Incapacity Planning

The bill would allow doctors to prescribe lethal medication to terminally ill patients. The bill already passed the State Senate in June, but faced strong opposition in the Assembly, due to a large number of Catholic legislators.

The legislation was inspired by Brittany Maynard, who, after being diagnosed with terminal brain cancer, moved to Oregon in order to have an option to end her own life in a dignified manner. Before she died, Maynard left a video asking the California lawmakers to amend the state laws to allow others to have the same dignity.

The bill has support of nearly 70% of state residents. The bill contains a lot of regulations to protect against fraudulent prescription of lethal medicine and it does not allow the patients to end their own life (the doctor has to administer the medication).

Currently, 4 states in the country have laws permitting a legal method of ending one’s life. New York State Senator Diane Savino introduced a Death with Dignity bill in Albany in February 2015. The bill would permit prescription of lethal medication to terminally ill patients. Terminally ill is defined as an incurable illness that is expected to result in death within 6 months.  The bill is currently being discussed in the State Senate.

Disclaimer: This article only offers general information.  Each situation is unique. It is always helpful to talk to a specialized attorney, to figure out your various options and ramifications of actions.  As every case has subtle differences, please do not use this article for legal advice. Only a signed engagement letter will create an attorney-client relationship.

When is it Necessary: Having a Power of Attorney and a Health Care Proxy are the best ways of ensuring that your wishes are honored by a person that you trust. Sometimes, however, an individual loses capacity and has not executed these advanced directives.  Without a Power of Attorney, NO ONE has the right to go into your bank account and withdraw assets to pay your own bills. NO ONE has a right to sell your house and move you into a more appropriate environment. And without a Health Care Proxy, NO ONE has a right to your health care records.

 In those cases, it may become necessary to apply to court to appoint a person who will be able to take care of the individual and effect his wishes. That person is called a Guardian. The process of appointing a Guardian is long, expensive and entails a complete loss of privacy.

 Judicial Standard: In order for a guardian to be appointed, there must be a judicial determination, based on a clear and convincing standard, that (1) the individual is unable to meet his daily needs for hygiene, food, clothing, medical care, financial affairs and personal safety, and (2) the individual is unable to comprehend his own inability to manage his own affairs.  

Both of the above prongs are necessary: if a person is simply eccentric and prefers to live in a squalid environment, no guardian will be appointed. Similarly, if a person is wheelchair bound, but retains his mental facilities and is able to arrange for his own care, no guardian will be appointed.

Guardianship Proceeding: 

1. Petition: A petition must be filed with the Court. Amongst other things:

              a.  The petition will provide a detailed description of the alleged incapacitated person’s (“AIP”) functional level and his understanding of his inability to manage activities of daily living.

              b.  The petition will list all the powers being sought by the guardian over the AIP.

              c.   The petition will list all the person’s assets, income, and debts.

 

2.   Appointees: If the petition is deemed not to be frivolous, the court will appoint:

             A. Court Evaluator. This is an independent person who will investigate the Petition. This person will interview the AIP, the AIP’s relatives, the AIP’s neighbors, the AIP’s doctors, the person who filed the petition, and anyone else who has any knowledge of the AIP. The Court Evaluator will provide a report to the judge, with this recommendation.

            B. Attorney for the AIP. This person will represent the wishes of the AIP. Very often, the AIP does not want a guardian to be appointed over him – after all, who wants to lose his autonomy?

 

3.     Hearing: A hearing is required before a guardian is appointed. During a hearing, the petitioner will present evidence about the AIP’s incapacity and need for a guardian. Petitioner and the AIP may both put witnesses on the stand and cross examine them. The Court Evaluator presents his report. The hearing is public, so anyone can attend.

4.     Decision: At the end of the hearing, and taking into account all the evidence presented, the judge makes the decision about the necessity of the appointment. If a specific person sought to be appointed as a guardian (i.e. a daughter sought these powers over the mother), then she may receive it. If Adult Protective Services sought the guardianship, because no family is available, then a non-profit organization will be assigned as a Guardian.

 

Disclaimer: This article only offers general information.  Each situation is unique. It is always helpful to talk to a specialized attorney, to figure out your various options and ramifications of actions.  As every case has subtle differences, please do not use this article for legal advice. Only a signed engagement letter will create an attorney-client relationship.

 

 

There are many considerations when planning for your children. There are even more issues to consider when planning for your child with Special Needs. Regardless of the child’s age, the need for special care will continue.

1. Advanced Directives. You need to have a trusted family member or a friend to make financial decisions and health care decisions on your behalf, if you are not able to do so. The documents needed are Power of Attorney and a Health Care Proxy. Having these documents will ensure that someone has access to your money and will be able to support your children even if you are incapacitated. .

2. Will. You can only name a guardian of your children through a Will. If you are named as a guardian of your special needs child, you can either specify an alternate guardian through the guardianship paperwork or do it through your will. You can also set up a Supplemental Needs Trust through a Will.  

3. Guardianship. Once the child turns 18, your authority to make decisions for him will end. Prior to this age, you may want to commence a 17A guardianship, which will permit you to continue making financial and health care decisions on the child’s behalf.

4. Supplemental Needs Trusts. These trusts provide funds for the enhancement of life for special needs children and adults, without jeopardizing their receipt of government benefits.

   1. These trusts can either be set up during life or through a Will.

   2. There are two types of Supplemental Needs Trusts:

      1. Payback Trusts: set up using the individual’s own money, need to have a Payback provision to the State

      2. Third Party Trusts – set up with other people’s money, there is no need for a payback provision.

5. Government Services. There are many government benefits available to special needs children and adults. You need to review the various options available and plan accordingly.  

1. Supplemental Security Income (SSI): provides a monthly stipend to a child once he or she is eligible. Funds are used to meet basic needs.

   1. Typically a child qualifies at 18 (when he is deemed to be cut off from parents’ income and assets

   2. SSI has a 3 year look back period for transfers of applicant’s own funds – so planning must start early

   3. Eligibility is based on resources (maximum of $2,000)

2. Medicaid and Medicaid Waiver Programs: provide for home and community care, prevocational services, supported employment, respite care, vehicle modification.

   1. Some programs are resource based, others are not

 

Disclaimer: This article only offers general information.  Each situation is unique. It is always helpful to talk to a specialized attorney, to figure out your various options and ramifications of actions.  As every case has subtle differences, please do not use this article for legal advice. Only a signed engagement letter will create an attorney-client relationship.

 

Less Policies Bought: The recent trend is for consumers to buy fewer long term care insurance policies. For those that are still buying them, the policies cover fewer years, provide less coverage, and do not have inflation riders.

Reason: Higher Premium and Uncertain Need. The reason for this decline is most likely the steep increase in premiums for long term care insurance policies. Premiums on existing policies may be rising as much as 25-50% per annum. Premiums for new policies may range anywhere between $2,000 - $6,000 per year. Since a lot of people are unsure that they will ever need long term care coverage, they are reluctant to pay these high premiums for uncertain benefits.

Different Options Available: There are policies available that combine the benefits of a regular life insurance policy with the benefits of long term care polices. In these policies, the money can be used EITHER for long term care, or, if long term care is not needed, the policy will pay out a death benefit to the beneficiaries.  This way, the insured should not feel that he is throwing out good money for something that he may never need, yet he can feels protected that he will have available long term care coverage.

Disclaimer: This article only offers general information.  Each situation is unique. It is always helpful to talk to a specialized attorney, to figure out your various options and ramifications of actions.  As every case has subtle differences, please do not use this article for legal advice. Only a signed engagement letter will create an attorney-client relationship.

 ¿Qué es? Un poder notarial es un documento que da a otra persona ( su agente ) la autoridad para tomar decisiones legales y transacciones en su nombre.

¿Por qué es necesario? Si una persona pierde la capacidad de actuar en su propio nombre, a continuación, el agente puede actuar en su nombre . Si no hay un poder firmado, tendrá que ser iniciado por un Tribunal Testamentario para obtener un tutor legal designado a un procedimiento de tutela - algo que consume mucho tiempo, es muy intrusivo, y también un procedimiento costoso.

¿Quién debe ser nombrado como mi agente ? A menudo, los cónyuges se nombran como sus principales agentes . Si usted tiene hijos mayores de edad , uno de ellos puede ser nombrado como agentes sucesores. Si no hay hijos mayores de edad , un padre competente , un pariente o un amigo puede ser nombrado como el agente . Usted puede nombrar a más de una persona para actuar como agentes simultáneos , y especificar si desea que actúen juntos o separados . Lo más importante es nombrar a alguien a quien usted pueda confiar.

¿Cuándo se hace efectivo? Un poder notarial duradero se hace efectivo de inmediato al firmar el documento . A menudo , ya que el documento se hace como parte de la planificación general, el documento firmado se mantiene en posesión del autor , junto con otro documento de planificación de sucesión . De esta forma , sólo si el autor pierde capacidad, su agente podrá obtener el documento y utilizarlo.

¿Qué tipo de poderes tiene mi agente sobre mis asuntos ? Usted tiene la capacidad de controlar la situación. La forma legal tiene una lista de los poderes que un agente pueda tener. Un abogado competente tendrá una forma que tendrá poderes adicionales que se pueden conceder . El poder más eficaz del abogado es el que otorga las más amplias facultades , porque no se puede anticipar el futuro. Sin embargo, si usted se siente incómodo con la concesión de su agente de todos los poderes , puede especificar cuáles desea ceder. Este es un documento muy importante , uno que le da a otra persona el control sobre su vida financiera , y es por eso que es muy importante que lo firme delante de un abogado competente que pueda explicar las implicaciones de las diversas disposiciones .

¿Qué puede el poder no se utiliza? El poder no se puede utilizar para tomar decisiones de atención médica en su nombre . Con el fin de designar a un representante de atención médica , debe firmar un Poder para la Atención de la Salud, un documento completamente separado.

¿Cuándo se vence el Poder? Hay 2 maneras en que el documento se expira . Primero, usted puede revocar su poder de abogado en cualquier momento de su vida , con tal que usted tenga la capacidad mental para hacerlo. Segundo , el poder legal se expira inmediatamente después de que uno muere. Al igual que uno no puede hacer negocios jurídicos después de la muerte , su agente también pierde toda su autoridad para actuar en su nombre después de que usted muera.

Es el documento objeto de abusos ? Absolutamente . Con la firma del documento , le está dando a otra persona el acceso a sus cuentas financieras y de sus propiedades . Es por eso que su agente debe ser alguien de confianza para actuar en su mejor interés.

Este artículo sólo se ofrece información general. Cada situación es única . Siempre es útil hablar con un abogado especializado, para averiguar sus diferentes opciones y consecuencias de las acciones . Como cada caso tiene diferencias sutiles , por favor no utilice este artículo para obtener asesoría legal. Sólo una carta de compromiso firmada creará una relación de abogado-cliente.

Multiple problems may arise when an adult lacks capacity.  Do you remember Terri Schiavo and the 7 year court battle that her family had to endure to determine the proper course of her medical treatment? Much to the extreme surprise of relatives and close friends, unless certain documents were signed ahead of time, they are not entitled to make health care decisions for another individual. A Health Care Proxy is an effective tool to carry out a person’s wishes after incapacity. 

What is a Health Care Proxy? It is a document by means of which an adult individual appoints an Agent to make health care decisions for him if he is unable to do so. The Agent will act as a surrogate for the principal.

What is the Purpose of a Health Care Proxy? To insure that treatment and non-treatment decisions respect and honor the wishes of the principal.  Similar to the Power of Attorney, this document affords the principal a certain piece of mind.

Who Can Sign a Health Care Proxy? Any competent individual may appoint a health care agent.

How Long Does a Health Care Proxy Last? Unless there were any limitations inserted by the principal, a Health Care Proxy does not expire and lasts until the principal’s death.

Contents of a Health Care Proxy: the document contains the name of the principal, the designation of an agent and an alternate agent, statement of principal’s wishes and instructions regarding various types of treatment, and a statement of principal’s wishes regarding organ donation.

Who Can Be an Agent? Any competent individual over 18 years of age, as long as he is not the principal’s attending physician and not an employee of a hospital or a nursing home where the principal is a patient. Unlike a Power of Attorney, where multiple simultaneous agents can be appointed, only one Health Care Agent can be appointed. However, alternate agents can and should be named, in case the primary agent is not available.

You should ensure that your agent is 1. someone that you trust and 2. aware of your wishes regarding your treatment.

When Does an Agent’s Authority Begin? A Health Care Proxy becomes effective as soon as a physician determines that the individual is incapable of making health care decisions. As long as a person is competent, he is free to make his own decisions about his own treatment.