Saturday, April 1, 2023

Arizona Senate Moves Reform To Probate Courts

(Photo by Tim Evanson/Creative Commons)

In what can only be described as a bold and broad reaching effort to reform a system that has made headlines for decades, Sen. John Kavanagh and Rep. Quang Nguyen are working to overhaul the laws that have been characterized as creating an environment that is ripe for corruption and abuse.

On the Senate floor Tuesday, February 28th, SB1038 passed with bipartisan support in a 27-2 vote with SB1291 passing with broad bipartisan support on Wednesday, March 1st. Both bills are now headed to the House of Representatives and are the product of hours of cooperative efforts between advocates, court representatives, and lawmakers in an effort to correct the issues that have brought stories of abuse, loss of freedom, familial separations, and tremendous loss of personal finances and liberty.

Since the 2014 story of Marie Long, once a millionaire, who died destitute due to the abuses from her court appointed guardian and conservator was covered by Laurie Roberts and the Arizona Republic, advocates have fought for changes to this system. While minor changes were achieved a decade ago, the effort to repair what remained broken in the system did not end. Advocates have since shared stories of being denied due process, personal freedom, family visitation with elderly parents, with a loss of financial freedom, and physical neglect in care homes among other issues.

The grassroots effort advocating for the reform current Arizona laws that guide the probate courts has been championed by Sherry Lund, who founded the advocacy group “5 14 Protecting Liberty” dedicated to reforming probate laws nationwide through abiding by the intent of both the Fifth and Fourteenth Amendments. Lund is unwavering in her commitment and said, “The Constitution is the law of our land, we cannot allow court rules or state statutes, or failure to follow those court rules and state statutes, to override our Bill of Rights by denying individuals their due process, respect for their personal directives, and a jury of their peers. It’s important to express my gratitude to the courts for their collaboration in this process of working toward a goal that is so needed. All involved agree, the time is now for these changes to our laws.”

The pair of bills look to achieve a two-fold approach to addressing the issues proactively, taking care of immediate needs and looking to the future for continued improvement. SB1038 is a forward reaching bill and returns the Probate Advisory Panel, with the responsibility to file an annual report to the legislature for continuous improvement in the probate process as they are identified. Addressing issues known to need immediate attention, SB1291 will require an increased level of evidence needed before a private citizen can have their individual rights restricted and codify into law the necessity for the individual’s directives, Power of Attorney and valid directives, to be a priority in determining who can be named a guardian or conservator.

Senator John Kavanagh-R, sponsor of both bills, speaking on the Senate floor Tuesday called probate law “very complicated” and had this to say, “We are working with the courts, with attorneys, with people who are involved with probate rights. It’s an area that really deserves good study.”

After the passage of SB1291 on Wednesday Sherry Lund said, “With over $50 billion in assets under management of guardians or conservators, the threat of corruption is real. People have been waiting for decades for these reforms, all the while they are separated from their families, unable to make even the most basic decision for themselves, and some have even had their personal wealth liquidated. The Advisory Panel is a huge accomplishment, but we cannot wait for a year to address the issues we know are a problem today. The combination of both bills is what will be required to ensure people are protected and probate law in Arizona is Constitutionally sound.”

Full Article & Source:
Arizona Senate Moves Reform To Probate Courts

Ohio Dept. of Health said a senior care facility made mistakes, yet there were no consequences

Ohio Dept. of Health says senior care facility erred, yet no one was punished

By: Sarah Buduson

AVON, Ohio — Less than three months after moving into an Avon assisted living facility, Garrett Murray was hospitalized. But even after the Ohio Department of Health substantiated what went wrong, the facility faced no consequences.

Just ten weeks after moving into St. Mary of the Woods, Murray was hospitalized in January 2021.

Medical records show the then 88-year-old widower had severe hypothyroidism, which can be life-threatening, especially in the elderly.

He was so ill, his family feared he wouldn't survive.

"We thought he was done," said his daughter, Nora. "We gathered around his bedside and told him that 'It was okay, he could go be with my mom."

A survey by ODH, which licenses senior care facilities, found the assisted living facility "in compliance" and "no licensure violations were cited" after Nora filed a 12-page complaint about her dad's care.

But News 5 Investigators found the facility failed to provide crucial services Murray had paid to be provided to him. 

What ODH substantiated

After reviewing the Surveyor Worksheet Notes completed by two ODH surveyors who inspected the facility in May, News 5 Investigators found the state substantiated two allegations that St. Mary of the Woods failed to provide proper care to Murray, including a failure to document whether Murray received prescribed medication to manage his thyroid condition.

One surveyor "substantiated" that St. Mary of the Woods "failed to accurately document the administration (or lack of administration) of resident medications."

The surveyor also noted a review of Murray's medication charts "revealed missing signatures."

"Somebody - we don't know who - somebody put initials in the boxes for days and times that my father wasn't even in the facility," Nora said.

The worksheet also said during Murray's stay, the facility used paper logs to record when residents were delivered their medications and that the facility changed its system prior to the survey, stating, "staff no longer records medication administration info on paper, it is all electronic."

The other substantiated allegation involves how the facility handled falls. The allegation said it "failed to provide the care and services to reasonably prevent resident falls and provide timely care thereafter" and "resident falls (were) not properly recorded in the incident log." 

Prior to his hospitalization, Nora said her father fell inside his apartment on Dec. 30, 2021. She said he then laid on the floor for approximately three hours, waiting for help.

What the expert said
"The accountability measures that we have in place are not really sufficient," said Loren Anthes, a health policy expert with the Center for Community Solutions, a Cleveland think tank.

"For the most part, it's a regulatory structure designed and paid for by the industry," he said.

Anthes said the senior care industry provides significant political contributions to lawmakers in both parties in the Ohio General Assembly. As a result, he said, "Both parties have a history of doing a lot of what the industry has outlined for them."

"We are valuing the opinion of the businesses and the folks making money in the system and not the people who are relying on the services," he said.

ODH response
The Ohio Department of Health declined multiple requests for an on-camera interview.

In an email, ODH Public Information Officer Ken Gordon wrote the following:

"The Ohio Department of Health (ODH) cannot comment on an individual complaint. We can explain, in general, how our complaint survey process works. There are many factors that go into the decision whether to cite a facility. One factor, for example, is whether the facility has taken steps to correct a possible violation between the time the incident(s) listed in the complaint occurred, and when an ODH surveyor visited the facility. Using this example, it is possible for an allegation to be substantiated, yet not rise to the level of issuing a citation."

St. Mary of the Woods responds
Atrium Centers Inc, which owns St. Mary of the Woods, also declined requests for an on-camera interview.

In response to our questions about the surveyor substantiating two allegations related to Garrett Murray's care, Megan Schardt, director of sales and marketing, wrote the following:

"Thank you for the additional information, we will opt to refrain from an interview. As you are likely aware, this was a complaint surveyed by the state of Ohio and found to be unsubstantiated. With consideration of privacy for this patient and in support of our team, we feel there are no additional details to disclose."

In the Surveyor Notes Worksheet, a surveyor wrote a St. Mary of the Woods employee said, "they are doing everything in their power to properly care for their residents." and the "biggest problem is staffing." 

What an industry rep said
"The state is doing plenty to make sure all facilities comply with the regulations," said Peter Van Runkle, executive director, Ohio Health Care Association, one of the largest lobbying groups for the senior care industry in Ohio.

He said ODH surveyors often do not issue citations when they substantiate allegations.

"That happens fairly regularly," he said. He blamed the "terminology of substantiated versus a regulatory violation," which he described as "confusing."

"When the surveyors come on site, they look at the whole picture," he said. ""There can be a lot of shades of gray in any situation."

What happened next
"What do you have to do to actually get cited or fined?" asked Nora. "Actually kill somebody?" 

After two weeks in the hospital, Murray's family moved him to a Lakewood facility, where he lives today.

Nora said her father then spent 100 more days recovering in its skilled nursing care center.

He celebrated his 89th birthday this summer.

But Nora said she noticed the incident at St. Mary of the Woods "slipped him into a deeper state of dementia."

"The sad thing is that it was a great place," she said. "We know personally so many families that had great experiences there and I'm sad that they're no longer that place."

She is even more "disgusted" with the ODH's failure to hold the facility accountable for making so many critical errors.

"If there's an industry where there's no consequence, how can we ever be assured our loved ones are being taken care of the way we are hoping they are?" she said. "Whose side are they on?"

Full Article & Source:
Ohio Dept. of Health said a senior care facility made mistakes, yet there were no consequences

Dog Stops Car to Help Save Owner Who Suffered a Seizure

Clover the dog saved her owner’s life in an incredible way. Haley Moore was with her Samoyed when she suffered a sudden seizure. Surveillance video from across the street shows Clover in distress, trying to wake Haley as she lay on the ground unresponsive. Then something remarkable happens — one car zips by and seems to give Clover an idea. She runs into the middle of the street, and sure enough, an oncoming vehicle comes to a halt. The driver jumps out and goes over to help. #InsideEdition

Dog Stops Car to Help Save Owner Who Suffered a Seizure

Friday, March 31, 2023

Voiceless No More, Indiana Woman Freed From Fraught Guardianship

Sara Abbott said she dreamed of the day she would escape her guardianship. This week, a judge granted her wish.
Photographer: Jim Vondruska/Bloomberg

by Ronnie Greene

An Indiana woman whose journey through adult guardianship was dogged by judicial scrutiny, steep legal fees and a profound sense of powerlessness has gotten her wish: freedom from the system.

More than six years after a judge put her under guardianship, Sara Abbott, 27, was formally removed from her arrangement Thursday—without a hearing—by a new judge overseeing her case.

“It’s finally done,” Abbott said. “It’s going to give me a lot more positive outlook on things. I couldn’t believe it really. I expected another possible big battle.”

Abbott’s experience was profiled as part of a Bloomberg Law investigation of the restrictive world of adult guardianships, In the Name of Protection, published earlier this month.

After Abbott was diagnosed with autism at age 20, professionals suggested her mother, Diana, put her under guardianship. The two live alone in Salem, Indiana.

But when Diana became her daughter’s guardian, she was given no formal training on the paperwork required. The guardianship petition had been approved without a hearing in August 2016, records show. Diana didn’t know, she said, she was supposed to file biennial reports documenting Sara’s care and finances.

In 2021, the presiding judge removed Diana and appointed a local lawyer as a temporary guardian. That guardian questioned the mother’s spending on everything from a used car to a new roof; the judge directed Diana to reimburse her daughter’s account more than $11,000. The two argued the spending benefited both of them because the roof keeps them safe and Diana provided all transportation for Sara, who doesn’t drive.

As the temporary guardian was questioning the family’s spending, she filed bills that, in one eight-month period, totaled 91% of Sara’s total income. Sara said she felt voiceless, requiring permission, for instance, to get her bank statements or host a yard sale to raise money. Ultimately her mother, who previously injured her back, had to return to work.

Sara’s lawyers, Justin Schrock and Amy Semones, filed a petition this week to formally end the guardianship. They said Sara demonstrated independence and doesn’t need a guardian. Sara’s new guardian, Loren Pilcher, also supported ending the guardianship.

A hearing on the petition had been scheduled for Friday. But on Thursday, Special Judge Susan Orth issued a three-page ruling freeing Sara.

Orth also ruled that Diana no longer has to reimburse Sara for spending that benefited them both. “At Sara’s request, Diana is hereby relieved of any responsibility to reimburse Sara’s estate for expenditures made as her former legal guardian and representative payee that have previously been questioned in this matter,” the judge wrote.

“I’m ecstatic,” Diana said. “She has her independence and everything and I thought all along I didn’t owe anything.”

Both said more needs to be done to ensure others aren’t ensnared in unnecessary guardianships. “I honestly think the system is broken,” Diana said. “They need to have somebody explain things. What guardianship is and what it entails.”

But on Thursday, they focused on the ruling Sara called “amazing.”

Diana asked her daughter how she wanted to celebrate.

“Mom, I want Kentucky Fried Chicken today,” Sara replied.

“And that’s what we got,” said Diana.

Full Article & Source:
Voiceless No More, Indiana Woman Freed From Fraught Guardianship

See Also:
In the Name of Protection, Part 1: The Profiteers: Guardians' Dark Side: Lax Rules Open the Vulnerable to Abuse

In the Name of Protection, Part 2: The Judges: Judge’s Errors, Jail Threats Haunt Georgia Family’s Guardianship

In the Name of Protection, Part 3: The Profiteers: 420 Cases, One Guardian: System Runs Amok on Just $35 a Month

In the Name of Protection, Part 4: The Lawyers: Peter Max’s Bare Ledgers Show Guardianships Drain Even the Rich

In the Name of Protection, Part 5: Guardians’ Abuses Persist as One State’s Easy Fix Goes Unmatched

U.S. Senate panel to investigate guardianship program practices nationwide

By Joshua Ceballos, Daniel Rivero 

WLRN Investigation: Unguarded

A key U.S. Senate panel has scheduled a hearing later this month to investigate guardianship programs across the nation and their role in managing the lives of tens of thousands of individuals deemed by courts to be unable to take care of themselves.

The March 30 hearing by the U.S. Senate Special Committee on Aging comes the same month that WLRN and Bloomberg Law published separate stories showing a lack of oversight and accountability in guardianships.

The Bloomberg Law investigation, In the Name of Protection, “explored the dark world of adult guardianships, where people placed under court-ordered control lose many of their rights while reporting to guardians rarely required to be formally trained or certified.”

The WLRN investigation found the Guardianship Program of Dade County, the biggest in Florida, sold 14 homes of those under its care to the same realty company, Express Homes, which sold three of the properties for profit within the same week — or even the same day. In two other instances, the properties were fixed up and sold within a year. The rest were sold more than a year later or are still owned by Express Homes.

The gains collected from those sales did not go towards the care of the program’s incapacitated clients.

Guardianship Program of Dade County Executive Director Carlos McDonald told WLRN that the nonprofit agency works with multiple realty companies to sell their wards’ properties, and does so with approval from the court.

Following WLRN’s investigation, Miami-Dade County Mayor Daniella Levine Cava directed the county administration to temporarily cease grant payments to the Guardianship Program and asked for an independent investigation of the agency’s sales of properties of its clients.

Advocates for the elderly and a former judge of guardianship cases told WLRN that the Guardianship Program of Dade County illustrates the lack of transparency of financial transactions and dire need statewide for more oversight of such agencies serving as public guardians.

The Guardianship Program, which is mostly funded by county and state taxpayers, takes responsibility for people who are declared "incapacitated" by the court system.

In some cases, the program sells the individual’s property so that the proceeds may go toward their care. County taxpayers, takes responsibility for people who are declared "incapacitated" by the court system. In some cases, the program sells the individual’s property so that the proceeds may go toward their care.

The Senate panel’s upcoming hearing in Washington, D.C., could lead to an overhaul of the guardianship programs nationwide, including Florida, and more oversight of its practices in caring for those deemed incapacitated.

“Guardianship is dangerous because of rampant guardianship overuse to abuse,” wrote Marian Kornicki, a New York woman who wrote to the Senate committee about her family’s horrific experience with the guardianship program in her state.

Kornicki later joined Victims and Families Harmed by Guardianship, whose mission is to protect older Americans and disabled individuals of all ages from exploitation by state probate guardianships.

Kornicki and other advocates had emailed the committee, urging it to hold hearings and citing the investigative stories by WLRN and Bloomberg Law.

Full Article & Source:
U.S. Senate panel to investigate guardianship program practices nationwide

Hillsborough County housing crisis forcing elderly residents into homelessness

"It's happening to everybody," said Michael Jones.

Hillsborough County housing crisis forcing elderly residents into homelessness

Thursday, March 30, 2023

Guardians’ Abuses Persist as One State’s Easy Fix Goes Unmatched

by  Ronnie Greene

Across the US, uneven oversight and accountability mar the legal process by which adults are placed under guardianship. The lack of rigor has opened the door to stolen funds, judicial errors, bulging caseloads, and legal entanglements for vulnerable people.

But one straightforward reform could help ensure adults placed under guardianship aren’t abused, defrauded, or silenced. Nevada overhauled its system and achieved meaningful results. Advocates are waiting for the rest of the country to catch up.

Triggered by high-profile guardianship scandals, Nevada in 2017 began requiring independent lawyers be assigned to represent adults whenever a petition for guardianship is filed. This legal help comes at no cost, much like in criminal cases where indigent defendants are guaranteed free counsel.

States typically say adults under guardianship have a right to counsel, but Nevada goes significantly further. It requires that representation come before a petition is approved, that the lawyer’s sole role is to represent the protected person’s interests, and that the legal guidance is free. Court fees pay the costs.

With more than 2 million people, Clark County, home to Las Vegas, is the epicenter of a system in which legal aid lawyers scrutinize guardianship petitions.

The idea was to stop guardians from depriving people unnecessarily of their liberty and stealing their money. “Before the scandal, most of the time the individual and their families didn’t even have notice that this was going on or didn’t have the ability to challenge it,” said Barbara Buckley, executive director of the Legal Aid Center of Southern Nevada.

When a petition is filed, Buckley said, lawyers start by asking their clients to-the-point questions.

“Do you know a guardianship has been filed against you? And in some cases, they may say yes, this is my daughter and I need their help and this is fine,” she said. “In some cases, they say, ‘What? By who? I have never met this person before in my life.’”

When the client has grounds to push back, Legal Aid Center lawyers press the point in court.

In 2021, they defeated 25% of guardianship petitions in Clark County, according to the center’s most recent annual report. The core reason: The guardianship wasn’t needed.

In January, Buckley said the office had 2,344 open adult guardianship cases, plus 563 involving minors. Buckley’s staff includes 15 adult guardianship attorneys, four focusing on minor guardianship cases, four advocates, and five legal assistants. Its annual budget for the unit: $3.2 million.

Filling a Void

Nevada’s overhaul alone couldn’t resolve all the problems documented in the Bloomberg Law series. But having independent lawyers on the front end, courthouse veterans say, can steer away unnecessary cases and provide protection for vulnerable adults.

Such protections are crucial. Across the US, adults can be placed under guardianship with little warning or legal help; once in, they encounter a system in which guardians are rarely regulated or certified, and where judges often provide scant scrutiny. More stringent oversight could’ve aided Britney Spears, who spent years fighting a conservatorship.

Lawyers like those in Nevada fill a void, providing accountability often sorely lacking.

Nevada’s system is “a wonderful step forward,” said Erica Wood, the former assistant director of the American Bar Association Commission on Law and Aging.

She noted that many state laws provide a right to counsel, but that can be “an empty right” unless the court consistently appoints counsel for those without representation and the state covers the cost for those who can’t pay. “Having the right to counsel doesn’t mean the person will actually get counsel in practice–or if they do, often it’s not counsel as an independent advocate but more of a court investigator.”

A December 2022 ABA survey bears this out. At least 25 states say those under guardianship are “entitled” to counsel, have the “right to be represented,” or can request counsel, all standards below Nevada’s mandate. Another 21 states say counsel “shall” be appointed, but that can be murky. Pennsylvania says, for instance, that counsel “shall be appointed in appropriate cases.” Maine says lawyers shall be appointed “when respondent requests” or under other conditions.

New Hampshire, by contrast, says the right to counsel is “absolute, unconditional,” and the state seeks to avoid unnecessary guardianships. Nevada says legal counsel “must” occur.

So why aren’t others following Nevada’s model?

“All of this stuff costs money,” said Alice Liu McCoy, who became executive director of New Mexico’s Developmental Disabilities Council after guardianship fraud left that state agency in turmoil.

McCoy, a former disability rights lawyer, said guardianship is too often a first resort when it should be the last. She agrees the changes to Nevada’s system have worked.

Alice Liu McCoy became executive director of New Mexico’s Developmental Disabilities Council after a guardianship scandal rocked the state.
Photographer: Adria Malcolm/Bloomberg

Legal Help

Across the country, independent lawyers have been the difference in guardianship cases for those who get trapped in the system, Bloomberg Law found.

In Indiana, disability rights lawyer Justin Schrock helped Nicholas Clouse end a guardianship that lasted several years after he recovered from a brain injury sustained in a traffic accident; Clouse remained under guardianship even after marrying, having a child, and gaining work. Now Schrock is working to help Sara Abbott, a young adult with autism whose case was also detailed earlier in this series, terminate a guardianship in which her former guardian billed nearly Abbott’s entire monthly income while questioning the family’s spending.

Georgia Advocacy Office senior staff attorney Julie Kegley helped Kalei Bulwinkle be freed from guardianship in a case in which the local judge was found to have improperly restricted her rights. In Texas, disability rights lawyer Kayla Puga helped Ruby Campos end her guardianship more than a decade after it began. “One of the biggest decisions I couldn’t make on my own was the right to speak for myself,” Campos said.

Without such legal backing and support, fraud or abuse can fester.

In New Mexico, directors of Ayudando Guardians stole nearly $12 million from 1,000 clients, leaving many destitute as the guardians globe-trotted and rented sports skyboxes. In Nevada, a court-appointed financial guardian named April Parks was sent to prison for up to 40 years in 2019 after admitting she stole more than half a million dollars.

Bloomberg Law asked legal professionals to analyze topics including the role guardianship plays in states and what reforms would serve vulnerable populations.

No Traction

With more transparency, abuses occurring in the shadows could come to light.

“All other states have done an excellent job of making sure that investigations like I ran in Nevada are almost impossible to do,” he said. “Because this profit center today is so big.” Experts speculate that guardians control more than $50 billion in assets for those under court control.

In Nevada, the changes have made a tangible difference.

Legal Aid Center lawyer Debra Bookout helped Victoria Gonzales, a 35-year-old woman with cerebral palsy, terminate a guardianship that had lasted more than a decade.

Victoria Gonzales, at left, escaped her guardianship with help of Legal Aid Center lawyer Debra Bookout.
Photographer: Bridget Bennett/Bloomberg

Gonzales had been adopted by her grandmother. But after her grandmother died, another relative became Gonzales’ guardian in 2009. Gonzales said she felt powerless. She later connected with Bookout, directing attorney for the office’s Guardianship Advocacy Project, and, in court in November 2021, officially escaped the system.

“Victoria, we’re going to give you your wish. We’re going to give you back your guardianship,” she recalled the judge saying. Her first thought: “Freedom!”

Now living on her own and working as a movie theater usher, she said she finally feels empowered to make her own decisions. “I feel like there’s a whole bunch of confidence,” she said, “and no one can tell me what to do.”

Full Article & Source:
Guardians’ Abuses Persist as One State’s Easy Fix Goes Unmatched

See Also:
In the Name of Protection, Part 1: The Profiteers: Guardians' Dark Side: Lax Rules Open the Vulnerable to Abuse

In the Name of Protection, Part 2: The Judges: Judge’s Errors, Jail Threats Haunt Georgia Family’s Guardianship

In the Name of Protection, Part 3: The Profiteers: 420 Cases, One Guardian: System Runs Amok on Just $35 a Month

In the Name of Protection, Part 4: The Lawyers: Peter Max’s Bare Ledgers Show Guardianships Drain Even the Rich


Not Just Britney: Guardianship System Rife With Abuse (Podcast)

by David Schultz

Court supervised guardianships are meant to protect people who can no longer manage themselves and their assets. But a Bloomberg Law investigation found that people in guardianships can easily be taken advantage of, and that getting out of one is extraordinarily difficult.

Listen here and subscribe to On The Merits on Apple Podcasts, Spotify, Google Podcasts, Megaphone, or Audible.

Reporters Ronnie Greene and Holly Barker just released a five-part series that looks at how guardianships can go wrong—from wealthy celebrities like Britney Spears to indigent senior citizens.

They join our weekly podcast, On The Merits, to talk about how a lack of oversight creates conditions ripe for fraud and abuse. Holly discusses the particularly galling case of a New Mexico guardianship company that stole millions from its clients and whose CFO she spoke to from jail.

Do you have feedback on this episode of On The Merits? Give us a call and leave a voicemail at 703-341-3690.

Full Article & Source:
Not Just Britney: Guardianship System Rife With Abuse (Podcast)

Elkton lawyer disbarred for misappropriating ‘hundreds of thousands’ from client

By: Madeleine O'Neill

A unanimous Maryland Supreme Court has disbarred a Cecil County lawyer who used a client’s power of attorney to withdraw hundreds of thousands of dollars from the woman’s bank account without permission.

The lawyer, Wendy B. Culberson, stopped practicing law in 2020 and claimed she “has no intention to practice or seek to practice law again,” according to the Supreme Court’s 31-page opinion.

Even so, her misappropriation of hundreds of thousands of dollars and subsequent efforts to cover up the misconduct merit disbarment, Justice Brynja M. Booth wrote.

“To say that misappropriation of a client’s funds ‘reflects adversely on the attorney’s honesty, trustworthiness or fitness’ is an understatement and constitutes an obvious violation of (the Maryland Attorneys’ Rules of Professional Conduct),” Booth wrote.

Culberson, who worked as a solo family law practitioner in Maryland from 1995 until 2020, could not be reached for comment. She did not appear for an evidentiary hearing on the Attorney Grievance Commission’s allegations in October 2022 and represented herself in oral argument before the Maryland Supreme Court, according to the opinion.

Acting Maryland Bar Counsel Erin A. Risch declined to comment on the case.

The disciplinary proceedings against Culberson stemmed from her representation of Gabrielle Buck, who lives on the Mt. Ararat Farm in Port Deposit, and is the beneficiary of two family trusts that were valued at $23 million as of 2014, according to the opinion.

Buck hired Culberson in 2014 to help manage her business interests and the farm, which cost several thousand dollars per month in upkeep and other expenses.

Buck agreed to pay Culberson a flat monthly fee of $3,500, with the cost of any additional legal matters to be added on top of the monthly fee. The agreement also required Culberson to provide Buck with an accounting of all payments made for Culberson’s services.

For the next two years, Buck wrote checks from her bank account to Culberson to cover the monthly fee and some additional expenses. In 2016, on Culberson’s advice, Buck gave the lawyer power of attorney and access to her bank account and to another account that held funds intended for the farm.

From April 2016 through July 2019, Culberson made 323 cash withdrawals totaling more than $940,000, according to the opinion. She deposited $342,500 into the farm bank account but could not account for the other $597,797 that was not deposited into the bank account, a hearing judge found.

Culberson did not provide her client with any documentation to support payments of more than $133,000, the amount in monthly fees she would have earned during that time, the hearing judge concluded. Culberson told Buck that the withdrawals were used to pay farm bills or to cover other expenses.

“The hearing judge found that Ms. Culberson failed to advise Ms. Buck that Ms. Culberson retained the majority of the cash withdrawals for her own personal use and benefit,” Booth wrote.

Buck terminated Culberson’s representation in July 2019 after discovering the cash withdrawals from her account. Culberson later provided Buck with invoices totaling about $300,000 for legal work, though they included costs that should have been covered under her monthly fee and did not provide an accounting for the cash withdrawals from Buck’s bank account, according to the opinion.

When bar counsel requested information from Culberson about the withdrawals, Culberson claimed that Buck had increased the monthly fee to $5,000 and had asked Culberson not to provide invoices.

The hearing judge concluded these were intentional misrepresentations, and that spreadsheets Culberson provided to bar counsel to explain the withdrawals contained numerous errors and had been created after the fact to cover up the misappropriation of funds.

The Supreme Court agreed with the hearing judge’s findings that Culberson violated attorney ethics rules governing communication with clients, conflicts of interest, safekeeping property, record-keeping and general misconduct.

The court overruled a series of exceptions raised by Culberson and found that the sole mitigating factor in her favor, a lack of prior disciplinary history, did not support a lesser penalty than disbarment.

Full Article & Source:
Elkton lawyer disbarred for misappropriating ‘hundreds of thousands’ from client

Wednesday, March 29, 2023

Senate Committee Sets Hearing on Troubled Guardianship System

The Senate’s Special Committee on Aging will hold a hearing on March 30 examining guardianships.
Photographer: Samuel Corum/Bloomberg

by Ronnie Greene

The US Senate’s Special Committee on Aging announced a hearing for March 30 on guardianships, a judicial process dogged by scattershot rules, restrictive rights, and scant oversight.

The hearing is intended to allow senators to hear from those affected by guardianships, potentially pointing the way to an overhaul of the system.

A Bloomberg Law investigation published this month, In the Name of Protection, explored the dark world of adult guardianships, where people placed under court-ordered control lose many of their rights while reporting to guardians rarely required to be formally trained or certified.

In the worst abuses, guardians have stolen millions of dollars while depriving the so-called “protected person” of their rights to make decisions on everything from entering contracts to buying property to marrying. It’s the same legal process that pop star Britney Spears fought to escape.

Next week’s hearing is entitled Guardianship and Alternatives: Protection and Empowerment.

Guardianships are run by states, and each state has its own rules. But experts and those affected by them told Bloomberg Law the Senate committee can push for changes so that the system operates under more uniform rules nationwide. Guardianships should be seen as a final resort, they say, not the first option.

“Once a person is in guardianship, it’s like stepping in quicksand – the harder one tries to get out, the quicker the person sinks,” said Elaine Renoire, a director with the National Association to Stop Guardian Abuse. “The best way to avoid guardianship abuse is to avoid guardianship.”

Renoire is among those supporting a uniform guardianship code that would be adopted by every state. Thus far, just a few states have done so.

Erica Wood, the former assistant director of the American Bar Association Commission on Law and Aging, said a vital reform would be to have legal counsel represent people every time someone files a petition for guardianship. Such a requirement is now rare across the US. Wood, too, supports “a much more full-fledged examination of less restrictive options” to guardianship before any court order.

Julie Kegley, senior staff attorney with the Georgia Advocacy Office, said her office supports changes such as having federal agencies, including the Department of Justice, train judges on the harms of guardianships.

Morgan Whitlatch, a director with the Center for Public Representation public interest law firm, said the federal government “must simultaneously and equally invest in strategies that encourage states and territories to divert their constituents away from guardianship and court systems and towards less restrictive options.”

The office of U.S. Sen. Robert P. Casey Jr., chairman of the Senate Special Committee on Aging, didn’t respond to two interview requests Thursday.

Full Article & Source:
Senate Committee Sets Hearing on Troubled Guardianship System

Taylorsville woman charged for allegedly stealing thousands from injured sister’s special needs trust fund

by: Chin Tung Tan

TAYLORSVILLE, Utah (ABC4) — A Taylorsville woman has been charged after allegedly stealing thousands of dollars from a special needs trust fund set up for her sister who was involved in a serious accident a few years ago.

Marcey Jean Heisey, 43, was charged at the Third District Court in Salt Lake County on Monday, March 13, with second-degree unlawful deal of prop by fiduciary and second-degree financial exploitation of a vulnerable adult. 

Heisey’s sister reportedly contacted the Taylorsville Police Department in November 2022 to report that Heisey had withdrawn a lot of money from a trust fund for personal use. According to court documents, the sister, who resides in Oklahoma, said she was involved in a serious traffic accident a few years ago in Utah and, as part of the settlement, she received $68,000 in a special needs trust fund. Heisey was appointed a trustee for the trust account.

In December 2022, Heisey reportedly purchased a new truck worth $9,000 with money from the trust and had only been giving her sister only about $500 per month for the past few months. Heisey had also allegedly made transactions with tanning services, Facebook and Cash App through the trust fund account. 

Detectives requested a balance for the account statement and found that the amount of money in the account went from around $64,000 in March 2022 to under $3,900 in November 2022.

According to court documents, an employee of America First Credit Union confirmed that Heisey made several in-person cash withdrawals between September 2022 and October 2022 that added up to about $11,940.

Heisey’s sister reportedly told detectives that Heisey called her on Thanksgiving and begged her not to pursue fraud charges against her. When the sister requested Heisey to pay the heating bills using the trust money, Heisey sent her a generator valued at $713.74 instead, the charging documents stated.  

Full Article & Source:
Taylorsville woman charged for allegedly stealing thousands from injured sister’s special needs trust fund

Tuesday, March 28, 2023

Ex-Beachwood lawyer who bilked special-needs clients’ trusts gets prison

Dorothea Kingsbury, 70, was sentenced on March 15, 2023, to four years in prison after she pleaded guilty to stealing misappropriating hundreds of thousands of dollars from clients.Cory Shaffer,

By Cory Shaffer

CLEVELAND, Ohio -- A 70-year-old former attorney who stole hundreds of thousands of dollars belonging to her mostly elderly and special-needs clients was sentenced Wednesday to prison.

Cuyahoga County Common Pleas Court Judge Jeffrey Saffold told Dorothea Kingsbury that placing her on probation after pleading guilty to second-degree felony theft and other charges for the yearslong scheme would “disrespect all of the truly bad deeds” she had committed.

Instead, the judge sentenced her to spend the next four years in prison.

“Of all of the people in the world to steal from, you picked the absolute most vulnerable among us,” Saffold said. “When I think of your behavior here, I’m stuck with the word ‘despicable.’ If you have remorse, I think you would agree with that statement.”

Kingsbury, who had asked Saffold to spare her a prison sentence, answered quietly, “Yes sir.”

Kingsbury, of Mayfield, pleaded guilty in September 2021 to theft and attempted theft -- both second-degree felonies -- as well as money laundering. She also pleaded guilty in a separate case to failing to file state income taxes for five years, which is a fifth-degree felony.

The charges carried a maximum sentence of more than 20 years in prison.

Kingsbury, whose legal career spanned four decades, agreed to forfeit her law license as part of the plea bargain. She also has repaid $125,000 and agreed to forfeit money in her retirement accounts to pay back the more than $500,000 that is still unaccounted for.

Saffold said during the sentencing that he would consider letting Kingsbury out of prison early, but only if she continues to pay back the surviving victims and locate the missing money.

Her sentencing was delayed when she was referred in January 2022 to the court’s psychiatric clinic.

Kingsbury admitted to taking nearly $600,000 from her clients’ trusts from 2012 to 2017 without explanation and transferring hundreds of thousands of dollars more between a total of 22 people’s accounts to cover up her financial malfeasance.

All told, investigators uncovered nearly $1.2 million in questionable transactions that Kingsbury made with money from the accounts she managed.

Assistant Cuyahoga County Prosecutor J.D. May said during the hearing that, after a forensic examination of the accounts that Kingsbury pilfered, investigators still cannot account for a large portion of the money.

Nearly all of Kingsbury’s victims were severely mentally and developmentally disabled. Some of them could not read or write.

Several family members and attorneys who serve as guardians to Kingsbury’s clients told Saffold that the money in their trusts was meant to pay for medical expenses that Medicare and Medicaid would not cover, including trips to dentists and wheelchairs.

Michelle Owen brought her sister, who lost $29,000 to Kingsbury’s crimes, into the courtroom. Owen moved her sister’s wheelchair so she would face directly at Kingsbury.

“This is the person whose heart you broke,” Owen said.

The sister twice told Owen that she loved her as Owen spoke to the judge.

“I love you, too, baby,” Owen replied, as she ruffled her sister’s short gray hair.

Kingsbury stole more than $50,000 from Theresa Manary’s brother. Manary decided to speak directly to the former attorney.

“I don’t know how you sleep at night,” Manary said.

Michael Lear, who defended Kingsbury alongside Larry Zukerman, asked Saffold to spare his client prison time.

Lear pointed to a court psychiatrist’s diagnosing of Kingsbury with depression, stress disorder and caretaker fatigue at the time she began the thefts. He also said that Kingsbury was working to pay back the money, and she was one of the most remorseful clients he has ever had.

Kingsbury read from a written statement in which she apologized to her victims and their families.

“Those families deserved the highest level of care and service from me, and I failed miserably,” she said. “The words ‘I’m sorry’ hardly convey the depth of grief and the number of sleepless nights that I have suffered, but they are the only words I have to offer.”

After Saffold announced the prison sentence, Lear asked if the judge would consider allowing Kingsbury to go home and report to prison at a later date.

“No, I think she needs go out the side door today,” Saffold said.

Sheriff’s deputies handcuffed Kingsbury and escorted her out of the courtroom.

After the hearing, the families of the victims said they were grateful that Kingsbury received a prison sentence.

“Seeing the handcuffs getting slapped on was most satisfying,” Karen Farrell, a friend of Manary who attended the sentencing, said after the hearing.

Manary and Owen agreed.

“I thought if they don’t punish her, then other lawyers may see this and think, ‘I can do this and get a slap on the hand too,’” Manary said. “And that cannot happen.”

Full Article & Source:
Ex-Beachwood lawyer who bilked special-needs clients’ trusts gets prison

See Also:
Cleveland lawyer indicted for taking funds from elderly, disabled people she served for as guardian

 Additional charges against Pepper Pike attorney accused of misappropriating funds: Update


Families of developmentally disabled people beg Gov. Hochul for more staffing

They want the governor to inject more cash into the budget to make sure families needing services are not left behind. CBS2's Carolyn Gusoff reports.

Families of developmentally disabled people beg Gov. Hochul for more staffing

92-Year-Old Man Found And Rescued By #teamHCSO

The Hillsborough County Sheriff's Office has rescued a 92-year-old man with dementia, reuniting him with his wife. "We are grateful that #teamHCSO deputies and our K9s were able to locate this man and bring him home," said Sheriff Chad Chronister. "This is a fantastic example of our team working together to serve and protect the residents of Hillsborough County."

92-Year-Old Man Found And Rescued By #teamHCSO 

Monday, March 27, 2023

Two Pa. Senate panels delve into guardian legislation

by Robert Swift

HARRISBURG – Legislation to upgrade state guardianship laws for incapacitated individuals was the subject of a hearing Tuesday by two Senate committees.

The Aging and Youth and Judiciary committees heard testimony from a judge, lawyers, advocates for senior citizens and disability rights advocates about Senate Bill 506 sponsored by Judiciary Majority Chair Lisa Baker, R-Luzerne, and Sen. Art Haywood, D-Montgomery.

“The bill before us has its roots in an embezzlement case that victimized over 100 people,” said Ms. Baker at the hearing’s start.

The bill’s goal is to ensure that the incapacitated have proper legal representation and their rights are safeguarded, added Ms. Baker.

SB506 would require that legal counsel be appointed as an advocate in guardianship proceedings regardless of one’s ability to pay and require guardians who represent three or more incapacitated people to meet certification requirements set by the Pennsylvania Supreme Court.

SB506 would also require courts to consider less restrictive alternatives before appointing a guardian and obtain findings of fact in a case. These alternatives could include advanced directives, living wills, powers of attorney for health care and finances and appointing representatives to handle paying bills and other financial matters.

Under current state law, appointing a legal counsel in guardianship cases is discretionary and there is limited oversight over guardians, said Ms. Baker.

More than 18,000 Pennsylvanians had been judged incapacitated and had guardians as of the end of 2022, said Montgomery County Judge Lois Murphy, a member of the Pennsylvania Supreme Court’s advisory council on elder justice in the courts.

These guardians collectively oversee $1.58 billion of funds, Judge Murphy added, based on a statewide tracking system started in 2018. Family members are guardians in 62% of cases, and 44% of guardian cases involve individuals over age 60.

Pennsylvania can expect more issues with the guardianship system as the population ages, said Aging and Youth Majority Chair Judy Ward, R-Blair.

“Placing a guardian in charge of a person’s medical, financial and other important life decisions should never be done lightly,” said Judge Murphy. “We have a duty in every case to protect the constitutional rights of the individual who may be deprived or his or her liberty and autonomy.”

The advisory council supports the concepts in the legislation that require certification and education of guardians and requiring courts to consider less restrictive alternatives to guardianship, added Judge Murphy.

Passing SB506 would move Pennsylvania forward towards meaningful reform of the guardian system, said Teresa Osborne, director of state advocacy for the AARP Pennsylvania Office and a former state aging secretary.

“AARP recognizes that guardianship reform means that in addition to updating state laws, we must also work with state courts and other stakeholders – including our state’s network of local Area Agencies on Aging – to improve the day-to-day practice of guardianship,” said Ms. Osborne.

Attorneys are getting more involved in guardianship cases as public agencies helping the disabled and aging face funding issues, said Sally Schoffstall, an elder law attorney in Lehigh County.

The Pennsylvania Association of Elder Law Attorneys seeks additional state funding to ensure that competent legal counsel can act on a timely basis and allow for review of guardianship reports, certification of professional guardians and training of non-professional guardians, she added.

The Pennsylvania Bar Association strongly supports SB506, said attorney Pamela Walz.

“We also strongly support the bill’s definition of the role of counsel as an advocate for the client’s expressed wishes and consistent with the client’s instructions, wherever the client is able to express wishes and provide instruction,” said Ms. Walz.

Full Article & Source:
Two Pa. Senate panels delve into guardian legislation

Guardianship Sought Over Elderly Man in Water Pipe Break Suit vs. Insurer

A woman is seeking guardianship over her elderly husband as the couple pursue a lawsuit against California Automobile Insurance Co., alleging that they were wrongfully denied proper coverage and benefits after a pipe broke in their San Fernando Valley home in 2022.

Dal Woong Park, 81, and his 77-year-old wife, Seung Ran Park, brought the breach of contract and negligent misrepresentation suit in Los Angeles Superior Court last June 1. Dal Park is permanently disabled from a traumatic brain injury and stroke, according to the suit, which also states that the claim denial forced the couple into inferior housing and caused the husband to become irritable and at times violent.

In court papers filed Feb. 14, attorneys for the couple say the appointment of Seung Park as guardian for her husband is necessary because his current mental condition renders him unable to communicate in a coherent manner for any significant period of time.

“For example, Mr. Park is unable to follow a conversation of any significant length, understand anything other than basic questions directed at him or communicate his own thoughts in a coherent manner,” the couple’s lawyers state in their court papers. “Providing testimony is therefore beyond his abilities.”

Dal Park thus cannot evaluate and determine if strategic decisions in the lawsuit, such as whether to accept a settlement offer, are in his best interests, according to the couple’s attorneys’ court papers.

During a conference dealing with discovery in the lawsuit on Tuesday, Judge Maureen Duffy-Lewis suggested that the couple’s attorneys check with the probate court about the guardianship appointment.

CAIC is a subsidiary of Brea-based Mercury General Corp., which dropped earlier as a defendant in the suit. In their court papers, CAIC lawyers deny any wrongdoing on the part of the insurer and say the plaintiffs were in breach of a condition of their policy.

According to the suit, the couple bought a homeowners policy in December 2021 for their one-story, 3,200-square-foot, ranch-style home on Vintage Street in Northridge. The policy provided that if the couple’s home is not fit to be habitable, the insurer would cover any necessary increase in living expenses incurred by the plaintiffs so they can maintain their normal standard of living, according to the suit.

The couple filed a claim in January 2022 after a water pipe under their concrete slab foundation leaked and caused damage, the suit states. CAIC had an obligation to tell the plaintiffs their rights, review the claim in good faith, confirm coverage, assist the couple in relocating to a house that would allow them to maintain their normal standard of living and pay for repairs, the suit states.

“Instead, the insurer has dragged its feet, transferred the claim to multiple new adjusters, insisted on countless, never-ending inspections, refused to confirm coverage in a timely manner and refused reasonable payment for repairs and loss of use required by its policy,” the suit states.

The insurer has also repeatedly ignored emails and calls and refused to provide the plaintiffs updates as the law requires, the suit states.

Due to the husband’s brain injury and prior stroke, he becomes easily confused and agitated, can get around only with the assistance of a wheelchair and cane and is cared for by his wife, the suit states.

While repairs are made, the couple was forced to move out of their one-story home that accommodates their needs and initially reside in their son’s two-story house before being given housing at a motel, the suit states. At minimum, the insurer should have provided replacement housing that maintained the plaintiffs’ standard of living, the suit states.

The insurer offered a $4,000 monthly stipend from Jan. 17 to June 15, 2022, but it is not enough to maintain their standard of living, the suit states.

Due to the lengthy displacement and living conditions, the couple’s health has deteriorated substantially, the suit states. The husband’s agitation has increased and his violent trait is unfamiliar to his wife and family, according to the suit.

“The wife now has difficulty caring for her husband, who may become violent at any point, and she is experiencing her own anxiety and depression,” the suit states.

Full Article & Source:
Guardianship Sought Over Elderly Man in Water Pipe Break Suit vs. Insurer

US Senate Special Committee on Aging Hearing 3/30/23: Guardianship and Alternatives: Protection and Empowerment

Full Committee Hearing

        Thursday, March 30, 2023
Time:         10:00 am
Location:    SD-106 

Witnesses:  Dr. Tina Paone
                    Professor & Licenses Therapist
                    Landsdale, PA

                    Mr. Ryan King
                    Guardianship Reform Advocate
                    Accompanied by Mr. Susie King, Ryan's Mother
                    Washington, DC

                    Mr. Nick Parker
                    Staff Attorney, Adult Guardianship Office
                    Indiana Office of Court Services, Indiana Supreme Court
                    Indianapolis, IN

                     Dr. Karrie Shogren
                     Director, KS University Center on Developmental Disabilities
                     Lawrence, KS

 WATCH THE HEARING: Guardianship and Alternatives: Protection and Empowerment

Sunday, March 26, 2023

State making thousands of wellness checks to developmentally disabled group homes

State making thousands of wellness checks to developmentally disabled group homes

After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates

Jen Coghlan sits with her father, Henry Ruhl, in his 832-square-foot home in Perry, Iowa. The home, valued for taxes at $81,470, is Ruhl’s main asset. Ruhl intends to leave the house to Coghlan after he dies, but she expects she’ll have to sell it to settle a large bill from the state Medicaid program for the care of her mother, who died in January 2022. (KC McGinnis for KHN)

By Tony Leys

PERRY, Iowa — Fran Ruhl’s family received a startling letter from the Iowa Department of Human Services four weeks after she died in January 2022.

“Dear FAMILY OF FRANCES RUHL,” the letter began. “We have been informed of the death of the above person, and we wish to express our sincere condolences.”

The letter got right to the point: Iowa’s Medicaid program had spent $226,611.35 for Ruhl’s health care, and the government was entitled to recoup that money from her estate, including nearly any assets she owned or had a share in. If a spouse or disabled child survived Ruhl, the collection could be delayed until after their death, but the money would still be owed.

The notice said the family had 30 days to respond.

“I said, ‘What is this letter for? What is this?’” said Ruhl’s daughter, Jen Coghlan.

It seemed bogus, but it was real. Federal law requires all states to have “estate recovery programs,” which seek reimbursements for spending under Medicaid, the joint federal and state health insurance program for people with low incomes or disabilities. The recovery efforts collect more than $700 million a year, according to a 2021 report from the Medicaid and CHIP Payment and Access Commission, or MACPAC, an agency that advises Congress.

States have leeway to decide whom to bill and what type of assets to target. Some states collect very little. For example, Hawaii’s Medicaid estate recovery program collected just $31,000 in 2019, according to the federal report.

Iowa, whose population is about twice Hawaii’s, recovered more than $26 million that year, the report said.

Iowa uses a private contractor to recoup money spent on Medicaid coverage for any participant who was 55 or older or was a resident of a long-term care facility when they died. Even if an Iowan used few health services, the government can bill their estate for what Medicaid spent on premiums for coverage from private insurers known as managed-care organizations.

Supporters say the clawback efforts help ensure people with significant wealth don’t take advantage of Medicaid, a program that spends more than $700 billion a year nationally.

Critics say families with resources, including lawyers, often find ways to shield their assets years ahead of time — leaving other families to bear the brunt of estate recoveries. For many, the family home is the most valuable asset, and heirs wind up selling it to settle the Medicaid bill.

For the Ruhl family, that would be an 832-square-foot, steel-sided house that Fran Ruhl and her husband, Henry, bought in 1964. It’s in a modest neighborhood in Perry, a central Iowa town of 8,000 people. The county tax assessor estimates it’s worth $81,470.

Henry Ruhl, 83, wanted to leave the house to Coghlan, but since his wife was a joint owner, the Medicaid recovery program could claim half the value after his death.

Fran Ruhl, a retired child care worker, was diagnosed with Lewy body dementia, a debilitating brain disorder. Instead of placing her in a nursing home, the family cared for her at home. A case manager from the Area Agency on Aging suggested in 2014 they look into the state’s “Elderly Waiver” program to help pay expenses that weren’t covered by Medicare and Tricare, the military insurance Henry Ruhl earned during his Iowa National Guard career.

Coghlan still has paperwork the family filled out. The form said the application was for people who wanted to get “Title 19 or Medicaid,” but then listed “other programs within the Medical Assistance Program,” including Elderly Waiver, which the form explained “helps keep people at home and not in a nursing home.”

Coghlan said the family didn’t realize the program was an offshoot of Medicaid, and the paperwork in her file did not clearly explain the government might seek reimbursement for properly paid benefits.

Some of the Medicaid money went to Coghlan for helping care for her mother. She paid income taxes on those wages, and she said she likely would have declined to accept the money if she’d known the government would try to scoop it back after her mother died.

Iowa Medicaid Director Elizabeth Matney said that in recent years the state added clearer notices about the estate recovery program on forms people fill out when they apply for coverage.

“We do not like families or members being caught off guard,” she said in an interview. “I have a lot of sympathy for those people.”

Matney said her agency has considered changes to the estate recovery program, and she would not object if the federal government limited the practice. Iowa’s Medicaid estate collections topped $30 million in fiscal year 2022, but that represented a sliver of Medicaid spending in Iowa, which is over $6 billion a year. And more than half the money recouped goes back to the federal government, she said.

Matney noted families can apply for “hardship exemptions” to reduce or delay recovery of money from estates. For example, she said, “if doing any type of estate recovery would deny a family of basic necessities, like food, clothing, shelter, or medical care, we think about that.”

Sumo Group, a private company that runs Iowa’s estate recovery program, reported that 40 hardship requests were granted in fiscal 2022, and 15 were denied. The Des Moines company reported collecting money from 3,893 estates that year. Its director, Ben Chatman, declined to comment to KHN. Sumo Group is a subcontractor of a national company, Health Management Systems, which oversees Medicaid estate recoveries in several states. The national company declined to identify which states it serves or discuss its methods. Iowa pays the companies 11% of the proceeds from their estate recovery collections.

The 2021 federal advisory report urged Congress to bar states from collecting from families with meager assets, and to let states opt out of the effort altogether. “The program mainly recovers from estates of modest size, suggesting that individuals with greater means find ways to circumvent estate recovery and raising concerns about equity,” the report said.

U.S. Rep. Jan Schakowsky introduced a bill in 2022 that would end the programs.

The Illinois Democrat said many families are caught unawares by Medicaid estate recovery notices. Their loved ones qualified for Medicaid participation, not realizing it would wind up costing their families later. “It’s really a devastating outcome in many cases,” she said.

Schakowsky noted some states have tried to avoid the practice. West Virginia sued the federal government in an attempt to overturn the requirement that it collect against Medicaid recipients’ estates. That challenge failed.

Schakowsky’s bill had no Republican co-sponsors and did not make it out of committee. But she hopes the proposal can move ahead, since every member of Congress has constituents who could be affected: “I think this is the beginning of a very worthy and doable fight.”

Jen Coghlan outside the modest home where she grew up in Perry, Iowa. Her father, Henry Ruhl, plans to leave the home to her, but Coghlan expects she’ll have to sell it after he dies to help settle a large bill from Medicaid for the care of her mother, Fran, who died in January 2022. Coghlan says the family didn’t realize that her mother was on Medicaid and that they are responsible to pay the program back for her care. (KC McGinnis for KHN)

States can limit their collection practices. For example, Massachusetts implemented changes in 2021 to exempt estates of $25,000 or less. That alone was expected to slash by half the number of targeted estates.

Massachusetts also made other changes, including allowing heirs to keep at least $50,000 of their inheritance if their incomes are less than 400% of the 2022 federal poverty level, or about $54,000 for a single person.

Prior to the changes, Massachusetts reported more than $83 million in Medicaid estate recoveries in 2019, more than any other state, according to the MACPAC report.

Supporters of estate recovery programs say they provide an important safeguard against misuse of Medicaid.

Mark Warshawsky, an economist for the conservative American Enterprise Institute, argues that other states should follow Iowa’s lead in aggressively recouping money from estates.

Warshawsky said many other states exclude assets that should be fair game for recovery, including tax-exempt retirement accounts, such as 401(k)s. Those accounts make up the bulk of many seniors’ assets, he said, and people should tap the balances to pay for health care before leaning on Medicaid.

Warshawsky said Medicaid is intended as a safety net for Americans who have little money. “It’s the absolute essence of the program,” he said. “Medicaid is welfare.”

People should not be able to shelter their wealth to qualify, he said. Instead, they should be encouraged to save for the possibility they’ll need long-term care, or to buy insurance to help cover the costs. Such insurance can be expensive and contain caveats that leave consumers unprotected, so most people decline to buy it. Warshawsky said that’s probably because people figure Medicaid will bail them out if need be.

Eric Einhart, a New York lawyer and board member of the National Academy of Elder Law Attorneys, said Medicaid is the only major government program that seeks reimbursement from estates for properly paid benefits.

Medicare, the giant federal health program for seniors, covers virtually everyone 65 or older, no matter how much money they have. It does not seek repayments from estates.

“There’s a discrimination against what I call ‘the wrong type of disease,’” Einhart said. Medicare could spend hundreds of thousands of dollars on hospital treatment for a person with serious heart problems or cancer, and no government representatives would try to recoup the money from the person’s estate. But people with other conditions, such as dementia, often need extended nursing home care, which Medicare won’t cover. Many such patients wind up on Medicaid, and their estates are billed.

On a recent afternoon, Henry Ruhl and his daughter sat at his kitchen table in Iowa, going over the paperwork and wondering how it would all turn out.

The family found some comfort in learning that the bill for Fran Ruhl’s Medicaid expenses will be deferred as long as her husband is alive. He won’t be kicked out of his house. And he knows his wife’s half of their assets won’t add up to anything near the $226,611.35 the government says it spent on her care.

“You can’t get — how do you say it?” he asked.

“Blood from a turnip,” his daughter replied.

“That’s right,” he said with a chuckle. “Blood from a turnip.”

Fran Ruhl often left affectionate notes for her husband, Henry, in their home in Perry, Iowa. Several are still posted, a year after her death. (KC McGinnis for KHN)

Full Article & Source:
After People on Medicaid Die, Some States Aggressively Seek Repayment From Their Estates