Health Care Planning for NYS
The Committee on Health Planning
The Health Planning Committee advises the Council on need-methodologies, health facility plans, and emerging health care issues. Monitors major health care initiatives and advises the Council on progress and/or problems.
The Committee has taken on the challenge of easing the regulations for some aspects of the Certificate of Need process regarding capital projects. They want to make recommendations to the Governor to eliminate the long period of time it takes for construction projects to go through the review process, to unify reviews that require multiple agency reviews and to raise the financial level of projects requiring review. The Committee is interested in hearing from stakeholders, including payers, that have an interest in
what is needed in their communities.
While they are discussing this, the Medicaid Redesign committee is asking the governor for more resources for the DOH.
The Rewards of Networking
My current client was referred to me by someone I only met once. I don’t know how to thank her, because I never had her card and I didn’t meet her at any official networking site or event. I met her through a client, who was using both of our services. It was just a chance meeting, actually more of an introduction, like “Caryn, this is so and so, so and so this is Caryn.” You can imagine my surprise when I got a call a week later saying that this person had highly recommended me.
I was more than surprised. I was stunned, since I spend hours every day networking online and at meetings and events.
This led me to wonder if other people I know from my networking were getting business from their efforts. I decided to put out a blast asking people if they would be interested in talking about networking. Here are the questions I asked:
1. Do you have occasions to refer clients to other professionals?
2. How do you include referrals in your regular work process?
3. How do you decide which referrals are appropriate for which client?
4. Do you get referrals from other professionals in return?
I thought this might make a good start for a series for the Patient Advocate Institute, where I write to help people who are learning to become Patient Advocates.
The first to answer me was Robert Israel, CLU, founder of Long Island Planning Group. “Making a decision about long term care planning is very difficult. Clients need to consult with attorneys, tax accountants, pension advisors and others. I am often asked for a referral to one or more professionals. I’ve developed a reputation as someone who is willing to answer questions, so most of my referrals come from current clients.” Bob explained in a phone conversation, “I go to networking events, so that I can keep up to date with my referral sources at least once a month.” Bob also has a Refer a Client button on his website.
Ellen Makofsky has been named among the Top 50 Women Superlawyers in the New York-Metro area. She invited me to her office, where we talked about the benefits of belonging to the Senior Umbrella Network, where I am a member and Ellen is President of the Board. Both of us agreed that SUN is one of the best networking groups around because the membership is so diverse and the directory is a tremendous resource. She made a statement that really brought home to me how attorney’s work with their clients. “Every client is unique. At Raskin & Makofsky, LLP, we take the time to get to know our clients and craft a strategy that best suits them. Our discussions with clients must include what they have done in every aspect of their lives and what they hope to achieve in their planning for the future. Our attorneys and staff believe that our duties go beyond tending to our clients’ legal needs to providing them with resources and referrals when necessary.”
David Taub of White Glove Consulting replied by email. “Yes, there are times that I would refer clients to other professionals, whether it be a home care agency, nursing home, assisted living facility or elder law attorney. Based on the situation of my client I determine what other services they are in need of or can benefit from and I would either give them that professionals contact information or complete a referral form and send it to the professional myself. Because of what we do and the type of services we provide, we do have dealings with other professionals on a daily basis and we cross reference clients to each other. We pretty much equally share our referrals with whomever we work together with but if there is a client with a specific situation that will benefit more from one professional over the other (whatever the reason may be) then we will refer them to the more beneficial one.
Our business does get referrals from other professionals as well. We establish referral sources by networking, and marketing our services to professionals that can benefit from them. After we send/receive a 1st referral to/from a professional or company and they experience the real benefit in working together with us, they usually become an established referral source.”
I’ve known Ron Fatoullah, Managing Partner of Ronald Fatoullah and Associates for many years. Most of what I know about elder law comes from Ron’s newsletters and the times I’ve heard him speak. He is a sponsor of Senior Umbrella Network of Brooklyn and until recently, I was a Board Member and still manage their website. We talked in his office in Great Neck. “We were never a jack of all trades. Our firm was founded as an elder law practice, before there was a term elder law.” Ron explained how he talks to clients, “Our initial consultation is over an hour and a half to two hours. We have to read between the lines of what the client is trying to tell us. We ask the client, would it help you to speak to an expert? We routinely refer to Patient Advocates, Geriatric Care Managers and Home Care Agencies to help people with their health care needs.” Ron shared that most of his referrals came from the lectures he gave, especially to other attorneys and to associations such as for nursing home administrators. “Professionals are comforted by knowing that they can get help with questions they have about their clients needs, especially about complicated issues like Medicaid Planning.”
Next, we will ask clients if they believe they received appropriate referrals and how satisfied they are with the referrals they have gotten.
Caryn Isaacs, Patient Advocate
GetHealthHelp.com
347-965-9222
SOURCES:
Robert Israel, Long Island Planning Group
300 JerichoQuandrangle West, Suite 310
Jericho, NY 11753
516-918-3535
risrael@jhnetwork.com
http://liplanning.com
Ellen G. Makofsky, Esq
Raskin & Makofsky, LLP
600 Old Country Road Suite 444
Garden City, NY 11530-2009
Phone: (516) 228-6522
http://www.raskinmakofsky.com
David Taub
White Glove Consulting
1222 Avenue M Suite 409
Brooklyn, NY 11230
P. 718-878-3666 ext. 100
David@whitegloveconsultants.com
http://whitegloveconsultants.com
Ronald A. Fatoullah, Esq
Ronald A Fatoullah and Associates
60 Cutter Mill Road, Suite 507
Great Neck, New York 11021
Telephone: 516-466-4422
rfatoullah@fatoullahlaw.com
http://elderlaw-newyork.com
Bklyn Borough Pres Advisory Committee on Disability Issues runs into Accessibility Snafu
Brooklyn Borough Hall Smells Like Gasoline
A smell of gasoline coming from the elevators caused the meeting of the Brooklyn Borough President’s Advisory Council on Disability Issues to be relocated. Nan Blackshear, Seniors and Disabilities Policy Analyst and Community Liaison, Bklyn BP’s office, put out chairs while attendees waiting in the rain for an hour before being relocated to another building. They really need a portable ramp for these emergencies. The meeting, moved to St. Francis, including refreshments, went off without a hitch.
Health Care Reform Victory
For Immediate Release
Tuesday, November 8, 2011
Contact: Vincent Eng
+1 703 981 6636
media@healthlaw.org
Health Care Reform Victory
Court Upholds Constitutionality of ACA
Washington, DC – The National Health Law Program (NHeLP) welcomes today’s ruling in the United States Court of Appeals for the District of Columbia, upholding the constitutionality of the Affordable Care Act (ACA). The ACA includes a significant expansion of Medicaid, one that will improve access to care for working poor and chronically ill people in particular.
“We are pleased with the court’s decision. The ACA has already improved the lives of millions of Americans,” said Emily Spitzer, executive director of NHeLP. “This decision will help ensure Medicaid coverage and eligibility to over 16 million people.”
In a 2-1 decision, Judge Laurence H. Silberman, affirmed the lower court’s ruling, finding that the ACA’s individual mandate — the requirement that nearly all persons have health insurance — is within Congress’ powers. Notably, Judge Brett Kavanaugh’s dissent disagreed with the conclusion, without taking a position on the merits of the law, stating that the case lacks standing until the law takes effect in 2014.
“NHeLP has been actively involved in implementation of the law and has been carefully monitoring challenges to the ACA in our courts,” said Jane Perkins, NHeLP legal director. “Today’s decision was the second appellate court that upheld the constitutionality of the ACA and it’s becoming clear that the earlier 11th Circuit decision is an outlier in the legal analysis of the law.”
This past August, the 11th Circuit Court of Appeals held the ACA’s individual mandate unconstitutional, but severable from the rest of the law. Judge Silberman’s decision today, however, joins the 6th Circuit Court of Appeals’ decision [Judge Jeffrey Sutton filed a concurring opinion] in upholding the constitutionality of the ACA. The U.S. Supreme Court is considering this week whether to resolve conflicting rulings over the law’s requirement that nearly all Americans buy health care insurance
Sunrise Senior Living Families Get Information
Sunrise Senior Living At Sheepshead Bay Family Day
Judith Grimaldi, Esq. of Grimaldi & Yeung LLP
Judith Grimaldi, Esq ran down the changes in Medicare and Medicaid. Henni Fisher,LCSW, BCD, Alzheimer`s and Aging Resource Center of Brooklyn filled in the blanks and fielded questions. Caryn Isaacs, Patient Advocate discussed how a Patient Advocate can help with decisions when faced with hospitalization, rehabilitation and home care. She introduced special guests Eilish and Ken Natton, who went through the process of getting their home ready for Eilish, who lives with Parkinson’s Disease. Several people from the neighborhood came in to see what Sunrise had to offer. They were treated to live entertainment and wonderful food. The family day health fair which included Sea Crest Health Center and Shore View Center for Rehabilitation and Health Care, Ramps/Lifts for Better Living, Mickey Green, Mutual of Omaha, Visiting Nurses and more was arranged by Anvernette Hanna, Director of Community Relations at Sunrise Senior Living of Sheepshead Bay and Bonnie Nogin, Quality Recreation Solutions.
Donations
As you open your pockets for the next natural disaster, please keep these facts in mind:
The American Red Cross President and CEO Marsha J. Evans salary for the year was $651,957 plus expenses
The United Way President Brian Gallagher receives a $375,000 base salary along with numerous expense benefits.
UNICEF CEO Caryl M. Stern receives $1,200,000 per year (100k per month) plus all expenses including a ROLLS ROYCE .. Less than 5 cents of your donated dollar goes to the cause
The Salvation Army’s Commissioner Todd Bassett receives a salary of only $13,000 per year (plus housing) for managing this $2 billion dollar organization. 96 percent of donated dollars go to the cause.
The American Legion National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Veterans of Foreign Wars National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Disabled American Veterans National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Military Order of Purple Hearts National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
The Vietnam Veterans Association National Commander receives a $0.00 zero salary. Your donations go to help Veterans and their families and youth!
Sometimes there isn’t any help.
The past few months have been busy with helping one of our favorite clients move. We set up a new blog for BeverlyTaylorJDL at worpress. Beverly just turned 86. We are going through everything she wants to have preserved and getting prices for things that will be sold to free up some space.
Peter is also moving, back to New Hampshire. He is recovering from knee surgery and can now live independently. We’ll be helping him pack up over the Labor Day holiday.
We’ve arranged for White Glove Consulting to help Arnold get the social services he needs, after a year of rejections and setbacks.
It’s great when you can help someone and accomplish what you set out to do. But sometimes, you just have to recognize that nothing more can be done. Issues related to mental health are something we’ve only dealt with in regards to seniors, dementia, Alzheimer’s, hoarding and personality changes. For the past few months, we’ve been helping a younger patient find health services. She came to us complaining of chronic fatigue and insomnia. As usual, we started with getting a medical clearance. Then, we arranged for a psycho-social exam for housing. We’ve gained an appreciation of the adult home business. They are truly dedicated people. The psychological assessment opened up a new diagnosis that changed our approach entirely. We were able to find many services that would have helped the patient. However, in our journey with her we found that she had a history of resistance to care and substance abuse. She was also under the influence of people who enabled her behavior.
After discussions with the psychiatrists, attorneys, the Department of Health, Abuse Victim Advocates and Mental Health Specialists we decided to end her services. This was a very difficult decision and one that included her family. They assured us that many had tried to help, but it was time to throw in the towel. The family will now move towards appointing a legal guardian. I’ve been told that we did help in many ways, just maybe not in the way we hoped.
Unexpected Illness & End of Life Planning
If you follow Caryn on LinkedIn, Facebook or Twitter, you probably have read about the client who was diagnosed with a benign meningioma. She was 77 years young and enjoying her retirement from the local University. Her children and grandchildren all lived with her in the home her late husband had purchased when he returned from the war.
Her youngest daughter had inherited her husband’s diabetes and recently she required a lot of medical care. The daughter was still working, but had used up all her FMLA and was hoping to get disability soon. The family had already used all their credit paying for these medical bills.
Then, one day Mom fell down and couldn’t get up. At the hospital, they found the tumor, but it was considered inoperable because the patient had many other health complications. I got the call for help when Mom’s Medicare was almost set to run out. The discharge planner at the hospital was pressuring the family to apply for Medicaid and move their mother to a nursing home. Mom was very upset about the idea and became very loud about her feelings. As happens, the doctors put her attitude down to dementia.
I met with the son and the daughter who was sick herself, but was the one everyone counted on to understand all the issues since she worked in health care too. Mom was suffering from many symptoms of the meningioma, physical and mental. To make matters worse, Mom’s social security check wasn’t in her account. I suggested they check with the discharge planner, and sure enough her check had been diverted to a rehab facility she was in briefly during this event.
The first steps I suggested, was for the sister to get the doctors to give the dementia diagnosis in writing. Then someone needed to go to the social security office and be made the payee. They also needed to arrange for a Power of Attorney and Health Care Agent. All the while, the hospital staff kept changing the plan from Mom going to a rehab, going to a psychiatric adult home and going in for more tests. Mom was now on a respirator, so she couldn’t express her wishes.
At this point, I suggested that the family ask the doctors about hospice care. It took the hospital another two weeks, while they did more tests before they arranged for the transfer to a hospice facility. As if that wasn’t enough, the family dog died at home. Mom was at the hospice for another week, when she passed peacefully with her whole family around her. The house was safe and her assets intact since hospice is covered by Medicare.
Now, this should have been a satisfactory ending to the story, but what happened next is why this story is about the need for preplanning. As far as anyone knew, Mom had never made out a will. The children thought she had some kind of life insurance policy, but no one could find it. The funeral parlor accepted a deposit and said they would take assignment of the insurance policy for the rest. The son called me just as the wake was about to begin. They couldn’t find the policy and her employer didn’t have any record of one. He couldn’t find any of the paperwork about the house either. The funeral parlor stopped the service and offered the family a lesser costing arrangement and the family made do with that.
Now, they have to go to the probate court to appoint an administrator, which will probably be the sister. She will have to research all of Mom’s assets including finding the deed and her creditors before she can distribute the estate. The family doesn’t have any access to Mom’s accounts, and their credit is all gone, so they can’t hire an attorney for help.
This story could have been so different if there was just a little preplanning. Mom, knowing she had three children who lived in her house with their children could have made a simple will. She could have appointed one of the children as her Health Care Agent, so they could have avoided the unnecessary medical treatment and bills. They could have made sure her final wishes were followed in regard to her funeral and spent the time mourning her now, instead of scrambling for paperwork. I can only imagine that Mom has her dog in her lap and is shaking her head for not doing that planning.
Hoarders
I have an unusual amount of new clients who could be considered hoarders. Here is an article about this condition and the senior population.
http://www.aarp.org/health/conditions-treatments/info-02-2011/the_hoarders_among_us.1.html
AGINGICON.COM
Have you lived a life of accomplishment, doing what fulfills
you? Have you reached an age where things are harder to do?
Are you a leader and you know that you cannot do it alone?
Then, you are an Aging Icon.
My name is Caryn Isaacs.
Having been at the helm of developing hundreds of healthcare
businesses and running several multi-million-dollar companies,
my journey includes pioneering a physician-owned HMO and
active engagement in Healthcare Reform.
As a Patient Advocate, my company, GetHealthHelp, LLC,
specializes in crafting solutions that enable Aging Icons to
continue pursuing their passions.
An example is a 98-year-old author, playwriter and poet who is
suffering from fibromyalgia and thought that all her work
would be forgotten. I found a way for her legacy to continue by
publishing them as books and now working on having them
made into films.
If this sounds like something of interest, let’s meet to talk
further.
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