing, and planning based on race or gender or gender identity, age and disability discrimination, and other topics.  The conception of the program is broad, and we are exploring publication options.

If you are interested in participating, please send a 400-600 word description of what you'd like to discuss.  Submissions should be sent to Professor Naomi Cahn, [email protected], by June 2, 2020, and the author[s] of the selected paper(s) will be notified by July 1, 2020.  

AALS is planning on hosting the annual meeting from January 5-9 and I personally feel the overall theme for the conference is apt in these fraught times:  The Power of Words

 

Make Your SSA Advance Designation Now, Just In Case?

Last week I got an email notification of a recent blog post from SSA.  Advance Designation: Choose a Representative Payee for Social Security to Consider Before You May Need One

Here's the info

The future can be uncertain. However, Social Security’s Advance Designation program can help put you in control of your benefits if a time comes when you need a representative payee to help manage your money.

Advance Designation enables you to identify up to three people, in priority order, whom you would like to serve as your potential representative payee.

The following people may choose an Advance Designation:

• Adults applying for benefits who do not have a representative payee.
• Adult beneficiaries/recipients who do not have a representative payee.
• Emancipated minors applying for benefits who do not have a representative payee.
• Emancipated minor beneficiaries/recipients who do not have a representative payee.

The blog post continues to explain more about how to do this and when it is used. The accompanying FAQ about the Advance Designation is available here.

What is the Best Way to Measure Appropriate Use of POLST Forms?

During a session at the first day of the  21st Annual Pennsylvania Elder Law Institute, we had an interesting dialogue about how best to utilize Physician Orders of Life-Sustaining Treatment (POLST) forms.  One attorney described how clients sometimes arrive at her law firm for advice on various estate planning matters, including a blank POLST form that was given to them in the hospital.  The client asks, in essence,"what should I do with this?"  One attorney said she walks through the form with clients, but always emphasizes that the most important part of the process is the conversation with the client's physician about her choices that should be happening before completing the document.  

Along that line, there is a timely post on the Health Affairs Blog today, with the headline "Counting POLST Form Completion Can Hinder Quality."   The authors, two physicians in Oregon, describe an incident in which a patient reported feeling pressured at a hospital to complete a POLST form, and they raise the potential for the pressure being a side effect of that patient's health plan keeping track of frequency of completion of POLSTs or other advance directives for all patients 65 or older, marking a high rate of completion as success.  They observe:

Many stakeholders have been concerned about how best to measure the quality of advance care planning and use of the POLST form. Some health plans and payers measure the frequency of POLST form completion without a clearly delineated eligible denominator population. Use of such a metric erodes the quality of the POLST program as the following case illustrates. . . . 

 

 When health care professionals encourage patients who are “too healthy” to complete a POLST form (instead of an advance directive), even when orders are for “CPR/Full Treatment,” they may cause harm. If the patient later loses decision-making capacity and clinically deteriorates to a condition in which he or she would have desired a comfort-oriented approach, the presence of the inappropriate POLST may increase the decision-making burden on the family. Another concern is that some healthy patients have been denied life insurance because their medical record inappropriately includes a POLST form; the company incorrectly believing the patient has a limited life expectancy.

The authors argue persuasively that:

Accordingly, we do not believe that POLST forms should be mandated or counted as a quality measure. Instead, POLST quality measures should count conversations about patients’ goals for care as they near the end of their lives.

I recommend the full article, linked above, including review of their "seven imperatives to preserve POLST quality." 

Still Working and Over 55? You Aren't Alone.

The AARP blog, Thinking Policy last week posted about new data: Labor force participation rate for people ages 55+ edges up in March

The monthly Employment Situation Report from the Bureau of Labor Statistics (BLS) shows the economy added 98,000 jobs in March 2017 — an unexpectedly smaller increase from the first two months of the year. The number of persons ages 55+ who are employed increased slightly from February. Meanwhile, the unemployment rate for those ages 55 and older remained unchanged, at 3.4 percent and approximately 1.2 million unemployed. The percentage of the 55+ population that is either working or actively seeking work, i.e. the labor force participation rate, increased slightly to 40.1 percent. The labor force participation rate of persons ages 55+ has remained at around 40 percent throughout the past year. In March the labor force participation rate of men ages 55+ was 46.1 percent, compared with 34.9 percent for women ages 55+.

The post specifically examines the data about women in the workforce, with the highest percentage of those 55 and older hitting the high in 2013.  "Education has been a key factor influencing women’s labor force participation and is likely to continue to have an impact in the future.  Over the past several years, women earned the majority of college degrees of all levels. If this trend continues, employers faced with the need for college-educated workers are likely to seek more ways to attract and retain female employees.  This in turn may influence the number of women in the labor market – and the number who continue to work at older ages."

Being a Guardian: Stories By Guardians for Guardians

The National Center on Elder Abuse is creating stories from guardians for guardians, with the first released February 20, 2017. Here's some information about the series.

The National Center on Elder Abuse asked various types of guardians to share their experience of being a guardian and offer advice for other guardians. We are delighted to share the first of two stories. If you would like to offer your story of being a guardian, please email us at [email protected].

The first story  is titled Living into Guardianship is available here. The second story, dated February 27, 2017, is titled A Unique Model to Addressing Guardianship and is available here.

You Tube Videos for Clients?

Robert Fleming sent out some info on a listserv about a series of videos his firm has created and placed on You Tube to educate clients about specific substantive areas of law as well as answers to practical questions. That got me thinking about the value of such a service to clients and how you could even have a video on what to expect when you go to your lawyer's office for the first time.  I wondered if any of our readers also have videos on You Tube (or on your firm's webpage) along these lines. Let us know?

BTW, the Fleming and Curti videos are just the first batch in a series. If you want to be kept apprised of new videos, you can subscribe to the Fleming and Curti You Tube channel (click on the red subscribe button-mine is on the top right hand of the screen).

AARP Beta Testing CareConnection Website

AARP has announced the beta version of their caregiving website CareConnection. According to the website

CareConnection is a new site aimed at connecting caregivers with information, other caregivers and helpful services. We’re listening firsthand to understand the concerns and challenges facing caregivers today, and we’d like to include you in the design of this site and its offerings. Explore the information, tools and solutions available, and share what works— and what doesn’t—so that we can build the best experience for caregivers like you.

The website lists articles and resources on a variety of topics, will offer a caregiver community that allows a caregiver to connect with other caregivers, provides an "ask-the-expert" free 30 minute consult with UnitedHealth care managers, and "caregiving tips and hacks" ("simple and inexpensive ways to use household items to solve every day problems, such as for those who have limited hand mobility, turning rubber bands into grips for a slippery glass or running a pen through a tennis ball to enhance the grip while writing") that are searchable by topic.

 

Elders and Social Media

All of us who use social media, raise your hands. Ok, so that is a lot of us.  And social media isn't just the province of the young, even though some of us may be digital immigrants. The New York Times ran a recent article about elders on Facebook. Why Do Older People Love Facebook? Let’s Ask My Dad explains about a recent survey done by Penn State. 

The press release about the study, Sorry kids, seniors want to connect and communicate on Facebook, too explains "[o]lder adults, who are Facebook's fastest growing demographic, are joining the social network to stay connected and make new connections, just like college kids who joined the site decades ago, according to Penn State researchers." The study looks at the reasons why elders would be drawn to use Facebook, including curiosity, keeping in touch with friends, and connecting with family, as well as communicating with those with shared interests, what the authors refer to as social bonding, social bridging and social surveillance.

The authors suggest that the social media designers need to look at making the media more elder-friendly, and "emphasize simple and convenient interface tools to attract older adult users and motivate them to stay on the site longer."  The volume of elder users is growing,  so "[d]evelopers may be interested in creating tools for seniors because that age group is the fastest growing demographic among social media users. In 2013, 27 percent of adults aged 65 and older belonged to a social network, such as Facebook or LinkedIn, according to the researchers. Now, the number is 35 percent and is continuing to show an upward trend."

Returning to the New York Times article, the author asked her dad about his Facebook use; "he wanted to be better at keeping in touch with family and with the friends he remembers from my childhood. He told me over Facebook chat (naturally) that his curiosity about what others were up to was his main motivator in finally learning to navigate Facebook."  The author quotes one of the co-authors of the study: "[a]s Facebook continues to be a bigger part of American life, the ever-growing population of older Americans is figuring out how to adapt. As people grow older, peer communication through chatting, status updates and commenting will become more important ... and Facebook will need to adapt tools that are suited for an aging audience."

Social Media and Advocates for Aging

Ever wonder if using social media helps advance the services and care for America's elders? According to a recent article in Aging Today on the website of the American Society on Aging (ASA), the answer to that question is yes. In Advocating for Aging Services in a Digital World, published on January 25, 2016, the author explains

Given all the issues that face older Americans, why is it worth the time and effort it takes to tend to a social media feed? Consider the dual nature of any effort to create social change. On every social issue, there is the “work-work” to be done—policies to be crafted, programs to be improved, risks to be reduced and funding to be secured—and then there is the “meaning-making work.” The latter involves defining the problem and its appropriate solutions, building public awareness and cultivating political will. Both efforts are essential to creating meaningful social change.

In aging policies, the author explains the importance of strategy and dissemination of the message:

So, engaging in social media is a powerful tool for shaping opinions and engaging key constituencies. But the power of this tool also means it must be handled with care. A communicator’s choices about what to emphasize and what to leave unsaid have a significant impact on how the communication is understood, interpreted and acted upon.

The article continues, offering suggestions for effective online advocacy, including how to frame a message by offering information and solutions. "[U]sing the power social media affords  [the chance] to shape the public conversation. By considering the frame effects of the narratives they tell—online or elsewhere—advocates for better policies around aging can help to mature the issue of an aging America."

New Blog from National Center on Elder Abuse

The National Center on Elder Abuse (NCEA) announced their new blog supported by the USC Davis School of Gerontology Center for Digital Aging. The announcement of the NCEA blog provides the following information:

The National Center on Elder Abuse is proud to be producing a new series of blogs featuring expert opinions and diverse views in the field. 

Each month, the blogs will focus on topics brought to us by the Elder Justice Roadmap.  Themes will concentrate on practice improvement, education, policy and research.

The blogs will also address trending topics based on technical assistance inquiries and social media conversations. 

News and resources surrounding our monthly themes will be disseminated on our Facebook and Twitter pages.

In addition, join us the third Thursday of every month for our Twitter chat series featuring national experts! 

The blog is available here.

Check Out Aging.gov

As part of the 2015 White House Conference on Aging, HHS posted a blog entry announcing the launch of a new website, aging.gov. According to the blog post from Nora Super, executive director of the WHCOA, "[o]ne of the lessons we learned through this journey is that older Americans, their families and other caregivers sometimes need help navigating the array of federal, state and local supports that are available." The website includes information on healthy aging, retirement security, and elder justice as well as links to various resources. Check it out!

Check Out This Blog

I always spend some time at the beginning of the semester talking with my students about language used to describe elders as well as attitudes and stereotypes. I was interested in seeing this blog, This Chair Rocks. As the blog author explains

So how come so many of us unthinkingly assume that aging equals a grim slide into depression, diapers, and dementia? That 20th century’s astonishing leap in life expectancy is a disaster-in-the making? Underlying all the hand-wringing is ageism: discrimination that sidelines and silences older people. And unlike racism and sexism, it has barely bleeped onto our radar.

So I’m on a crusade to get people of all ages to wake up to the ageism in and around us, cheer up, and push back.

The author also has a question & answer blog, Yo, Is This Ageist? that allows readers to submit questions that the author answers. What a great tool for students!

 

Follow the happenings with the White House Conference on Aging 2015

Directly from the White House:

The first White House Conference on Aging (WHCoA) was held in 1961, with subsequent conferences in 1971, 1981, 1995, and 2005. These conferences have been viewed as catalysts for development of aging policy over the past 50 years. The conferences generated ideas and momentum prompting the establishment of and/or key improvements in many of the programs that represent America’s commitment to older Americans including: Medicare, Medicaid, Social Security, and the Older Americans Act.

The 2015 White House Conference on Aging

2015 marks the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. The 2015 White House Conference on Aging is an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.

In the past, conference processes were determined by statute with the form and structure directed by Congress through legislation authorizing the Older Americans Act. To date, Congress has not reauthorized the Older Americans Act, and the pending bill does not include a statutory requirement or framework for the 2015 conference.

However, the White House is committed to hosting a White House Conference on Aging in 2015 and intends to seek broad public engagement and work closely with stakeholders in developing the conference. We also plan to use web tools and social media to encourage as many older Americans as possible to participate. We are engaging with stakeholders and members of the public about the issues and ideas most important to older individuals, their caregivers, and families. We also encourage people to submit their ideas directly through the Get Involved section on this website.

Great New Resource on "Elder Abuse Prevention" via Greater Boston Legal Services

We recently heard from Emily Crim, a Public Interest Fellow working in Boston with the "Elder Abuse Prevention Project" under the auspices of Greater Boston Legal Services.  The project's important  mission, now more than a year in development,  is to "offer legal advice and representation of victims, provide training to care providers, community members, and seniors, as well as to advocate for systemic reform and build local networks that can prevent and intervene in cases of abuse."  As part of this Project, they have recently launched a great new "Project Blog" to help get the word out.  

Here's a link to their most recent post on "LGBT Elder Abuse: An Invisible Problem within an Invisible Community."  Here's a link to the Project website too.  Certainly the topics addressed here are relevant beyond the Greater Boston area! 

Thanks, Emily, for reading our Elder Law Prof Blog and for sharing your latest news!  

Catch Up on Blogs-Elder Justice

The NYC Elder Abuse Center ran a post last week that listed the 10 top blogs from the past year. 10 Elder Justice Blogs to Inform & Inspire includes summaries as well as links to "ten great blogs from the July 2013 – June 2014 stellar blog collection that collectively discuss myriad elder justice issues – from elder abuse in popular culture to podcast interviews with leaders in the field."  Check it out and make sure you haven't missed anything!

 

What Should You Look For In An Elder Law Attorney?

ElderLawGuy (and good friend) Jeff Marshall has a great blog post on "How to Find A Good Attorney for Older Adult Issues"  He knows whereof he speaks and starts off by explaining the important reasons for asking the right questions:

"Planning for senior issues like incapacity and long term care is an important aspect of the services provided by what have become known as “elder law attorneys.”  Unfortunately, in most states any lawyer can say he or she practices elder law or hold themselves out as being an “elder law attorney” even if the lawyer has little or no experience with the issues that are especially important to older adults. This means seniors must be particularly cautious in choosing a lawyer and carefully investigate the lawyer before hiring." 

Jeff explains the significance of "certification" as a specialist and how to assess "ratings" or particular approaches to planning, such as "life care planning."  The post is useful both for consumers and young attorneys thinking about how to build a respected career.  

Wolters-Kluwer soliciting student-authored blog posts for competition

Wolters Kluwer Law & Business is a leading global provider of intelligent solutions for legal and business professionals.  Hospitals, lawyers, government healthcare agencies and medical organizations require robust and transparent processes to operate with optimal efficiency and manage risk effectively. Our editors provide intelligent workflow tools and content to ensure that your resources are employed in the most productive way, saving time and cost for true bottom line impact. The Wolters Kluwer Health Law editorial team is based in Riverwoods, Illinois.

Winning posts from the Law School Legal Scholar Program can be found here.

The Wolters Kluwer Health Law Legal Scholar program is beginning its second contest allowing current law students to compete for the chance to have their work published. Wolters Kluwer will accept blog post submissions through Friday, April 18, 2014.

One post per category may be submitted by any student currently enrolled in an ABA accredited law school. Categories for submission are:

1. Medicare;
2. Medicaid;
3. Health care reform;
4. Food, drugs, devices, or biologics; and
5. Tricare or Veterans health programs.

Depending on the number of entries, one to two winners per category will be selected and published by Wolters Kluwer on their Wolters Kluwer Law and Health blog and website. The website, which averages over 9,000 monthly views, is read by leading law firms, health care systems and government agencies including individuals at the Department of Health and Human Services, the US Senate and the US House of Representatives.

More info here.

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Tips for Elder Law Prof Blog Readers: Comments and Subscriptions

Readers sometimes send emails to us, rather than adding comments to an individual post.  That's great, of course.  We welcome all forms of communication about the contents of the blog, especially ideas, topics, links to new academic articles or presentations, or news items. 

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