Linda Ershow-Levenberg, Esq.

About Linda Ershow-Levenberg, Esq.

Linda is the managing partner at Fink Rosner Ershow-Levenberg, LLC. She takes care of legal problems involving people who are aged or who have disabilities, by protecting access to government benefits and helping them make the necessary arrangements for life-long assistance or care. Linda has been certified in Elder Law (C.E.L.A.) by the National Elder Law Foundation since 1999. She strives to provide her clients with responsive representation delivered with personal attention, compassion, and commitment. Find out more about Linda Ershow-Levenberg

Medical Aid-in-Dying Act signed by Governor Murphy

On April 12th, New Jersey joined seven other States which have enacted laws authorizing a terminally patient to self-ingest a drug that would end their life. Oregon was the first State to allow this, in 1997. The New Jersey bill was A1504/S1072. It will go into effect on August 1, 2018. Over two dozen other States are actively considering such legislation.

The Act specifies criteria for who is eligible to take advantage of its protections: The individual must be an adult over 18 and able to self-ingest the medication. They must have a terminal diagnosis with a prognosis of six months of less, and they must be determined to have full mental capacity. The Act allows such an individual to make and carry out an “informed decision” to ingest a fatal drug. Informed decision is defined as:

   “a decision by a qualified terminally ill patient to request and obtain a prescription for medication that the patient may choose to self-administer to end the patient’s life in a humane and dignified manner, which is based on an appreciation of the relevant facts and after being fully informed by the attending physician of:

(1)   the patient’s medical diagnosis;

(2)   the patient’s prognosis;

(3)   the potential risks associated with taking the medication to be prescribed;

(4)   the probable result of taking the medication to be prescribed; and

(5)   the feasible alternatives to taking the medication, including, but not limited to, concurrent or additional treatment opportunities, palliative care, comfort care, hospice care, and pain control.

 

There are many steps in the procedure protocol. First, the individual must originate the request by making two spoken (oral) requests to the physician, with a 15 day waiting period in between; the doctor must bring in a consulting specialist to confirm capacity; the doctors may refer the individual for psychological or psychiatrist for further capacity evaluation if capacity is not clear; the doctor must offer the patient the option to rescind his or her request. The individual also must complete a specific form and submit it to their doctor; the form will be titled “REQUEST FOR MEDICATION TO END MY LIFE IN A HUMANE AND DIGNIFIED MANNER.”

The written request must be witnessed in a manner similar to other legal documents, in which two witnesses attest to the individual’s capacity (competence) and willful voluntary act. One of the witnesses must be “disinterested” — not standing to benefit in any way from this death. The physician must also refer the individual to an appropriate health care professional for a discussion about other treatments or palliative care at the end of life. Ultimately, the doctor can then prescribe the medication.

The law contains requirements related to patient record-keeping so that every step of the process is well documented. Persons who participate in good faith with the process, or to decline to participate, are given immunity against criminal and civil liability, and are protected against professional disciplinary action related to their licenses. There are also protections that prevent life insurance and other contracts from restricting an individual’s rights under the Act, and each step of the way must be carried out by the individual and not by a proxy.  For example, neither a legal guardian, agent under power of attorney, or health care representative could act in the place of the individual.

For individuals facing harrowing end of life decisions, the new Act will provide important and welcome relief from suffering. A plan can be put in place to assure that the transition for the individuals, and the safety and security of those left behind, can be as peaceful as possible.

Talk to us about life care planning and elder care planning… 732-382-6070

Remarriage terminates widow’s eligibility for disabled veterans property tax exemption

There are some circumstances in which a person’s eligibility for governmental benefits is affected by his or her marital status. This is certainly the case with Medicaid/MLTSS; Supplemental Security Income; and exemption from inheritance tax on receipt of an inheritance. The NJ Appellate Division had the opportunity recently to decide whether a veteran’s widow would retain her eligibility for his veterans’ property tax relief if she remarried. In  Pruent-Stevens v. Toms River Twp., the property owner’s first husband was an honorably-discharged Viet Nam veteran. He died before 1997 at a time that he had a pending claim for service-connected compensation benefits due to exposure to Agent Orange defoliant. She remarried , and her second husband died in 1997.  eventually, in 2014 (!) the Veterans Administration approved the claim and declared that the first husband had died of a service-connected disability. She then filed for disabled veterans property tax relief from Toms River.

The relevant statute allows a town to grant tax relief to the widow/widower of a disabled veteran  provided that s/he “has not remarried.”  The issue in the case was whether that status only pertained to the time that the application for the exemption was filed, or if it was a blanket cut-off for exemption eligibility for a widow who remarries at any time.  The New Jersey Tax Court  decided that the phrase “has not remarried” should be interpreted to mean that as long as the widow/er wasn’t married at the time of the application for exemption, the exemption would be available. In other words, it could turn on and off. She was unmarried in 2016 when her application was filed, so the Tax Court ruled in her favor. The Town appealed.

The Appellate Division reversed.  Finding that she had no “vested right” at the time of her 1997 remarriage, and that in other areas of New Jersey law, “widow” is defined as a person who has not remarried,  the court ruled that the potential entitlement to the exemption was lost as a result of having ever remarried.

Call us for advice on senior care planning and estate planning ….

732-382-6070

Hearing Monday in Trenton on Social Isolation and Age-Friendly communities

New Jersey is working on efforts to encourage municipalities to become “age-friendly communities.” Age Friendly is spreading across the country, with interesting initiatives in many places. Take a look at South Orange-Maplewood, Chatham, and Elizabeth for starters. Looking for volunteer opportunities? Contact your Mayor — you may be able to get involved with those initiatives or help to jump-start a new process. Age-friendly is an approach to community development that looks at the impact on seniors of a community’s physical space, transportation, recreation opportunities, public building access, access to municipal government and services, housing, etc. etc. and what might be done to improve those systems to make it more feasible for people to “age in place.”

Two new bills will be introduced to the NJ legislature which addressing key issues concerning older adults.  Click here to read the text

https://www.njleg.state.nj.us/2018/Bills/AR/246_I1.PDF

 https://www.njleg.state.nj.us/2018/Bills/A9999/5314_I1.PDF

 A-246 is a Resolution co-sponsored by Assemblyman Herb Conway and Assemblyman Wayne DeAngelo that urges New Jersey counties and municipalities to take the steps necessary to be accepted into the AARP network of age-friendly communities as defined by the World health organization.

A-5314 requires the Commissioner of the Human Senior Services “within 180 days and biennially thereafter” to assess and report to the Legislature on the state of social isolation in New Jersey as if affects individuals who are over 65, have disabilities, are suffering with mental illness, or are otherwise vulnerable. The bill marks a recognition that extreme social isolation is a problem in the State which adversely affects many citizens and might be alleviated if better understood and tackled. The report must also include recommendations for strategies to counter this problem. 

The Committee hearing will take place Monday morning May 19th at 10 am in the Committee Room 11, 4th Floor, State House Annex, Trenton.

If these issues are of interest to you, contact your Legislators, and read more here.

 

Planning for a good old age involves looking at a wide array of issues, and each person’s situation is unique. Call us for individualized elder care legal planning …. 732-382-6070

SS to allow predesignation of future Representative Payee

Congress has passed, and the President has signed,  the “Strengthening Protections for Social Security Beneficiaries Act of 2018”.  This statute makes changes to the Representative Payee system of the Social Security Act.

A Representative Payee is appointed by the Social Security Administration to handle the benefits of a person whom the SSA deems incapable of managing his or her own benefits. Examples are adults under guardianship, minors, and persons who suffer with severe cognitive or physical disabilities. A Representative Payee is like an informal Trustee — s/he is expected to keep the SSA income in a designated account [under the Social Security # of the incapable individual, of course] and spend it only on the SS recipient, unless there is a court order that allows other spending. The SSA sends out an annual report statement to the Representative Payees, who are expected to complete it, sign it under penalty of perjury, and return it to the SSA. Apparently there are insufficient resources to audit and monitor the millions of such reports that are filed each year, so there will be federal grants to state and local auditing entities..

Under Secn. 201,  Social Security or SSI recipients over age 18 can designate “at any time” a person — but not an organization — who they want as their Representative Payee should the SSA determine that such appointment is required. The Social Security Administration must select the designated individual as Rep. Payee with certain exceptions, most notably, if the person had been convicted of any of a wide range of crimes. Even that exclusion can be waived in certain cases involving a designated person who is in a close family relationship to the benefits recipient or in the “best interest” of the benefits recipient. Section 201 amends 42 USC sec. 405 (j)(i) by adding (C) (1) to the end of that subsection.

The Act doesn’t specify the form of document that the person needs to sign when making his or her own designation.  I think that it could be included as a paragraph in their Durable Power of Attorney. A State Guardianship Court could order that the Guardian have preference for appointment as a Representative Payee. Section 201 amends 42 USC sec. 405 (j)(i) by adding (C) (1) to the end of that subsection.

Within 18 months the SSA is required to issue regulations. Among other things, there must be forms provided, and the regulations must specify the information that beneficiaries must provide to SSA about the designated individuals. Also, the SSA will be required to notify beneficiaries who have designations annually with the names of the advance designees. The forms and instructions must be published by December 13, 2019.

Another useful amendment is found in Secn. 102. Under this amendment,  the Spouse or parent need not become Rep Payee for someone whose benefits they handle, if they live in the same household. This should make things more convenient for most cases. Of course, in a very bad situation, there could be a need for someone to intervene on behalf of the vulnerable adult in that household, but such an action can be initiated by any interested party if they become aware of the need for a protective arrangement.

Link to the statute permitting designation of a representative payee in advance is below:

https://www.congress.gov/bill/115th-congress/house-bill/4547/text

The law is effective two years after the date of signing, which will be April 13, 2020.

Pre-designation of a Representative Payee is just one component of a senior care and disability protection plan. Updated estate plan documents, powers of attorney, beneficiary adjustments, and other steps may be appropriate depending on the situation.  Each situation is unique and has its own special concerns.

For legal advice and assistance with elder care and disability planning, call us at ………. 732-382-6070

 

Marinaro is new NAELA Federal Policy Co-Chair

The National Academy of Elder Law Attorneys held its annual meeting in Fort Worth, Texas last week. Lauren S. Marinaro was selected as the incoming Co-Chair of NAELA’s Federal Policy Committee.

Marinaro is  President of the New Jersey Chapter of NAELA (NJ-NAELA), which advocates on legislative and policy matters that affect senior citizens and people with disabilities in New Jersey. She’s a Partner with Fink Rosner Ershow-Levenberg in Clark. She  attended the NAELA Annual Meeting and Trust Workshop in Ft. Worth, Texas on May 8-10th. While there, she participated in discussion groups on various Trust topics, facilitated a workshop on NAELA State Chapter advocacy and growth, and was announced as the 2019-2020 Federal Policy Committee co-Chair. The members of both state and national NAELA are attorneys who are experienced and trained in working with the legal problems of aging Americans and individuals of all ages with special needs. Established in 1987, NAELA’s mission is to educate, inspire, serve, and provide community to attorneys with practices in elder and special needs law. The organization also provide plenty of information for the public who may need such legal services.

Among the “hot topics” in Federal Policy that Lauren will work on through her activity with NAELA for 2019-2020 and beyond are monitoring 1115 Medicaid Waivers, fighting for improved spousal impoverishment standards for community-based Medicaid, supporting the Money Follows the Person initiative, protecting inherited IRAs for disabled and vulnerable heirs, and civil rights initiatives for disabled individuals and the elderly. Read more by clicking on those links, and contact Lauren or your legislators if these issues are of interest to you.

For advice on elder care senior planning and special needs, contact us at 732-382-6070