"Guardianship: As your Special Needs Child Becomes An Adult:" New Video from Summit County Probate Judge Stormer

Summit County Probate Court Judge Elinore Marsh Stormer has released a new video titled "Guardianship: As your Special Needs Child Becomes An Adult," to help parents of developmentally disabled children make decisions about their child's transition into adulthood.  In the video, parents ask questions about guardianship, and share their hopes and dreams about their developmentally disabled child.  

The video is just another in a series of videos that Judge Stormer has published to help people understand the probate court's role, and facilitate probate and guardianship related decision-making.  All of the videos can be found here. 

B Cepacia Outbreak at Nursing Homes Traced to Contaminated Medical Products

Researchers have traced an outbreak of Burkholderia cepacia ,  also called B. cepacia, at skilled nursing facilities (SNFs) spanning five states to contaminated saline flushes. B. cepacia poses little medical risk to healthy people, but poses serious risk to the elderly, young children, cancer patients, pregnant women, and people with chronic health problems like weakened immune systems or chronic lung diseases.  B. cepacia bacteria are often resistant to common antibiotics, and the mortality rate for already compromised patients, for example, those with lung diseases like Cystic Fibrosis, is particularly high. 

The outbreak was discovered on Sept. 22, 2016, when four B. cepacia bloodstream infections were found in patients receiving IV therapy at a Maryland skilled nursing facility. Officials notified colleagues across state lines, and clusters of B. cepacia infection were discovered in other SNFs.  Investigators abstracted patient records and visited SNFs affected by the outbreak in two states in the hope of finding the source. The investigators found that all the infected patients were staying at SNFs supplied by a certain pharmacy that on Sept. 1 began distributing saline flushes from a specific manufacturer. They then focused on SNFs using flushes from that manufacturer.

The investigators found 162 cases of B. cepacia infection at 59 facilities in five states. Epidemiologic and laboratory evidence indicates the contamination of saline flushes produced by the manufacturer was the source of the outbreak, but  investigation and surveillance for more cases of B. cepacia are ongoing.

This is not the only recent outbreak of B. cepacia linked to contaminated medical products. A 2016 multistate B. cepacia outbreak was traced to syringes of liquid docusate, a stool softener. 

Universal Life Insurance Policy Holders Face Premium Hikes

Over just the last two years, tens of thousands of universal life policyholders have been hit with double-digit premium increases from companies such as Axa Equitable, Voya Financial, and Transamerica.  

Universal life is a permanent and somewhat flexible hybrid life insurance policy that is intended to combine the reasonably affordable aspects of term insurance with a savings element similar to whole life. Universal life insurance typically offers policyholders a “cash value” savings account that earns tax-exempt interest along with the flexibility to adjust premiums and to increase or decrease death benefits. The policy’s investment account accumulates cash when interest rates are high, but can plummet when rates are low. In the 1980s and ’90s, the most common guaranteed rate in universal life contracts was 4%; some insurers guaranteed more.  Many new policies are tied to the stock market and don’t guarantee returns at all.  

Life insurers blame the economy for the premium increases. Interest rates began to slowly decline in the 1980s, but then plummeted during the 2008 recession as the Federal Reserve tried to improve economic conditions by making money cheap to borrow. But low interest rates are bad for the investment.  Low interest rates mean  lower profits.  In response, life insurers have begun to raise premiums on older universal life policies.

Understandably, universal life policyholders, many of whom were assured by agents that their premiums would never increase, are angry.   There are now a dozen lawsuits against insurers who sold those policies

Of course, regulatory reforms are suggested to help minimize the impact of these premium increases.  The New York Department of Financial Services, for example, proposed a rule that would require insurers to notify the agency at least 120 days before an “adverse change” in “non-guaranteed elements of an in-force life insurance or annuity policy.” This rule would also force insurers to notify consumers at least 60 days before the change. The regulation could be used as a precedent for other state insurance departments.  The Consumer Federation of America last year sent a letter to all state insurance commissioners asking them to study and prohibit any unfair price increases being imposed on consumers owning universal life policies.  Regardless, these reforms don't offer insureds a financial solution- only time to react.

Scott Hanson, a senior partner and founding principal of Hanson McClain,  a financial advisory firm in Sacramento, California,  offers the following advice to insureds holding universal life policies:

• Get ahead of the curve by contacting your insurer to find out just how much your policy’s cash reserves are worth.  Depending on the amount you have accrued over the years, you might be able to afford future premium hikes.

• Alternatively, consider working with your insurer to lower the policy’s death benefit, and by extension, your costs.

• You could also inquire about changing policies. What else does your insurer have to offer you? Fair warning: It can be hard to get approved for a life insurance policy when you’re in your 60s or older.

• If all else fails, you could look for a life insurance agent or company who would buy the policy from you now in exchange for receiving the death benefit later.

For more information regarding life insurance in estate and financial planning, go here.

Oregon Court Orders DHS to Restore In-home Care- An Object Lesson in a State's Lack of Commitment to Home and Community Based Care

When state and federal agencies proclaim support for aging in place and home based care, there is reason to doubt their resolve.  A recent example can be found courtesy of a court case against the Oregon Department of Human Services (DHS).  A court has ordered Oregon DHS to restore previous levels of in-home care services, at least temporarily, to people with intellectual and developmental disabilities in a federal lawsuit contesting recent cuts.

DHS determines every year how many hours of in-home care someone with an intellectual or developmental disability is eligible to receive.  Disability Rights Oregon, an advocacy organization that filed the suit last week, objects to how those decisions are made, saying the process lacks clarity.

The lawsuit alleges that under federal law, the agency violated the civil and due process rights of Oregonians receiving these services, as well as the Medicaid requirement that the Office of Developmental Disabilities Services must provide such services “as needed.”  Last year, the agency implemented a new assessment method on a rolling basis, which the lawsuit argues resulted in a reduction of in-home care hours for many people — although the amount of help they needed at home had not changed.  Not all people receiving in-home care services have yet felt reductions, because the changes have been implemented gradually.

In 2013, after the expansion of Medicaid under the Affordable Care Act, and a specific federal funding option called the Community First Choice Plan that provided funds so people with disabilities could access community-based services, there were significant increases in those eligible for in-home care — and in costs to the state.  In 2015, Oregon legislators agreed to pay for the unanticipated costs in the upcoming budget cycle, but asked DHS to come up with a way to contain the rate of cost growth in the future. That became the method that advocates are now contesting in court.  Cost of care

The Department of Human Services makes up a significant chunk of the state’s approximately $20 billion general fund budget, which lawmakers are busy trying to balance in the face of an approximately $1.6 billion shortfall.  Reducing in-home care for people with intellectual and developmental disabilities by 30 percent, as DHS had planned prior to the court order, would have saved the state’s general fund a comparatively paltry  $6 million in the upcoming two-year budget.  

Cost considerations, i.e., saving $6 million of a $1.6 billion shortfall, could send people with intellectual and developmental disabilities currently being treated at home to foster care, group homes, and skilled nursing facilities.  To put this in context,  a state audit found that Oregon Health Plan caseworkers were “knowingly” extending benefits to illegal immigrants and unqualified people. Also, 4,400 people who were above the income limits still received benefits. The total cost to Oregon taxpayers is $4.3 million a year.   Further, an Oregonian survey helped to unveil $1.4 billion in uncollected debts to the state. It appeared that most state agencies have a collection problem and the actual cost may be even higher than $1.4 billion. Among the examples was a business that bought $50,000 of supplies made by blind workers under the State Commission for the Blind, for which they never paid. 

Home and community based care, it would seem, is a too-easy target for money-grubbing administrators.   

This article is heavily reliant upon the article found here.

May is Older Americans Month

May is  Older Americans month. The Administration for Community Living (ACL)  has a website dedicated to older Americans month.  The theme for 2017 is Age Out Loud.  Need ideas for events? ACL offers that here.  Helpful hints for using social media are offered as well.

The following comes from ACL:

Getting older doesn’t mean what it used to. For many aging Americans, it is a phase of life where interests, goals, and dreams can get a new or second start. Today, aging is about eliminating outdated perceptions and living the way that suits you best.

Take Barbara Hillary, for example. A nurse for 55 years who dreamed of travel, at age 75 Hillary became the first African American woman to set foot on the North Pole. In 2011, at age 79, she set another first when she stepped onto the South Pole. Former president George H.W. Bush celebrated his 90th birthday by skydiving. Actress Betty White, now 95 years old, became the oldest person to host Saturday Night Live in 2010, coincidentally during May—the same month recognized as Older Americans Month (OAM).

Since 1963, OAM has been a time to celebrate older Americans, their stories, and their contributions. Led by the Administration for Community Living (ACL), the annual observance offers a special opportunity to learn about, support, and recognize our nation’s older citizens. This year’s theme, “Age Out Loud,” emphasizes the ways older adults are living their lives with boldness, confidence, and passion while serving as an inspiration to people of all ages.

Our firm will use OAM 2017 to focus on how older adults in our community are redefining aging—through work or family interests, by taking charge of their health and staying independent for as long as possible, and through their community and advocacy efforts. We can also use this opportunity to learn how we can best support and learn from our community’s older members.

Throughout the month, I and my paralegals will conduct activities and share information designed to highlight changes in care giving and long-term care than empower aging Americans to age in place.  We encourage you to get involved by sharing this post and other articles from this blog, referring a client to suitable social, financial, or legal services that s/he might protect themselves from medical, legal, and financial threats.  Later this month, we will post a video regarding Aging in Place, and its importance in medical, legal, and financial planning. 

Join us and ACL as we speak up for #OAM17 and #AgeOutLoud this May!