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Documents that Parents and College Students Need
Here are a few documents that families will need if parents are to remain involved in the medical and financial affairs of a child who has reached adulthood.

By EILEEN AMBROSE, Senior Editor
September 24, 2019
From Kiplinger’s Personal Finance


QNow that my daughter is in college and living away from home, are there any legal documents we need so we can step in to help her if necessary?
AMany parental rights disappear once a child legally reaches adulthood, at age 18 in most states. But with a few key documents, you can still be involved in your daughter's medical and financial affairs, and even see her grades.

Many parents don't realize they need these documents. They assume they can access a child's medical and other information because the child is still on the family's insurance plan and Mom and Dad are paying the medical and tuition bills, says Jessica M. Pannell, estate planning strategist with Cassaday & Co. in McLean, Va. Pannell says she saw the importance of these documents in the aftermath of the Virginia Tech shooting in 2007. "We had clients who were obviously concerned about their children, couldn't get in contact with them and were calling the local hospitals in Blacksburg," says Pannell. "They were being told, 'We're sorry. We can't give you information. We can't even tell you if your child is here.'"
Here are four documents you and your daughter will need.
ADVERTISEMENTHIPAA authorization form. The Health Insurance Portability and Accountability Act is a federal law that protects the privacy of medical records. You child must sign a HIPPA authorization form to allow you to receive information from health care providers – including from the college's health clinic – about her health and treatment. If your daughter doesn't want to share her entire medical record, she can set restrictions on what information you can receive, says Pannell.
Medical power of attorney. This document allows your child to designate someone to make medical decisions for her if she is incapacitated and can't make medical decisions on her own. Pannell recommends your child choose a primary agent to act on her behalf, as well as a secondary agent in case the first one is unavailable.
Durable power of attorney. This document will allow your daughter to authorize someone to handle financial or legal matters on her behalf. A durable power of attorney is usually written so it takes effect when a person becomes incapacitated. But if your daughter wants you to manage her financial accounts or file her tax returns while she's away at school, she can make the document effective immediately, says Pannell.
Family Education Rights and Privacy Act waiver. Once your daughter is an adult, you're no longer entitled to see her grades without her permission. "It seems counter intuitive that you can be sending your kid off to college and paying for tuition, but you won't have access to academic records," says Pannell. This waiver signed by your daughter will grant you permission to receive her academic record. Many colleges provide this form, or you can find it online. Once you get these documents, make sure you have ready access to them, if needed.

I thought this was a pretty interesting article.  Anyone willing to push this boundary a bit with me?
From ​https://blog.eldercounsel.com/the-uniform-electronic-wills-act-is-here?utm_source=hs_email&utm_medium=email&utm_content=77298507&_hsenc=p2ANqtz-9ie1u4Ja3rw_9XcXCBXHFx7DILB4MrJCGnKmY4JU6uwPgUEa0AUxPofwH1hXV19aIDs6Ny-lnLd1aSATtyS82UhUiKhw&_hsmi=77298507

The Uniform Electronic Wills Act is Here By  J. Roamer
Once upon a time, the legal field relied on face-to-face interactions, loads of paper files, and gallons and gallons of ink. This is not so in the current day and age. Our legal documents were once handwritten, then typed and printed, and are now becoming a series of ones and zeros. Most attorneys now harbor a hybrid mix of paper and electronically stored data. For elder law attorneys, shifting their historically physical procedures into electronic practices is a foreign concept – a concept now coming to fruition in the form of electronic wills.What are Uniform Acts?Our nation is made up of sovereign states – meaning that each state governs itself separately from its neighbors. Although Federal law looms over the union generally, each state has leeway to vary its specific laws to reflect the needs and values of its population. The separation between states and the federal government also allow for discrepancies – and sometimes competing positions – on hot topics like medical marijuana or gun rights.
Because of individual state independence, states are not required to match one another’s laws, rules, and expectations. This often creates an inconsistent result regarding behavior in one state versus another. For example, some states permit physician assisted suicide or ban the unsolicited distribution of single-use straws, and others do not. Each state has its own version of laws relating to overarching issues – state laws on proper will execution, driving ages and restrictions, probate processes, elements of crimes, etc.
To combat these disparities, and to promote greater uniformity of laws amongst the states, the National Conference of Commissioners on Uniform State Laws (a.k.a. the Uniform Law Commission [ULC]) was established. The ULC is comprised of a vast collection of legal professionals that propose model rules for state adoption. While not laws, in and of themselves, these proposed rules provide a foundation for uniformity for adopting states to build from. Since 1892, “the ULC has promulgated more than 300 uniform and model acts.”
The Uniform Electronic Wills ActRecently, the ULC approved the Uniform Electronic Wills Act. The Act builds a bridge between traditional will execution and technological advancements affecting the field. Historically, wills have been a document signed with pen on paper. In the day in which “e” everything exists, e-wills have started to emerge.
What is it?This model Act outlines the process for effectively creating and executing a will via use of technology and online processes. It builds upon the notions of the Federal Electronic Signatures in Global and National Commerce Act (ESIGN) and the state’s Uniform Electronic Transaction Act (UETA); adopted by all but New York, Illinois, and Washington.
What is its purpose?If uniformly adopted by the states, this potential law would permit a testator to create, sign, notarize, and execute a valid will without ever having to be in the physical presence of another person. Traditionally, and generally, creating a will was a formal event requiring a number of witnesses, a notary, and the testator, to be in one location together at the time of execution – with the exception of holographic wills, for the states that permit them. This model law allows a testator to create an electronic representation of their wishes, have it witnessed and notarized online, simply by way of audio-visual communications.
How Does it Work?Under the model law, testators will be able to create an electronic document reflecting their post-death desires. The testator would then gather their witnesses, access an online notary, and participate in a real-time audio-visual meeting as a group, to execute their last will and testament. Successfully performing this process would result in a valid will. The model law retains traditional, in-person, procedures as well. A hybrid approach to the process appears permissible as well.
How is this different from other electronic documents?E-signatures are widely accepted across the country. However, e-notarizations are not – yet. E-notarization acceptance is on the rise across the country. Requirements for the legitimacy of various documents differ; and the requirements for will execution are especially particular. The validity of a will depends upon the state in which it is created. A will requires notarization for the self-proving affidavit portion, if included or permitted in your state. Notarization is usually not necessarily required to create a valid will, but is highly recommended. 
Signing a typical legal document, electronically or pen to paper, is a perfectly acceptable means of affirming the contents of the document. Signing before a notary provides an added element of seriousness and legality – an element required for many legal documents. Notarization in the physical presence of a notary has always been the norm. However, the enhancement of the internet’s capabilities has created access to notaries without the need for physical proximity.
This concept is foreign to many states and the attorneys licensed in them. Uniting the formalities of will execution with the intangibility of e-documents is not a comfortable maneuver for many practitioners.
ConcernsBoilerplate WillsElder law is a highly individualized area of practice. Having online access to will execution is a concern for many attorneys. Clients are likely to find boilerplate internet wills that lack the specificity that the client actually needs. From a practicing perspective, attorneys are concerned that their clients will not have their wishes fully outlined using these one-size-fits-all documents. Even with editing to their individual needs, clients face the possibility of neglecting to use important legal terminology or creating ambiguities that could be avoided by employing an experienced elder law attorney.
Fraud and DuressThere is added concern that testators will be more susceptible to fraud and duress in the execution of their e-will. While the e-process requires real-time audio-visual communication, who is to say that an ominous presence is not influencing the individual from behind the camera?
Storage and ProtectionsThe model law does not specify what form the final document must be in. Would a word document suffice, or is a PDF version necessary to combat potential tampering? No encryption requirements are noted in the model law either. Nor is there any guidance for who is to retain the “original” copy in the finalized form.
RevocationRevocation of an existing physical will requires an overt act – such as stating so in a subsequent will or by intentionally destroying it. How then, without a subsequent will, would an e-will be destroyed by a preponderance of the evidence? Simply by clicking delete? How many of us have unintentionally deleted a file by mistake? The burden to show the intent to destroy an e-will poses additional challenges than that of a will in physical form.
BenefitsAccessThe greatest benefit to offering electronic wills is simple: accessibility. The adoption by states of the model law will benefit those unable, or unwilling, to physically travel to a notary. Further, other accessibility hurdles – like documentation in braille or providing interpreters – will become obsolete, as those with accessibility needs generally have these resources implemented on their computers. Individuals in long-term care would no longer need to find transportation to an attorney or notary, nor need to request that they come to them. The convenience of e-wills creates an opportunity for testators to bring the formal process into their homes. This luxury increases the likelihood that more individuals can have their desires formally addressed through a will.
AvailabilityFortunately, there are many companies offering these online notarization services. In addition to the final document, many of these services also keeps records of the video conference, identifying documents, audit trails tracking the date and time of the signing, and also provides encryption to evidence any tampering of the document. These additional pieces of evidence could be quite useful in proving the authentication and validity of contested documents – additional evidence not available for the pen to paper method. Most of these businesses provide the multi-person video conferencing necessary for a fully remote execution.
Will states adopt it?Many states have already legislated approval for the use of online notarization. Others are on the cusp of permitting it. Several states have already enacted laws that permit the use of e-wills, specifically. See our previous ElderCounsel blog on the specific states that allow these electronic versions.
ForecastThe internet is an amazing thing. We can order groceries to be delivered to our door. We can watch how-to videos to learn to remodel a house. Packages can be ordered and delivered the very same day. We can access case law, court documents, and legal forms at the click of a button. It is only logical that our legal system will become more and more electronic friendly as technology advances and access to resources grow.
The world relies on the ability to transmit information electronically – we have become irreversibly dependent upon it. While legal constructs have been built upon the expectation and practice of face-to-face interaction, practitioners must prepare themselves for the inevitable – e-everything.

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Challenging A Will Based On Unequal Treatment Of Sons And DaughtersInheritance can be a source of tension without religion and cultural customs interfering.By CORI A. ROBINSON
Aug 27, 2019 at 3:19 PM(Image via Shutterstock)
Cultural norms and religious values often guide testators when considering provisions for their last wills and testaments. In some cultures the eldest child is deemed to receive more as a result of his birth order. In other cultures sons receive more than daughters. The latter practice was the center of a recent lawsuit in British Columbia, Canada wherein four sisters challenged a last will and testament wherein they were bequeathed only 1.7 percent of their parent’s estate worth $6.8 million (U.S. Dollars). Their two brothers were bequeathed 93 percent between them.
Last month a British Columbia Supreme Court granted each sister approximately $1 Million, overturning the contested last will and testament, to bring each one’s share to 15 percent. The brothers each received 20 percent as a result of the ruling.
The last will’s fairness was challenged on the basis of “tradition-based preference.” British Columbia’s Wills Estates and Succession Act (WESA) includes a provision that allowed the sisters to challenge their parent’s last will because of unequal treatment based on their sexes. In response to this kind of objection, certain parents argue that based on their tradition, it is common to treat sons and daughters differently under a last will and testament and such inequity should be allowed. In British Columbia, this has been a recurring issue especially amongst the East Asian population.
In the instant case, the East Indian family owned a farm. Although the parents’ wills did not explain the imbalance between the sons’ and daughters’ bequests, in prior legal documents pertaining to the family farm, the father referenced the custom of leaving property just to sons. Although the last will and testament was silent on the imbalance, the British Columbia court held that the distribution “fell far short of the moral standards of Canadian society, which provide for men and women to be treated equally.” The daughters aptly noted that there was no actual reason given in the testamentary document  for their unequal gifts, e.g. a failed relationship or disappointment. Often children are disinherited because of lack of contact, dispute or other issues. In this case, there was no reason for the imbalance in the testamentary scheme except for the parents’ cultural views of son and daughter inheritance which gave them standing to object under the WESA statute. The Court readjusted the percentages, ultimately giving little more to the brothers than their sisters, a nod to the parents’ cultural beliefs.
This case and others like it demonstrate the tension between testamentary intent and what is acceptable under the law. For example, one cannot disinherit her spouse. Jurisdictions have statutory mechanisms, often called a “right of election” to allow a disinherited spouse to claim one-third of a deceased spouse’s estate. This includes assets passing through a will and also outside of a will, via operation of law (notably WESA does not pertain to assets passing outside of probate). In right of election and WESA cases, public policy dictates how you may or may not treat your closest family members.
The British Columbia case highlights issues that arise in estate planning for individuals in many cultures and religions. Throughout  history we have seen different variations of the concept of priomogeniture, the right, by law or custom, of the firstborn son to inherit the parent’s entire estate which was a common practice in various monarchies.
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The directive to give a firstborn son “extra” is rooted in the Book of Deuteronomy: “He (the father) must acknowledge the firstborn . . . and give him a double share in all that he possesses, for he (the firstborn son) is the first fruits of his strength; the right of the firstborn is his.” Deuteronomy 21:17. For observant Jewish testators the practice of giving the eldest son a double portion, is an issue that must be resolved in light of the parent wanting sons and daughters (who do not inherit under Biblical law) to be treated equally. There are several mechanisms employed to equalize the inheritance including the creation of a debt to the children (who receive a lesser share in accordance with the law) for a significant sum of money, larger than the expected value of the estate. The debt becomes due one hour preceding the testator’s death. The debt passes to the legal heirs and it includes a provision voiding the debt if the legal heirs equally share their inheritance with the others.
Inheritance is already a source of tension without religion and cultural customs interfering. In addition to the actual property at stake, so are emotions and feelings. It would behoove all testators to consider the ramifications of any unequal treatment in a last will and testament as it will surely give rise to some form of conflict among the family.
–CORI A. ROBINSON

Valerie Harper's husband says he can't send her to hospice 
(CNN)Valerie Harper's husband says he will not follow doctors' advice to put his wife in hospice care.

Tony Cacciotti posted a note on his wife's official Facebook page Tuesday regarding her current medical state. 
"I have been told by doctors to put Val in Hospice care and I can't [because of our 40 years of shared commitment to each other] and I won't because of the amazing good deeds she has graced us with while she's been here on earth," the note began. "We will continue going forward as long as the powers above allow us, I will do my very best in making Val as comfortable as possible." 
The actress, who shot to stardom in the early 1970s as Rhoda Morgenstern on "The Mary Tyler Moore Show" and later starred as that character in a spinoff, has been battling cancer for years.Harper was first diagnosed with lung cancer in 2009.
In 2013, she was given three months to live after she was diagnosed with leptomeningeal carcinomatosis, a condition that occurs when cancer cells spread into the fluid-filled membrane surrounding the brain, known as the meninges.
But the 79-year-old actress has defied the odds and even participated in the reality competition show "Dancing With the Stars" in 2014.
Her family recently announced a GoFundMe account had been established to help pay for Harper's medical care.

On Tuesday, her husband posted in his note that "For those of you who have been in this position, you will totally understand that 'it's hard letting go.'"
"So as long as I'm able and capable, I'll be where I belong right beside her," Cacciotti wrote. "Many, many thanks for your outpouring of kindness and support."

Top concern of seniors?  Transportation. 

Well past time to bring the rails back.

Virginia Groups Call for New East-West Trains 
Demographic trends show need for greater transportation options.
Richmond, VA— A new report finds that expanding Virginia’s rail service to add an east-west corridor would make colleges and universities across the Commonwealth more accessible to students, increase economic development and tourism, and give 3.7 million Virginians additional access to passenger rail. 
 “This expansion to our rail system would increase points of access for so many people across the state and beyond,” said Danny Plaugher, executive director of Virginians for High Speed Rail, “the corridor could serve nearly 3.7 million Virginians who live within 20 miles of a rail station by expanding our transportation connectivity.”
Virginians for High Speed Rail, the Southern Environmental Law Center, the Hampton Roads Chamber, Virginia21, and Roanoke Regional Chamber jointly released the report, Expanding Virginia’s Passenger Rail: Connecting the Blue Ridge to the Beach with the Commonwealth Corridor. 


The benefits of creating an east-west rail service include: 

• Links 45 percent of our jobs and is estimated to generate millions in economic benefits. 
• Serves communities where 32 percent of Virginia’s anticipated population growth will happen. 
• Connects more than 300,000 students to 35 higher education schools across the state, including: Virginia Tech, University of Virginia, Virginia Commonwealth, Virginia State University, University of William & Mary, and Old Dominion University. 
• Increases connectivity for millennials and citizens over age 65 who are driving less. 
• Cuts fuel consumption by 800,000 gallons, and reduces carbon pollution by 15.4 million pounds when the corridor is fully operational. 
• Relieves roadway congestion on a corridor that has seen time stuck in traffic increase 6 percent from 2014 to 2019 according to the Texas Transportation Institute. 

“Since 1990, passenger rail has become one of the fastest growing mode of transportation in Hampton Roads.” stated Bryan Stephens, President & CEO of Hampton Roads Chamber “By connecting nearly half of the Commonwealth’s jobs with new cross-state passenger rail service, we’re giving our citizens and businesses even more travel choices. That makes good business sense!” 
“Mobility is a significant issue for Virginia’s college students and young professionals” said Jared Calfee, executive director of Virginia21. "Virginians under 35 possess the fewest drivers’ licenses per capita of any generation; exploring new options to get from point A to point B has the potential to make our colleges more accessible for students and our communities more attractive to the workforce of tomorrow."
“The Roanoke region is served by the top Regional train in the nation, which generates millions in economic benefits for our region,” stated Joyce Waugh, President and CEO of Roanoke Regional Chamber, “a cross-state train will open numerous economic opportunities for our communities including increased tourism and connectivity.”
“The need for more travel options is obvious,” said Trip Pollard, director of the Southern Environmental Law Center’s Land & Community Program. “To travel by train from Roanoke to Norfolk today would take 16 hours—including a 6-hour layover in Washington, DC. We can and we must do better for Virginians.”
We are asking that the Virginia Department of Rail and Public Transportation complete a feasibility study on the Commonwealth Corridor and outline potential next steps to launch this service as soon as possible.  
For more information, please visit www.CommonwealthCorridor.com or here to read the report. 
###
Virginians for High Speed Rail is a non-profit coalition of citizens, businesses, localities, community organizations, and economic development agencies that educate and advocate for the expansion of fast, frequent, and reliable rail service connecting our communities to increase the economic potential of the Commonwealth. We were founded in 1994 as a partnership between the Chamber RVA and the Future of Hampton Roads.  www.VHSR.com.
For over 30 years, the Southern Environmental Law Center has used the power of the law to champion the environment of the Southeast. With more than 80 attorneys and nine offices across the region, SELC is widely recognized as the Southeast’s foremost environmental organization and regional leader. SELC works on a full range of environmental issues to protect our natural resources and the health and well-being of all the people in our region. www.SouthernEnvironment.org
The Hampton Roads Chamber is a vigorous advocate for the economic success of its nearly 2,000 member businesses, which employ 280,000 men and women in southeastern Virginia. The Chamber promotes Hampton Roads’ healthy business climate through economic development, public policy initiatives, services, and benefits to members. The Chamber is dedicated to creating economic opportunity and enhancing the quality of life in Hampton Roads. www.HamptonRoadsChamber.com
Virginia21 is a 501(c)3 organization that has engaged over 100,000 young people in the political process by providing information, directing advocacy and coordinating political action on a non-partisan platform that includes higher education, student health and safety, and economic development. www.virginia21.org/
The Roanoke Regional Chamber fosters the growth of our members and our community by offering relevant programs and events designed to address business needs, solve business problems and increase opportunities for members. The Chamber promotes regional business by providing invaluable referrals and connections and influencing public policy to benefit all businesses. The Chamber was founded in 1889 and represents more than 800 businesses with over 75,000 employees and an estimated payroll of more than $1.5 billion. www.roanokechamber.org

A $100 million payday would solve a lot of problems...

​https://www.wsj.com/articles/executors-of-leona-helmsleys-estate-to-get-100-million-payday-11566912024

Genetic-Testing Scam Targets Seniors And Rips Off MedicareBy Melissa Bailey July 31, 2019
Republish This Story

Sherry Swan is one of many Californians who have filed complaints to the state’s Senior Medicare Patrol about potential fraud related to genetic tests. “It was just a scam from the minute he opened his mouth,” Swan says of a man who knocked on her door in June. (Ana B. Ibarra/KHN)

This story also ran on USA Today. This story can be republished for free (details). The 86-year-old woman in rural Utah doesn’t usually answer solicitations from strangers, she said, but the young couple who knocked on her front door seemed so nice. Before long, she had handed over her Medicare and Social Security numbers — and allowed them to swab her cheek to collect her DNA.
She is among scores of older Americans who have been targeted in a scam that uses DNA tests to defraud Medicare or steal personal information. Fraudsters find their victims across the country through cold calls, door knocking, email, Facebook ads and Craigslist. They also troll low-income housing complexes, senior centers, health fairs and antique shops. Sometimes they offer ice cream, pizza or $100 gift cards. Some callers claim to work for Medicare, according to a fraud alert issued July 19 by the Federal Trade Commission.
The woman in Utah said she didn’t know the purpose of the DNA test she submitted to this month — “I’m too old to remember” — but the visit troubled her for several nights, she said.
“I’d lie awake thinking about it, saying, ‘You fool, you shouldn’t have done that.'” (She spoke on the condition of anonymity for fear of being targeted by other scams.)
In interviews with Kaiser Health News, seniors around the country reported feeling betrayed, exposed and confused.
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Sign UpCapitalizing on the growing popularity of genetic testing — and fears of terminal illness — scammers are persuading seniors to take two types of genetic screenings that are covered by Medicare Part B, according to experts familiar with the schemes. The tests aim to detect their risk for cancer or medication side effects.
The scammers bill Medicare for the tests. The patients, who might never receive any results, typically pay nothing. But they risk compromising personal information and family medical history. And taxpayers foot the bill for tests that may be unnecessary or inappropriate.
Scammers can really cash in: Medicare pays an average of $6,000 to $9,000 for these tests, and sometimes as much as $25,000, according to the Office of Inspector General at the Department of Health and Human Services.
DNA test scams appear to be ramping up: Complaints to the inspector general fraud hotline have poured in at rates as high as 50 per week, according to Sheila Davis, an OIG spokeswoman. That’s compared with one or two complaints a week at the same time last year, she said.
The inspector general issued a fraud alert in June, urging seniors to refuse unsolicited requests for their Medicare numbers and take DNA tests only with the approval of a doctor they know and trust. By Medicare rules, DNA tests must be medically necessary and approved by a physician who is treating the patient.
In cases that have gone to court, scammers were accused of breaking those rules by paying kickbacks to doctors who agreed to order DNA tests for patients without ever treating them. The front-line recruiters who solicit the tests might work directly for a lab, or as independent contractors who divide revenue with a laboratory in exchange for bringing in extra business.
Some solicitors try to scare seniors into cooperating, said Shimon Richmond, an assistant inspector general for investigations. They warn seniors that they could be vulnerable to heart attacks, stroke, cancer or even suicide if they do not take the DNA tests.
“That’s a pretty egregious form of patient manipulation and emotional abuse,” Richmond said.
Richmond said the two tests involved in the scams are: CGx, which tests for genetic predisposition to cancer, and PGx, a pharmacogenomic test for genetic mutations that affect how the body handles certain medications. They’re part of a new frontier of preventive genetic health.
In New Jersey, three people were sent to federal prison in May for a scheme that used a purported nonprofit called Good Samaritans of America to persuade hundreds of seniors to take DNA tests. The co-conspirators raked in $100,000 in commissions from labs that ran the tests, according to the government.
“This is a gold-rush area for folks. It’s leading to a big response by the government,” said Assistant U.S. Attorney Bernard Cooney, a prosecutor in the case.
This month, a Florida doctor was charged in federal court for his role in an alleged fraud scheme to order DNA tests for patients in Oklahoma, Arizona, Tennessee and Mississippi. Patients were recruited through Facebook ads offering $100 gift cards, according to court records. The doctor allegedly confessed that he was being paid $5,000 per month to approve these tests, even though he never spoke to any of the patients involved.
Some labs accused of billing Medicare for unnecessary genetic tests — including Companion DX Reference Lab — agreed to repay the government but declared bankruptcy before doing so, leaving taxpayers on the hook.
Meanwhile, older Americans are encountering sales pitches that leave them feeling deceived.
In Weslaco, Texas, Will Dickey, a 71-year-old retired police detective, submitted to a DNA test at a health fair in February.
“I have a bunch of cancer in my family,” he recalled thinking, so “it’d help if I had an idea of what genes I had in me.” Three weeks later, he saw the same salesperson rounding up business at his RV park, where his wife and several neighbors got their cheeks swabbed. Dickey, who spent 10 years working with DNA tests in a police crime lab, said he was surprised at the cost: A lab in Mississippi charged Medicare $10,410 for his tests.
He didn’t get results until he requested them by phone. The report, which listed results as “uncertain,” was “a bunch of gobbledygook that makes no sense to anybody who’s not in the medical field,” he said. He reported the case to authorities as possible fraud.
As in Dickey’s case, scammers often gain access to places that seniors trust by persuading gatekeepers to let them make presentations. Bev Beatty allowed a genetic testing company to run a booth at a senior health fair she organized in Oak Forest, Ill., last year. At least 10 seniors took the tests. Afterward, she was irate to discover they had been roped into a scam. Test-takers told her they never received their DNA results, even though Medicare paid thousands of dollars.
“If somebody’s going to be fraudulent and bill Medicare, it kind of riles me up,” she said. “I would like to see them hanged.”
In Paducah, Ky., Donald McNeill, a 72-year-old Vietnam War veteran, was persuaded at an event at his senior center in December to submit a cheek swab for a DNA cancer screening. The company never sent results, he said. But it billed $32,212.86 to his Medicare supplement insurance plan. He’s worried his personal information will be misused.
“I’ve lost my identity to these people,” he said. “They got my DNA and they got my information through this scam. I’m extremely upset.”
Others may face consequences for merely engaging with scammers. In Idaho, a woman in her late 60s said she responded to an online ad for free genetic testing and got a callback 20 seconds later. She received a cheek swab kit in the mail but, suspecting a scam, never sent it in. Now, she said, she finds her phone suddenly plagued by robocalls.
In California, 1 in 4 cases reported to the state’s Senior Medicare Patrol this year for potential fraud have been related to genetic tests, according to Sandy Morales, statewide volunteer coordinator.
An employee of Whole Home Solutions left a flyer at Sherry Swan’s door. Pathway Labs handled about 20 tests sent in by Whole Home Solutions, but cut ties with the company after receiving complaints about how seniors were being solicited for the DNA tests.(Ana B. Ibarra/KHN)
Sherry Swan of Roseville, Calif., is one of many who have filed complaints. She said she was home one Sunday afternoon in early June when a man named Caleb knocked on her door, and said, “I’m here to do your DNA testing.”
“What are you talking about?” she recalled asking him. She said he failed to produce an ID when asked. “It was just a scam from the minute he opened his mouth.”
Swan said she spent five minutes arguing with the man, then called the police when he left.
“I’m aggressive. I work with homeless in the county,” said Swan, who is 64. But she said she worried about the more passive and trusting neighbors in her senior living complex. She later discovered that many had been persuaded to take the tests and divulge their family medical histories.
A man named Freddy, who answered a number on a flyer that Caleb had left at Swan’s door, said he supervised Caleb as part of a team from Whole Home Solutions. He said the operation was aboveboard because they enrolled only eligible Medicare beneficiaries, and that a teledoctor would consult with the person’s treating physician before the tests were sent in. The tests were handled by Pathway Labs in Colorado Springs, Colo.
Pathway Labs CEO Rene Perez confirmed his lab handled about 20 tests sent in by Whole Home Solutions. But he said he cut ties with the company on July 6 on the advice of his attorneys after receiving complaints about how seniors were being solicited for the DNA tests. The lab worked with the outfit for about 45 days, Perez said.
Such experiences make him “reluctant to take on new business” from similar entities sending in DNA tests, Perez said.
“We strongly advocate and believe in the benefits of genetic preventative health,” he said. “But the problem that we see right now is that it’s really picking up momentum on the national level. Unfortunately, when that happens, you get a variety of different sorts of groups that essentially may see dollar signs.”
To seniors curious about these DNA tests, Richmond of the inspector general’s office has this advice: “If anyone calls you, or sends you an unsolicited request for your Medicare number or to convince you or scare you into taking a genetic test, either hang up the phone or say no.”
Seniors interested in the tests should call their primary care provider, he said: “Don’t give into the manipulation or the scare tactics to get this health care test from someone you don’t know.”
If you suspect Medicare fraud, contact the OIG Hotline online or at 1-800-HHS-TIPS.
[Correction: A previous version of this story incorrectly stated the terms of a bankruptcy case involving Millennium Health; as part of its case, the firm paid a government settlement in response to accusations that it billed Medicare for unnecessary tests.]

Tips for Older Consumers to  Stop Illegal Robocalls
Tip Sheet •  July 2019
Jeremiah Battle, National Consumer Law Center
Robocalls, the persistent automated telephone calls to cell phones and landlines, are a favorite tool of telemarketers, debt collectors, and scammers. Older adults anticipating important calls from medical providers and others may be reluctant to answer the phone due to excessive or unwanted telephone calls. There is no completely effective method to stop unwanted robocalls, and real solutions require that the Federal Communications Commission use the laws effectively to regulate robocallers and require phone companies to authenticate all calls. Yet, the following tips can help consumers take some control:

1. File complaints with the Federal Communications Commission (FCC): Complaint data is the best tool federal agencies have to gauge the extent of the robocall epidemic. While filing a complaint may not prompt an immediate response, complaint data may prompt the FCC to take action. The Telephone Consumer Protection Act (TCPA) is the only legal defense to robocalls and texts made  without your consent, and the FCC is tasked with upholding and strengthening the TCPA’s rules and regulations. File a complaint here.

2. Add your number to the Do-Not-Call List: While the Do-Not-Call list does not stop all robocalls, it is a valuable resource for removing your number from the call lists of companies that do not want  to violate the law. Sources of robocalls that you do business with, such as banks or loan servicers, and sources of scam calls that ignore the law, will still get through. Add your number here.

3. Revoke consent: If you are receiving robocalls from a bank, lender, or other company you do business with, they likely have your consent (hidden in the fine print) to robocall you. While they like having the option to robocall, it isn’t their right, and you can revoke your consent at any time. Tell the caller you “revoke consent.” If the calls continue, contact customer service and tell them that you do not consent to receive calls and that you want your number to be added to their “do not call” list. This won’t stop illegal scam calls but it will reduce the volume of robocalls you receive.

4. Don’t engage with the caller: Most autodialed robocalls include a prompt to press a key or give a voice command. DON’T! Pressing a key, even if the recording says it’s to remove your number from the list, tells the caller that your number is active and that you’ll likely answer future calls. Even worse, the voice commands can be recorded and used against you by scammers to represent consent to purchase products or services.

5. If possible, block or do not answer calls from unknown numbers on your mobile device: Easier said than done, taking this action will help avoid robocalls. But important calls can come from unknown numbers and most landline phones don’t have call-blocking features. Plus, listening to voicemails left by robocallers can be just as annoying, and costly (if you purchase phone service by the minute), so use this method as a last resort.

6. Install call-blocking apps: Various call-blocking apps, like YouMail and NoMoRobo, provide a free or low-cost service to mobile smart phone users that filter out identified scam robocalls and allow users to block specific numbers and report the calls. However, typically these apps don’t help landline users.

7. Let them know they are calling you at a nursing home or other medical facility: The TCPA prohibits robocalls to a patient or guest room at a nursing home, hospital, or similar health facility.  

8. Find out what type of debt collector is calling: Collectors can call about debts owed or guaranteed by the federal government without your consent. There are exceptions to this rule in some states. In those states, robocalls to cell phones from debt collectors collecting federal debt can only be made with consent, as is the rule for all other robocalls to cell phones.

9. Sue the caller: A lawsuit can be challenging, but the TCPA allows consumers to file a lawsuit to stop the robocalls. If successful, the consumer can receive money, either actual damages or $500 per violation, whichever is greater. The damages can be tripled for knowing or willful violations.
​
This Tip Sheet accompanies NCLER’s webcast and Chapter Summary on Protecting Older Adults Against Abusive Telemarketing Scams. You can also find more information at the National Consumer Law Center’s Robocalls and Telemarketing page.
Case consultation assistance is available for attorneys and professionals seeking more information to help older adults. Contact NCLER at [email protected]

A 'catastrophic' trend in Maine: A shortage of caregivers

​Jeff Stein, The Washington Post
 Published 9:32 pm EDT, Wednesday, August 14, 2019

DOVER-FOXCROFT, Maine - Janet Flaherty got an alarming call last October from the agency tasked with coordinating in-home care for her 82-year-old mother. It could no longer send her mom's home caretaker. It knew of no other aides who could care for her mother, either.
Flaherty's mother, Caroline, has for two years qualified for in-home care paid for by the state's Medicaid program. But the agency could not find someone to hire amid a severe shortage of workers that has crippled facilities for seniors across the state.
With private help now bid up to $50 an hour, Janet and her two sisters have been forced to do what millions of families in a rapidly aging America have done: take up second, unpaid jobs caring full time for their mother.
"We do not know what to do. We do not know where to go. We are in such dire need of help," said Flaherty, an insurance saleswoman.
Across Maine, families like the Flahertys are being hammered by two slow-moving demographic forces - the growth of the retirement population and a simultaneous decline in young workers - that have been exacerbated by a national worker shortage pushing up the cost of labor. The unemployment rate in Maine is 3.2 percent, below the national average of 3.7 percent.
The disconnect between Maine's aging population and its need for young workers to care for that population is expected to be mirrored in states throughout the country over the coming decade, demographic experts say. And that's especially true in states with populations with fewer immigrants, who are disproportionately represented in many occupations serving the elderly, statistics show.
"We have added an entire generation since we first put the safety net in place but with no plan whatsoever for how to support them," said Ai-jen Poo, co-director of Caring Across Generations, which advocates for long-term care. "As the oldest state, Maine is the tip of the spear - but it foreshadows what is to come for the entire country."
Last year, Maine crossed a crucial aging milestone: A fifth of its population is older than 65, which meets the definition of "super-aged," according to the World Bank.
By 2026, Maine will be joined by more than 15 other states, according to Fitch Ratings, including Vermont and New Hampshire, Maine's neighbors in the Northeast; Montana; Delaware; West Virginia; Wisconsin; and Pennsylvania. More than a dozen more will meet that criterion by 2030.
Across the country, the number of seniors will grow by more than 40 million, approximately doubling between 2015 and 2050, while the population older than 85 will come close to tripling.
Experts say the nation will have to refashion its workforce, overhaul its old-age programs and learn how to care for tens of millions of elderly people without ruining their families' financial lives.
The results of not doing so fast enough are already visible in Maine. At the Hibbard Nursing Home in a rural slice of the state, Beth Lagasse cried softly as her father recovered down the hallway in Room 113.
Lagasse's mother broke her back in May and died in June. Her father suffered a stroke in July. The nursing home near her has no open beds, so she drives an hour every day to care for her ailing father after spending months caring for her mother.
Lagasse has not been able to read a book, go canoeing or take care of her 1-year-old Shetland puppy, Paddy, since her mother first got sick. Lagasse, a physical education teacher, and her three siblings cannot afford the cost of 24/7 care, although Medicare temporarily covered her father's hospitalization.
"I love them. I love them dearly," Lagasse, 55, says of her parents. "I just wish this weren't so hard."
- - -
Over the past two years, Mark Honey's rare form of muscular dystrophy has proved so debilitating that he has lost control of his hands, legs and arms. Living alone in the small town of Ellsworth, Maine, Honey, 63, has for about 18 months looked for a nursing home where he can receive 24-hour care.
But with nursing homes across Maine closing at an unprecedented rate, Honey has been unsuccessful. Medicaid pays for a care aide to come to his home for 70 hours a week. But the state has told Honey it cannot find enough workers to cover the hours, even though he legally qualifies for the care.
Care workers in Maine were paid about $11.37 an hour in 2017, according to an AARP report, with a 2019 minimum wage of $11 an hour. As Kristi Penny, who has cared for Honey for four years, noted over the phone: "Even Dunkin' Donuts pays you more."
Honey said he lives in fear of one of the caretakers getting sick and quitting or finding another job. "When you're confined to a bed, there's not much you can work with," Honey said. "It only takes one or two of the girls being sick, or one of the two of them quitting, for me to not be covered. And then you're up the creek without a paddle."
With its 65-and-older population expected to grow by 55 percent by 2026, Maine needs more nurses, more home-care workers and more physicians than ever to keep pace with demand for long-term-care services.
But the rising demand for care is occurring simultaneously with a dangerously low supply of workers. About one-third of Maine's physicians are older than 60. In several rural counties in the state, close to half of the registered nurses are 55 or older and expected to retire or cut back their hours within a decade.
Maine's largest long-term-care provider, North Country Associates, has been forced to temporarily close admissions in each of its 26 nursing homes because of staffing shortages, sometimes for as long as several months, in an unprecedented change from a few years ago.
It has also permanently shut down two of its nursing homes over the past year, while about a dozen nursing homes across the state have closed their doors over the past several years. Mary Jane Richards, chief operating officer at North Country Associates, said she has already raised wages four or five times in a bid to hire or retain staff.
"There are simply just not enough people to go around," she said. "We try to elevate our wages, but then the nearest facility brings theirs up."
Betsy Sawyer-Manter, president of the SeniorsPlus agency responsible for placing care workers with Medicaid enrollees, said she was not surprised by Flaherty's story of failing to find a worker for her mother, despite qualifying for care. Sawyer-Manter said that every week her agency cannot fill more than 6,000 hours of direct care that have been authorized by the state because of worker shortages.
"If there aren't any workers in that area, there's nothing we can do," Sawyer-Manter said. "As people retire, we just don't have enough workers to do all the jobs we need done."
- - -
From 2015 to 2050, the number of Americans 85 and older will increase by more than 200 percent, while those ages 75 to 84 will rise by more than 100 percent, according to AARP. By contrast, the number of Americans younger than 65 will increase by about 12 percent.
America's federal programs have not kept pace with this enormous demographic shift. With a few minor exceptions, Medicare does not pay for long-term-care services. Medicaid offers limited benefits but is available only to the very poor. The private market also has not been able to fill the void, as 7 percent of costs in the long-term-care market are covered by private long-term insurers.
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The United States is projected to have 7.8 million job openings for care workers by the middle of the next decade, making it among the fastest-growing professions in the country, with millions of new openings created by higher demand; millions of care workers retiring; and millions more finding new professions, according to the Paraprofessional Healthcare Institute, an advocacy organization. The total cost of caring for America's elderly will double from $2.8 trillion to $5.6 trillion by 2047, a report by the consulting firm PwC found.
"The U.S. is just starting this journey, and Maine is at the leading edge," said Jess Maurer, executive director of the Maine Council on Aging. "As we are living longer, all the systems that have always worked for us may have to be changed."
Congress created a commission to study the long-term-care problem. In 2013, it issued dozens of recommendations, including a "national strategy" to help family caregivers, but "a fair number of these things have not been implemented. Those that have been implemented are being implemented far too slowly," said Bruce Chernof, co-author of the commission's report and president and chief executive of the SCAN Foundation, which advocates on long-term-care issues.
"Left unaddressed, this will be catastrophic. We as a country have not wrapped our heads around what it's going to take to pay for long-term care," Chernof said.
Other countries have responded to their aging populations with government-provided care, and many have beefed up the number of aides and providers. America and England are the only economically developed nations in the West that do not provide a universal long-term-care benefit, said Howard Gleckman, author of a book about long-term care and a senior fellow at the Urban Institute, a nonpartisan think tank.
"With climate change, towns get burned down, or people die in fires," which helps focus national attention, Gleckman said. "This is one family at a time suffering in silence."
- - -
Albert Rose sits on the wharf of his seafood business and fumes that he cannot find help with his daily work of moving and unloading 50 crates of lobster, each often more than 100 pounds. In Harpswell, median age 57, he lives in the oldest town of America's oldest state.
Rose, 40, has suffered from two torn rotator cuffs and a herniated disk but continues to perform the heavy labor himself in part because he has for the past five years been unable to find young workers, absent sporadic help from college students during their summer vacations.
"Ten years ago, every spring you had young people wanting work on the wharf or want to work on a lobster boat," Rose said. "I haven't seen a single person this spring or summer looking for boatwork."
Maine's aging population, and its dearth of young workers, falls particularly hard on poorer businesses and parts of the state that do not have enough resources to compete amid the shortfall.
Piscataquis County, a region in the north battered by the closure of its lumber mills, will see the number of people ages 75 to 84 increase by 81 percent from 2015 to 2025, according to the Muskie School of Public Service at the University of Southern Maine.
The biggest impact likely is in health care for the elderly.
There are 34 physicians in the county, about 70 percent less than the state average per person, and fewer available nursing home beds per person, according to a Maine Health Access Foundation report. Half the physicians in the county are older than 50, as are half the nurses.
Stepping into the breach is Pine Tree Hospice, one of the few dozen volunteer hospices in the United States. The hospice's volunteers do not provide medical services, but they go to the homes of patients in end-of-life care, cooking, cleaning or playing a game of cribbage. About one-quarter of the volunteers are themselves in their 70s. They like reciting the hospice's motto: "We can't add years to your life, but we can add life to your years."
When Jane Stitham began as the executive director of the hospice about a decade ago, she urged as many elderly people as possible to call for free end-of-life care. But over the past two years, Stitham said, the hospice has shifted its focus to recruiting new volunteers, as its waiting list has grown dramatically. Every month, Stitham has to turn away one to two people whom the hospice cannot reach.
"There are far too few younger people in the mix of volunteers," said Meg Callaway, who ran a program in the county focused on helping older people.
Cliff Singer, who runs an Alzheimer's clinic in an isolated northern region of the state, said his waiting list has more than doubled to 70 people, meaning it takes 10 months for patients to see him. Singer is trying to hire nine nurses, which would allow him to cut his waiting list dramatically, but he only has three, in part because of fierce competition from other hospitals and clinicians.
"It feels awful not to be able to help more people," Singer said. "But we really can't."

Aging In Place Programs That Really Work
Richard Eisenberg Contributor



Aging in place is an appealing idea to many of us: the ability to continue living in the homes we cherish as we age into our 70s, 80s and 90s, rather than move. There are just two problems: many homes aren’t designed for health issues that can come with getting older and aging in place alone can be lonely. Have I got some ideas for you. Four, actually.
They’re the three winners and one honorable mention of the Innovation@Home contest for smart, effective age-friendly housing practices around the world. (The National Association of Area Agencies on Aging also recently honored 48 programs that help older adults age in place, with its 2019 Aging Achievement and Innovations Awards.)
The Innovation@Home competition was conducted jointly by Grantmakers in Aging (a group for philanthropies who aim to improve the experience of aging) and the World Health Organization Global Network for Age-Friendly Cities and Communities. It was funded by the Robert Wood Johnson Foundation.




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Today In: Money The Innovation@Home Competition
The idea: to find the best age-friendly housing innovations that could be implemented around the U.S. Clearly, there’s a huge interest — the Innovation@Home report was downloaded 1,200 times the first two weeks after it was released.
When the judges selected among aging in place entries from 15 countries, two winners came from Europe — the Home Refurbishment Program of Barcelona, Spain and the Aconchego home-matching program in Porto, Portugal. One winner, the No-Cost Building Permits program of Sausalito, Calif., and the honorable mention , CHORE Volunteer Handyman Service of Bergen County, N.J. are in the United States.“People don’t want to be forced to go to someplace they’ve never lived in their life,” said John Feather, CEO of Grantmakers in Aging (and a 2016 Next Avenue Influencer in Aging). “And a lot of programs we saw emphasize that.”
Feather said he believes aging in place in the United States is developing rapidly around the world but added that “there’s still very far to go.” One reason: “Practically none of the people who do zoning have training in aspects of aging,” Feather said. “And traditionally, aging services agencies have not developed a willingness to talk to them on a systematic basis.”
Susan Mende, senior program officer at the Robert Wood Johnson Foundation, said the competition’s judges were “looking for approaches and programs that could be adapted and replicated somewhere else. The question they asked was: ‘Is this a one-off or can it go to scale?’”
Here’s a bit about the three Innovation@Home winners and the honorable mention:
Winner: No-Cost/Low-Cost Building Permit Program of Sausalito, Calif.
Sausalito is a gorgeous, quaint seaside community just over the Golden Gate Bridge from San Francisco; 34% of its residents are over 60. But since many Sausalito homes are multi-level and built on a steep hillside, they can be difficult for older inhabitants and can lead to falls.
So, Age Friendly Sausalito, a volunteer group of older residents, worked with municipal officials, to create The Age-Friendly Home Adaptation Grant program in 2018. It lets Sausalito homeowners age 60 and older (or younger ones with a disability) get free or reduced-cost building permits for projects of up to $10,000 to improve the safety and accessibility of their residences. The program has been so successful, all California cities and counties can now waive building permit fees for this purpose.
“For a $2,400 construction job putting in a ramp or a chairlift, you might save $800,” said Sybil Boutilier, chair of Age Friendly Sausalito. “One person said, ‘I was thinking I would have to leave. There are so many entry stairs in my home. I was able to put in a ramp and handrail and make my bathroom more accessible. It really made a huge difference.’”
Winner: Aconchego Home-Matching Program of Porto, Portugal
This program in the university town of Porto matches residents age 60 and older who have extra room in their homes with students ages 18 to 35 who need a place to live. The older people get
companionship; the students get free housing. Nearly 400 people have participated in the Aconchego Program since it was launched by Porto City Hall and the Academic Federation of Porto in 2004.
“Social isolation and loneliness is a very big issue for many older people around the world, including in the U.S., and it’s tied to ill health,” said Mende. “At the same time, housing can be expensive in university towns. Lots of students in Porto had trouble finding places they could afford.”
An added bonus: the Aconchego program helps prevent older people from spending time only with older people and younger ones from spending time only with younger ones.
Winner: Home Refurbishment Program of Barcelona, Spain
Here, the most vulnerable people age 65 and older in the Barcelona region (other than the city of Barcelona itself) can get non-structural home repairs, mostly in bathrooms and kitchens.
The Home Refurbishment Program, run by La Diputació de Barcelona, also improves home energy efficiency and provides technology like assistive devices to help residents have greater independence and a better quality of life.
The Barcelona County Council coordinates and finances projects and works with a private firm to manage the construction. Roughly 10,500 people have been helped since the program began in 2009.
“Sometimes, it’s just a question of getting someone in to fix that broken step or that cracked tile or that broken light that a person can’t reach,” said Mende. “That can make a big difference to being safe at home.”
Honorable Mention: CHORE Volunteer Handyman Service of Bergen County, N.J.
Bergen Volunteers’ CHORE helps residents age 60 and older in the 70-municipality northern New Jersey county (as well as people with disabilities) live safely in their homes by performing minor home repairs.
What’s more, most of the crew volunteers in this 42-year-old program are retirees. Some are skilled and a lot “are home tinkerers” said Lynne Algrant, CEO of Bergen Volunteers.
“There is something about seniors helping seniors that is very special about this program,” noted Algrant. “There’s a really charming sensitivity on the part of the volunteers about making a visit and puttering around and asking how folks are.”
CHORE charges clients for parts, if the residents can afford it, but not for labor.
“We’ve done a couple of thousand grab bars,” to help people maintain balance and grab onto in case of a fall, noted Michelle Ogden, CHORE’s director. “We can change light bulbs. We also do banisters and light electrical work and light plumbing work. It’s really a relief for seniors to get a service call. An electrician or plumber is outrageously expensive.”
CHORE estimates clients save an average of $500 by using the service.
Kimberly Malone, director of Bergen Volunteers, recalls a client who said CHORE had been coming to her home for 20 years. The woman said, “My children sometimes want me to transition [to another place], but this is my community, and this is what I know,” noted Malone.

Richard Eisenberg I'm the Senior Web Editor of the Money & Security and Work & Purpose channels for Next Avenue, a new site for people 50+ from PBS. I have helped people manage th...
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