Safe Driving Bill Approved by Massachusetts House of Representatives

On February 4, 2010, the House of Representatives in Massachusetts amended and approved a bill dealing with safe driving in the Commonwealth. If passed by the Massachusetts Senate, this bill will have a direct impact on the senior citizens of Massachusetts because it will require drivers over the age of 75 to renew their licenses every 5 years instead of every 10 years.

Issues concerning elderly driving have been in the news on and off for many years now, but after a series of accidents involving elder drivers last year, the state legislature is looking to make some changes. The current bill does not just involve seniors though. It also seeks to completely ban text messaging by all drivers, and it provides for higher penalties for drivers under the age of 18 who are caught using cell phones while driving.

For seniors, the requisite 5-year renewal will include passing a vision test that will be administered at the local branch of the registry of motor vehicles. However, the bill would permit the registrar to create regulations allowing seniors to submit a vision screening certificate, signed by an optometrist or ophthalmologist that asserts they meet the minimum vision requirements to hold a driver’s license.

This bill further seeks to allow health care providers to notify the registry of anyone over the age of 16 whose cognitive or functional impairments make it unsafe for them to drive. Decisions regarding whether to revoke a license will depend more on the effects of the cognitive or functional impairment, rather than simply on the diagnosis of such impairment. More detailed regulations will be drafted by the registry with the assistance of various health care professionals, and any reports filed under this section of the proposed law would remain confidential.

Finally, this bill seeks to codify a rule that drivers of any passenger vehicle shall not use mobile telephones, hands-free mobile telephones, or any other mobile electronic devices while driving on duty.This section was drafted in response to the rising number of accidents involving the T in recent years where drivers were text messaging, or using mobile electronic devices in other ways.

Now that the House has published and amended the safe driving bill, it moves on to the Senate Committee on Ways and Means. State Senator Stephen M. Brewer, is one member of the Ways and Means Committee, and he represents parts of Worcester, Hampden, Hampshire, and Franklin. If you are interested in voicing your opinion on this bill, call Mr. Brewer at (617) 722-1540, or email him at Stephen.Brewer@state.ma.us.Click here for the full text of the current bill.

Astor Matter Reminds Us that Trustworthiness is Essential When Nominating Substitute Decision Makers

Lately, the matter of Brooke Astor’s estate has been covered in the media. Like many people she had an estate plan in place which included a Durable Power of Attorney and Health Care Proxy, which nominated subsituted decision makers in the event she would lose the capacity to make important financial and/or medical decisions at some point during her elder years. She did not want to burden her family with obtaining a Guardianship and/or Conservatorship through the courts. She did end up suffering from Alzheimer’s disease and her son took over her financial powers. He just didn’t do a very good job…

The following is an exerpt from this week’s AZCentral.

Anyone who has signed a financial document has to be squirming a bit over Brooke Astor’s estate case.

Her son, Anthony Marshall, recently was convicted of stealing millions of dollars from Astor while she suffered from Alzheimer’s disease before her death. Although the case largely centered on a contested will purportedly signed by Astor, other estate-planning issues also came into play.

One was a financial power of attorney signed by Astor that gave Marshall authority to direct her affairs if she became incapacitated - and the means to steal from her.

The episode provides a wake-up call for people who use financial powers of attorney. These legal documents can be highly effective in ensuring that someone else will be around to handle financial matters for you if you’re alive but unable to do so - as in the case of mental incapacity.

A power of attorney can be as short as a page or much longer, depending on the detail desired. They’re often included with a trust, will, health power of attorney (addressing medical issues) and other estate-planning documents.

For all the benefits of using a power of attorney to avoid a potential court-supervised conservator situation, there are pitfalls, too.

In particular, you need to trust the person whom you designate to act on your behalf. And you should make sure he or she is responsible, diligent and reasonably astute.

“They really are documents that people should pay attention to,” said Denise McClain, a financial principal and attorney at wealth-management firm Lowry Hill in Scottsdale. “You’re potentially passing along a lot of power.”

Elder Mediation: A Great Option to Diffuse Family Tensions When Planning for Elder Care

Can’t we all just get along?  

I see it more and more and it really saddens me: families unable to “get along” when it comes to decision making for elder loved ones. It can be as simple as whether Mom and/or Dad need to meet with an Elder Law Attorney, to concerns over finances and inheritance issues, to whether siblings agree on who should serve as primary caregiver, and/or to whether assisted living/nursing home care is necessary.

Often as family members age, family dynamics can become more complicated. Conflicts that have simmered below the surface can boil up and make conversation impossible. Sometimes the elders are involved in the discussions, but unfortuntately sometime they are too far gone to meaninfully participate.

Either way, even the most harmonized family can sometimes hit a bad note or two and require some assistance.

(Dun, dun, dun, dun!) Enter the Elder Mediator. Mediation provides an opportunity for the Elder and all concerned members of the family to participate in creating a thoughtful plan for future. In most cases Elder Law Attorneys can act as Elder Mediators with certain issues. However the scope of the disagreements can often rest in other issues that are not related to the elder law topic. An Elder Mediator, working closely with your Elder Law Attorney, is trained to assist families in identifying the real issues, separating them from the crucial issues of planning for elder care, and developing the best plan of care.

National Public Radio has recognized the usefulness of elder mediation for families dealing with aging issues.

As baby boomers age and options for their care increase, we will all face many difficult choices concerning how we handle transitions during our elders’ declining years. Families will have to be able to evaluate resources, options and develop flexible strategies to support their elders. Even when not legally competent to make decisions, it is important to include an elder’s wishes and expressed preferences when putting a plan into place. Elder mediation is a rational first step for families to help them address their changing needs while enhancing problem solving/communications skills and avoiding messy litigation.

States Moving to Expand Long-Term Care Insurance

Have you ever considered purchasing Long-Term Care Insurance (LTCI) but were unsure because of the seemingly high cost? Have you ever decided that you were willing to fund a LTCI policy just to find out that you were no long eligible? Several States across the nation have been working on expanding LTCI in their jurisdictions to increase coverage and make it more affordable and accessible. Hopefully Massachusetts will follow shortly.

Check out this article where Kaiser Health News reports on States Moving to Expand Long-Term Care Insurance.

MassHealth to Update Regs to Include Same-Sex Marriage Language

The Executive Office of Health and Human Services, Division of Medical Assistance, commonly known as MassHealth is making a much overdue amendment to their existing regulations. Finally same-sex marriages, which have been recognized in the Commonwealth since late 2003, will be officially recognized by MassHealth. Governor Deval Patrick also signed the MassHealth Equality Bill nearly one year ago.

So what does this mean to spouses in same-sex marriages? They can now receive the same benefits as heterosexual marriages when applying for MassHealth for longterm care, meaning their assets can be considered jointly for eligibility purposes and MassHealth will also not penalize transfers between spouses in same-sex situations, as they currently do for traditional marriages. The definition of “family member” is also slated to be amended under the change.

The full text of the memo can be found below.

COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

DIVISION OF MEDICAL ASSISTANCE

NOTICE OF PROPOSED AMENDMENT OF REGULATIONS

The Division proposes to amend its regulations under the authority of M.G.L. c. 118E, ss. 7 and 12 and pursuant to M.G.L. c. 30A, s. 3. The Division describes the substance of the proposed actions as amendments to regulations found at 130 CMR 408.000: Adult Foster Care; 130 CMR 414.000: Independent Nurse; and 130 CMR 422.000: Personal Care Attendant.

On July 31, 2008, Governor Deval Patrick signed into law the MassHealth Equality Bill, which requires MassHealth to recognize state marriage laws when determining member eligibility for MassHealth programs. Accordingly, as stated in recently issued Eligibility Operations Memo 09-02, the definition of “spouse” in MassHealth regulations at 130 CMR 501.001 and 515.001 has been revised to include persons in same-gender marriages.

As a result of the above changes, a revision to the definition of “Family Member” for Adult Foster Care regulations under 130 CMR 408.000 and for Personal Care Attendant regulations under 130 CMR 422.000 is required, as is the definition of “Caregivers” for Independent Nurse regulations under 130 CMR 414.000. These revisions adjust the definition of “Family Member” and “Caregiver” to include a spouse “as defined at 130 CMR 501.001 and 515.001.”

It is anticipated that these amendments will not go into effect before September 1, 2009.

All persons desiring to submit data, views, or arguments concerning these proposed actions may submit them in writing to the Medicaid Director, EOHHS, One Ashburton Place, Room 1109, Boston, Massachusetts 02108, or e-mail them to masshealthpublicnotice@state.ma.us. E-mailed comments should contain the sender’s name, mailing address, and organization or affiliation, if any. Comments will be accepted through July 31, 2009.

All persons desiring to review the current draft of the proposed actions may go to http://www.mass.gov/masshealth/proposedregs or request a copy in writing or in person from the MassHealth Publications Unit, 600 Washington Street, Boston, Massachusetts 02111.

The Division may adopt a revised version of the proposed actions taking into account relevant comments and any other practical alternatives that come to the Division’s attention.

By Order of the Division of Medical Assistance

TOM DEHNER, MEDICAID DIRECTOR July 10, 2009

Major Life Events Provide an Opportunity for your Estate Plan Review

Last night I spoke at the Lutheran Health Care Center in Worcester. One attendee asked, “How often should I review my current estate plan?” It is very important to review your family’s financial and estate plan at least every 3-5 years. The general rule is that the older you are, the more frequent your reviews should be.

Another way to determine when you should schedule a review is when you or your family is/will be experiencing a major life event. Some examples of major life events include:

• Marriage (yourself or your child)
• Divorce (yourself or your child)
• Birth of a child or grandchild
• Death of a spouse or child
• Change jobs with significant increase or decrease in income
• Retirement
• Purchase new/additional real estate
• You move to another state or country
• Start, close, or sell a business
• Major Illness or disability of self, spouse, or child
• Life Insurance/annuities
• Wanting to make major gifts to friends, family, and/or charity
• Major change in tax law

So, how are you supposed to keep track of “major changes in tax law?” Don’t worry. That’s where I come in. Every time there is a major change in a tax or estate planning law thay may effect your estate plan, I’ll send a letter out to you informing you of the change and suggest an estate plan review. Additionally, you’ll receive a similar letter if I haven’t sat down with you in the last five years.

As more major life events, how can I keep track of when ALL my clients have a baby, get divorced, change jobs, retire, etc. I’d love to, however, simply put, I can’t. That’s where you come in. Always remember to keep your estate planning and elder law attorney informed when major life events occur. That way I can determine if a review is necessary for your particular situation.

The Value of a Health Care Proxy for Your College Student

Who do you know that is getting ready to go off to college this fall? Perhaps it’s your own child, a niece/nephew, grandchild, or son/daughter of a friend. Families will soon be shopping for bedding, mini-fridges, Easy Mac, and textbooks.  With the myriad of things to be done before the fall, I’ll bet you very few family “to-do” lists include a check off box for Get Junior a Health Care Proxy. This often overlooked necessity is something that should, at the very least, be considered.

When your child turns 18 they are a bona-fide adult and Mom and Dad cannot step in to make medical decisions for their now “adult” children. In Massachusetts, the only document legally recognized to name a substitute decision maker is a Health Care Proxy. However, the overwhelming majority of college students do not have a Health Care Proxy in place.

A Health Care Proxy names someone to make health care decisions for you in the event you are unable to do yourself. So, for example, let’s say that Sally comes down with a bad case of meningitis her freshman year. She deteriorates very quickly and ends up in a near-unconscious state, unable to make or communicate medical decisions. If she had a Health Care Proxy in place naming Mom, Dad, or older sister as her health care agent, they would be able to communicate with Sally’s treating physicians more completely and have legal authority over her health-related decisions.

What if Johnny has a tragic accident on the football field leaving him paralyzed from the neck down? On top of that the doctors say the outlook is grim if Johnny will ever regain mental functioning and is in a permanent, vegetative state on total life support. Without a Health Care Proxy in place, Johnny’s family won’t be allowed to decide the level of support he will receive. Johnny’s family may even be forced to go to the county Probate Court to get a legal guardianship and ask a judge to make any changes to Johnny’s treatment. Most students would rather have a trusted family member make this decision than a total stranger.

It may seem unnecessary to prepare health care documents for someone so young and healthy, unlikely to come down with serious illnesses. However, when accidents happen to young adults, their legal needs are not often protected and important decision can be left up to disinterested parties, limiting close family involvement.

This may be an unsavory topic to discuss with an 18 year old, but very important, especially if your child still wants Mom and Dad helping them handle their affairs until they get older or are married.

Why I Also Make Housecalls

While some clients book traditional consultations at my office, I always make myself available for home visits with my clients. While the idea of a housecall has gone the way of black & white televisions, I find that meeting clients in their home, on their “turf,” helps make what is usually an emotional process, a bit more comfortable. In their home, clients tend to be more relaxed and at ease. The conversation goes a different way and I can sense the pride they have in sharing their home with someone. Coffee and tea flow more easily and taste better from your favorite mug than a styrofoam cup.

As an elder law attorney, our conversation eventually moves to the business at hand and it’s much much easier for a client to get an idea of what they’ll be leaving behind if the items are right there. Important paperwork is never forgotten as it’s right where the client always keeps it. Clients tend to be more thoughtful and less distracted when in a familiar environment. With so much legal language to deal with, it’s better for a client to be relaxed and more attentive.

Ultimately, a home visit allows me to get to know my client and understand their needs better. It gives me the chance to be attentive to them without outside distraction. With seniors, I can also see their current state of living, if they have all the things they need and maybe attend to some previously unaddressed issues. What many might see as a bother - a housecall - I consider an honor and a blessing.