We work with our clients to help them achieve their goals all while assuring their wealth is transferred along with Wisdom – the passing of one’s values, insights and stories for future generations.
Our Life Planning practice focuses on Elder Law & Disability, Home Health Care, Disability & Medicaid, Young Adults & College Students, Pre-Nuptial Agreements and Wisdom Transfer.
Elder Law & Disability
Elder Law is a general term that has been used in a variety of ways to mean legal work needed to help seniors put their affairs in order. One size does not fit all.
“An ounce of prevention is worth a pound of cure.”
Elder Planning is best done when a family or loved one is not in crisis (“blue sky” planning). Although it is never too late for us to help, it is always best if you can meet with an attorney before you or your spouse is headed into a nursing home.
Long Term Care Planning
Whether you have the luxury of planning years in advance or come to us in crisis mode, Attorneys in our firm have the specialized knowledge to be able to help you. We can advise clients on Medicaid eligibility and on ways to protect your home and other assets for your children or other loved ones in the event you should need to enter a nursing home and remain there for an extended period of time (“long term care”). Although recent changes in the federal law concerning Medicaid has made it more difficult for elders to protect their home and other assets for their loved ones, there are still a variety of options available. We can advise you regarding these options, including on how to legally spend down your assets in order to qualify for Medicaid or other government benefits, so that you can afford nursing home care without impoverishing your spouse or other family members.
Aging at Home
We also understand that most of our clients would prefer to find ways to be cared for at home rather than in a nursing home. We can assist you with that and, if necessary, help you to qualify for Community MassHealth, so that you can obtain the necessary services that will allow you to comfortably and affordably age at home.
Medicaid Applications, Fair Hearings and Court Appeals
Our firm also can assist you with Medicaid applications, and can represent you in fair hearings before MassHealth or further court appeals in the event that you have been denied Medicaid coverage. We can also advise you about Medicare coverage.
We frequently meet with clients whose loved ones have been denied Medicaid coverage that they should have been lawfully entitled to receive, because they did not seek the help of an attorney in preparing the Medicaid application or because they consulted with an attorney who did not specialize in this area of law. We therefore strongly recommend that you always consult with an elder law attorney who specializes in this area of law if you ever anticipate applying for Medicaid.
Guardianship and Conservatorship Proceedings
Families often become concerned when a loved one becomes mentally incompetent. We can assist by providing advice to the family concerning Guardianship and Conservatorship proceedings and go to court, if needed, to obtain a guardian or conservator or other related matters. It is our preference, of course, to do proper estate planning so that one would rarely need to rely on the court process to decide these important issues.
Referrals to Other Professionals
We work with a variety of allied professionals in helping families in times of need. There are a number of organizations, including geriatric care managers and home service agencies, who we have worked with in the past and who we would be willing to refer you to. We also encourage our clients, if feasible, to visit with a long term care insurance specialist and discuss options for long term care insurance while they are still young and healthy enough for such insurance to be affordable.
Meetings with Disabled, Elderly or Critically Ill Clients
We understand that it may be difficult, especially for our elderly clients, to come into Boston to meet with us. In most such cases, we are willing to meet clients in their home or wherever else it is convenient to meet. We are also prepared to provide emergency services for a variety of legal matters in the event that someone is critically ill.
Home Health Care, Disability & Medicaid
The world of health care is becoming more and more complex. To meet the demands of the changing field, when you create your estate plan with us, we help you also prepare the following documents: HIPAA Release, Health Care Proxy, Advance Directive (sometimes known as a Living Will) and a Durable Power of Attorney. Each is explained in a little more detail below.
We have all heard and read about privacy laws in recent years. In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a major federal law that deals with a patient’s right to privacy with respect to medical records. An unfortunate side effect of this legislation, however, is that sometimes doctors, nurses, and other health care providers are reluctant to share medical information with a patient’s trusted loved ones. In some places, only a patient’s spouse—and not his/her children—will be allowed to see the records and/or speak with the professionals about the care plan. A HIPAA Release is a document that allows doctors and other health care professionals to share your medical information with anyone you designate in the document, such as (but not limited to) a child, spouse, unmarried life partner, relative, friend, or other loved one.
Health Care Proxy
A Health Care Proxy is a legal document that gives a close, trusted person the power to make all health care decisions for you in the event you cannot communicate your wishes directly to your health care providers. Massachusetts law requires that only one person at a time be designated as your health care agent in order to avoid disagreement among family members in the event of an emergency.
Such documentation can be especially important for same-sex spouses (although such couples are now legally recognized in Massachusetts, they will not be in every state where they might travel). Having a properly executed health care proxy is imperative in such situations including access to these documents regardless of where you are and without having to carry them with you.
Many individuals have strong feelings about what they want to happen to them should they ever be in a persistent, irreversible vegetative condition at the end of life. The advance directive (also commonly known as a “Living Will”) is frequently used to address this situation. It can request that doctors not resuscitate you, or use extraordinary means to prolong your life, once certain critical irreversible milestones have passed, or provide whatever guidance you desire to communicate in these situations. Advance directive can help to alleviate the confusion and even extended, bitter disputes between loved ones and family members.
This document is meant to speak clearly to the family and doctors when the patient becomes incapable of speaking for him or herself. We build an automatic “check” into the advance directive document; by requiring that at least two doctors concur in the diagnosis of the patient, before acting in accordance with the instructions of the advance directive. This check can ensure that your interests are being looked after and acted upon, based upon objective diagnoses. Although these directives are not legally binding in Massachusetts, they provide substantial help to loved ones (and physicians) about what your wishes are in these circumstances.
Power Of Attorney
A Durable Power of Attorney allows you to give someone whom you trust (often referred to as “the Attorney-in-Fact”) the authority to handle financial and other related matters for you (the “Principal”) in the event of your incapacity. This document is valuable in that it allows you to choose who shall act for you if you are incapacitated, rather than allowing a court to make this determination. The powers can be broad, and may even include gifting, especially if it is anticipated that that the Principal may want or need to transfer assets for tax or Medicaid planning purposes. It is for this reason that you should make sure that you have a power of attorney that is carefully crafted to your needs. This document is effective only during the lifetime of the Principal.
Using these Documents
Studies show that 70% of Americans who create these very types of health care documents don’t use them! The most common reason is that the documents cannot be found at the actual moment of crisis. In order to address this problem, we have developed a system to store these documents electronically and which allows clients to retrieve their documents at a moment’s notice. Every client for whom we provide these documents receives a wallet sized card that has a personalized access code to an on-line, secure storage facility. Medical professionals can simply dial the number and 24/7 your documents will be sent via fax or pdf to the hospital or medical office where you are being treated. As part of this service, we also include certain emergency information you provide, such as who to call and in what order, whether you have any allergies or serious medical conditions, and the name and contact details of your Primary Care Physician. Clients find this an enormously helpful tool in time of need. It’s part of our way of creating estate plans that work!
Young Adults & College Students
An interesting dilemma that parents of young adults and college age students is that your rights to information about healthcare and decision-making as a parent are limited unless you have an agreement with your child. While you are probably still providing health care coverage and are the designated responsible financial party, your rights change drastically when your child turns 18. In order to help your young adult child you may need to have these three documents in place: A durable Power of Attorney, a HIPPAA Release and a Medical Power of Attorney. We work with a company that makes storage of these documents available to your child and to medical professionals when needed.
Another area we can help with is in Pre- and Post-Nuptial Agreements (sometimes referred to as Pre-Marriage or Post-Marriage) agreements. These agreements are often entered into as part of the estate planning process when one spouse may have inherited, or is expecting to inherit, family wealth that is intended to remain within that family. In other cases, one or both parties may have children from previous marriages whom they want to provide for in addition to providing for each other. Recent changes in tax law have eliminated tax deductions for alimony for the paying spouse and made the receipt of alimony tax-free. Whether agreements executed before 2019 will be grandfathered under the prior treatment depends on classification of the agreement, so parties may consider reviewing their agreements to determine how they may be affected by this change.
Most importantly, we work closely with clients to ensure we understand their goals and objectives before rendering advice. Sometimes we draft the agreements for our clients; other times we review drafts prepared by the other party’s attorney. In all cases, we only represent one person in the couple and require that the other person is represented by another qualified and experienced attorney in this area.
We have come to believe that capturing your life’s lessons is an essential part of our life and estate planning practice. We therefore offer clients the opportunity to record a “Priceless Conversation” when we are working with them on their Estate Plan. This may include a collection of individual and family stories of wisdom or memorializing other important stories. Some other clients have the need for an ethical will or a comprehensive life biography. In either case, we have relationships with a variety of professionals who can help execute these documents.
Beyond collection of individual and family stories and wisdom, we offer clients the opportunity to engage in values-based trust planning, a process whereby they can include instructions to their loved ones about the values that underlie the provisions of their trust and overall estate plan, as well as hopes and aspirations for their family members, including future generations.