Articles Posted in NY Elder Law

Last year federal legislation was passed affecting elder care issues. In particular, the new law eliminated a floundering attempt to create a national long-term care insurance program. At the same time, the law also called for the creation of a commission to study issues of senior care financing, delivery, and workforce needs. Known as the “Long-Term Care Commission,” the general idea was that the diverse Commission would investigate the issues, create policy proposals, and submit the ideas to Congress to spur possible legislation.

The Status Update

Unfortunately, as a recent Forbes story shares, the Commission is still in dock and there are serious doubts as to whether it will be able to achieve its mission at all. The first issue is that the slate of 15 people to sit on the panel have yet to be decided upon. Apparently the White House has yet to make its three choices, and nothing can be done until the roster is actually complete.

ElderCare Locator recently released a helpful new brochure that offers basic (but important) reminders about the need to be vigilant to prevent senior financial exploitation. The guide provides information about the scope of the problem, information on what to do if you suspect financial abuse, and prevention tips. You can download your own copy of the guide by clicking this link.

The Scope of the Problem

Getting accurate information of the significance of the problem is notoriously difficult. The vast majority of these incidents are never reported. In fact, one study found that even seniors who did report the misconduct, later denied ever having been victimized by financial exploitation in follow-up surveys. There remains a cloud of embarrassment, confusion, and shame surrounding these issues. That is unfortunate. The more discussion about these issues between family members, the more likely we are to tackle the problem.

Last Thursday a group of elder care advocates, seniors, and local politicians held an event to raise awareness of the possible closure of area senior centers. According to a report in Staten Island Live, the gathering was specifically called to ask Governor Cuomo to refrain from making changes to state Title XX funding. The proposed changes would essentially cut roughly $25 million from the budgets of senior centers citywide. Held on the steps of City Hall, state Senator Diane Savino led the event where more than 15,000 letters were unveiled written by seniors explaining how the cuts would affect their lives. Our New York elder law attorneys are aware of the ways that many local elders rely on various support services offered at these facilities.

The Title XX funding accounts for about a third of the total financial support provided to these centers. However, the funding is discretionary and some are proposing that it be moved over to support child welfare services. If the changes are made over a hundred senior centers will be forced to close. Lillian Barrios-Paoli, the Department for the Aging Commissioner repeatedly emphasized that the lives of thousands of seniors would be made qualitatively worse if these proposals were to advance. She explained that “this is an issue that shouldn’t even be debated.”

Others are questioning why such a proposal would even be brought forward in light of the changing demographics. As we have often reported, the elderly population is the quickest growing age group nationwide. The trends are no different in our area. Baby Boomers are now beginning to retire–a trend that will last for decades. The growing senior population means that New York elder care planning needs to be conducted now in anticipation of the needs of this population. Eliminating services to this group would seem to be a step in the wrong direction. Senator Savino commented on the pressing concerns already facing seniors by noting that “we have enough things to worry about. Take this off the table.”

On Wednesday Congressman Ted Deutch published an editorial in Politico advocating on behalf of a stalled federal initiative known as the Community Living Assistance Services and Supports Act (CLASS). The measure was hailed as the first federal attempt to address the nation’s long-term care crisis. All those in our area who have dealt with the complexities and expense of finding proper New York elder care are likely familiar with this crisis. CLASS was part of the high-profile Affordable Care Act that passed Congress, but CLASS was recently suspended by the President.

The Representative explained that CLASS was essentially a means by which middle class families could have a voluntary and affordable long-term care insurance option. An important part of the CLASS program that needed to be addressed was the idea of “adverse selection”–the notion that insurance would only be bought by those who already needed the care. Of course, the maximum benefit is derived only when individuals have this insurance plan in place ahead of time. The measure is currently stalled specifically because of concerns about adverse selection. Yet, many, including Representative Deutch, believe that federal officials have statutory power to implement anti-adverse-selection measures.

CLASS was pushed by those who understand the looming problem facing the long-term care system. Only five percent of Americans have long-term care insurance, even though seventy to seventy five percent of all Americans will need some form of long-term care. The gap is often replaced by federal programs, like Medicaid. The Congressman explained that the reliance on Medicaid is unsustainable at the federal level. This is in addition to the fact that qualifying for Medicaid often requires residents to spend themselves into poverty, especially when planning is absent. Fixing the problem before it gets worse was the motivation behind CLASS. The measure hopes to steer residents away from the most expensive institutionalized care to more balanced programs that encourage cost-effective and resident-focused community care. Besides the cost savings, these programs are almost always preferred by seniors, because they allow them to live at home, maximizing their freedom.

An article yesterday at Forbes explored an issue that has been dubbed “the ticking time bomb of eldercare.” It is well known that many families are forced to adapt their lifestyle once they start having children to make concessions for childcare. However, our New York elder law attorneys know that many families are also forced to make similarly tough decisions to account for eldercare when aging parents are in need of day-to-day assistance. Many local residents still fail to appreciate the demands placed upon adult children and other loved ones when a senior reaches the point where they cannot live on their own without help. The challenges are particularly harsh for local residents when no elder care planning has been conducted ahead of time to ensure that resources are available to provide the needed aid.

Yesterday’s article explains how eldercare expectations are very much rooted in old cultural norms. Specifically, in many families it is assumed that daughters will take care of parents as they age. Decades ago this was more logical as women were far less likely to be in the workforce and were more often available in their homes to assist parents throughout the day. However, those old realities are less and less true. Many more women have careers just as demanding as men. It is no longer easier for many adult daughters fit the care of their elderly parents into their lifestyle. Yet, cultural expectations persist, often making daughters disproportionately more responsible than sons for ensuring the well-being of their elders.

This cultural pressure may affect some women more than others. In particular, women with family backgrounds rooted in certain cultures–including Russia, India, China, and others–often face immense pressure to provide eldercare. For some that means ending a career that has taken a lifetime to build. As the authors of one study on the topic noted, “Eldercare is a serious issue…because its obligations and attendant guilt derail woman who are just hitting the peak of their careers.”

Every New York elder law estate plan should likely include a Power of Attorney and Health Care Proxy. These documents allow another person to handle a variety of legal, financial, and medical affairs on your behalf in the event of disability. Our New York elder law attorneys know that preparing for all possible contingencies is the main purpose of this planning, and so inclusion of these documents remains essential.

Some residents are less familiar with the importance of these decision-making tools and may assume them to be unnecessary in their particular case. They may believe that their friends or family members will step up and handle affairs appropriately without the need for formal legal documents. Unfortunately, that assessment is misguided because very often family disagreement arises among these individuals under the stress of dealing with the disability–setting the stage for conflict without prior delegation of decision-making power. The director of a local public aging services center explained that “the last thing you want is if you age and lose capacity, to become a pod in a power struggle between your kids or your grandkids.” On top that, even if one’s family members do not disagree on any financial or medical issue, the law will not automatically grant these powers to a certain friend or family member. In many cases, the disability requires court intervention to appoint a guardian which is a situation that should always be avoided.

Failure to provide this legal clarity ahead of time can have wide ranging effects. For example, KFBB News reported late last week on one man who is facing felony kidnapping charges after allegedly taking his 92-year old mother out of her long-term care facility and bringing her into another state without permission. The man was not his mother’s Power of Attorney. The family was confused about the local elder care laws, and the man assumed he had the right to move his mother. He didn’t. He is now awaiting extradition to face possible criminal sanctions for his conduct. It is likely that the man would not be facing any charges at all had a Power of Attorney been drafted.

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