Sunday, April 19, 2015

Can better oversight cure Florida’s guardianship abuses?

Alan Smith

Guardians are court-appointed advocates who use their “substituted judgment” for the benefit of their incapacitated wards, often frail elderly people suffering from dementia, or people severely impaired by accident or illness.

The Legislature is considering several bills to step up oversight and regulation of court-appointed guardians.

Unfortunately, investigative reporters have found egregious anecdotes of guardians who have milked their wards’ estates by charging exorbitant fees, and occasionally allowing the vulnerable to languish.

The Post’s John Pacenti described the mindset of the bad actors: “Litigate, isolate, medicate and take the estate,” he wrote, quoting Dr. Sam Sugar, an activist.

In 15 counties around the state, including Palm Beach County since 2011, clerks and comptrollers have assigned auditors to review guardians’ charges. But that’s a small fraction of the state.

Anthony Palmieri, with the Palm Beach County Clerk and Comptroller’s Office of Inspector General, audits guardians’ fees here. About 2,800 individuals locally have court-appointed guardians, and their assets are worth about $500 million, he said.

Since 2011, 700 wards’ cases have been audited, Palmieri said, and $4.1 million in fraud, unsubstantiated disbursements, and missing or lost assets has been discovered, he said.

Bills before the Legislature, developed with the help of activists, the Florida Bar and court clerks, should improve the situation statewide, he said.

HB 1225 / SB 1226 would add oversight and consumer protections by creating a new Statewide Public Guardianship Office under the Department of Elder Affairs, and giving it more authority to take complaints, and monitor and discipline guardians.

HB 5 / SB 366 would clarify standards for who can serve as a guardian; make it easier to end guardianship once incapacitation is over; spell out how guardians are to be paid; and allow for mediation in disputes, to minimize attorneys’ fees.

Do you think these bills will help Florida weed out the bad actors from its guardianship program?

Full Article & Source:
Can better oversight cure Florida’s guardianship abuses?

Calif. Unscrupulous Elder Care Referral Agencies Bill Approved by Senate Committee – SB 648

SACRAMENTO, Calif. /California Newswire/ — Senate Bill 648, authored by Calif. Senator Tony Mendoza, was approved this week by the Senate Health Committee. The bill will protect seniors and their families from elder care referral agencies that engage in unscrupulous business practices by strengthening their licensing and financial disclosure requirements. The bill now goes to the Senate Judiciary Committee for consideration.

As the population of aging adults who need specialized medical care and support services has grown in the last several years, there has been an explosion of for-profit businesses that offer referral assistance to seniors and their families to find suitable long term care housing options in extended care, skilled nursing home or intermediate care facilities and residential care facilities.

While these agencies provide a valuable service, current licensing requirements leave room for abuse. For example, some referral agencies advertise their services as free of charge to the consumer.
However, they often contract with care facilities and receive commissions, incentives and bonuses for each senior or family placement. These financial incentives are largely undisclosed to the senior or families being placed, and may lead to a placement that is not helpful and may even be harmful to the patient.

“I want to ensure that seniors and their families are not taken advantage of by strengthening the licensing and financial disclosure requirements for referral agencies. This will help protect against referral agencies that engage in unscrupulous business practices” said Senator Tony Mendoza.

“Seniors and their families who use these services have a right to know what financial relationships may be influencing the referral to a specific nursing home or long term care facility,” said Senator Mendoza. “My bill requires a more transparent process so that seniors will be able to make a more informed decision about what long term care options are available.”

“A decision to find long-term care quickly creates an environment that makes families and seniors more susceptible to pressure, misinformation and unscrupulous business practices,” said Senator Mendoza. “Minimum standards for disclosure are needed to ensure that seniors, and their families, are making the most informed choices when it comes to their long-term assisted care needs.”

In spite of their proliferation, referral placement agencies are largely unregulated in California. Under current law, only certain referral agencies are required to be licensed and there are no requirements for ensuring that referrals are made solely to licensed care facilities. There is a need to address these gaps in current law in order to ensure that every placement agency meets some licensing requirements and financial disclosure requirement and to ensure that seniors are not being referred to facilities that have lost their license to operate in California.

“Referral agencies targeting a senior or family member during one of the most difficult times in their life and profiting from it without full disclosure of their financial interest is just wrong. My bill will end this practice,” said Senator Mendoza.

SB 648 will:
Require a referral agency to disclose any financial interest shared with a care facility, including all fees, commissions received, and other financial benefits resulting from the placement.

Require disclosure of how often a referral agency has inspected a facility; and, a notice advising clients as to where complaints can be directed.

Require the referral agency to protect the medical privacy of seniors by prohibiting the sharing of a client’s personal information.

Require the referral agency to maintain liability insurance, and prohibits the referral agency from holding any power of attorney or property of a client.

Add “residential care facility for the elderly” to the definition of referral agency for licensing purposes.

In 2011, the state of Washington became the first state in the nation to regulate elder placement referrals in response to an investigative report conducted by The Seattle Times. The Times reported that some referral companies did not disclose the commissions they collected from facilities, oftentimes steering seniors to those facilities regardless of the patient’s needs. Agencies also referred patients to facilities with known histories of poor care and neglect, a practice that SB 648 will address.

“The Consumer Federation of California is sponsoring this bill to give the elderly and their families the information they need to make good decisions in difficult times. They have a right to know whether a placement agency is being paid to promote a facility, whether from fees, commissions or other considerations. They have a right to know that a recommendation is based on first-hand observation of a facility over time – actual visits, not public relations or glossy brochures. And they have a right to know what qualifies a placement agency to advise them on such a life-changing decision. Our elders ought to be able to count on these agencies to have their clients’ best interests at heart, not their own profits,” said Richard Holober, Executive Director of the Consumer Federation of California (CFC). Since 1960, CFC has been active in safeguarding the rights of the elderly and all Californians.

Senator Tony Mendoza, a Los Angeles native and former elementary school teacher in East Los Angeles, represents the 32nd Senate District encompassing portions of Los Angeles and Orange Counties. For more information about Senator Mendoza visit his website

Full Article & Source:
Calif. Unscrupulous Elder Care Referral Agencies Bill Approved by Senate Committee – SB 648

New UCLA study reports bedsores can be fatal

Actor Christopher Reeve is a famous example of the complications of bedsores. The famous actor, who became quadriplegic after falling from his horse, succumbed to complications of a pressure ulcer, more commonly known as a bedsore. Bedridden patients not uncommonly develop bedsores. A new UCLA-led study published in the October issue of the Journal of the American Geriatrics Society has reported a direct correlation between hospital bedsores and patient mortality.

Researchers affiliated with the UCLA School of Nursing report that they believe that their study is the first of its kind to use data directly from medical records to assess the impact of hospital-acquired pressure ulcers on Medicare patients at national and state levels. The study authors note that seniors who developed pressure ulcers were more likely to die during their hospital stay, to have longer stays in the hospital, and to be readmitted to the hospital within 30 days of their discharge. They evaluated data on more than 51,000 randomly selected Medicare beneficiaries hospitalized across the United States in 2006 and 2007. “Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality,” noted Dr. Courtney Lyder, lead investigator on the study and dean of the UCLA School of Nursing. He added, “It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission.”

The investigators noted that individuals at the highest risk are those with existing chronic conditions, such as congestive heart failure, pulmonary disease, cardiovascular disease, diabetes and obesity, as well as patients on steroids. While conducting the study, the investigators discovered that there is no large single database to help determine the incidence of pressure ulcers among hospitalized Medicare patients. This prevented a challenge; thus, they extracted the data from Medicare’s claim history, a national surveillance system designed to identify adverse events — or “unintended harm” — within the hospitalized Medicare population. They evaluated this data to determine the cause and patterns of hospital-acquired pressure ulcers.

The researchers found that 4.5% of the patients tracked acquired a pressure ulcer during their hospital stay. The majority of these bedsores were found on the tailbone or sacrum, followed by the hip, buttocks and heels. The study also revealed that of the nearly 3,000 individuals who entered the hospital with a pressure ulcer, 16.7% developed at least one new bedsore on a different part of their body during their hospitalization. “This is a serious issue, and now we have data that can help the healthcare system address this ongoing problem,” explained Dr. Lyder. He added, “When individuals enter the hospital with the risk conditions that we’ve identified, it should send up an immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occurring.”

Take home message: If a loved one is hospitalized at a facility such as Ronald Regan UCLA Medical Center, steps to reduce the risk of pressure ulcers will be taken to prevent pressure ulcers. If they occur, they will be promptly treated. However, some hospitals and nursing homes do not provide the same level of care as that provided by UCLA. Furthermore, many bedridden seniors are cared for at their home. These individuals are at significant risk of developing a pressure ulcer. If you have a loved one at risk for pressure ulcers, you must assume the role of an advocate to insure that he or she does not develop a pressure ulcer and if one develops that it is promptly treated.

A bedridden should be checked for pressure ulcers every day. A head-to-toe examination should be conducted. Pay special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters.

Take the following steps to prevent pressure ulcers:
  • Change position at least every two hours to relieve pressure.
  • Use items that can help reduce pressure: pillows, sheepskin, foam padding, and powders from medical supply stores.
  • Insure that the patient is eating well-balanced meals that contain enough calories to promote health.
  • Encourage the patient to drink plenty of water (8 to 10 cups) every day.
  • Assist in a daily exercise program, including range-of-motion exercises.
  • Keep the skin clean and dry.
  • After urinating or having a bowel movement, check to see that the area is clean and dry.
  • Apply physician-recommended creams to help protect the skin.
Full Article & Source:
New UCLA study reports bedsores can be fatal

Saturday, April 18, 2015

The Genesis of Incapacity

Probate courts use the magic phrase "incapacitation" to cash in on Guardianships illegally imprisoning 10's of thousands of American citizens each year. This video explains why the term is the password to these criminally imposed "guardianships".

YouTube:  The Genesis of Incapacity

'The Age of Dignity: Preparing for the Elder Boom in a Changing America'

The baby boomers are getting older: This year, 4 million people in America will turn 65.
In her new book, The Age of Dignity: Preparing for the Elder Boom in a Changing America, author Ai-jen Poo says that means the country is on the cusp of a major shift.

"The baby boom generation is reaching retirement age at a rate of 10,000 people per day," she tells NPR's Arun Rath. "What that means is that by 2050, 27 million Americans will need some form of long-term care or assistance, and that's the basis for this book."

Poo is the director of the National Domestic Workers Alliance and the co-director of Caring Across Generations, an organization focused on improving the long-term care system in U.S. She says that the current approach of caring for the elderly comes from "a place of scarcity and fear," which has led to a flawed health care model.

Weaving research with stories from seniors and caregivers, she lays out solutions on how to avoid a potential nightmare.

As America Grays, A  Call for Dignity in Aging and Elder Care

Friday, April 17, 2015

Steve Miller: Private "Guardian" Jared E. Shafer's Racket Exposed by Nevada's Largest Newspaper

For more than a year, Las Vegas Review-Journal investigative reporter Colton Lochhead has been quietly preparing a feature story on the activities of local for-hire guardian Jared E. Shafer, and the men and women who enable him and others in his racket to bilk the fortunes of helpless senior citizens and disabled people living in Southern Nevada.

In three front page stories published in the Sunday, April 12, 2015 RJ, Nevada's largest newspaper, Lochhead describes Shafer's rise from snake oil salesman to one of Sin City's leading political players, all at the expense of hapless well-to-do Las Vegas and Henderson retirees and others who had the misfortune of being "discovered" to be in need of special "help" by one of Shafer's Clark County Family Court judges.

In his stories, Colton weaves between Shafer's involvement in a Ponzi Scheme wherein he used money taken from his court appointed "wards" to enrich himself and his CPAs Bruce Gamett and Shawn King, to a strange political billboard company owned by an LLC run by Shafer's attorneys Patricia Trent and Elyse Tyrell, and managed by Shafer's assistant Amy Deittrick from his Pecos Road guardian office. A sign company that coincidentally donates or rents billboards to local judges and politicians who could - in a pinch - help Shafer maintain his power over the elderly without local or state court or government intervention.

Since 2013 when INSIDE VEGAS first attempted to schedule an interview with the shadowy guardian, he has refused to answer numerous telephone calls, emails, or faxed requests, and has held true to his lack of transparency by also refusing to talk to reporters from KTNV TV ABC News or the RJ to tell his side of this sordid story of elder exploitation - a story that if widely known could put a damper on one of Southern Nevada's most lucrative industries, retirement.

Full Article and Source:
Private "Guardian" Jared E. Shafer's Racket Exposed by Nevada's Largest Newspaper

Half the states look at right-to-die legislation

More than a dozen states, plus the District of Columbia, are considering controversial medically assisted death legislation this year.

The laws would allow mentally fit, terminally ill patients age 18 and older, whose doctors say they have six months or less to live, to request lethal drugs.

Oregon was the first state to implement its Death with Dignity Act in 1997 after voters approved the law in 1994, and four other states — Montana, New Mexico, Vermont and Washington — now allow for medically assisted death.

As of April 10, at least another 25 states have considered death with dignity bills, according to Compassion & Choices, a Denver-based nonprofit organization that advocates for these laws. Some of those bills already have died in committee.

"The movement has reached a threshold where it is unstoppable," said President Barbara Coombs Lee of Compassion & Choices, who was also chief petitioner for the Oregon Death with Dignity Act.

The issue of medically assisted death rose to prominence last year with the case of Brittany Maynard, 29, who was told she had six months to live after being diagnosed with brain cancer. Maynard was a strong advocate for Death with Dignity, and when she learned of her grim prognosis, she moved from her home state of California to Oregon where terminally ill patients are allowed to end their own lives.  (Click to continue reading)

Full Article & Source:
Half the states look at right-to-die legislation

Bank teller sentenced for theft

SUMMERSIDE — A former city bank employee has been sentenced for stealing thousands of dollars from sick and elderly clients.

Heather Sue Morrison, 56, of Sherbrooke was sentenced Tuesday to three months in jail, plus three years of probation.

A request for her to serve her time in jail on weekends so she could continue with her extensive and long-standing volunteer work, was denied.

She was also ordered to pay back $20,491 to her former employer.

In sentencing Morrison, Judge Jeff Lantz made it clear that the court was granting leniency in this case because of her terminal cancer prognosis.

Otherwise, said Lantz, the gravity of the offence, given the position of trust she was in and her choice of vulnerable victims, would have warranted a harsher sentence.

Morrison was employed with the Bank of Montreal in Summerside between 2002 and 2014 as a financial services co-ordinator and backup teller.

In December of 2013, BMO corporate security approached Summerside Police Services with a case it had been working on involving Morrison. Branch management had received complaints from a handful of customers regarding unauthorized withdrawals from their accounts.

In total, $20,491 was taken from 16 accounts via several transactions over about 10 months.

Morrison was charged following a police investigation and pleaded guilty to theft over $5,000 in January 2015.

Full Article & Source:
Bank teller sentenced for theft

Thursday, April 16, 2015

Tonight on T.S. Radio: Marti Oakley's special guest is Carole Herman

After a three-year uphill battle with apathetic officials, files that mysteriously disappeared, several closures of her Aunt’s case with no action, and a pattern of stonewalling by state agencies created to protect patients from abuse and poor care, two things happened: The district administrator of the agency that licensed and monitored nursing homes was fired and Carole Herman, who fought the system for three years, founded FATE, Foundation Aiding The Elderly.

Carole protects the weak, fights the powerful, demands government do its job and doctor's to fulfill the Hippocratic Oath.

In October 2001 Carole was a Volunteer Spirit Award winner receiving the Lifetime Achievement Award for her work with FATE on behalf of the elderly and in February 2002 Carole was presented with a Resolution from the Sacramento County Board of Supervisors for "her dedication and care for the elderly of our community."

Today, FATE has affiliated organizations and colleagues fighting elderly patient's rights in Texas, Kansas, Ohio, Tennessee, Illinois, Nebraska, Oklahoma and South Carolina. FATE has helped families all over the country.

Civil actions have been filed on behalf of patients and their families. And the movement to illuminate and reverse the all-too-common incidents of abuse such as neglect, psychiatric drugging and criminal assaults of the elderly is growing.

FATE fulfills a vital and increasing need of providing direct action advocacy and education that will ensure that care is received with the dignity that everyone deserves.

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