Hos­pital dis­charge law con­cerns advoc­ates

by Sarah Volpen­hein

A bill passed by the Wis­con­sin Legis­lature will make it easier for hos­pit­als to dis­charge cer­tain patients deemed inca­pa­cit­ated to nurs­ing homes, free­ing up hos­pital beds that might oth­er­wise be tied up for weeks.

The bill, which Gov. Tony Evers signed into law on March 20, has the sup­port of hos­pital sys­tems that com­plain of long, costly delays in dis­char­ging patients who can no longer make med­ical decisions for them­selves and haven’t des­ig­nated someone to act on their behalf. At present, they remain in the hos­pital while await­ing court pro­ceed­ings to appoint a guard­ian.

“This legis­la­tion will help ensure patients can move more quickly to the most appro­pri­ate set­ting for their recov­ery, while also improv­ing hos­pital capa­city for those who need hos­pital care,” said Kyle O’Brien, pres­id­ent and chief exec­ut­ive of the Wis­con­sin Hos­pital Asso­ci­ation, a trade group rep­res­ent­ing hos­pit­als.

The legis­la­tion was opposed by dis­ab­il­ity and aging rights advoc­ates, who say it cir­cum­vents the guard­i­an­ship pro­cess, designed to pro­tect the rights of vul­ner­able indi­vidu­als, and could res­ult in patients becom­ing con­fined to insti­tu­tions against their will.

“The guard­i­an­ship pro­cess is com­plex for a reason,” Lisa Has­sen­stab, pub­lic policy man­ager at Dis­ab­il­ity Rights Wis­con­sin, said dur­ing a Novem­ber hear­ing on the bill. “That reason is due pro­cess.”

The Sen­ate voted 28-5 in favor of the legis­la­tion on March 17 dur­ing what could be the body’s last floor ses­sion for the year.

The bill passed the Assembly in Feb­ru­ary with bipar­tisan sup­port, fol­low­ing an amend­ment adding price trans­par­ency require­ments for hos­pit­als.

Health sys­tems engaged in heavy lob­by­ing for bill

The legis­la­tion received a major push from Wis­con­sin health sys­tems, hos­pit­als and industry trade groups, which col­lect­ively spent more than 400 hours lob­by­ing in favor of the bill, accord­ing to reports made to the Wis­con­sin Eth­ics Com­mis­sion.

Wis­con­sin hos­pit­als spend hun­dreds of mil­lions of dol­lars every year hous­ing patients who no longer need hos­pital care and are await­ing dis­charge or trans­fer to nurs­ing homes or other facil­it­ies. While the reas­ons behind

dis­charge delays are many, the bill addresses only the guard­i­an­ship issue.

It does not address other under­ly­ing causes, such as lim­ited bed avail­ab­il­ity at nurs­ing homes or the lack of med­ical facil­it­ies accept­ing com­plex patients.

Up until now, if phys­i­cians deemed a patient no longer able to make med­ical decisions for them­selves and they did not have a power of attor­ney, the hos­pital could not dis­charge the patient to a nurs­ing home until a guard­i­an­ship peti­tion was filed with a court, even when fam­ily mem­bers agreed to the trans­fer. Those pro­ceed­ings could take weeks or months, hos­pital offi­cials said.

The patient may be someone who had a stroke, suffered a trau­matic brain injury, or has demen­tia or another agere­lated dis­ease and lacks the abil­ity to man­age their own health care, whether tem­por­ar­ily or per­man­ently.

The new law removes the require­ment to file for guard­i­an­ship and allows a fam­ily mem­ber, called a patient rep­res­ent­at­ive, to agree to the patient’s admis­sion to a nurs­ing home, make health care decisions for them and approve health-related spend­ing.

Dis­ab­il­ity advoc­ates argue the legis­la­tion removes pro­tec­tions like court over­sight that come with the guard­i­an­ship pro­cess while also grant­ing a lot of the same author­ity as a guard­ian. They say the legis­la­tion does not require that the patient be noti­fied of the rep­res­ent­at­ive’s appoint­ment or of their rights to ask for a ree­valu­ation of their men­tal capa­city. Nor does it require the rep­res­ent­at­ive to con­sider the wishes of the patient, they say.

The legis­la­tion, they said, also lacks pro­tec­tions against an abuser or estranged rel­at­ive assum­ing the role.

“Often­times the per­son who is an abuser is the per­son who is really keep­ing an eye on the per­son in the hos­pital,” said Tami Jack­son, pub­lic policy ana­lyst and legis­lat­ive liaison with the Wis­conVon sin Board for People with Devel­op­mental Dis­ab­il­it­ies. “Some­body who gets picked under this bill ends up with a whole lot of author­ity.”

Under the new law, the patient or another fam­ily mem­ber may object to the nurs­ing home place­ment, if aware.

Any­one may ask a court to review the patient rep­res­ent­at­ive’s actions or may request a ree­valu­ation of the patient’s capa­city.

Exten­ded hos­pital stays can con­trib­ute to over­crowding

While pro­mot­ing the bill, health sys­tems argued that patients may miss out on cru­cial rehab­il­it­a­tion or other health care while wait­ing in the hos­pital for dis­charge. By remain­ing in the hos­pital, they also are at increased risk of hos­pital-acquired infec­tions or falls espe­cially dan­ger­ous for eld­erly patients.

From Janu­ary to Octo­ber 2025, Mayo Clinic Health Sys­tem coun­ted about 35 patients with exten­ded stays at its north­w­est Wis­con­sin hos­pit­als, Gina

Ruden, a Mayo senior nurse admin­is­trator, said at a Novem­ber hear­ing on the bill. At Mayo’s Eau Claire hos­pital, that added up to patients spend­ing a col­lect­ive 1,200 days in the hos­pital because of guard­i­an­ship delays, she said.

The exten­ded stays con­trib­ute to hos­pital over­crowding. Mayo Clinic has seen an influx of patients, Von Ruden said, ever since the abrupt clos­ure in 2024 of two area hos­pit­als by Hos­pital Sis­ters Health Sys­tem, a com­pet­ing health sys­tem.

When over­crowded, the Mayo hos­pital in Eau Claire has to board patients in the emer­gency depart­ment, Von Ruden said, where they may spend the rest of their hos­pital visit if no bed becomes avail­able on an inpa­tient floor.

“They might be in a hall­way in the emer­gency depart­ment or even in the ambu­lance bay when things get real tight,” Von Ruden said.

The bill has a three-year sun­set pro­vi­sion, which allows legis­lat­ors to check if the bill is work­ing as inten­ded before renew­ing it. 

Full Article & Source:
Hos­pital dis­charge law con­cerns advoc­ates 

Bills would cap number of guardianship clients, require monthly visits

by: The Unicameral Update

In the wake of evidence of guardians who are not adequately serving their clients, the Judiciary Committee heard testimony Jan. 29 on two proposals that seek to improve Nebraska’s guardianship system.

LB 985, sponsored by Bennington Sen. Wendy DeBoer, would prohibit a private person from accepting appointment as a guardian or conservator if they already have 20 clients.

DeBoer said the cap would mirror the one already in place for the state’s Office of Public Guardian, which serves as guardian when no alternative is available.

While abuse by a guardian is rare, she said, it does occur. In December of last year, she said, an alleged case of fraud and abuse was made possible, in part, by the lack of a cap on how many clients a private guardian may serve.

“The more individuals you serve as a guardian for, the more accounts you have access to and the more you can bill for your services,” DeBoer said. “In order to limit the potential for abuse, I believe a cap is necessary.”

Amy Miller testified in support of LB 985 on behalf of Disability Rights Nebraska. She said the organization has spent the last three years researching the state’s guardianship system.

Approximately 10,000 people are under guardianship in Nebraska, she said, and an estimated 90% of those are full guardianships — meaning the guardian makes almost all life decisions for the client.

“Your guardian gets to decide where you live, what type of medical care you receive, whether you’re able to get a job or take classes and all of the money matters related to your life,” Miller said. “It’s hard to imagine how one person with even 20 wards under their care could thoroughly represent all of those issues for so many people.”

Jina Ragland also supported the measure. Speaking on behalf of AARP Nebraska, she said a caseload cap would ensure that guardians aren’t stretched too thin.

“This [bill] would increase the likelihood that they could spend more time with older adults and respond quickly to emergencies,” Ragland said.

Tim Hruza testified in opposition to LB 985 on behalf of the Nebraska State Bar Association. Being a guardian is difficult and intense work, he said, and making it harder to find individuals who are willing to serve may not be the answer.

“Our concern is simply that a cap of 20, while well intended … may not get to the root cause [of the problem],” Hruza said.

The committee also heard testimony on LB 1178, sponsored by DeBoer, which would allow individuals under a guardianship or conservatorship to attend required hearings either virtually or in person. The bill also would require guardians to make at least monthly monitoring visits, keep written records of those visits and maintain periodic contact with care providers.

Finally, the bill would authorize courts to award costs and reasonable attorney’s fees in specified proceedings, payable either from the trust involved or by another party.

“Monthly visits ensure guardians actually know their ward’s current condition, living situation and needs, and are not just managing their affairs on paper,” DeBoer said.

Miller testified in favor of LB 1178. Currently, she said, guardians file an annual report that consists of two pages of questions. In examining those reports, she said, Disability Rights Nebraska found one attorney who indicated that he did not visit his ward of 10 years who lived only eight miles away.

“If any guardian doesn’t visit, how do they know the condition of their ward?” Miller said. “It makes common sense to go lay eyes on a person.”

No one testified in opposition to LB 1178 and the committee took no immediate action on either proposal.

The Unicameral Update is the official news service of the Nebraska Legislature. 

Full Article & Source:
Bills would cap number of guardianship clients, require monthly visits 

Letter to the editor: Vermont slow to comply with federal guardianship rules

The Vermont legislative bodies and probate courts have not been keeping up with the federal rules in state and federally licensed residential settings. This causes due process violations. 

Response to David Searles letter “In family division, guardianship is in name only”:

I believe that the Vermont Legislature and the Vermont probate courts need an education on developmental disabilities. Funding priorities are determined by the Adult Developmental Service Division. Yet, if funding is already available, it can be used appropriately under state and federal regulations.

Vermont operates under unique state managed care rules with the “goal of quality and cost containment.” In doing so, Centers for Medicaid federal rules must be implemented under the Vermont System of Care, as well. 

Most recently, Vermont was federally mandated to comply with a “legal guardian authorized Residency Agreement in all home and community based settings.” Vermont remained out of compliance since 2014 and was enforced to comply with the “settings rules” on March 17, 2023. 

The Vermont legislative bodies and probate courts have not been keeping up with the federal rules in state and federally licensed residential settings. This causes due process violations. Here is the new-to-Vermont residency agreement that was federally mandated by Centers for Medicaid. If Vermont does not comply, medical records matching legal guardian authorized disclosures may cause a failed integrity audit, causing sanctions.

It is my understanding that Vermont can legislate/enforce state compliance with Centers for Medicaid final rules, or a federal judge can mandate it, if individuals are being harmed because of it. Maybe there will be case-by-case reviews. I don’t know how out-of-compliance issues will be addressed. The Agency of Human Services Department of Vermont Health Access is deemed to provide full transparency to its stakeholders. 

My entity is awaiting Vermont licensure of providing housing under our mission statement until federal compliance issues are corrected. I am too honest and ethical to operate otherwise. The Department of Vermont Health Access ensures continuous improvement. It just appears to be taking a very … long … time, as the most vulnerable among us don’t have time to wait, or they may risk losing Medicaid from a failed integrity audit, or ending up under the Office of Public Guardian and the state chooses where they live. 

In my opinion, the Department of Aging and Independent Living federal mission statement needs to collaborate a bit closer with legal guardians to understand the unmet needs until the courts and legislative bodies catch up. A funding priority is based on a new need or a crisis. A crisis of a vulnerable loved one should be avoided with appropriate communication with those deemed with authority. This is called an “internal grievance” and can happen by bringing an issue to the grievance officer at the designated agency. 

Vermont made a “promise” after closing Brandon Training School. The most vulnerable need to be prioritized. Only the legal guardian can speak on their behalf and, as Mr. David Searles identified, the legal guardian voice is not being heard in the current system.

Speak up. Provide your designated agency with an independent clinical assessment of your loved one. Hold the designated agency accountable to providing the clinical recommendations in it. It is their job to do so.

Kathleen Burke Kourebanas

President, Martha’s Barn Inc. 

Essex

Full Article & Source:
Letter to the editor: Vermont slow to comply with federal guardianship rules

See Also:
Letter to the editor: In family division, guardianship is in name only

Letter to the editor: In family division, guardianship is in name only

How can the Legislature and judiciary allow second-class treatment of over 600 adults with developmental disabilities?

 

At the time the current family division system of guardianship for developmentally disabled adults was adopted in 1978, the procedural protections were in fact better than the protections in the probate court system.  

But in the following year and in amendments since, the Legislature revoked the old probate adult guardianship system and adopted a set of procedural protections and options far better than those now in the family division. For example, different from the probate division system, annual reports to the family division on the well-being of the person under guardianship are not required, nor is voluntary guardianship an option in the family division system. By today’s standards, guardianship through the family division has become guardianship in name only. 

It is not just a scattered number of cases throughout the state in which this is a problem.  A communication by the commissioner of the Department of Disabilities Aging and Independent Living to the Legislature in January 2023 shows there are more than 600 adult Vermonters with developmental disabilities over whom the family division has open guardianships.

The questions must be asked: How does the Legislature, and how does the judiciary, allow this abject impropriety to continue? Similarly, why do Vermont’s disability and civil rights organizations remain silent?  

David Searles

Full Article & Source:
Letter to the editor: In family division, guardianship is in name only

Guardianship reform being considered in Michigan legislature

Jehan Crump-Gibson, managing partner of the Great Lakes Legal Group, explains the importance of understanding who is overseeing finances within a family and the need for reform for guardianship rules in Michigan

Full Article & Source:
Guardianship reform being considered in Michigan legislature

A Dangerous Curve Ahead: Access to Florida Guardianship Proceedings at Risk

by Melody Lynch

 

This week, the Orlando Sentinel reported that The Florida Bar Board of Governors, at the recommendation of The Real Property Probate and Trust Law Section of The Florida Bar, is considering a proposal to change Florida’s guardianship law to further reduce and limit the information available to family members regarding their loved ones involved in guardianship proceedings. In addition to limitations on family members, the media and other groups would also be barred from accessing guardianship records if the new proposal is adopted and ultimately ends up in the legislature.

 

For a lawyer who frequently represents the family members of wards involved in Florida guardianship proceedings, this recommendation is extremely concerning since it would further limit information available to the families who are looking out for the best interests of their loved ones. If the new proposal becomes law, family members would be left in the dark when, for example, a guardian moves to sell a ward’s home and would be unable to receive and object to filings related to things such as the payment of fees for guardians or their lawyers – essentially giving carte blanche to utilize a ward’s assets to benefit the guardian and the lawyers who represent the guardian without appropriate checks and balances to protect the ward.

 

As we have repeatedly seen with the Rebecca Fierle professional guardian scandal, which resulted in the untimely death of at least one ward, family members play a vital role in keeping their loved ones safe. Sometimes guardianship proceedings are commenced without notice or an opportunity for family members to be heard at the initial hearing. When family members are not involved at the onset (and adequately represented by their own counsel), there is a higher likelihood for abuse, exploitation, and neglect of the ward and the ward’s express wishes. Pursuant to Florida law, the ward will be assigned a lawyer who is charged with representing the ward’s express wishes, not what the lawyer deems to be in the ward’s best interest. Nevertheless, left unchecked, the attorney for the ward has wide latitude and power to make significant changes affecting the ward’s life and livelihood and may not be arguing what is in the ward’s express interest.

 

It is extremely important for families to be represented and engaged in the guardianship process to protect their loved ones, even in cases when a professional guardian is appointed. Denying access to family members or other interested persons would further jeopardize the transparency and accountability of the guardianship system which may result in higher incidents of fraud, abuse, and neglect of Florida’s most vulnerable population.

Full Article & Source:
A Dangerous Curve Ahead: Access to Florida Guardianship Proceedings at Risk

Legislature adopts sweeping reforms for senior care homes

By Carrie Teegardin

A bill to improve staffing, training and accountability in Georgia’s senior care homes is headed to Gov. Brian Kemp after the House on Wednesday approved a Senate version of HB 987.

The House unanimously signed off on the Senate’s version of the bill, which added requirements for handling COVID-19 to the bill’s reforms of the senior care industry.

“I am so proud of Georgia’s House and Senate for making the necessary changes to ensure the safety of our seniors who choose to live in assisted living facilities,” said Rep. Sharon Cooper, R-Marietta, the lead sponsor of the bill.

Kemp has said he strongly supports the legislation, which will bring dramatic changes to the state’s assisted living communities and large personal care homes. Memory care units would have to get certified and have more staff, directors would have to be licensed and homes that break the rules would face higher fines. Assisted living homes would be required to have nurse staffing. Homes would also have to disclose financial problems to residents and families.

Plus, senior care homes must plan for a pandemic, have a short-term supply of personal protective gear, test residents and staff and notify residents and families of an outbreak.

Cooper drafted the bill to help prevent the types of neglect and abuse in senior care homes that were exposed last year by a series in The Atlanta Journal-Constitution.
 
Advocates applauded the Senate’s move to add the COVID-19 requirements.

Most of the bill relates to assisted living and personal care homes with 25 beds or more. But the additional COVID-19 requirements would also apply to the state’s nursing homes.

“Georgia’s seniors gain new protections in this landmark legislation,” said Kathy Floyd, executive director of the Georgia Council on Aging.

Full Article & Source:
Legislature adopts sweeping reforms for senior care homes

Legislature balks on significant pay bump for home health aides

Texas lawmakers aren’t expected to approve any substantial wage increases for attendants who care for aging Medicaid recipients with disabilities, despite state agency requests for a raise and widespread evidence of a workforce shortage.

The Texas Health and Human Services Commission has asked the Legislature this session to raise the $8 hourly base wage for attendants by 50 cents, saying that they “can earn higher wages in the fast food and other industries that hire low-wage workers.” Advocacy groups are pushing for $15 an hour.

The Texas House, however, has proposed raising the base wage by just 10 cents, and the Texas Senate envisions no raise.

With less than half of the legislative session left and most of the budget spoken for by larger priorities such as boosting school spending and providing homeowners with property tax relief, the likelihood of a pay raise is slipping, even though Medicaid recipients have for years pushed for higher wages for their attendants. Raising the hourly wage of attendants by 50 cents would cost the state about $150 million over the next two-year budget.

“It’s a matter of life and death for me,” said 63-year-old East Austin resident Gene Rodgers, who is paralyzed from the head down after he fell from a cliff at age 17. “With inflation, the buying power of (attendants’) wages has gone down. They could be flipping burgers for 15 bucks an hour or working at Amazon.”

Attendants’ duties, which vary depending on the need of a client, can include cooking, feeding, bathing, house cleaning and operating medical equipment. They allow disabled people to live healthier and more independently in their own homes rather than in nursing homes or assisted living facilities that are costlier to the state.

“We have a tendency to duck away from funding cost-effective preventative programs like reliable attendant care and then complain when people are paying these high bills because we didn’t keep them healthy,” said Dennis Borel with the Coalition of Texans with Disabilities.

He said lawmakers’ lack of interest in boosting attendant wages is a slap in the face.

A state health agency spokeswoman could not say how many Medicaid recipients need attendant services or how many attendants would be affected by an increase in the base wage. According to the U.S. Bureau of Labor Statistics, there are about 276,000 attendants (personal care aides and home health aides) in Texas, and as the population ages, the demand for attendants is expected to grow.

The Legislature has increased attendant wages by 50 cents since 2014. Agency officials noted in their recent pay raise request to the Legislature that without a change, “providers will continue to experience high turnover among community attendants.”

Advocates say reliable attendants are becoming harder to find and keep. State officials have acknowledged that Austin is particularly affected by a workforce shortage because of the high cost of living. But rural areas that have fewer attendants to begin with are also seeing workforce shortages.

High turnover

For a period of time, Rodgers had a new attendant every two weeks. Rodgers’ longest-serving attendant, Shirley Eason, has been with him for five years.

“The whole mental outlook, attitude is changed when they send in new people and I have to train them from the very beginning everything to do,” Rodgers said.

Attendants typically don’t receive health or retirement benefits or paid vacation, sick or personal days.

Eason said she wouldn’t be able to survive off her $10 an hour attendant wage — she is paid a little more than the base wage because Rodgers has higher needs — if she did not draw Social Security benefits. Eason, 73, doesn’t think she can do the job for longer than two more years even though she’s grown to enjoy Rodgers’ company.

“Attendants should be paid according to what they have to do,” Eason said, adding that her job requires her to be physical, such as when she’s dressing Rodgers.

Sandy White, 56, who makes about $1,000 a month as an attendant for Susie Angel, 48, and Juan Muñoz, 47, who live together and both have cerebral palsy, said she has only $10 left every month after she has paid for rent, utilities, food for her and her dogs, and anxiety and blood pressure medication.

“You can probably make more working at Buc-ee’s, and this job has more responsibilities,” she said.
Angel said low pay has led to poor quality attendants. Once, an attendant was startled by one of her spasms and walked off the job in the middle of showering her, she said.

“Minimum $14 to $15 an hour,” Muñoz said when asked what rate he believes White should be paid. “Enough that they can survive. We’re not asking for them to be sitting pretty. If they can’t survive, we’re not going to survive.”

Budget cuts

Attendants who serve Medicaid recipients with higher needs, such as those with intellectual and developmental disabilities, also have struggled with low pay even though their wages are set at a slightly higher rate. The Statesman reported in December that an Austin woman, Sue Schnars, had trouble finding and keeping attendants at $11 an hour and was forced to place her 43-year-old daughter, who has cerebral palsy, in a nursing home. Her daughter had lived at home all of her life.

Private agencies that employ attendants also told the Statesman they were having to redirect money from other programs and cut their administrative costs to keep attendant wages competitive. Losing money, some private agencies had stopped serving individuals in certain Medicaid programs such as Texas Home Living.

The state health agency has whittled away at the higher wages paid to smaller Medicaid programs that serve individuals with intellectual and developmental disabilities. In 2017, the agency cut rates in Texas Home Living and Home and Community-based Services by 21 percent to $17.73 an hour to align the rates with other Medicaid programs. The decision affected caregivers for about 8,000 people in both programs.

“We want to raise those lower wage programs,” Borel said. “Texas has consistently missed the boat on developing a sustainable Medicaid program, one they can handle increasing demands and needs as our population grows and our population ages.”

The Legislature does not appear to be incentivizing the state agency to increase Medicaid services either. Over the past several budget cycles, the Legislature has directed the state health agency to cut Medicaid costs. This budget cycle, the Legislature told the agency to cut $350 million. The Legislature is poised to ask the agency to do the same again over the next cycle. This would result in a reduction of $550 million in federal matching dollars.

“The Legislature has been intently focused on constraining the cost of Medicaid recipients for the last 20 years, so the only way attendant rates go up is if the Legislature specifically identifies that’s something they want to do,” said Anne Dunkelberg with the left-leaning Center for Public Policy Priorities. “And they have done increases; they’re just still woefully inadequate.”

Full Article & Source:
Legislature balks on significant pay bump for home health aides

Proposal to probe elder deaths receiving little pushback in Florida Legislature

Proposals to create teams to review deaths of the elderly when abuse or neglect is suspected and to prevent future deaths are moving forward with little pushback in the Florida Legislature.

Elder advocates say establishing elder death review teams in Florida could help cut down on the number of cases of nursing home neglect and mistreatment like those identified in a recent USA TODAY NETWORK – FLORIDA investigation.

The proposal, included in Senate Bill 452 by state Sen. Audrey Gibson, D-Jacksonville, has unanimously passed three committees since mid-February with little discussion. Most recently, the Senate’s Governmental Oversight and Accountability committee approved it March 26.

 

Police officers talk to an employee at the Rehabilitation Center at Hollywood Hills in Hollywood, Fla., Wednesday, Sept. 13, 2017. Several patients at the sweltering nursing home died in Hurricane Irma's aftermath, authorities said. The nursing home lost power during Hurricane Irma.(Photo: AP Photo/Marta Lavandier)

The bill would allow, but not mandate, the creation of elder death review teams in each of Florida’s 20 judicial circuits. The teams would review cases in their judicial circuit where abuse or neglect has been found to be related to or the cause of an elderly person’s death.

“I believe this task force and the team is critically important to the state,” Gibson said when explaining her bill to the Senate’s Children, Families and Elder Affairs committee in February.

As part of its investigation, the USA TODAY NETWORK - FLORIDA reviewed 54 nursing home deaths where state inspectors cited neglect and mistreatment as factors from 2013 through 2017. The network investigation found Florida’s Agency for Health Care Administration rarely took action and often didn’t investigate the deaths at all.

The network’s nursing homes series also showed that AHCA rarely takes serious action against poor-performing nursing homes, and it has allowed dozens of Florida nursing homes to limp along for years providing substandard care, and abusing, neglecting and even killing patients with little consequence.

Gibson’s bill would limit reviews to closed cases and to deaths where abuse or neglect has been verified by a state attorney, a potential roadblock that could prevent probing of many nursing home deaths in Florida. State attorneys didn’t prosecute any of the 54 nursing home deaths reviewed in the network's investigation.

The goal of the elder death review teams would be to identify problems or gaps in service, to recommend solutions, and to author annual summaries of their findings, according to the bill.

The teams would be comprised of volunteers from a variety of vocations, including attorneys, police officers, medical examiners, nurses and members of the state’s Long-Term Care Ombudsman program. The teams would be housed, administratively, in the Department of Elder Affairs, but would be initiated by states attorneys in the judicial circuits.

The only expected expenses of the program would be administrative costs incurred by the Department of Elder Affairs, according to a Florida Senate analysis of the bill.

The Alzheimer’s Association supported Gibson’s proposal during a Judiciary Committee hearing in mid-March.

“Anything we can do to support our most vulnerable population is going to be good. And I think this is a good way to support them,” Michelle Branham, the association’s vice president of public policy in Florida, said in an interview.

This is the third year in a row Gibson has sponsored elder death review team legislation. Her efforts failed during the last two legislative sessions.

A companion bill by Rep. Barbara Watson, D-Miami Gardens, unanimously passed its first House committee Monday, March 25. Watson stressed that the purpose of the bill is to learn from closed cases, not to re-investigate them.

“We’re just looking at the ability to find the best practices, and how we can learn from what has transpired in the past,” she told the House Children, Families and Seniors subcommittee.

The Florida Legislature established the Child Abuse Death Review Committee in 1999, with the goal of reducing child deaths in the state. Ten years later the state established domestic violence death review teams in response to an increase in domestic violence-related homicides in Florida.

But there is no comparable review when an elderly or vulnerable adult dies in Florida, even under suspicious circumstances.

The same year Florida created its committee to review child deaths, the U.S. Department of Justice recommended the development of death review teams for the elderly. But unlike child death review teams, which exist in every state, only 13 states have established elder death review teams, according to The National Center for Fatality Review and Prevention in Washington, D.C.

Florida is not among them.

The Women's Center in Jacksonville is in the planning stages of an elder fatality review team pilot project examining closed criminal cases involving elder abuse, neglect and exploitation. But the team would not look at a nursing home case where there was no criminal prosecution, even if there was a finding of neglect by Florida's Department of Children and Families or another state agency.

Full Article & Source:
Proposal to probe elder deaths receiving little pushback in Florida Legislature

Don’t ‘lock them up’

By Allen Cooper on February 21, 2019 1:00 am

 

During the last presidential elections cries of “lock her up” energized the crowds. Have our city supervisors taken a page from that book by yelling “lock the homeless up?’

The California legislature passed a law that would allow San Francisco, to institute a new type of conservatorship. Supervisor Mandelman with the encouragement of Mayor Breed has proposed legislation to implement this.

When someone is conserved they lose all civil rights and a court appointee has authority to make all decisions for them. The new law states that an individual who is seriously mentally ill, has a substance use disorder and has been brought to a hospital for competency evaluation (5150) eight times in one year can be taken to court by the Sheriff, the head of a hospital, or the head of the Department of Health for a conservatorship hearing to determine if they can care for themselves.

The law requires that housing, mental health and substance abuse treatment as well as other services be made available to them. In general, these are homeless people who are considered nuisances by the police and residents of the neighborhoods where they stay. It has been estimated that currently 55 individuals meet, and about 48 more may soon meet, the requirements for a hearing. This has the appeal of allowing the City to say it is doing something about bothersome homeless people.

This is a bad idea for many reasons. The people in question have already been found to be able to care for themselves on eight evaluations, thus it ignores the opinion of medical professionals and puts the decision in the hand of lay bureaucrats. Further, when these people get housing, treatment, and other services, they will go to the head of long waiting lists for these services, thus pushing out the elderly, disabled and pregnant as well as other high priority unhoused who are waiting for these services.

Past experience suggests the forced treatment approach is not likely to be successful in rehabilitating the conserved individuals. Many of these seriously mentally ill people have had drug treatment in the past and have failed. In fact, 30 percent of the seriously mentally ill are drug resistant and will never respond. Putting these people in the hospital and trying to medicate them will probably lead to expensive hospitalizations.

Forced treatment for substance use has been tried for many years but evidence that it leads to long term success is lacking. It tends to lead to reduced substance use while a person is in the program with relapse when they are discharged. The best one group studying this could say is that it is probably better than nothing. This is a contrast to those who enter treatment voluntarily, where there is reasonable rate of long-term success. Eventually many of these people may end up being conserved and housed out of the city at a cost of about $160,000 per year, or in even more expensive chronic psychiatric hospital beds.

Is there an alternative? A coalition of groups and individuals with expertise and experience in this area have suggested “voluntary services first.”

This would require intensive case management to encourage the people to enter supportive housing and encourage voluntarily entrance to treatment. This will require trained case managers who will see their patients on an almost daily basis to establish a relationship and coax them into supportive housing where they can manage them over the long term. Let’s try it before we end up depriving these unfortunate people of their civil rights. Call your supervisor and tell them don’t “lock them up.”

Allen Cooper, M.D. is a professor of medicine emeritus at Stanford University who worked for Healthright360 at the Treasure Island Job Corps and the Height Ashbury Free clinic after retirement. He has treated numerous patients with alcohol and drug use problems, as well as mental illness and homelessness.

Full Article & Source:
Don’t ‘lock them up’

Ending abuse of the disabled

Nicky’s Law, originally filed by state Senator Mike Moore of Millbury and state Representative Linda Dean Campbell of Methuen, passed the Senate 36-0 last summer but got stalled in the House Ways and Means Committee when the Legislature ended its formal sessions.

A society is — or should be — judged by how well it protects its most vulnerable citizens. But when it comes to protections for those with intellectual and developmental disabilities, Massachusetts still has a long way to go.

And by every statistic available, the problem of physical and sexual abuse is growing worse with every passing year.

“It is an epidemic of abuse against people with disabilities,” Nancy Alterio, executive director of Massachusetts’ Disabled Persons Protection Commission (DPPC), told a legislative oversight committee recently.

One way to make a dent in the problem is rather straightforward: a registry of caretakers against whom claims of abuse have been substantiated. The idea has gone by many names — often named for those victimized. The current version is called “Nicky’s Law,” after Nicky Chan, whose parents, Nick and Cheryl Chan, were made aware of a caretaker’s physical abuse of their son. The case against their son’s abuser actually went to court — few make it that far — but the caretaker was found not guilty and can, therefore, continue to work in group homes.

“I can tell you that the systems that are in place are not working,” testified Anna Eves, vice president of the Massachusetts Coalition of Families and Advocates. Her son, too, was the victim of abuse and neglect last year. Abuse claims were substantiated against seven people who worked with her son. Two of those workers were still on the job, she said.

The problem is that in many instances the victim is nonverbal, and absent visual evidence — and, sad to say in some cases, even with visual evidence — cases may be “substantiated” by the DPPC but not result in a successful criminal prosecution. (The standard for the latter is much higher.)

The victim remains the victim. But the abusing caregiver is free to move on to the next group home.
The numbers alone are horrifying. Last year the DPPC received 11,895 reports of abuse on the 24/7 hotline it operates — half of them involving people with intellectual and development disabilities. Of those reports, 878 dealt with allegations of sexual abuse — 387 involving people with intellectual disabilities, 409 involving those with mental health disabilities.

DPPC has seen a 30 percent increase in abuse allegations in the past five years, Alterio testified.

Thursday, members of a number of advocacy groups, including the Arc of Massachusetts, plan a vigil at the State House to make one last push for the registry legislation this year. Nicky’s Law, originally filed by state Senator Mike Moore of Millbury and state Representative Linda Dean Campbell of Methuen , passed the Senate 36-0 last summer but got stalled in the House Ways and Means Committee when the Legislature ended its formal sessions.

The bill was actually much improved as it made its way through the Senate, which added due process safeguards for accused caregivers, including an appeals process, and put the registry under the umbrella of the DPPC.

Massachusetts has made significant improvements in how its agencies handle reports of abuse and the level of services it now provides to victims. But all of that is after the fact. The registry can help prevent abuse by ridding the system of those who have no business being left to care for our most vulnerable citizens. They ought not have to wait another year for the Legislature to act.

Full Article & Source:
Ending abuse of the disabled

Statutory durable powers a tool to avoid guardianship

A little more than a year ago the Texas Legislature made substantial changes to the law establishing a Statutory Durable Power of Attorney (SDPOA). Given those changes, made effective September 1, 2017, persons who created a SDPOA prior to should review those instruments with their attorneys. As important as it is for those with SDPOAs to revisit them, a more fundamental problem exists concerning SDPOAs: many, if not most, people don’t have a good understanding of what a SDPOA is and why they need one.

A Statutory Durable Power of Attorney is a document which gives a designee power to act as an agent for, and to act in place of, the person creating the POA. The document must be signed by the principal – the one granting the power - and it must be notarized. The instrument grants the agent authority to handle whatever items of business the principal has designated to the agent. Under a SDPOA, the principal may grant all or some of a broad list of powers to handle transactions involving real estate, tangible property, stocks and bonds, commodity and options, banking and other financial institutions, business operating, insurance and annuities, estate, trust and beneficiaries, claims and litigation, personal family and maintenance, federal benefits, retirement plans, tax matters and even digital assets.

The SDPOA is a powerfully effective instrument that can often be used to prevent the necessity of an expensive guardianship proceeding and naming of a guardian of the estate of an incapacitated person. For this reason, all persons should execute a SDPOA for themselves.

In general, persons creating a SDPOA intend to handle their own financial affairs until such time as they are incapacitated or incapable of doing so. However, the SDPOA gives the person creating the SDPOA the option to choose one of the following: (1) “This power of attorney is not affected by subsequent disability or incapacity of the principal” or (2) This power of attorney becomes effective on the disability or incapacity of the principal.”

Option No. 1 (in my opinion, inartfully stated) means that the SDPOA goes into effect immediately, without requiring that a physician designate in writing that the person creating it is disabled or incapacitated. The second option means that the SDPOA does not give the agent the power to act until after the principal has been declared disabled or incapacitated in a writing by a physician.

Whether Option 1 with immediate effectiveness or Option 2 with effectiveness delayed until a doctor establishes disability depends upon the particular circumstances of the principal and the agent being named. With either option, it is imperative that the agent named is a person the principal trusts completely to handle his or her affairs in the principal’s best interest.

Given a trustworthy agent, in most instances, Option 1 is often preferable for these practical reasons:

1. Many, if not most, doctors do not like making the assessment that a person is disabled or incapable of handling his or her affairs;
2. Even when a doctor is willing, the doctor may not be the best person to make that decision, given that often an individual’s decision-making capability can vary from day to day; and
3. Even if the doctor is willing and can make a valid assessment, often action needs to be taken sooner than is possible when the assessment must be secured beforehand.

Even when the SDPOA is made effective at once, the principal can still continue to handle their own affairs until they themselves determine they no longer can do so.

The 2017 version of SDPOAs gives the principal the option of designating whether the agent will receive reasonable compensation for performing the duties required under the SDPOA or will merely be entitled to reimbursement for any expenses incurred in performing those duties.

In my experience, most principals name a spouse or another person who will ultimately inherit from them and choose to have that agent perform without compensation.

The SDPOA form enacted in 2017, makes clear that, unless the principal answers “yes” to specific designations, the agent will not have the authority to: (1) create, amend, revoke or terminate a trust the principal has established during life; (2) create or revise rights of survivorship; (3) create a beneficiary designation; or (4) authorize another person to exercise the authority given under this power of attorney.

Full Article & Source:
Statutory durable powers a tool to avoid guardianship

Elder abuse reform returning to Minnesota Legislature as advocacy groups search for consensus

DULUTH — The 2019 Minnesota Legislature will again take up reforms aimed at keeping vulnerable and elderly Minnesotans safe and holding accountable those who are charged with their care. Efforts to do so earlier this year failed.

Rep. Liz Olson, DFL-Duluth, who will be the majority whip in the DFL-controlled House when the Legislature convenes in a month, said she’s hopeful her chamber and the Republican-controlled Senate will come together to create meaningful change. So are her fellow lawmakers.

“We don’t have another year to put this issue on the backburner,” said Sen. Karin Housley, R-St. Mary’s Point. 

After a StarTribune investigation last fall that found very few reported allegations of elder abuse were being fully investigated, a consumer-led task force in January called for “far-reaching policy and agency practice changes to prevent and deter abuse.” 

Specifically, the group recommended:

• Strengthening and expanding rights of older and vulnerable adults and their families
• Enhancing criminal and civil enforcement
• Developing new licensure frameworks for assisted living and dementia care
• Improving licensing regulation, enforcement, investigations and reporting

A bill born of those recommendations did not get a hearing.

Housley, chairwoman of the Senate Aging and Long-Term Care Committee, shepherded a bill to allow electronic monitoring of residents, require residents and family members be notified of abuse investigations, increase oversight of the Office of Health Facility Complaints and expand the Home Care Bill of Rights, among other initiatives.

Gov. Mark Dayton vetoed the bill as the session crashed to a close in May.

Since then, stakeholders across six working groups have been working to find common ground.

“We’ll start over, and hear bills early on where there’s agreement and work out the details where there isn’t,” said Rep. Jen Schultz, DFL-Duluth, who will be chairwoman of the House subcommittee on long term care.

Requiring assisted living facilities to be licensed is one issue where there is industry support.

“I do think we absolutely need to have a licensing structure for assisted living facilities. Minnesota is way behind the rest of the country on that particular measure,” said state Sen. Tony Lourey, DFL-Kerrick.

Gov.-elect Tim Walz agreed there is a need for better oversight.

“In many cases, it’s an industry that has grown rapidly with an aging population, and we haven’t quite figured out how to keep up with that,” he said.

Housley said she’ll consider all proposals the House sends over.

“Some of the things I’m hearing go too far for me and my constituents,” she said. “But I’m always going to have that discussion, and absolutely we’ll sit down and work together.”

Little oversight

Seven days newspapers piled up. Seven days he was missing from meals.

It took seven days for someone to realize that Kristine Sundberg’s father had died in a senior living facility. In the months that followed, Sundberg found she had little recourse to hold the facility accountable.

“I went to start looking at who are the authorities? I was blown away you could have no oversight of a facility like that,” she said at a meeting of a senior group last month.

Sundberg is now the board president of Elder Voice Advocates, an advocacy group that was part of the coalition that called for “far-reaching” reforms.

Industry group LeadingAge Minnesota, which represents more than 1,100 senior care-focused organizations, is open to a number of changes.

“We believe the working groups have provided the foundation from which to build, particularly in the areas of assisted living licensure, dementia care standards and electronic monitoring,” LeadingAge Minnesota CEO Gayle Kvenvold said. 

That broader coalition should signal success early in the session, Kvenvold said.

“When we get to the details, that it is perhaps where it is most difficult to find that consensus, but I’m more than hopeful, in fact I’m optimistic, that we have broad enough agreements around some of the core principles,” she said.

Elder abuse resources

Call 911

Call the Minnesota Adult Abuse Reporting Center at 1-844-880-1574

Call the Ombudsman for Long-Term Care at 651-431-2555

Reach the Office of Health Facility Complaints at 651-201-4200 or health.ohfc-complaints@state.mn.us or visit http://bit.ly/mnOHFC

Full Article & Source:
Elder abuse reform returning to Minnesota Legislature as advocacy groups search for consensus

Editorial: Protecting seniors requires funding from the Iowa Legislature

Child abuse is not simply a “family matter” others should ignore or dismiss. We all know this.

Educational campaigns and troubling news stories prompt people to take action when they believe a child is being mistreated. In fact, we feel obligated to report it to authorities.

Yet there is less public awareness and feeling of communal responsibility when it comes to mistreatment of older people. Elder abuse may not be on our radar, even though older adults, particularly those who are frail or have diminished cognitive function, can be just as vulnerable as children.

They need to be protected too, a point made in a recent report compiled by University of Iowa researchers for the U.S. Department of Justice.

Researchers focused their study on 1,000 square miles in east-central Iowa, including Cedar Rapids and Iowa City. They held meetings, conducted interviews, compiled information from law enforcement and reviewed laws, regulations and other data.

They found prosecution of elder abuse is a relatively rare occurrence. That means abusers go unpunished, seniors continue to suffer and the rest of us are in the dark about problems.

“One thing that really jumped out at us was a sort of acceptance or lack of awareness about elder abuse in general,” said Brian Kaskie, an associate professor at the U of I and co-author of the report.

Abuse is not necessarily physical. He’s heard stories about family members moving into homes and taking advantage of seniors. A bank worker shared an anecdote about an elderly customer's relative trying to withdraw thousands of dollars. A law enforcement officer said victims themselves frequently do not want to file charges against an abuser, particularly if it is someone they rely on for daily help.

Kaskie hopes eventually there can be as much awareness about senior abuse as there is about child abuse and domestic abuse.

“Protecting seniors is a bipartisan issue,” he said.

Iowa lawmakers can do more to help. They should begin by recognizing government is not the enemy, but the best entity for helping protect the most vulnerable people, including the more than 500,000 Iowans over the age of 65. And government can do its job only if it’s adequately funded.

Recommendations from the report include: increased funding for state and county attorneys to prosecute elder abuse; involving social workers and therapists in the investigative process; funding for individuals and organizations who can serve as guardians for elders; and public awareness campaigns.

Those things are not free. Yet the GOP-controlled Iowa Legislature insists on cutting taxes and trying to shrink the size of government. A lack of funding for state agencies has consequences for not only older Iowans, but all taxpayers who fund their health care through Medicare and Medicaid.

“Victims of elder abuse have an increased risk of hospitalization and death. Victims are also more likely to be placed in a nursing home and are at an increased risk of developing mental disorders such as depression and anxiety,” according to the report.

In 2017, the Iowa Department on Aging received about $250,000 in state appropriations specifically to support elder abuse prevention and awareness, according to the report. Yet budget shortfalls meant the use of those funds was limited to supporting efforts and making referrals to understaffed government agencies.

Iowans understand the importance of looking out for those who cannot look out for themselves. The people we elect to represent us need to make sure government has the resources to do it.

Click to View

This editorial is the opinion of the Des Moines Register’s editorial board: Carol Hunter, executive editor; Kathie Obradovich, opinion editor; Andie Dominick, editorial writer, and Richard Doak and Rox Laird, editorial board members.

Full Article & Source:
Editorial: Protecting seniors requires funding from the Iowa Legislature

Bill passage could help protect vulnerable adults

State Representative Marcus McEntire

The Oklahoma Legislature has passed a bill establishing the Commission on the Prevention of Abuse of Elderly and Vulnerable Adults. House Bill 3328 bill was signed into law last month by Gov. Mary Fallin.

Rep. Marcus McEntire, R-Duncan, the bill’s author, said it is time Oklahoma begins looking into abuse and scams elderly adults face.

“So what we’ve done is we’ve created a commission to look at the laws concerning court-appointed guardianship of elders and vulnerable adults. And so, what we’re trying to do is make sure that we can head off any kind of fraud that occurs in that relationship. And, of course, it’s going to be much broader than that.”

According to the National Council of Disability, an estimated of 1.3 million adults are under guardianship across the nation.

Oklahoma is not a state that requires guardians to be certified. In most states, guardians also are not required to go through criminal or financial background checks.

The bill brings attention to the lack of regulations involving guardianships and the fraudulent activities that come from the lack of oversight. Guardians have legal power over their wards. In cases where the guardian has full guardianship, they have complete access to their ward’s bank account and health records. Under guardianship, wards are no longer able to manage their finances, buy or sell property, make medical decisions, marry and vote.

“What you’ve had in other states is you have a court-appointed guardian and a judge who maybe is in cahoots, and so basically the court-appointed guardian handpicks who they want to be guardian of and then strolls into their house, tells them, ‘Hey, I’m your guardian. We’re gonna move you out,’ and they move them to a nursing home somewhere and then they sell their assets,” McEntire said. “Just liquidate them, and say those are fees. It’s happened in other states, and we’re gonna make sure it doesn’t happen here.”

McEntire is going to a symposium Tuesday in Oklahoma City at the Oklahoma Bar Association to look into how to combat elderly exploitation.

“Other states are ahead of us,” he said. “We’ve got to get working on this as quickly as possible to make sure we can prevent further exploitation of elderly adults.”

Full Article & Source:
Bill passage could help protect vulnerable adults

With a week to go at the Legislature, what issues are alive, on life support and not dead yet?

Ideas never really die at the Minnesota Legislature.

There’s almost always a glimmer of hope that a proposal will make it through, until the House and Senate are forced by state law to adjourn on “the first Monday after the third Saturday in May.”
This year, that’s May 21.

After that, lawmakers who couldn’t get attention for certain issues turn into a sort of disappointed Minnesota sports fan — There’s always next year…

There’s no way to tell what proposals might make it in at the last minute as lawmakers are engaged in heated end-of-session negotiations.

Especially with a Republican-led House, a slim GOP majority in the Senate and a Democratic governor.

HEALTH AND HUMAN SERVICES

Elder abuse: The revelation last year that most complaints of elder abuse were never properly investigated shocked lawmakers and they returned to the Capitol calling for widespread reforms. Some of those changes have cleared committees and floor votes, but there is concern among advocates for seniors and vulnerable adults that the changes won’t go far enough.
Status: Alive.

Full Article & Source: 
With a week to go at the Legislature, what issues are alive, on life support and not dead yet?

Massachusetts Legislature Poised to Give Immunity to “Guardians”

There is currently an act before the Massachusetts Legislature to establish the Office of Adult Guardianship and Decisional Support Services. (S.1177/H3027). The purpose of the bill is to provide guardianship services to “unbefriended” people who are unable to manage their affairs.

These people are the most vulnerable in society. They have no one to complain if they are subjected to abuse by a guardian. They are the perfect victims. Any system for providing guardianship services to the “unbefriended” has to have iron clad protections against abuse.

On the contrary, this bill gives immunity to guardians. Guardians are already given immunity by judges of the Probate Court. Regardless of the intent of this immunity the result has been to create a system of legalized crime where guardians commit crimes with impunity. Other health care providers (doctors, nursing homes, etc. ) have to carry liability insurance. Conservators have to be bonded. Guardians should have liability insurance, not immunity.

Democracy was invented to prevent abuse of authority by government. The best way to stop abuse of guardianship is to use principles of democracy such as separation of powers (no one has sole control), checks and balances, accountability (no immunity), avoiding conflict of interest by putting authority in the hands of disinterested parties, etc.

The current bill has none of these protections of democracy. The Governor’s Advisory Council has no authority.  A careful reading of the bill shows that the Executive Director of the Office of the Adult Guardianship and Decisional Support Services is the only entity given any authority. The Office of Adult Guardianship has no authority as an entity. All its duties and powers are executed by the Executive Director.

I have attempted to rewrite the bill in a way that makes maximum use of the principles of democracy to prevent abuse of power.

All comments, corrections, suggestions, etc.  are welcome.

—————————

Thank you,

David Arnold

~~~~~~~~~~~~~~~~~~

Read these bills here:

https://malegislature.gov/Bills/190/H3027

https://malegislature.gov/Bills/190/S1177

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

 REVISED BILL WITH IMPORTANT CHANGES HERE:

“An Act to establish the office of adult guardianship and decisional support services.

Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority of the same, as follows:

Sections highlighted in red are to be inserted.

1 SECTION 1. The General Laws are hereby amended by inserting after Chapter 19D the
2 following chapter:.
3 CHAPTER 19E
4 OFFICE OF ADULT GUARDIANSHIP AND DECISIONAL SUPPORT SERVICES
5 Section 1. Definitions
6 As used in this chapter, the following words shall, unless the context clearly requires
7 otherwise, have the following meanings:.
8 “Act,” the Adult Guardianship and Decisional Support Act.
9 “At Large Member,” a person with personal or professional experience with
10 guardianship, conservatorship or voluntary decisional support for elderly,
11 intellectually/developmentally disabled persons, and/or mentally ill persons. “At Large Members” shall be disinterested parties from all walks of life who do not derive income or other benefits from guardianship or conservatorship.
12 “Chief Justice,” the individual who is the Chief Justice of the Probate and Family Court
13 Department of the Trial Court of the Commonwealth of Massachusetts.
14 “Council,” the Governor’s Advisory Council for Adult Guardianship and Decisional
15 Support, as established and empowered herein.
16 “Decisional Support Services,” a range of informal and formal services to meet the needs
17 of persons with diminished decisional capacity.
18 “Executive Director,” the executive director of The Office of Adult Guardianship and Decisional

19 Support Services, as appointed and empowered herein. The “Executive Director” shall be a disinterested party who does not derive income or other benefits from guardianship or conservatorship.
22 “Incapacitated person,” someone as defined in MGL Ch. 190B, Section 5-101 (9).
23 “Office,” the Office of Adult Guardianship and Decisional Support Services, as
24 established and authorized herein.
25 “Public Guardian,” the entity designated as such under applicable provisions of the Act.
26 “Volunteer,” a person recruited, trained and supervised by the Public Guardian to assist
27 the Public Guardian in carrying out the duties of a guardian, conservator or other decisional
28 support person on behalf of the Public Guardian.
30 Section 2. Office of Adult Guardianship and Decisional Support Services created; duties.
31 (a) The Governor shall create an Office of Adult Guardianship and Decisional
32 Support Services and shall appoint
33 the executive director.
The appointment shall be confirmed by a 2/3 vote of the Council. The executive director shall be knowledgeable of (1) the clinical causes and (Click to Continue)

Full Article & Source:
Massachusetts Legislature Poised to Give Immunity to “Guardians”

Texas Legislature Passes Law Protecting Seniors From Financial Abuse

A law making it more difficult to exploit seniors financially has passed both houses of the Texas Legislature and is on its way to the governor for signature.

House Bill 3921 gives banks and securities firms the authority to place a temporary "hold" on suspicious transactions in an elderly or disabled person's account. It is designed to bolster fraud protection procedures already in place at most banks, said Jordan Taylor, a spokeswoman for Tan Parker, the representative who sponsored the bill with state senator Kelly Hancock.

The law will allow banks and other financial firms to scrutinize any type of large, unusual transaction in a senior citizen's account before it's processed.

"By allowing banks and securities firms to place temporary holds on suspicious transactions, the legislature is giving them a powerful tool to stop elder financial exploitation in its tracks," AARP said in a release.

Full Article and Source:
Texas Legislature Passes Law Protecting Seniors From Financial Abuse

Column: A great need for more reform in guardianship

Kathy Bosse

I applaud the Ohio Legislature for the sweeping changes in the area of guardianship. Our mother is an incompetent ward and while we are deeply grateful for Superintendence Rule 66, there is great need for more reform.

Hamilton County Probate Court under Judge Ralph Winkler as superior guardian desperately needs better laws to ensure the ward is pre-eminent before the court, that lawyers and guardians reflect that priority. The ward’s wishes and best interest should be paramount. Sadly, that is not the case.

As the ward’s daughter, I compiled a list of complaints with substantiations about the conduct of the guardian and lawyer in a letter presented to them. Their response letter pointed out one area I was wrong about, the other issues were not satisfactorily addressed or completely ignored including three medical issues. Contained within was an offer to resign with stipulations added.

Naively, I forwarded the situation to Judge Winkler, thinking the court would be appalled also. I expected my efforts to warrant internal quality assessment at minimum. What occurred was a hearing; still thinking the court would protect our mother, my brother and I went pro se.

Response filings by the lawyer for the guardian and lawyer further shocked us. One purposefully omitted information that would have conveyed a completely opposite conclusion. Another further stipulated “the guardian is willing to resign without litigating the propriety of removal.” The audacity to withhold the truth and tell the court not to apply the law seemed to bolster our point.

The court denied removal of the guardian and lawyer saying no evidence was adduced.

The magistrate was given the evidence and laws my brother and I felt were violated, however, we found out later, it was not specifically presented as exhibit “A,” etc... nor given at the hearing to the other side, therefore, not adduced. In addition to the burden of providing evidence, researching appropriate law violations, we were expected to know how to properly adduce and find replacements for the guardian and lawyer. A policy brochure for guardianship families outlining the handling of grievance procedure would have been invaluable in our quest on our mother’s behalf.

Instead of the court acknowledging that confidence, trust, competence and effectiveness are totally lacking in this situation, they have done a huge disservice at the literal expense of their incompetent ward. The law has to contain enough discretion to rule favorably for their ward.

None of the above reflects person centered care, best interest or wishes of the ward. The National Guardianship Association has done a tremendous job formulating standards, a coordinating checklist, a code of ethics – it is remarkably well done. Precedence in court is already set using this fantastic tool. Again, this was given to the magistrate. It is time to hold this inadequate, misaligned court system liable.

Full Article & Source:
Column: A great need for more reform in guardianship

Bill targets ‘license to steal’ from elderly, disabled adults

Dan Goerke, State Rep. Chuck Efstration & Vernon Keenan

ATLANTA - The director of the GBI says a legal maneuver is being used as a “license to steal” from vulnerable Georgians, and he’s looking for passage of a bill in the state Legislature to change that.

“We want to stop the elderly and disabled adults having their assets stolen by family members and others who get that power of attorney,” Vernon Keenan said at the state Capitol on Tuesday. “When … they steal all the assets and they’re confronted by law enforcement, they pull out that power of attorney and wave it around like it’s their defense.”

A power of attorney is a document that someone signs to grant a trusted friend, family member or other agent to act on their behalf. Many people sign one for medical reasons, such as an Alzheimer’s disease diagnosis.

Keenan was speaking at a news conference on House Bill 221. If it passes, Keenan said, his office would train law enforcement and prosecutors to go after such fraud under the new law. State Rep. Chuck Efstration, author of the bill, filed a similar bill last year.

“I think an important aspect of the testimony we’ve heard is that there’s not a specific mention in the elder abuse statute for these types of crimes, and the danger is that law enforcement responding to reports of these offenses are in a position, or an argument is made, that this is a civil matter, (that) this isn’t a criminal matter,” Efstration said.

He said his bill makes it clear that abusing a power of attorney is a crime that should be investigated and prosecuted.

He also said the measure will make it clear that the agent — the person who has the power — must act in the best interest of the person who has signed over those powers.

Efstration said his bill would bring Georgia’s law into line with 21 other states that have enacted uniform power-of-attorney laws.

“That will provide for a form that users of this power of attorney can easily find in the law and utilize,” the Dacula Republican said.

Full Article & Source:
Bill targets ‘license to steal’ from elderly, disabled adults