Saturday, May 12, 2018

Lawyers face higher risk of mental illness and the Fla. Bar Assoc. wants to help

If you need a lawyer chances are you’ve got a problem. Maybe a big one.

But the lawyer you’re depending on might have an even bigger problems. So who’s looking out for you?

Jack Schwartz runs a family business built on honesty, and the Better Business Bureau gives it an “A+” rating. When a business deal went bad in 2013 he got referrals and hired a lawyer.

Schwartz said the attorney that was supposed to protect him, J. Patrick Buckley, started taking money from him.

Within a year Buckley was suspended by the Florida Bar Association and disbarred.

“He took money from me after his license was suspended,” Schwartz said, wondering when it would end “…And he never stopped until he was arrested.”

DOCUMENT: Petition for Buckley’s Emergency Suspension

Buckley is serving prison time after pleading no contest to felony charges related to other clients, and for practicing law without a license.

Schwartz trusted recommendations, “He was referred to me by good local business people. So I would assume at some point he was a good lawyer, but something happened, something in his personal life.”

Buckley’s former attorney representing him said Buckley blamed his problems on alcohol and personal issues.

Michael Higer is the president of the Florida Bar and acknowledges the problems lawyers face, and he wants to get out in front of a staggering problem.

“33 percent of lawyers have been diagnosed with some kind of mental disorder,” Higer said.

Anything from mild anxiety to something more serious.

Higer added that 19 percent of lawyers have been treated for some kind of high anxiety disorder. 18 percent, or nearly 1 out of every 5, attorneys have an alcohol problem, which is double the general population.

Higer thinks getting lawyers to talk about issues like this can help, “If you don’t start having a conversation … If you don’t elevate the conversation … You’re not going to address the issue in a real, meaningful way.”

The Bar is starting a 24/7 hotline for lawyers and creating other ways they can more easily seek help in a system where showing weakness can be career ending.

“You want to give off this image that we’re invincible. Our clients want us to go to battle for them. To be that warrior.” Higer said.

He hopes it will help stop some issues before they get as big as Buckley’s.

How do you find a good lawyer, especially if you need one quickly?

Referrals are a good start.

The Florida Bar lets you search a lawyer’s education and discipline history. And if something doesn’t feel right at any point, you can start your research over.

There are links on the Florida Bar’s website that can help.

Full Article & Source:
Lawyers face higher risk of mental illness and the Fla. Bar Assoc. wants to help

Former Trump advisor's father's death in Philadelphia labeled 'suspicious': multiple agencies investigate

It is being investigated as a suspicious death.

On Thursday, the medical examiner determined the cause of death to be blunt impact head trauma.

The manner of death is accidental. However, the medical examiner, says the manner does not mean an act of negligence could have led to it.

H.R. McMaster served as President Trump's national security advisor from February 2017 until earlier this month.

The elder McMaster died on April 13 at Cathedral Village in the 600 block of E. Cathedral Rd in Roxborough, a senior living Continuing Care Retirement Community.

He was receiving care at Cathedral Village after suffering a stroke.

The allegations are that McMaster Sr. fell, hit his head, was put in a chair and then died. He allegedly did not receive proper care.

Investigators are probing information from some staff members who informed the McMaster family that records were falsified pertaining to this death.

Philadelphia police executed a search warrant at the facility Tuesday.
Cathedral Village spoke with 6abc Wednesday evening and stated that they are fully cooperating with the agencies investigating the death of H.R. McMaster, Sr.

Village officials say they contacted the Department of Health the same day of his death and launched an internal investigation into the allegations being made.

A spokesperson said, "We remain committed to the safety and welfare of all our residents and have made every effort to cooperate."

A spokesperson for the Pennsylvania Attorney General's Office said, "We are working closely with the Philadelphia Police Department to thoroughly and carefully review this tragic incident. This investigation is in the very early stages."

The McMaster family issued the following statement:

"My brother and I are proud of my father's service to his nation, which he began as a teenager when he volunteered to serve in the U.S. Army in combat during the Korean War. He lived a life of service and was known for his courage, toughness and compassion. We are deeply saddened by his loss.

He deserved treatment far better than he received at Cathedral Village. Our main concern is that we honor our father's memory by working with those who will hold accountable those responsible and prevent others from suffering."

Full Article & Source:
Former Trump advisor's father's death in Philadelphia labeled 'suspicious': multiple agencies investigate

Wisconsin DOJ Files Charges Against Minnesota Man for Allegedly Preying on Elderly in Wisconsin and 8 Other States

COTTAGE GROVE, Minn. – Today, Attorney General Brad Schimel announced the Wisconsin Department of Justice (DOJ) filed criminal charges against Matthew D. Erickson of Cottage Grove, Minn., for contracting to deliver snow removal services, and never completing those services for 111 victims nationwide, 28 in Wisconsin. Many of the victims were over the age of 60. The Elm Grove Police Department in Wisconsin and local law enforcement in Minnesota assisted DOJ with the arrest of Erickson today and he remains in custody in Minnesota, awaiting extradition to Wisconsin.

DOJ’s criminal complaint alleges that victims contracted with Erickson’s company, Snow Angels, for snow removal services, but the services were never completed. 111 victims have been identified nationwide, across the following states: Wisconsin, Connecticut, Illinois, Massachusetts, Maine, Michigan, Minnesota, New York, and Rhode Island. 28 victims are from Wisconsin, and reside in Waukesha, Milwaukee, Washington, and Racine counties. In Wisconsin, the total amount of restitution is currently $13,060; nationwide, the amount is in excess of $50,000.

A defendant in a criminal case is innocent until proven guilty. Relevant court filings are available below. This case is being prosecuted by DOJ Criminal Litigation Unit Assistant Attorney General Rich Chiapete.

If you have further information about Erickson or the company Snow Angels, please contact Wisconsin DOJ Consumer Protection investigators at (608) 266-8063.

Wisconsin Attorney General Brad Schimel launched the Attorney General’s Task Force on Elder Abuse in August 2017, charging the task force with compiling the resources and knowledge of a multi-disciplinary team of professionals to study the impact of elder abuse in Wisconsin and assess ways to improve outcomes for this growing population of citizens. In addition to developing strategies to address barriers in investigations and prosecutions of elder abuse, the task force will strengthen consumer protection for seniors and create recommendations for improved cross-system communications.

“Elder abuse is vastly underreported; only one in 44 cases of financial abuse is ever reported[1],” said Attorney General Schimel. “The Wisconsin Department of Justice is working hard to get resources out to communities, increase collaboration in order to better serve elderly victims, and hold criminals exploiting our loved ones accountable.”

In addition to the task force’s work, Attorney General Schimel has moved quickly to provide public safety tools to seniors and their loved ones. In October 2017, Attorney General Schimel expanded Dose of Reality, a statewide prevention campaign designed to raise awareness about prescription drug abuse and its effect on the opioid epidemic, to include resources and information unique to seniors and caregivers.

This year, the attorney general launched a radio ad campaign to raise awareness about elder abuse and encourage citizens to report abuse against seniors at Medicaid-funded or other senior care facilities. The attorney general also started “Safe Seniors Camera Program” a new pilot project in Brown, Outagamie, and Winnebago counties that allows Wisconsin residents, who suspect a caregiver is abusing their loved one, to use a covert camera to provide surveillance over someone who may have been harmed by a caregiver in their residence.

To report suspected financial, physical, emotional, or sexual abuse, please contact your county elder adult-at-risk agency or call 1-800-488-3780. If you witness an act of abuse, neglect, or exploitation that requires immediate attention, please call 911.

Full Article & Source:
Wisconsin DOJ Files Charges Against Minnesota Man for Allegedly Preying on Elderly in Wisconsin and 8 Other States

Friday, May 11, 2018

The metro-east has some of Illinois' worst nursing homes, data says. Here's why.

In 2015, Ellen Paule, 79, of Belleville was admitted to St. Paul’s Nursing Home in Belleville. Within two months, a wound on her heel deteriorated to the point that live larvae and maggots were found crawling inside it.
Paule was hospitalized on June 28 with “a wound infection and maggot infestation,” according to reports from the federal Centers for Medicare and Medicaid. Another resident reported that the dressing on Paule’s leg ulcer would at times go two or three days without being changed.

CMS blamed the nursing home staff for the neglect of Paule and issued the home a severe violation.

Paule died two years later in April 2017. Efforts to reach her family for comment were unsuccessful.

At Belleville's Midwest Respiratory and Rehab, a diabetic resident fell into a “permanent vegetative state” in 2015 when staff failed to give her insulin for two weeks, according to reports from the Illinois Department of Public Health.

The facility, which is owned by Integrity Healthcare, was fined $25,000 and issued a severe violation by IDPH.

St. Paul’s executive director, Tammy von Yeast, said via email she could not comment on Paule's case because she is prohibited from providing information regarding residents' care and treatment.

An Integrity Healthcare representative also said she could not comment on specific cases due to privacy laws.

The citations issued to St. Paul and Midwest Respiratory and Rehab are just a few of hundreds issued to metro-east nursing homes in the past three years. It and many other local nursing homes have been issued violations at a rate that far exceeds state and federal levels.
St. Clair County Nursing Home Ratings
Thirteen out of St. Clair County's 18 nursing homes score "below average" in overall care, according to CMS. Six of those had a rating of "much below average" Kaley Johnson 
Nursing homes across the state, and especially in the metro-east, appear to be struggling to provide quality care. Critics say this is possibly due to inadequate government reimbursement or perhaps a failure to invest enough in staffing and patient care.

Local facilities have been issued numerous violations for neglect, bedsores, failure to investigate residents’ injuries and other issues.

Some blame nursing home owners for the lack of proper care in these homes, claiming corporations and owners are funneling money away from staffing and residents’ care and into their own pockets.

Others, however, blame Illinois’ privatized Medicare and Medicaid system, from which medical reimbursements arrive months late and are often too low to cover costs. Facility representatives say a backlog in reimbursements from Managed Care Organizations, health insurance corporations who control Illinois Medicare payments, are causing a crisis for facilities.

Whatever the cause, state and federal data shows metro-east nursing homes are facing a problem with violations issued on the state and federal level.

​Six residents died due to improper care in metro-east nursing homes from 2015-17, according to the Illinois Department of Public Health. Two more residents were sent into permanent comas because of nursing home errors, the department said.

​Thirteen out of St. Clair County’s 18 nursing homes score “below average” in overall care, including Midwest Rehab, according to the Centers for Medicare and Medicaid Services. Four of those have a rating of "much below average."

​In the past three inspection cycles, five of Belleville’s nursing homes have received a total of 260 federal violations, for an average of 17.3 health violations per home each inspection. This is more than double the state average of 6.2 per inspection and more than triple the national average of 5.8, according to the Centers for Medicare and Medicaid Services.

Columbia-based lawyer Steve Buser, who has worked in the metro-east for 40 years, said each year he works on 10 to 15 cases alleging nursing home neglect, abuse or improper deaths. However, he noted he receives requests for about 10 times that amount.

“I keep getting calls, usually several a month at least, and I probably only take one out of 20 cases,” Buser said. “My phone doesn't quit ringing.”

A pattern of neglect

Buser serves clients throughout Missouri and Illinois, but said most of his nursing home cases come from St. Clair and Madison counties. 

Nursing homes can receive violations on the state and federal level and are inspected at least once every six to 15 months.

Federal inspections, organized by CMS, issue 12 levels of violations. The level depends on the amount of harm caused and the number of people potentially or actually harmed.

nursing home scope and severity grid.jpg
The Centers for Medicare and Medicaid Services issue 12 levels of violations based on the severity and scope of the infraction.
An “A” violation, for example, means there was the potential for minimal harm for a very small number of people. An “L” violation, the most severe a home can receive, means there was widespread, immediate jeopardy to residents’ health or safety.

The Illinois Department of Public Health also issues violations to homes based on CMS inspections and range in severity.

Since November 2014, only 28 L violations have been given by the state. Eight of those violations, 28.6 percent overall, were given to metro-east nursing homes. Seven were issued in St. Clair County alone, according to CMS.

When a violation is issued, an agency can fine the home up to $25,000 per offense depending on its severity. CMS can revoke a home’s Medicare and Medicaid reimbursement if they see fit. 

Some violations, such as four issued against Cahokia’s Autumn Meadows, were based around a specific incident. In July 2016, the home received multiple “L” violations when a fire broke out in the home. IDPH claims staff did not have an adequate emergency plan in place for patients. Autumn Meadows representatives disagree and say they are appealing the violations.

Other severe violations in the area indicate a pattern of neglect and endangerment of patients. 

For example, Integrity Healthcare in Wood River was issued a violation after a patient was sent to the hospital in a coma on Christmas with a 104.1 degree fever and sepsis. The man had been unresponsive for five days prior to his hospitalization, according to the report, and the facility had failed to “recognize, assess and treat” the man’s condition.

Data shows many homes are not issued a violation just once, but instead are repeatedly given citations for the same problems over and over again.
L Violations
Since November 2014, 28 L level violations, the most severe CMS can give a facility, were issued in Illinois. Eight of them were in the metro-east. Seven were issued in St. Clair County alone.
Kaley Johnson 
All deficiency data used in this story is based on 2015 to 2017 CMS reports available as of April 1, 2018.

At Cahokia’s Autumn Meadows, 9 of the 13 violations issued in 2017 were repeat violations, such as keeping residents free from physical restraints.

Jeff Davis, the director of operations of Southwest Healthcare Management, which owns Autumn Meadows, said repeat violations do not necessarily indicate the exact problem is recurring. In some cases, he said, a new violation may differ from a previous one but still fall under the same code because the categories are so broad.

“We may have corrected part of the problem but not all the aspects of it,” he said. “We have systems designed to prevent any violations that we have here, and sometimes those things need to be improved upon and they’re called out by state violations. We always take steps to re-mediate those.”

Integrity Healthcare in Belleville was issued four citations in two years for not providing care that ensured the highest well-being of each resident. Within an overlapping 15-month period, the facility was cited four times for not preventing avoidable accidents or protecting against accident hazards.

One of these violations in 2015 resulted in the hospitalization and severe injury of a resident whose tracheostomy tube was ripped out because he was moved improperly.

Full Article & Source:
The metro-east has some of Illinois' worst nursing homes, data says. Here's why.

Judge: Mayor will no longer manage womans finances

CHARLESTON, SC - The Charleston County Probate Judge filed a court order against Charleston Mayor John Tecklenburg to limit the powers he has as conservator over an elderly woman's finances.

In a motion, Judge Irv Condon said it was in the best interest of 92-year-old Ms. Johnnie Wineglass.  He appointed Thiem & McCutcheon, CPAs, PA as Special Conservator to manage her finances.

According to the court document,  in 2008 the Charleston Elder Support Office filed an Emergency Ex Parte petition to appoint a temporary conservator and guardian for Ms. Wineglass. After the preliminary hearing, the court appointed Mayor Tecklenburg to care for her assets and monthly income.

In April 2009, the court the appointed Tecklenburg as the conservator for her estate and affairs, without limitation. The letters of conservatorship stated:

"John Tecklenburg, as Conservator, shall not sell or dispose of any real or personal property belonging to [Ms. Johnnie Wineglass], without prior Probate Court Approval. THIS RESTRICTION DOES NOT APPLY TO THE LIQUID ASSETS BELONGING TO [MS.] JOHNNIE WINEGLASS; INCLUDING BUT NOT LIMITED TO SAVINGS ACCOUNTS, CHECKING ACCOUNTS, CD'S INVESTMENT ACCOUNTS, ETC."

According to court paperwork, in March, 2010, transactions show Tecklenburg made unsecured loans to himself and to his family members' business. Earlier this year, the annual accounting review was filed, showing loan repayments, apparently made by Tecklenburg.  Some were as large as $20,000.

The court also noted a transaction of a purchase of $25,000 at a tax sale on December 7th, 2011.  From that, $28,000 was repaid to the conservatorship.

The Goddaughter of Ms. Wineglass sent the following letter to Judge Condon:

"Dear Judge Condon,

Thanks for sending me a copy of the order about my Godmother, Johnnie Wineglass. I live in Maryland now but was in Charleston during the time my Godmother was committed to the care of John Tecklenburg. I worked with him and his wife Sandy as incredible efforts were taken to take care of her affairs and well being. John and Sandy are like family to Ms. Johnnie and I am so thankful for all they have done for her. I highly recommend that John remain on as Conservator for my Godmother.

Leila Potts Campbell"

Judge Condon wouldn't speak on the case, sending us this statement:

"I have received media inquiries regarding a pending case. State law prohibits a judge from publicly commenting on a pending case. Below is the specific canon of the Code of Judicial Conduct, Rule 501 Canon 3(B)(9):"
  •     (9) A judge shall not, while a proceeding is pending or impending in any court, make any public comment that might reasonably be expected to affect its outcome or impair its fairness or make any nonpublic comment that might substantially interfere with a fair trial or hearing. The judge shall require * similar abstention on the part of court personnel * subject to the judge's direction and control. This Section does not prohibit judges from making public statements in the course of their official duties or from explaining for public information the procedures of the court. This Section does not apply to proceedings in which the judge is a litigant in a personal capacity.
The mayor issued a statement about the matter on his Facebook page which can be found here.

Full Article & Source:
Judge: Mayor will no longer manage womans finances

Rochester judge still suspended, will continue to get paid

In this June 8, 2017 frame from video provided by 13WHAM, Rochester City Court Judge Leticia Astacio, looks in the direction of her attorney during an appearance in a Rochester, N.Y., courtroom.
A Rochester City Court Judge will continue to get paid during her suspension, as she faces being removed from her job.

The State Court of Appeals affirmed the suspension of judge Leticia Astacio on Tuesday but allowed her to keep her salary, according to the Democrat & Chronicle.

Earlier this month, Astacio's lawyers submitted paperwork requesting that she continue to get paid. Her pay increased to $187,200 per year as part of a salary increase for city court judges across the state.

Astacio's attorney Robert Julian stated that other judges have done worse and received lesser punishment.

According to the D&C, Julian argued that "it would be a further prejudice for her to be deprived of pay in the interim where other judges in a similar circumstance were paid."

Astacio is currently on probation after she was originally charged with drunken driving in April 2016. She was sentenced to a conditional discharge, however, she was arrested again in November 2016 for attempting to start her vehicle after testing positive for alcohol on the ignition interlock device.

In May 2017, she skipped a court-ordered alcohol test and failed to appear, having departed for a lengthy trip to Thailand. She was sentenced to 60 days in jail and put on probation.

The Commission on Judicial Conduct voted to remove Astacio from office last month. She has until May 24 to appeal the Commission's decision.

Last month, Astacio also attempted to buy a shotgun from Dick's Sporting Goods. The store refused her. She was arrested and charged with a felony for trying to buy a gun, a violation of her probation.
The proceedings to remove Astacio from her judgeship began before the gun incident. 

Full Article & Source:
Rochester judge still suspended, will continue to get paid

Financial abuse against the elderly most often committed by those closest to them

Financial fraud against the elderly is most often perpetrated by those closest to the victims: family members, friends or other trusted individuals, according to a new survey.

While 68% of older investors believe that a stranger would be the likely perpetrator of financial exploitation against them, the reality is starkly different, according to Wells Fargo & Co., which released the results of its elder needs survey on Tuesday morning. Two-thirds of financial crimes against the elderly are committed by those who are closest to the victims, the survey found.

Nearly one in five Americans 65 and older have been impacted by elder financial abuse, and each year as much as $36.5 billion is lost to financial exploitation, criminal fraud and caregiver abuse, according to the survey.

The survey found that typical types of abuse include using ATM cards and stealing checks to withdraw money from the victim's accounts. Abuse by in-home care providers can also include keeping change from errands, paying bills that don't belong to the vulnerable adult, asking the elderly client to sign falsified time sheets, spending their work time on the phone and not doing what they are paid to do, according to the survey.

The survey, which was conducted by a third party, was based on interviews with 784 older Americans, ages 60 or older who had at least $25,000 in investible assets. The survey also included 798 adult children, ages 45 to 59 with at least $25,000 in investible assets, who communicate regularly with a parent.

Meanwhile, strangers have plenty of scams to trick elderly individuals into giving up money, personal information, or property, according to Wells Fargo.

Those include "government scams," "granny scams," "prize and sweepstakes fraud" and "sweetheart fraud."

In government scams, the scammers pose as government officials requiring their victims to wire cash or use prepaid debits or gift cards to pay bogus IRS tax bills. Or they may provide sham Medicare services at makeshift mobile clinics in order to bill insurance companies, according to Wells Fargo.

Playing on the emotions of grandparents, fraudsters "identify themselves as grandchildren calling or emailing about an emergency situation" and plead for money.

In prize and sweepstakes fraud, the victim will receive a fake telemarketing call and be informed he or she won a lottery or sweepstakes but must pay taxes on the jackpot before claiming the prize money.

And in sweetheart fraud, elders are conned into trusting a new friend that they meet in person or through social media with the false promise of love and companionship. The romantic partner then swindles them out of money and/or property before disappearing.

Full Article & Source:
Financial abuse against the elderly most often committed by those closest to them

Thursday, May 10, 2018

Florida Bar has money-back guarantee for clients of thieving lawyers, but collecting isn’t easy

P.J. Osborne, who runs The Florida Bars Clients’ Security Fund
The Florida Bar has a pot of money available for swindled law clients.

But getting some isn’t easy. For starters, you have to document exactly what your thieving lawyer extracted during your attorney-client relationship. The breakup must have been painful.

After the Florida Supreme Court disciplines an attorney, P.J. Osborne swings into action. Osborne, who runs the Bar’s 50-year-old Clients’ Security Fund, wants to reimburse the bad lawyer’s client. Or clients, as there’s often more than one.

“It’s what I eat, live and breathe,” said Osborne, who has worked with the fund for a decade. By all accounts, she’s not exaggerating.

Osborne coordinates with one assistant in her Tallahassee office and two-dozen volunteer lawyers to vet every claim–there were 329 in the 2015-2016 fiscal year–and makes recommendations to the Florida Bar’s Board of Governors, the final arbiter of payments.

A few headline-making cases produce big numbers. Bar leaders were concerned that the many victims of notorious ex-Fort Lauderdale lawyer Scott Rothstein’s $1.2-billion Ponzi scheme would strain fund resources. Fortunately that didn’t happen.

“Most of the victims didn’t want to admit publicly that they fell for that cock-and-bull story,” said S. Grier Wells of Gray Robinson in Jacksonville. From 2004 to 2014, Wells served as liaison between the Bar committee that oversees the fund and the Board of Governors.

Rothstein wannabes

Still, Rothstein wannabes pop up occasionally. The numerous paid claims for disbarred Coconut Creek lawyer Nicholas Steffens, now serving a 10-year prison term for stealing from foreclosed homeowners all over the state, totaled $731,976.11.

“You need a few bad apples stealing a lot of money and the fund gets creamed,” said David Schulson, the Broward assistant state attorney who prosecuted Steffens. He works closely with Osborne to locate victims in Bar-generated public corruption cases.

In theory, any shortfall is temporary because the convicted lawyer must eventually repay the fund the amount it pays out in claims. In practice, the ex-con likely has a hard time making restitution–though there’s always the chance of a lottery win, Schulson offered hopefully.

Lori Holcomb, director of the Florida Bar division that runs the Clients’ Security Fund, said, “Yes, we do get restitution. Do we ever recoup 100 percent? No.” As part of the rehabilitation required for a disbarred lawyer to be readmitted to practice, the Clients’ Security Fund bill must be paid in full.

Most claims are under $10,000, Osborne said. And it should be noted that crooks like Steffens comprise a tiny percentage of licensed Florida attorneys: 0.1 percent, according to the Bar.

The other 99.9 percent are the fund’s involuntary underwriters. Out of every $265 Bar dues paid, $25 goes there. That’s roughly $2.5 million a year from the Bar’s just over 100,000 members. The fund is supplemented by the $250 fee that every out-of-state lawyer pays to appear in a Florida court for a single matter.

The Florida fund and others like it in virtually every state perform a public–and public relations–service for the legal profession. The fund is not well publicized outside the circle of people whose lawyers clearly victimized them. There’s a reason for that.

“It wouldn’t make much sense to say file a claim if you’re not eligible, because that will cause more bad feelings toward the Bar,” Holcomb said.

Don’t wait too long

The fund most often turns away people who wait too long to file, complain about a theft that didn’t happen within an attorney-client relationship, or fail to provide “some sort of proof” of payment, she said. There’s a two-year window for claims following the lawyer’s death or discipline, which stretches to four years for good cause such as the lawyer’s successfully hiding the scam.

If defrauded clients fill out the fund’s paperwork correctly and wait patiently for disciplinary actions and Bar procedures to play out over two to three years, they can be handsomely rewarded and come away with warm feelings toward the Florida Bar.

“We were absolutely thrilled to death … and everybody was so great to work with,” said Pam Kuklinski of Ingleside, Illinois. She and her husband Wayne, both retirees, recouped the entire $3,000 they thought they were spending on a loan modification after a Florida lawyer named Sarah Pashaee convinced them she could reduce their mortgage payments.

Pashaee, who claimed an affiliation with an Orlando law firm, actually represented a California boiler room-type operation that did no mortgage loan modifications. In Florida she was suspended twice before her 2015 disbarment.

The Kuklinskis said they were one of the first to file a complaint against Pashaee. Spotting a list of 50 victims, they feared they would never see their money again. “For us, living on pensions and Social Security, we were frightened,” said Pam Kuklinski, a retired financial officer. Wayne Kuklinski was a teacher and coach.

Similarly, oncology nurse Ellen Atas of Palm Beach Gardens did well with the fund, retrieving 100 percent of her family’s $150,000 loss to Julie Kronhaus. The disbarred Winter Park lawyer was criminally prosecuted for a wide-ranging scheme and is serving a 10-year sentence in federal prison.

Kronhaus was supposed to handle money from the sale of the house Atas’s late parents left to her and her two siblings. When Kronhaus dragged her feet about distributing the money, Atas’s brother, a Maryland lawyer, started hounding her, and she finally sent the checks.

They bounced, and the siblings had a problem. “Our parents worked very hard and we knew they would be thrilled to leave us the inheritance and when the money was stolen, we took it very personally,” Atas said. They also took it to the police, who brought in the FBI.

Even bigger losses

Several former Kronhaus clients suffered even bigger losses, sued her and won judgments they may never collect. She’s on the hook for $2.7 million in restitution.

Karma favored Atas and her siblings.

“We chose to go through the fund rather than sue for practicality reasons,” Atas explained. “There was a lot going on and we didn’t have near as much money stolen as the others did. I felt we had a better chance to get something through the fund.”

They were also lucky that Kronhaus’s other victims didn’t file claims with the fund because all successful claimants in a given year are paid at once on a pro rata basis. If the fund holds $2.5 million and claims total $2 million, for instance, everybody gets 100 percent; if claims amount to more than $2.5 million, everybody takes a proportionate cut.

Of course, the fund can’t please all cheated clients all the time. Victims of malpractice or outrageous fees must look elsewhere for justice. A conniving lawyer can perform the bare minimum to avoid detection and punishment.

Yet the client gets burned. The duped payer may be an innocent relative of a criminal defendant or inmate who loses not only money, but the opportunity to save or improve a cherished life.

Lawyers who deal with the attorney disciplinary system describe the client security fund as imperfect but worthy. “Obviously it’s a fund of last resort, a safety net,” said Andrew S. Berman, a Miami attorney who has represented lawyers in disciplinary actions. “We take responsibility for the bad apples as a group, but we don’t have the wherewithal to act like an insurance company and write somebody a check.”

Full Article & Source:
Florida Bar has money-back guarantee for clients of thieving lawyers, but collecting isn’t easy

He let an embezzler of $7.9 million handle his law firm's books. What could go wrong?

Hollywood attorney Randall Gilbert met Steven Sacks in 2005 while Sacks was in a halfway house after doing federal prison time for wire fraud related to embezzlement. Still, Gilbert hired Sacks to handle the accounting books for his law practice.

And that decision, eventually, cost Randall Gilbert $1 million and his law career.

Gilbert has been disbarred, according to the Florida Bar discipline report, for failing to exercise proper control of Sacks as the embezzler stole $4.8 million from Gilbert's clients through the firm's trust account. The Federal Bureau of Prisons now exercises control of Sacks, 60, until June 2021 after he pleaded guilty to wire fraud.

"Whether Gilbert was aware of or personally involved in the theft is not the critical inquiry," the Florida Supreme Court stated in its disbarment decision. "Indeed, this case gives new meaning to the phrase 'turning a blind eye.' "

Read more here:

Read more here:
Sacks told Gilbert, who was referred to Sacks by a friend and client, he was a disbarred attorney and a CPA. As both the Supreme Court and the Referee's Report pointed out, minimal investigation would've pulverized those lies. The Referee's Report called Gilbert "curiously uncurious" regarding Sacks' past.

Whether Gilbert didn't do any fact-checking or did and chose to ignore Sacks falsehoods, it played a role in the disbarment decision.

Federal probation officer Jeffrey Feldman wasn't Gilbert's friend or client, but nobody gave Gilbert a bigger legal hint. Feldman made Gilbert sign a PROB 32 form two months after Gilbert hired Sacks. A PROB 32 formally states the employer knows the risks of employing the person on probation and the nature of the probationer's crimes.

Gilbert signed the form that stated Sacks had been convicted of 11 counts of wire fraud in 2002 and been sentenced to 41 months in prison with five years' probation and $7,906,332.14 in restitution.

Feldman told the Referee that despite the thousands of people he had supervised on probation, he'd required only a few dozen employers to sign a PROB 32.

"Officer Feldman also told Gilbert that he felt it was inappropriate for Sacks to be working at a law firm given Sacks’ history of fraud and embezzlement," the state Supreme Court's opinion read.

Feldman knew of what he spoke. Three months later, in July 2005, Sacks stole one of the firm's operating checks and forged Gilbert's signature to pay $20,950 for Sacks' girlfriend's cosmetic surgery.

Sacks returned the check before the surgery when Gilbert found out about it. Gilbert fired Sacks, but rehired him by October 2005. In the interim, he deflected Feldman's questions about Sacks' firing, knowing the check theft would get Sacks busted on a probation violation. Gilbert also didn't tell Feldman he'd made Sacks the chief financial officer for Gilbert & Caddy.

By 2010, Sacks was off probation and in charge of Gilbert & Caddy's real estate closing side. That's all the experienced embezzler needed.

As Sacks' federal court admission stated, he created a shell company, Sqwerty. Instead of wiring real estate closing money to pay off clients' mortgages, he wired the amounts out of the law firm's client escrow account at Chase Bank to the Chase Bank account for Sqwerty. Sacks hid the embezzlement by making the monthly payments on the mortgages.

Meanwhile, Gilbert kept a lax attitude toward Sacks. Bar discipline documents say he reviewed monthly account statements for two to four minutes per month. He thought Sacks' lifestyle upgrade came from his girlfriend's trust fund.

Gilbert knew nothing until he got a Feb. 27, 2014, call from an attorney wondering why a client's mortgage was still being paid when it should have been paid off. In the 12 days between that phone call and Gilbert closing the firm trust account, Sacks stole another $96,000.

"From February 2010, through March 2014, Sacks stole $4,750,708.70 from Gilbert’s trust account," the state Supreme Court said. "Of that amount, $4,542,410.70 benefited Sacks and other third parties to whom he gave stolen trust account funds. The difference, according to the Bar, $208,298.03, benefited Gilbert’s law firm.

"Old Republic was the single largest victim of Sacks’ thefts, paying out $3,612,374.10 in title insurance claims. Gilbert himself lost approximately $1 million when Sacks failed to pay off the original mortgage on Gilbert’s home when he and his wife refinanced it."

Gilbert self-reported Sacks' thievery to the Florida Bar. He stopped taking paychecks from the firm and devoted net profits to reimbursing those who suffered losses. He eventually dished out $1.03 million in reimbursements.

Still, the Supreme Court found Gilbert's absence of oversight and hiding of Sacks' firing from Feldman created the scenario for the fraud. So, the court rejected the Referee's recommendation of a two-year suspension and went for disbarment.

Read more here:

Read more here:
Full Article & Source:
He let an embezzler of $7.9 million handle his law firm's books. What could go wrong?

Read more here:

Nursing home eviction notices to be sent Thursday

BATON ROUGE — Louisiana's Department of Health will begin sending nursing home eviction notices Thursday to more than 30,000 residents who could lose Medicaid under the budget passed by the state House of Representatives.

"The Louisiana Department of Health is beginning the process of notifying all impacted enrollees that some people may lose their Medicaid eligibility," Department of Health spokesman Bob Johannessen said. "The goal of the department is to give notice to all affected people as soon as possible in order that they begin developing their appropriate plans."

Gov. John Bel Edwards' staff has planned a press conference Wednesday for more details, a day before the notices are set to be mailed to 37,000 Medicaid recipients in nursing homes or other long-term care facilities.

"(The Department of Health) told us they're sending out the letters May 10," said Mark Berger, executive director of the Louisiana Nursing Home Association, during testimony at the Senate Finance Committee meeting Monday.

The issue was front and center in Senate Finance, which was hearing public testimony on the budget sent to it by the House for most of the eight hours the panel met.

"This sounds like mass chaos," said Sen. Regina Barrow, D-Baton Rouge, who called the letter notification "very troublesome."

"What type of people are we in Louisiana if we put people out who built Louisiana?" Sen. Greg Tarver, D-Shreveport, said of the potential evictions. "This is horrible."

Next year's budget begins July 1, which is when the evictions could technically begin.

The budget passed by the House and sent to the Senate contains deep cuts to healthcare because of a shortfall of between $550 million and $648 million, depending on who's doing the calculations.

Next year's shortfall was created because about $1.4 billion in temporary taxes expire June 30. The bulk of the expiring taxes, about $880 million, comes from a one-cent sales tax.

Last week one of the state's safety net hospitals, Lafayette General, sent notices to 800 employees that the medical center will close and they will lose their jobs under the budget being debated now. The other safety net hospitals are expected to follow suit.

Edwards wants lawmakers to mitigate the cuts with new permanent taxes in a Special Session, but the Legislature declined to raise any new taxes in a February Special Session.

"This is our cry for help," said Laurie Boswell, chief executive of Holy Angels in Shreveport, which supports long-term residential care for people with developmental and intellectual disabilities. "There is no place for them to go."

"This make us look heartless," said Senate Finance Chair Eric LaFleur, D-Ville Platte.

Berger said the scheduled notification "will cause unimaginable grief and stress" to nursing home residents and their families.

He said if the $230 million in Medicaid cuts remain intact, "the vast majority of nursing homes will close." The would also eliminate more than 25,000 jobs in the industry, Berger said.

Sen. Bodi White, R-Baton Rouge, said he believes sending the notification to nursing home residents and others in long-term residential care is premature.

"I don't see how in good conscience they can do that to these older folks," White said.

Sen. Sharon Hewitt, R-Slidell, said the Department of Health should be focused on identifying fraud and saving money there "rather than kicking grandma out of the nursing home."

The governor wants to end the ongoing Regular Session early and convene another Special Session to try again. Taxes can't be considered in this year's Regular Session.

"This budget may have to come out as it is hoping we get more revenue," said Sen. Bret Allain, R-Franklin.

Edwards, House Speaker Taylor Barras, R-New Iberia, and Senate President John Alario, R-Westwego, have agreed on the concept of ending early and convening a Special Session in mid-May, but they haven't made a concrete commitment.

That has frustrated the governor.

"Nothing is more important than fixing this budget and we can't do that in the Regular Session," Edwards said last week.

Full Article & Source:
Nursing home eviction notices to be sent Thursday

Wednesday, May 9, 2018

How Medicare's Conflicting Hospitalization Rules Cost Me Thousands Of Dollars

Catherine Fitzgerald, the author's mother, spent four nights in a hospital after falling in her home. But Medicare refused to pay for her rehab care, saying she had only been an inpatient for one night.

A few months ago, I wrote a check for $12,000 but couldn't figure out exactly why.

The payment was to secure a place for my mother at Sligo Creek Center, in Takoma Park, Md. It's a nursing home and rehab center owned by Genesis Healthcare.

My mother was about to be discharged from Holy Cross Hospital, in nearby Silver Spring, after a fall. Medicare wouldn't pay for her rehabilitation care.

So before the Sligo Creek Center would let her through the door, I had to prepay for a month — $12,000 — or nearly $400 a night.

Now, my mother had paid into Medicare her entire working life, and since she retired, the Social Security Administration has automatically deducted $130 for her basic Medicare premium from her $1,650 monthly check. On top of that, she pays about $300 a month for a prescription drug plan and supplemental "Medigap" insurance.

But because of dueling rules and laws that have been well-known to Medicare officials and members of Congress for years, none of that covered my elderly mother when she needed care.

This is a story of how money, outdated laws and federal budget rules can interfere with patient care and leave elderly patients vulnerable.

The fall

I found my mother lying on the floor of her apartment one evening in early January. I had stopped by because she didn't return my calls. It was Wednesday, and she had fallen sometime in the previous 24 hours.

She was awake, but confused. Her lips were chapped, her skin was too pink, and her thick white curls were a mess on her head. I needed help getting her up and into bed. When my husband and I couldn't do it, we called the local fire department.

There were no obvious injuries and she was speaking coherently, so I spent the night with her and tried to care for her the next day, thinking she just needed rest and food. But it soon became clear she needed medical help.

She couldn't walk, couldn't even move her left leg. Her confusion was getting worse. Her doctor recommended I take her to the emergency room at Holy Cross Hospital in Silver Spring.

An ER doctor there examined her, saw that she couldn't move her leg, couldn't really even hold her body upright and had trouble with her memory. He said he would admit her to the hospital's observation unit to figure out what was going on. He mentioned she might need rehab care to get up and walking again.

The word observation triggered an alarm deep in my brain. I had read that patients on observation status sometimes weren't eligible for rehab care, and I told the doctor that I was concerned.

He said he and the hospital "do all they can to be sure their patients' care is covered." I was reassured.

My mother spent four nights at Holy Cross. She was on IV antibiotics for an infection. She got nine X-rays, two MRIs, scans of her carotid arteries and lungs, and a CT scan. Hospital staffers drew blood no less than six times because they were concerned she might have had a mild heart attack or stroke that had caused her to fall.

Administrative maze

On the day they decided to release her, a social worker named Jay called to say the doctors were recommending she go to an inpatient rehab center — and then he said Medicare wouldn't pay for it.

My mother was caught in an administrative wonderland where she slept at a hospital for four nights, but the paperwork said she was an inpatient only one of those nights. Medicare's rules, dating back to the 1960s, require people to spend three nights in a hospital before the federal program will pay for inpatient rehabilitative care.

It would cost upward of $12,000 a month, Jay told me.

I sped to the hospital in a rage. I demanded to know why they were releasing her when she still couldn't walk. Further, I wanted to know, why were they calling her an "outpatient" when she was sleeping in their bed, under their blankets, wearing their hospital gown and being cared for by their staff.

Here were some of the things a parade of social workers and nurses told me that day.
  • The doctor couldn't admit her as an inpatient because she didn't have a qualifying diagnosis.
  • Her status was changed from observation to inpatient on the third day because Medicare requires that.
  • They could not change her status to inpatient for the entire stay because they didn't want to be audited.
  • She couldn't go to acute rehabilitation, which Medicare pays for, because there was no evidence she had had a stroke or heart attack.
They didn't say much about her medical care. It was all about the rules.

For the record, my mother has no money. She lives on Social Security. She has no car, no house, no savings. My siblings and I help pay her bills.

And now they were saying she had to leave the hospital. But she obviously couldn't go home.

Holy Cross kept her one more night — at no charge — while we figured out where she could go. They said she could apply for Medicaid, and a social worker handed me a 17-page application. I picked a handful of rehab centers from a list, after a quick search of reviews on my iPhone. One was full, one rejected her because she was listed as "Medicaid pending," and finally, Genesis Healthcare said they would take her — on the condition that I come by with a $12,000 check that day.

So I did.

Rules, rules, rules

So now I was out $12,000 — borrowed from a home equity line of credit — and I wanted to know why.

And here's what I learned.

Medicare, in its zillions of pages of guidelines and regulations, has two competing rules. The first says patients must spend three nights as a hospital inpatient to qualify for inpatient rehabilitation or skilled nursing care once they're discharged. The second encourages hospitals to keep patients on observation status or risk being audited.

The reason? Medicare pays more for short inpatient stays than short outpatient stays. But once a patient has been at the hospital for a number of days, that calculus flips, and outpatients end up costing more. So in its effort to control costs, Medicare forces hospitals to justify their decisions about inpatient and outpatient status.

"It was always kind of assumed that when you go to the hospital, people know what hospital care is," says Judy Stein, executive director of the nonprofit Center for Medicare Advocacy. "Hospital admission is when you're admitted to the hospital."

Her group is leading a class-action lawsuit against the Department of Health and Human Services, seeking to give patients the right to appeal their status as observation patients.

Stein says the use of observation status has grown dramatically in the past decade, in part because Medicare has become far more aggressive in going after hospitals the agency said were inappropriately — and expensively — admitting patients who didn't need hospital care.

A study in the journal Health Affairs found that the number of Medicare patients who spent three or more days in a hospital under observation rose 88 percent from 2007 to 2009. That increase came just after Congress authorized Medicare to use contractors to audit hospitals for overcharges. But the trend in observation care has continued.

A report by the HHS inspector general found that in fiscal year 2014, more than 633,000 Medicare beneficiaries spent three or more days in the hospital but were considered outpatients, an increase of 8 percent over the previous year. A separate report found that in 2012, about 24,000 patients went to skilled nursing homes or rehab centers and had to pay their own way.

New Unit

Holy Cross built a dedicated observation unit around 2011, according to Yancy Phillips, the hospital's chief quality officer, who spoke to me at length about the use of observation status.

That was where my mother spent those four nights. She had her own room, with glass doors that were covered by a curtain. The nurses station was right outside her door. It looks like a cross between a traditional patient floor and the emergency room. Doctors came around at least once a day.

Phillips says that Holy Cross has no financial motive to classify patients like my mother one way or another because Maryland law requires the same payment for the same services. It's the only state with such rules.

But the hospital still has to follow Medicare's rules when it comes to inpatient and observation care.
"There's really no financial advantage to us except if we get the status wrong," he said. "Medicare has come back to us and said, 'No, no, no, this should not have been an inpatient.' "

When that happens, Medicare pays nothing at all.

To avoid losing money, Holy Cross, like many other hospitals, uses "decision support" software — in this case a package called InterQual, sold by McKesson — that guides doctors or case managers in making the call on whether a person should be admitted or kept on "observation."

The programs are designed to ensure that hospitals don't get dinged by Medicare for overcharging or providing inappropriate services.

Phillips says doctors use their own judgment about whether a patient should be admitted. But he also acknowledges that InterQual is embedded in the electronic health record software used at Holy Cross. It was likely this program that concluded that my mother didn't meet Medicare's criteria for inpatient care.

The thing about all this is that this problem is well-known to everybody involved.

But lawmakers and Medicare haven't taken action to fix it.

A bipartisan group of lawmakers, led by Sen. Sherrod Brown, D-Ohio, and Rep. Joe Courtney, D-Conn., have proposed bills multiple times that would simply require Medicare to count all the time patients spend in a hospital toward its requirements for nursing care.

The House version attracted 162 co-sponsors from both parties, but neither bill has gotten a hearing on Capitol Hill or been close to a vote.

Jonathan Blum, the former Medicare director at CMS, suggests another fix: Get rid of the three-night requirement altogether.

"It's really an artifact," he said. "It was put in place as a budgetary control and it was designed when the average length of a hospital stay was seven, eight or nine days."

Everyone I talked with agrees that the root of the problem is money. There has been no formal analysis from the Congressional Budget Office, but most people believe that eliminating the three-night requirement would end up costing the government more money.

"These are insurance rules. They're policies. They can be changed," says Phillips of Holy Cross Hospital. "But it would have enormous financial implications for the country. And we may have an appetite for tax cuts, but I don't see that we have an appetite for something that would increase Medicare costs."

It's not clear that it would cost more, however. Two pilot programs from the late 1970s showed mixed results from eliminating the three-night rule, with Medicare costs rising in Massachusetts, but falling in Oregon, according to an article in JAMA, the Journal of the American Medical Association.

That article concluded, however, that the rule may be preventing patients from getting appropriate care.

And that would have been the case with my mother, who couldn't have written a $12,000 check to secure a rehab bed for herself.

Two weeks into her therapy at the Sligo Center, my mother fell again. This time, she broke her hip and needed hip replacement surgery. Because she didn't stay the whole month getting rehab care, I got a refund of about $6,000.

Under Medicare's rules, that surgery meant she was automatically eligible for post-surgical rehab care. So after she was released from the hospital, she went to a new center — no deposit required.

Full Article & Source:
How Medicare's Conflicting Hospitalization Rules Cost Me Thousands Of Dollars

Abuse of elderly often unreported

Brianna Kirkham/Commercial-NewsState's Attorney Jacqueline Lacy talked to police officers on Friday about elderly abuse.
DANVILLE — Police officers throughout Vermilion County received special training Friday to help with an underreported issue — elder abuse.

Officers from Danville, Catlin, Westville and Georgetown police departments, as well as Vermilion and Champaign county sheriff departments, participated in the eight-hour training.

The Vermilion County Task Force was awarded a federal grant through the Department of Justice for this curriculum that is “proven to identify and curtail elder abuse,” according to a press release.

Their key focus points included understanding victim safety, being aware of and avoiding assumptions, recognizing abuser tactics and working collaboratively with others.

The training team included Vermilion County State’s Attorney Jacqueline Lacy, Vermilion County Sheriff's Department Sgt. Bill Hurt, Danville Detective Danielle Lewallen, Tawnya Morgan of Crosspoint at the Y, Rachel Kenner of the Vermilion County Rape Crisis Center and Melissa Courtwright of Adult Protective Services at CRIS Healthy-Aging.

Sgt. Hurt explained elder abuse is a reoccurring issue in the area and that Adult Protective Services exist to help officers with cases.

Of Vermilion County’s residents, 18 percent are aged 65 and older, according to 2016 data from the U.S. Census Bureau. This is higher than the U.S. percentage of the same age group, which is less than 15 percent.

“APS (Adult Protective Services) can do things we can’t do,” he said. “There is help out there.”

According to the curriculum, for every one case reported, there are 23 more that go unheard.

Lacey said older adults can experience an array of different kinds of abuse, including physical, sexual, exploitation, emotional, neglect and financial.

These cases happen in all different areas of the county, Lewallen said, and aren’t specific to one race, religion or socioeconomic background.

“The majority of victims are female, but abuse also happens to older males,” she said.

Morgan explained that abusers can be relatives or caregivers. Many of them target their victims’ vulnerabilities by hiding their walkers, glasses and medication.

Some will deny them of their spirituality, refusing to take them to church.

Hurt said the worst elder abuse case he worked on involved a theft of more than $100,000, but the victim said the most painful experience was having his Bible taken away from him.

“We don’t know the privileges we’ll lose when we’re older,” Morgan said. “The ones we have, we want to keep.

The police officers participated in the lessons and discussed ways to identify victims and abusers.

“Abuse – in all actuality – is a choice,” Lewallen said. “Don’t assume it’s an accident.”

Full Article & Source:
Abuse of elderly often unreported

Bill signing ceremony celebrates new guardianship law to assist those with disabilities

In February, the State of Alabama launched Achieving a Better Life Experience (ABLE) accounts, a new financial savings tool for individuals with disabilities.

The Enable Savings Plan is a financial program that allows individuals with disabilities to open tax-exempt savings accounts to save for disability-related expenses without impacting resource-based benefits. The program permits individuals with disabilities to save more than a total of $2,000 in assets (cash, savings, etc.) in their name in an Enable account without jeopardizing their public benefits like Medicaid and Supplemental Security Income (SSI).

In March, Moulton-Republican State Rep. Ken Johnson and Montgomery-Republican State Sen. Dick Brewbaker, introduced legislation to assist those eligible for an account by granting their guardians full financial capabilities when opening and managing an ABLE account.

The bill ultimately passed both chambers and moved to Gov. Kay Ivey‘s desk for a signature. On Thursday, the State celebrated the new guardianship assistance law with a ceremonial bill signing at the state capitol in Montgomery, Ala.

“Alabama’s recent guardianship decision will serve to benefit many individuals and their families throughout the state, providing greater access to an important resource, the Enable Program. Giving guardians this power simplifies matters for individuals with disabilities by allowing guardians to open, invest in, and manage an Enable account,” said Alabama Treasurer Young Boozer, who attended the ceremonial bill signing.

Full Article & Source:
Bill signing ceremony celebrates new guardianship law to assist those with disabilities

Tuesday, May 8, 2018

Caretakers arrested, accused of stealing over $1 million from elderly woman

BROWARD COUNTY, Fla. - Two women working as caretakers were arrested over the weekend, accused of stealing more than $1 million from an elderly woman in Fort Lauderdale after she died, police said.

Angella Morrison, 54, and AnnaKay Johnson, 29, each face changes of grand theft, exploitation of an elderly victim, and dealing in stolen property, WPLG-TV reported.

Detectives said Morrison and Johnson wiped out the woman’s bank accounts after she died in March 2016 by making withdrawals that totaled more than $1 million, according to WPLG.

Police said that Morrison and Johnson gained the victim’s trust while working for her and allegedly convinced her to give them big bonus checks before she died.

Morrison and Johnson also stole more than 50 pieces of the woman’s jewelry and pawned it for cash, according to the arrest report.

The women were booked into the Broward County Jail and released after Morrison posted a $51,000 bail and Johnson a $44,000 bail, state records show.

Full Article & Source:
Caretakers arrested, accused of stealing over $1 million from elderly woman

Hawaii Law Prescribes Death in Paradise

HONOLULU — “Nana, how is suicide okay for some people, but not for people like me?”

Eva Andrade’s teenage grandson, who had previously been hospitalized for suicidal ideation, had asked his grandmother that question recently: Hawaii became the seventh state to legalize physician-assisted suicide April 5, a year after a previous legislative attempt.

Proponents claimed the law would give people with terminal illnesses (and a diagnosis of less than six months to live) the personal autonomy to make that decision. The teenager did not see why the circumstances made a big difference for one group having the legal right to end life on their own terms, while others did not.

“This is a 15-year-old child making this connection on his own, just based on the conversations he was hearing,” Andrade said.

Andrade, communications director for the Hawaii Catholic Conference, told the Register that the “Our Care, Our Choices Act,” which goes into effect Jan. 1, 2019, threatens negative social repercussions and will have a “very detrimental effect on our community.”

For one thing, the new law undermines the state’s own efforts to help young people choose life over death.

The law specifically invokes “the right to choose to avoid an unnecessarily prolonged life of pain and suffering” to justify assisted suicide.

Hawaii averages more than 200 suicides a year and leads the U.S. in suicide attempts for youth 10-24 years old, according to Hawaii’s Department of Health.

Andrade said representatives of Queen’s Medical Center on Hawaii took a neutral position on the bill, but expressed concern that youth would be more prone to consider suicide if normalized for some groups.

Jennifer Popik, legislative counsel for the National Right to Life Committee’s Robert Powell Center for Medical Ethics, agreed.

“We’re very concerned that when you normalize suicide for some groups, and condemn it for others, that it sends the wrong message,” she said.

The issue is starting to be explored in peer-reviewed literature. Popik pointed to initial findings that show either assisted suicide increasing the rate of non-assisted forms of suicide, or assisted suicide leading to no reduction of the overall non-assisted suicide rate.

Oregon, the first state to legaliize doctor-assisted suicide, itself ranks in the top 10 states for suicide, and the state’s health department data show the suicide rate increasing to 42% higher than the national average by 2012.

However, proving direct causation is difficult, as western U.S. states and Alaska generally have higher rates of suicide compared to the rest of the country.

Mental Illness Underserved

Since 2000, the U.S. has seen a steady increase of suicide rates, which are now at a 30-year high.

Alex Schadenberg, executive director of the Euthanasia Prevention Coalition, told the Register that legislation geared toward expanding mental-health services has not kept up with the need.

“Mental-health care is being lost in this whole equation,” he said. Oncologists understand that cancer patients need mental-health support, in addition to pain management, since patients have to deal with the emotional pain of their illness.

He pointed out that assisted suicide sends the message that society is “abandoning somebody at the lowest time in their life.”

Popik told the Register that Hawaii’s assisted law, like all assisted-suicide laws in the country except in Vermont, are based on Oregon’s “Death With Dignity” law. But Popik said Oregon’s law is being given a wide interpretation to include more people.

For example, she said the requirement that a person have an “incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, produce death within six months” would potentially fit a person with diabetes who must depend on insulin treatments to survive and live an otherwise healthy life.

Andrade said Hawaii has a “high incidence of diabetes,” and a diagnosis of clinical depression could also prove deadly under the new law. She pointed out the law’s mental-health protections are weak. She said a clinical social worker is allowed to make the mental-health diagnosis, even through telemedicine.

“Many social workers are not trained to recognize depression and mental illness,” Andrade said, adding there is a great need in educating medical professionals in how to correctly evaluate a patient’s mental health.

Blocking Medical Treatment

The rise of assisted-suicide laws is expected to have a negative impact in the kind of medical care that people with disabilities, or those with negative medical prognoses, receive, according to Marilyn Golden, a senior analyst at the Disability Rights Education and Defense Fund.

Golden said the poor, elderly and persons with disabilities are vulnerable to coercion to assisted suicide from the health care system, where in the constant effort to cut costs, “suicide immediately becomes the cheapest treatment.”

Her organization has seen a pattern emerge out of Oregon and California, where insurance companies deny or delay expensive medical treatments for patients, offering assisted-suicide pills instead.

“We’ve noticed overall where assisted suicide is legal, some people’s lives will be ended without their consent through mistakes, coercion or abuse,” she said. “No safeguards have ever been enacted or proposed which can prevent this outcome or ever be undone.”

The logic of assisted suicide also kills the push for improved palliative care, Golden added. In the Netherlands, where euthanasia and assisted suicide have been legalized, there is “significant absence of the push for improved palliative care, because the Dutch were simply using assisted suicide and euthanasia instead.”

Andrade said elder abuse is an issue the Hawaii Catholic Conference is concerned will increase. Hawaii has found that elderly abuse and coercion had been up 300% over the past 10 years.
But the assisted suicide law gives a person the option to not inform family members about the intention to kill oneself. The death certificate will list the underlying condition, not suicide, as the cause of death.

Andrade explained that, effectively, “if there is some kind of coercion or abuse, there’s no way to prove it.”

Schadenberg also added that assisted-suicide laws cast a shadow over hospice care, where patients need to be assured that doctors intend to take care of them until they die naturally.

Not Yet a Trend

At the same time, there have been more successes than failures in the U.S. in holding back assisted-suicide legalization. Although Hawaii finally succumbed to assisted-suicide legalization after a two-decade campaign, 10 states this year passed or strengthened laws against assisted suicide.

Popik said there is not “huge momentum” on the side of assisted suicide. Popik pointed out that the assisted-suicide lobby group Compassion & Choices tried to advance legislation in 36 states this year, but only had one success:  Hawaii, where it had been trying for two decades. And in the District of Columbia, which passed assisted-suicide legislation in 2017, not one person availed themselves of the law, and only 2 out of 11,000 eligible physicians registered to help people kill themselves.

She said, “We hope — and we’re going to work to make sure — this [legalization in Hawaii] is not part of some broader trend.”
Peter Jesserer Smith is a Register staff reporter.

Church Teaching on Assisted Suicide and Euthanasia

“Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick or dying persons,” the Catechism of the Catholic Church states. “It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his creator.”

It goes on to say, “The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. Discontinuing medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘overzealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted” (2277-2278).

Full Article & Source:
Hawaii Law Prescribes Death in Paradise