Monday, December 31, 2007

Happy New (2008) Year!

The Capitol Tree 2007, in the Capitol Rotunda, Harrisburg, PA.
Its decorations were hand-crafted & donated by members of senior centers throughout Pennsylvania.
May that creative & caring spirit persist throughout the coming year, 2008.

Friday, December 28, 2007

Town Meetings for PA's "Plan on Aging"

The Pennsylvania Deparment of Aging announced that preparation is in progress for its next four-year "State Plan on Aging"; and now requests public input through "town hall meetings" scheduled from January 31st, through March 17th, 2008.

PA DoA's 2008-2012 State Plan on Aging is described on its website:

Every four years the Department of Aging is required by both state and federal law to develop and submit to the Administration on Aging a "State Plan on Aging."

The plan is mandated by both federal and state law and is a requirement in order for the Commonwealth to receive federal funds under the Older Americans Act.

Additionally, the State Plan on Aging helps to structure the Department’s priorities and to set an aging agenda for the Commonwealth. * * *

The Plan will cover the four-year period — October 1, 2008, through September 30, 2012.

To solicit public input for the Plan, PA DoA will hold seven "town hall meetings" from 9 am to noon in locations throughout Pennsylvania:

Interested consumers, caregivers, and providers, are encouraged to attend and participate.

A Discussion Guide is available to provide more information about topics that will be discussed during the meetings. * * *
Presently, neither the referenced "Discussion Guide", nor an anticipated "On-line Survey", have yet been implemented online.

The schedule of meetings, however, is available (PDF format, 1 page). These are the scheduled dates & places for the sessions:

Elizabethtown -- January 31
Masonic Village at Elizabethtown
Freemasons Cultural (Visitor) Center
One Masonic Drive--Elizabethtown
Area Agency on Aging (717) 209-7979

Clarion -- February 7
Clarion Holiday Inn
45 Holiday Inn Road--Clarion
Area Agency on Aging (814) 226-4640

Pittsburgh -- February 8
Community College of Allegheny County
North Campus-Auditorium
8701 Perry Highway--Pittsburgh
Area Agency on Aging (412) 350-5460 or:

Nanticoke -- February 21
Luzerne County Community College
Main Campus, Educational Conference Center
Building 10, Auditorium
1333 South Prospect Street--Nanticoke
RSVP: Judy McAnnally (570) 822-1159 Ext. 2317

Bedford -- March 7
Heartland Hall
5564 Business 220--Bedford
RSVP: Penny Clark (814) 623-8148 or:
(800) 892-7903

West Chester -- March 14
West Chester University
Sykes Student Union Building
Theatre-Ground level
110 West Rosedale Avenue--West Chester
RSVP: Lois or Marilynn (610) 344-4546

Williamsport -- March 17
Pennsylvania College of Technology
Main Campus, Klump Academic Center-Auditorium
One College Avenue--Williamsport
Office of Aging (800) 332-8555 or:
(570) 323-3096

There will not be any charge to attend a meeting. Reservations are recommended, and can be made by calling the telephone numbers associated with each location.

Thanks go to Marielle F. Hazen, Esq., of Harrisburg, PA, for posting the schedule of meetings on the Pennsylvania Bar Association's Elder Law Listserv today.

Update: 01/02/08:

On January 2, 2008, the PA Department of Aging issued a Press Release entitled "Department of Aging Plans Town Meetings to Gather Input for New State Plan on Aging" announcing these Town Hall Meetings.

The Press Release quoted comments made by the Secretary of Aging, Nora Dowd Eisenhower:

“Through these public meetings we receive information that will help us develop new services and enhance existing programs,” said Secretary of Aging Nora Dowd Eisenhower.

“We are seeking public input to make sure our priorities accurately reflect the needs of the older Pennsylvanians we serve.” * * *

“Public participation is absolutely essential to the success of our town meetings,” Secretary Dowd Eisenhower said.

“We are encouraging organizations involved in our state’s aging network to spread the word and encourage their members to make their voices heard.”

Update: 01/25/08:

The referenced "Discussion Guide" (PDF, 9 pages) is now available.

On January 24, 2008, the
PA Department of Aging issued another Press Release, entitled "Department of Aging to Host Town Meeting in Elizabethtown to Gather Public Input for its State Plan on Aging", encouraging public participation in these "Town Meetings", and highlighting the upcoming meeting to be held in Elizabethtown, PA, on January 31, 2008.
To help shape the future direction of services for older Pennsylvanians, the Department of Aging will host a town meeting on Jan. 31 in Elizabethtown, Lancaster County.

“I invite older adults and their advocates to share ideas that will help us to develop new services and enhance existing programs for older Pennsylvanians,” said Secretary of Aging Nora Dowd Eisenhower. “We are seeking input to make sure our priorities accurately reflect needs.” * * *

The meeting will be held from 9 a.m. to noon at the Masonic Village’s Deike Auditorium, in the Freemason’s Cultural Center. People planning to attend should call the Area Agency on Aging at (717) 299-7979 to make a reservation.

This session is one of seven meetings that will take place across the state. They will focus on issues including public awareness of healthcare and long-term living options; enabling individuals to live in the setting of their choice; empowering individuals to stay active and healthy; ensuring the rights of individuals to prevent abuse, neglect, exploitation and abandonment.

A discussion guide to further help the public understand the purpose of the meetings is available [online].

“Public participation is absolutely essential to the success of our town meetings,” Dowd Eisenhower said. “We are encouraging organizations involved in our statewide aging network to spread the word and encourage their members to make their voices heard.” * * *

See: PA EE&F Law Blog posting "PA Aging Plan "Discussion Guide" Now Available" (01/25/08).

Thursday, December 27, 2007

SAMHSA's Coping Resources

The U.S. Department of Health & Human Services, through its Substance Abuse & Mental Health Services Administration (SAMHSA) offers numerous resources that appear particularly helpful now, during the year-end holidays.

Despite the festive spirit advertised & projected during these days, many folks experience exactly the opposite -- pronounced sadness, sorrow, anxiety, or other feelings of depression, fear, or isolation. This can be the case where a loved one is absent, as in the case of families with military volunteers.

Such feelings can also emanate from the death of a loved one, a physical trauma, a lifestyle adjustment, or other significant change, whether recent or long-past.

SAMHSA, on its website, offers some quick, to-the-point suggestions for coping with such feelings.

In particular, I am impressed with SAMHSA's "
Resources for Coping With Traumatic Events", targeted at certain groups:

The first three categories focus heavily on group trauma, such as occurred at Virginia Tech University on April 16, 2007, or in Nickel Mines, PA, on October 2, 2006.

The latter two categories focus more on individual trauma.
The heading "For Adults" offers resources relevant to the concerns of this Blog.
Thanks to Diana Carra Haugh, Senior Advocate, of the Disability Rights Network of Pennsylvania, in Harrisburg, for drawing the SAMHSA resources to my attention today, by her reference in our email exchange.

Wednesday, December 26, 2007

Seniors Scoring on Nintendo's Wii Games

Sports -- golf, tennis, billiards, bowling, baseball, & more -- can be played on an electronic gaming system, displayed on a screen, & directed by a remote, motion-detection controller. Many seniors are taking up the challenge of virtual sports, sometimes in teams.

The possibility was noted after last year's introduction of the Nintendo "Wii" game system. In "
Even Senior Citizens Love the Nintendo Wii", posted by blogger Tom Samiljan on Yahoo's Technology Forum on Feb 23, 2007, the unlikely new audience was identified:

Nintendo may have been going beyond their traditional core gaming audience with the Wii and its user-friendly, motion-sensitive remote controller, but getting to the senior citizen demographic is truly trailblazing.

And that's exactly where the Wii is turning out to be a big hit, if this Chicago Tribune piece about a bunch of Wii-loving seniors is to be believed. It turns out the gaggle of gaming grandparents is all over the Bowling game from Wii Sports. * * *

And Nintendo has been actively pursuing the over-50 market since the Wii's launch, as this Siliconera post from the AARP Life@50 event attests [10/30/06]. * * *
The referenced article, published in the Chicago Tribune on February 16, 2007, was entitled "Wii bowling knocks over retirement home", by .
At the Sedgebrook retirement community in Lincolnshire, where the average age is 77, something unexpected has been transpiring since Christmas.

The residents, most of whom have never picked up a video game controller in their life, suddenly can't put the things down.

"I've never been into video games," said 72-year-old Flora Dierbach last week as her husband took a twirl with the Nintendo Wii's bowling game. "But this is addictive." * * *

The Wii has become so popular at Sedgebrook that on Sunday afternoon there will be a video game bowling tournament in the lounge. More than 20 residents have signed up to compete. * * *

If the retirees in Lincolnshire are any proof, video games are no longer just kids' play. And that's the whole idea, said Beth Llewelyn, Nintendo's senior director of corporate communications. * * *

The reaction to the system by seniors has been a pleasant surprise. * * *

Since that publication, another Christmas has passed. Interest by senior citizens in Nintendo's "Wii" appears to have grown. Now, retirement communities & care facilities encourage such use.

An article posted on Christmas Day, December 25, 2007, entitled "
Grandpa and grandma get their game on with the Wii", by Kevin Reece, of KHOU-11 News (Houston, TX), reported that "[r]etirement communities turn to Wii to help keep residents active."
The sounds of a major sporting match wafted from an unlikely place Monday – the Eagle’s Trace Retirement Community. Art Lewicki was among the residents there who left their walkers behind to play a little baseball.

Baseball on his Wii, that is. In fact, Lewicki happens to be the local homerun derby champ.

“Well, I beat nine other guys. I guess that’s alright,” he said. He and his friends are members of one of the supposedly unintended audiences for Nintendo’s incredibly popular Wii game console -- seniors. * * *

Retirement homes across the country have added
Wiis to their recreation rooms and programs. That’s because seniors have found the consoles to be as much of a welcome escape as their grandkids.

Kimball says the exercise isn’t the only benefit from the
Wii. The competition gets her blood pumping as well.

“And of course, your temper may get up on you too,” she added.

The phenomena was also noted also by the Christian Science Monitor, in its article entitled "Nintendo's Wii a surprise hit with seniors" (11/27/07), which reported that "video-game versions of bowling, boxing or tennis can offer an adrenaline rush that older players haven't experienced in years."

The Nintendo Wii was so popular that the residents clamored for their own.

Today, all of the Erickson chain retirement communities in the US own at least one
Wii. Other retirement communities and municipal senior centers in recent months have followed, many using wellness grants and public funds to pay for the video-game system.

Nintendo scrambled to tap this demographic. Proponents say the
Wii offers a welcome reprieve from a sedentary lifestyle, and boosts hand-eye coordination among the over-60 set in a way that Bingo and Mahjong can't.

However, some find that when it comes to the
Wii, which retails for about $250, money is less a problem than getting comfortable with the game.

Many retirement communities that purchased the games are encouraging hesitant seniors with tournaments, trophies, and cash prizes.

Some centers are placing their
Wiis in high-traffic areas where seniors congregate, or for the bashful, behind a moveable privacy screen. * * *

See also: "More Wii Gaming for Older Adults" (10/11/07), posted by the Senior Friendly Libraries blog.

In New England, some younger folks even started a movement, with a website, promoting use of the Wii by seniors -- WiiSeniors.

WiiSeniors was created to bring video game systems into senior care facilities in New England.

These games allow people to experience sports and activities that they have not been physically able to experience in years.

It’s a very new idea, but we feel like it could change the way we look at aging and its impact on enjoying life. * * *

That Christian Science Monitor article noted use of the Wii in Pennsylvania by a senior for -- "float like a butterfly, sting like a bee" -- boxing!

In Allentown, Pa., 200 to 300 people arrive at the Lehigh County Senior Center daily for pursuits ranging from orchestra to ceramics.

The center unveiled its Wii this fall and put it in the lunchroom. "They've got time to hang out there," says Rick Daugherty, executive director of the center.

The Wii isn't always a hub of activity – that is, until Eddie Smith, a former lightweight boxer from Philadelphia, fires it up and begins to throw punches on the Wii's boxing game.

"They watch me doing it, and I get a big crowd there," says Mr. Smith, a patron and part-time employee of the center. "Next thing you know, somebody will want to play."

For Smith, the game and the spectators offer an adrenaline rush that he hasn't experienced in decades.

"When I score a knockdown, it actually feels like I'm going through it again. It's a good feeling," he says. "I imagine the people using this, it gives them self-confidence."

Plus, Smith says, it's a good workout, though not without its perils.

"Jabbing and hooking, you've got to be careful," he says. "You can throw your arm out of whack."

Mr. Daugherty, himself an enthusiast of the boxing game, is grateful that "nobody's gotten injured," he says. * * *

It's an updated, healthy version of "shadow boxing" that can benefit seniors.

On the other hand, my search of the web does not reveal any widespread senior use of "Guitar Hero III: Legends of Rock" on the Wii -- yet.

Update: 12/28/07:

On December 5, 2007, WBTV-3 (Charlotte, NC) televised a segment entitled "Wii, Video Games Keeping Senior Young". The video segment is available online.

The article expands the focus from the Wii and into other gaming systems that challenge seniors' thinking skills & reaction times:

The Nintendo Wii has been out since last year and found a decent amount of young followers. But now, all of a sudden, a new group of folks are clammering for it. * * *

The Nintendo Wii really is a lot of fun, but what makes it such a must get for just about every senior home and assisted living complex I've talked to is its interactive ability.

Essentially seniors can do things they used to do like bowl, without putting hardly any stress on their bodies.

The problem is, the Wii's are hard to find, but some homes are making due in other ways.

It's not the Nintendo Wii, but the concept is the same, video games that get folks moving and thinking. * * *
Update: 02/20/08:

On February 20, 2008, the Pittsburgh Post-Gazette posted an article entitled "WILD ABOUT Wii!", by Marylynne Pitz, who reports that this "[v]ideo game system is bowling over [the] senior citizen crowd" at the Turtle Creek Senior Citizens Center.

See also the accompanying "Video: Senior citizens tackle gaming system", by Steve Mellon, which summarizes, then visually demonstrates, the effects of this new senior activity:
People tend to think of gaming systems -- Play Station, X-Box and Wii -- as something designed especially for the younger set. But don't tell that to the folks at the Turtle Creek Senior Citizens Center. On Friday nights, Wii bowlers are so gleeful they're oblivious to February's gray skies.

"It's brought so many more people in here," says Theresa Pollitt, 77, of Turtle Creek. "We have a gal on a walker who bowled over 200." * * *

The Friday virtual bowling draws many people together and appears to create a genuine sense of camaraderie, says Jan McDowell, the center's director.
Update: 12/14/09:

A Pennsylvania senior squad took home the silver bowl in
the finals of the first National Senior League (NSL)Wii Bowling Championship. See: PA EE&F Law Blog post "PA Seniors in Online Wii Championship Bowl" (12/14/09).

Friday, December 21, 2007

Scrooge: Broker, Lawyer, Accountant, or Banker?

A Christmas Carol, written by Charles Dickens in 1843, is a classic story, set on Christmas Eve, about physical suffering, mental dysfunction, and spiritual redemption.  The narrative spans the past, present, and future, and leads to healing in a few of the story's characters.

The full text of the original publication is available on many websites, such as Wikisource,
Project Gutenberg, Public Literature, the University of Adelaide, and StormFax (with antique text and a rich background). Contemporary illustrations are posted by the University of Glasgow.

The main character,
Ebenezer Scrooge --the one most miserable and the one most changed -- is described by Wikipedia:
Ebenezer Scrooge is the main character in Charles Dickens' 1843 novel, A Christmas Carol. He is a very cold-hearted, selfish man, who has no love for Christmas, children, or anything that even provokes happiness. * * *

His last name has come into the English language as a byword for miserliness and misanthropy, traits displayed by Scrooge in the exaggerated manner for which Dickens is well-known.

The story of A Christmas Carol begins on Christmas Eve, with Scrooge at his place of business.

The book does not specifically state what business he is in, though it is usually assumed that he is a banker or professional money lender. Some recent versions portray him as a solicitor.

Whatever his main business is, he seems to have usurious relationships with people of little means. * * *
Since Scrooge was so focused on "business", and since his well-known miserly character could reflect on that profession, I wonder: What was the occupation of Ebenezer Scrooge?

In the opening lines of the story, Dickens mentions the place of business where Scrooge worked:
Scrooge never painted out Old Marley's name. There it stood, years afterwards, above the warehouse door: Scrooge and Marley. The firm was known as Scrooge and Marley.

Sometimes people new to the business called Scrooge Scrooge, and sometimes Marley, but he answered to both names: it was all the same to him. * * *
The reference to "warehouse" suggests storage of some commodity.

Could Scrooge have been a commodities broker?

The 1984 movie version of A Christmas Carol, starring George C. Scott, adopts this interpretation completely. Scrooge sells warehoused corn in transactions negotiated at an exchange in London, as depicted in this conversation:

Ebenezer Scrooge: Yes, I have changed my mind. The price has gone up.

Mr. Pemberton: Gone up? But that's impossible!

Ebenezer Scrooge: If you want my corn, gentlemen, you'll meet the price I quoted yesterday... plus five percent interest for the delay.

Mr. Tipton: That's outrageous, Scrooge. You'll be left with a warehouse stuffed full of corn!

Ebenezer Scrooge: Well, that's my affair, isn't it?

Mr. Pemberton: If we have to meet your price, our bread will be more expensive. The poor will suffer.

Ebenezer Scrooge: Then buy someone else's corn. Good day, Sirs. * * *
Or, instead, could Scrooge have been an English "solicitor", that is, a lawyer?

Wendy R. Liebowitz, an editor, of Washington, D.C., had assumed that he was. However, in her listing of "Lawyers in the Movies", posted on her WendyTech website, she reconsidered that impression, which was based on the 1951 movie version of A Christmas Carol, starring Alastair Sim.

She investigated that impression, and then rejected it in her description of that movie.

I always assumed that Ebenezer Scrooge was a lawyer, of the London firm of Scrooge and Marley. * * *

But a careful reading of the text does not support this decisively.

During a conversation at a law office about this question -- on Christmas Day, appropriately enough -- I learned that in England, the name of a law firm cannot bear the name of a deceased person, and the name of Scrooge's firm was Scrooge and Marley.

As Marley was dead as a doornail -- we learn this early on -- perhaps Scrooge was just a generic miserly businessman.

Well, Scrooge was Marley's "sole executor, his sole administrator, his sole assign, his sole residuary legatee, his sole friend, and sole mourner." * * *

Estate lawyers have a field day imagining Scrooge's will. * * *
Some people believe that Scrooge was an accountant.

This view may be based on multiple references to Scrooge's "counting house", such as those found in
Stave One ("Marley's Ghost").
Once upon a time -- of all the good days in the year, on Christmas Eve -- old Scrooge sat busy in his counting-house. * * *

The city clocks had only just gone three, but it was quite dark already -- it had not been light all day: and candles were flaring in the windows of the
neighbouring offices, like ruddy smears upon the palpable brown air. * * *

The door of Scrooge's
counting-house was open that he might keep his eye upon his clerk, who in a dismal little cell beyond, a sort of tank, was copying letters. * * *
"Counting-house" is an archaic term. In response to the question, "What is a counting house?", posted on a Yahoo "Victorian" forum, one responder opined:
It was what is now called an accountant's office. They would have handled financial transactions for clients, such as collecting rent, paying bills, auditing etc.

It is analogous with today's certified public accountant which is what Bob Cratchitt probably was.
But another responder to the same question offered a different answer:
It's basically a loan office or a collection office. In the Christmas Carol, Scrooge would collect money from loans or rent from properties, a variety of things. So he'd be counting money in his "counting-house".
So, was Scrooge, instead, a lender, that is, a banker?

The ghost of Jacob Marley, in his visitation to Scrooge, woefully referred to their "counting-house" and their work together as money-changers:

My spirit never walked beyond our counting-house -- mark me! -- in life my spirit never roved beyond the narrow limits of our money-changing hole; and weary journeys lie before me!" * * *
In Stave Four ("The Last of the Spirits"), during the visitation by the silent "Ghost of Christmas Yet to Come", Scrooge observes this conversation, which occurs between a husband and his wife about the death of a businessman (who is Scrooge):
‘We’re quite ruined?' she asked.

‘No. There is hope yet, Caroline,' he replied.

‘If he relents,' she said, ‘there is. Nothing is past hope, if such a miracle has happened.'

‘He’s past relenting, ' said her husband. ‘He’s dead.'

She was a mild and patient creature…but she was thankful in her soul to hear it, and she said so, with clasped hands. She prayed for forgiveness the next moment, and was sorry; but the first was the emotion of her heart.

The husband continued: ‘What the woman whom I told you of last night, said to me, when I tried to see him and obtain a week's delay -- and what I thought was a mere excuse to avoid me -- turns out to have been quite true. He was not only very ill then, but dying.'

‘To whom will our debt be transferred?' asked the wife.

‘I don't know. But before that time we shall be ready with the money; and even though we were not, it would be bad luck indeed to find his successor so merciless. We may sleep tonight with light hearts, Caroline!' * * *
Throughout the developing story, and up to its climax, what Scrooge does in business remains a mystery.

While being conducted towards the place to be occupied by himself in the future, Scrooge veers off the indicated course to peer, instead, into his "office" where he had practiced his "occupation":

The Ghost of Christmas Yet To Come conveyed him, as before -- though to a different time, Scrooge thought -- until the Spirit was asked by Scrooge to tarry for a moment.

‘This court,' said Scrooge, ‘through which we hurry now, is where my place of occupation is, and has been for a length of time. I see the house. Let me behold what I shall be, in days to come.'

The Spirit stopped; the hand was pointed elsewhere.

‘The house is just there,' Scrooge exclaimed. ‘Why do you point away?'

The finger underwent no change.

Scrooge hastened to the window of his office, and looked in. It was an office still, but not his. The furniture was not the same, and the figure in the chair was not himself. The Phantom pointed as before. * * *
This, then, is what we have learned about Scrooge: He worked in an office; he and managed the firm as surviving partner; he employed a clerk; he conducted commerce with both businessmen and consumers; and he controlled assets and collected debts.

Most importantly, we observe that he conducted commerce in such a way that the commerce consumed him . . . until the night of his reclamation.

Considering that transformation -- which is the point of the story -- must we know his self-centered pre-occupation? Perhaps it could be our occupation, too. Perhaps it is you or me who is the successor occupant of Scrooge's office.

Dickens' focus rests on Scrooge's
redemption within it. The alteration of Scrooge's character -- after reflections on his past, review of the present, and renewal for the future -- avoided a destructive lonely death, brought healing to himself and others, and then became widely known in his community.
He did it all, and infinitely more; and to Tiny Tim, who did not die, he was a second father. He became as good a friend, as good a master, and as good a man, as the good old city knew, or any other good old city, town, or borough, in the good old world. * * *

He had no further intercourse with Spirits, but lived upon the Total Abstinence Principle, ever afterwards; and it was always said of him, that he knew how to keep Christmas well, if any man alive possessed the knowledge.

May that be truly said of us, and all of us!

"At this festive season of the year, Mr. Scrooge," said the gentleman, taking up a pen, "it is more than usually desirable that we should make some slight provision for the Poor and Destitute . . . ."  -- Charles Dickens

Update: 2010-12-22:

The same question -- What is Scrooge's occupation? -- was asked by Professor Stephen C. Behrendtas as the first of thirteen study questions for his college students "intended to lead you to particular sorts of information that will be useful for seeing A Christmas Carol as a work that reflects its times and some of the issues that characterized the culture of the times."  See: Background questions — Charles Dickens, A Christmas Carol, posted by the University of Nebraska - Lincoln (01/12/10), which includes some useful Internet resources about the fictional work.

Update: 2010-12-23:

Ultimately, I doubt that Scrooge was a lawyer, since he did not talk like a lawyer, even for that time. See: EE&F Law Blog post, Lawyer's Christmas Greetings (12/23/10).

Thursday, December 20, 2007

"Elder Abuse" Responses Vary by State

On December 16, 2007, The Providence (RI) Journal posted an excellent article entitled "Response to elder abuse varies widely across U.S.", by Tracy Breton, which summarized results of that newspaper's 50-state survey about "elder abuse" reporting & response.

Every year, an estimated 2.1 million older Americans are victims of physical, psychological or other forms of abuse, according to the American Psychological Association. Congress says the number could be closer to 5 million.

But the nation’s safety net for seniors is not nearly as good as it is for children.

A survey of all 50 states conducted by The Providence Journal over the past several months shows that even though most states have mandatory reporting laws for elder abuse, fewer than half of them have statewide, 24-hour-a-day hot lines to record complaints and offer immediate response.

By contrast, all but five states have social workers on duty 24 hours a day responding to complaints of child abuse — even though the elderly population is booming. * * *

But there are seven states that don’t have any after-hours hot line services for the elderly to report abuse, and most states that do take calls on nights and weekends don’t provide immediate response from a social worker. That leaves victims with no one to turn to after state government closes down for the day — unless the victims want to call in the police or the local sheriff. And that doesn’t often happen.

That’s because most elder abuse and neglect occurs in domestic settings. Ninety percent of the time, the perpetrator is a family member, most often an adult child or spouse, according to the National Center on Elder Abuse. And most elderly people don’t want a loved one sent to prison, even if the abuse is recurrent. Many depend on the perpetrator to perform essential tasks for them such as cooking, driving and cleaning. If their abuser is incarcerated, many of them would have to move into a nursing home.

Consequently, just 1 in 14 incidents of elder abuse is ever reported to the police. And the figure is even less for financial exploitation: Current estimates put the overall reporting of elder financial exploitation at only 1 in 25 cases. * * *

The article notes, of course, the reporting & response system in Rhode Island, as well as Massachusetts & Connecticut. But Florida's extensive & well-funded system is highlighted.

Florida's elderly population is the highest in the nation, so it faced "elder abuse" cases more frequently than other states. That situation now spreads to other states, such as Rhode Island, as the general American population ages:
The elderly, which the federal government classifies as anyone over 62, are the fastest-growing segment of the nation’s population.

In 2005, almost 17 percent of Rhode Islanders were 62 or older, according to the U.S. Census Bureau. By 2030, almost 25 percent of the state will be populated by people 62 or older; just 5 percent of the state will be younger than 5. From 1990 to 2000, Rhode Island experienced a 30.5-percent increase in the number of residents aged 85 or older.

Over the next 30 years, the proportion of the entire U.S. population over 60 will drastically increase as more than 76 million baby boomers age. * * *
Pennsylvania is also advanced in efforts to address "elder abuse", which likely will expand as our population, already quite sedentary, ages. For more details, read the many posts on this Blog under the heading "Elder Abuse", including (most recently) "POA Abuse Cases Pressed by PA AG" (12/03/07).

This article then considers the effect of the federal "Elder Justice Act" legislation, which despite reintroduction annually, still remains only a proposal, with seeming low political & funding priorities.

If the Elder Justice Act — introduced in the U.S. Senate nearly six years ago — ever passes, it would provide hundreds of millions more in federal financing for adult protective services to the states — money to detect, investigate, prevent, prosecute and study elder abuse and to train more people who interact with victims.

The act would also provide money for research and data collection to track elder abuse and determine the effectiveness of various forms of intervention to make elders safer. But there is no line item in the bill that would compel the states to create statewide hot line services to respond to after-hours complaints. So unless the legislation is amended, experts say, there will be continuing disparity in how the states respond to this problem. * * *

The Elder Justice Act, which has been stalled in Congress for years, recognizes that “differences in state laws and practices in the areas of elder abuse, neglect and exploitation lead to significant disparities in prevention, protective and social services, treatment systems and law enforcement, and lead to other inequities.” * * *

The article examines efforts by some of the states -- Delaware, New Mexico, & West Virginia, for example -- to identify elder abuse through "hotlines", but finds them wanting in effectiveness.

Perhaps I should revisit some assumptions noted in my prior post, "
Verizon's "HopeLine": Phones in PA?" (09/25/07) -- as to states other than Pennsylvania.

I had the impression that, in other states, the needs for reliable reporting of "elder abuse" were met by such "hotlines".

According to this article, they are not.

Wednesday, December 19, 2007

PSU-DSL Publishes Its Elder Law Clinic Newsletter

The Fall, 2007 issue of the newsletter "Adventures in Law and Aging" (PDF, 6 pages) was recently posted online by the Elder Law and Consumer Protection Clinic, of Penn State's Dickinson School of Law.

This issue of the Newsletter was introduced by Professor Katherine C. Pearson, who supervises the Clinic & teaches elder law at PSU/DSL.

Our Elder Law and Consumer Protection Clinic is now in its seventh year of operation. I’m pleased to announce developments, including relocation to the Dale F. Shughart Community Law Center at 45 North Pitt Street in Carlisle, where we share space with Penn State Dickinson’s long-established Family Law and Disability Law Clinics and the newest in-house clinic, the Children’s Advocacy Clinic.

Our students represent older adults on referrals from central Pennsylvania’s Area Agencies on Aging. * * *

With recent developments in federal and state laws, we’ve seen big changes in services for older adults. These changes put me on the road frequently, not just within the state but also nationally and internationally, to talk about the future of laws affecting older adults and their families. For example, in November I’ll be speaking in Vancouver at an international elder law conference hosted by the Canadian Centre on Elder Law Studies, as well as at the National Council on Family Relations’ annual meeting, focusing on my research into filial support laws.

This newsletter is written in large part by current students in the Clinic, who are certified to practice law under the guidance of our Clinic’s terrific visiting practitioners, Mark Allshouse, Douglas Roeder, and
Nichole Walters, who each bring special knowledge and skills to bear for tough cases. * * *
The contents of the Newsletter (See: "Inside this issue", above) reflect a variety of elder law matters in this Commonwealth, viewed from the client cases conducted by law students, and also from the research & educational efforts of their Clinic's supervisors.

Professor Gerry W. Beyer recognized the Newsletter in a posting on his Wills, Trusts & Estates Prof Blog, dated December 14, 2007, entitled "Fall Issue of Penn State’s Elder Law and Consumer Protection Clinic News".

This Clinic, its Newsletter, and the students who power such efforts, provide a vision of the future for "elder law" in Pennsylvania, from those who prepare to serve that clientele.

Tuesday, December 18, 2007

NBC Reports Rampant Fraud in Medicare

On December 10th & 11th, NBC's Nightly News aired a two-part series that documented massive, widespread fraud successfully conducted by criminals who claim Medicare payments for non-existent services & equipment.

It is easy to make $6 million a year by defrauding the compliant, predictable, "trusting" Medicare system, with little risk of getting caught or punished. Read the articles only if you are prepared to become outraged.

While this system wastes
$60 billion a year in bogus claims paid, the loss is dutifully covered by U.S. taxpayers, who are compelled to support Medicare with taxes automatically deducted from their payrolls.

The articles report little or no response to complaints made by users or providers who identify obvious fraud situations. This fraud appears systemic in a program originally intended to help seniors. Such fraud, like a growing parasite, could threaten its collapse. It already severely compromises its mission.

Criminal fraud is already a "national scourge" crippling the Medicare system. With anticipated increased enrollment by the "baby boomers", such fraud could undermine its processing of payments for basic services, or the political support for its continued funding.

These are the articles in the series, both by Mark Potter, available online:

Here are some snippets from the extensive (5 webpages) series:
Law enforcement officials said it's just one of the many widespread, organized and lucrative schemes to bilk Medicare out of an estimated $60 billion dollars a year — a staggering cost borne by American taxpayers.

Officials say the array of criminals running these schemes are stealing blatantly from the social safety net that cares for 43 million seniors and the disabled, and along the way are hurting honest patients, physicians and legitimate businesses. * * *

Most taxpayers likely have no idea of the scope and cost of the Medicare billing schemes, which they all fund through their payroll deductions.

To show just how bad it can be, federal officials in Miami pointed to a red electric wheelchair they seized from an illicit company. Normally it would cost about $5,000. But by billing Medicare over and over, nor ever delivering the wheelchair to an actual patient, criminals charged a total of $5 million for that one item alone. * * *

"We are up against an organized foe here, this is very organized," said HHS Secretary Leavitt, referring to the many experts who specialize in setting up illicit medical companies.

Kirk Ogrosky, who headed the Justice Department strike force against Medicare fraud in South Florida said, "The problem stems from what we've seen in our cases, time and time again, is that there's a culture of corruption. This culture starts with the patient." * * *

In a recent interview with NBC News, a man who made millions of dollars by defrauding Medicare before his arrest explained how easy it was to steal from the government. * * *

One thing he found shocking was how agreeable Medicare was in paying his phony claims, even after patients whose names were used without permission filed complaints.

"Why is Medicare paying" he asked. "Medicare keeps on paying, so who's at fault? I think the government is at fault, the government doesn't have any control of this."

The man said stealing from Medicare can be a very lucrative endeavor. "If in a year you want $6 million or $8 million you can do it." * * *
Comments by television viewers and by readers on NBC/MSN blogs independently confirm the key points of the investigative reports:
The Centers for Medicare & Medicaid Services issued a short response to the series. See: "Response by The Centers for Medicare and Medicaid Services".

This is one of the most scathing reports on government waste, mismanagement, and unresponsiveness that I have ever read.

taxpayer, any patient under Medicare, any provider in the Medicare system -- each should be devastated. And then all should demand reform & safeguards.

Monday, December 17, 2007

Outliving Medicare's Hospice Benefits

According to recent news reports, Medicare is assessing charges against some hospice institutions that cared for substantial numbers of terminally-diagnosed patients who outlived the six-month hospice benefit period.

On December 17, 2007, the Providence Business News posted an article entitled "When life doesn’t end as expected", by Marion Davis, who reported:

Lengths of stay for hospice patients are increasingly under scrutiny nationwide because some hospices – particularly, for-profit institutions in the South and West – have had so many patients exceed the six-month time frame that Medicare has charged them back millions of dollars: $166 million from 220 hospices in 2005, according to the Medicare Payment Advisory Commission. * * *
The article focused on the "hospice benefit" provided by Medicare:
Medicare pays for hospice – specialized end-of-life care focused on physical and emotional comfort, spirituality and support for the family – when a patient has been given less than six months to live and agrees to forgo life-extending treatments. * * *
The publication "Medicare Hospice Benefits" (Rev. 09/2007; PDF, 16 pages) issued by the Centers for Medicare & Medicaid Services, explains the program.
Hospice is a program of care and support that you may want to consider if you or someone you care for is terminally ill.

Here are some important facts about hospice:
  • Hospice provides comfort and support services to people who are terminally ill. It helps them live out the time they have remaining to the fullest extent possible.
  • Hospice care is provided by a specially trained team that cares for the “whole person,” including his or her physical, emotional, social, and spiritual needs.
  • Hospice provides support to family members caring for a terminally ill person.
  • Hospice is generally given in the home.
  • Hospice services may include drugs, physical care, counseling, equipment, and supplies for the terminal and related condition(s).
  • Hospice isn’t only for people with cancer.
  • Hospice doesn’t shorten or prolong life.
  • Hospice focuses on comfort, not on curing an illness.
Medicare Hospice Benefits -- You can get Medicare hospice benefits when you meet all of the following conditions:
  • You are eligible for Medicare Part A (Hospital Insurance)
  • Your doctor and the hospice medical director certify that you are terminally ill and have six months or less to live if your illness runs its normal course
  • You sign a statement choosing hospice care instead of other Medicare-covered benefits to treat your terminal illness*
  • You get care from a Medicare-approved hospice program
*Medicare will still pay for covered benefits for any health problems that aren’t related to your terminal illness.
The problem occurs when substantial numbers of patients certified for hospice benefits actually live longer than the expected six months.

The article describes one individual's case where benefits continued, and also addresses the problem on an institutional level when charges are levied upon the provider.

U.S. Senator Pete V. Domenici is aware of the problem. On October 26, 2007, he issued a press release entitled "Domenici Seeks 3-Year Moratorium on Medicare Hospice Repayments, Says Penalties Could Sink N.M. Programs":
U.S. Senator Pete Domenici today warned that some New Mexico hospice programs that serve eligible non-cancer patients face financial ruin if they are forced to repay millions of dollars in Medicare payments.

Domenici has formally asked the leadership of the Senate Finance Committee to impose a three-year moratorium on Aggregate Hospice Cap (Cap) repayment notices being issued by the Centers for Medicare and Medicaid Services (CMS), the agency that administers Medicare programs.

Domenici asked that a moratorium—covering fiscal years 2005, 2006 and 2007—be written into Medicare legislation now being developed by the Finance Committee. * * *
The New York Times reported about the effects on hospice providers in an article entitled "In Hospice Care, Longer Lives Mean Money Lost", by Kevin Sack, published November 27, 2007:
Hundreds of hospice providers across the country are facing the catastrophic financial consequence of what would otherwise seem a positive development: their patients are living longer than expected.

Over the last eight years, the refusal of patients to die according to actuarial schedules has led the federal government to demand that hospices exceeding reimbursement limits repay hundreds of millions of dollars to Medicare.

The charges are assessed retrospectively, so in most cases the money has long since been spent on salaries, medicine and supplies. After absorbing huge assessments for several years, often by borrowing at high rates, a number of hospice providers are bracing for a new round that they fear may shut their doors. * * *
On December 3, 2007, The NY Times published letters to the editor sent in reaction to that article. See: "Hospice Care: When the Dying Live On".

In his letter, J. Donald Schumacher, the President and Chief Executive Officer of the National Hospice and Palliative Care Organization, identified the first priority:
There is one very simple point that must be emphasized: No person in need of hospice care should encounter unnecessary barriers to quality care at the end of life. * * *

Friday, December 14, 2007

Fiduciary Administration Software

On November 29, 2007, "Fiduciary Administration Software for the Professional" was the topic of a one-hour presentation during the second day of the 14th Annual "Estate Law Institute" conducted by the Pennsylvania Bar Institute, at the Pennsylvania Convention Center, in Philadelphia.

The format for this presentation was similar to that for the session on estate planning & drafting software, which had occurred during the first day of the Institute.
See: PA EE&F Law Blog posting "Estate Planning & Drafting Software" (12/11/07).

The session occurred at the end of the very successful & well-attended Institute, which I had anticipated previously in a posting, "
PBI's "Estate Law Institute" Nov 28th-29th" (10/24/07). The panelists included:

I began the session by referring to the Pennsylvania Uniform Trust Act (Chapter 77, of Title 20's "Probate, Estates & Fiduciaries Code"), which took effect on November 6, 2006. I highlighted the sections of the PA UTA that address accountings of a fiduciary's administration of a trust.

Gene Gillin then reviewed the model accounting forms developed by the
Pennsylvania Supreme Court's Orphans' Court Procedural Rules Committee. These forms are required statewide for audit filings made on & after April 30, 2007. See: PA EE&F Law Blog postings, "PA's New Orphans' Ct Accounting Forms" (04/02/07); "Comparison of PA's Old & New Accounting Formats" (04/03/07); and "Clarifications on PA's New Accounting Formats" (04/06/07). He noted that vendors of fiduciary administration software have incorporated these model forms into their products.

Kathy Dever then demonstrated the FASTER Systems software, which she described as "my baby for the past 20 years". She first encountered it as a data entry clerk at Fidelity Bank, in Pennsylvania; and now, she is a principal owner of the company.
FASTER Systems provides Court Accounting, Estate Tax and Gift Tax Software and Preparation Services to help today's trust and estate professional meet their compliance requirements.

FASTER ASP Software is the only on-line, fully integrated software for court accounting, estate tax and gift tax return preparation. Designed and developed by industry professionals for industry professionals.

FASTER Accounting Services provides court accounting preparation services and estate tax preparation services to law firms, accounting firms, trust companies and banks on a fee for service basis.

She demonstrated FASTER ASP software, including its interface, online data storage, transaction & information entry, modules, customization, and output (such as the form of a PA model form accounting).

FASTER is the user-friendly Fiduciary Accounting System for Trusts and Estates Reporting for Windows®.

Using 32 bit technology, FASTER produces Court Accountings, Estate and Inheritance Tax Returns, Decedent and Guardian Inventories, Schedules of Distribution, Bring-Down Statements and Trust Accrued Income Statements.

The software is provided through an on-line hosted environment.

The characteristics of this software can be explored further on FASTER's website:

Vince Lackner then demonstrated "his baby" -- 6-in-1 for Windows -- which he & his company have developed over the past 22 years.

Since 1986, the company has been providing estate and trust software to hundreds of law firms, banks and accounting firms, in over thirteen states.

The Lackner Group pioneered the one-write solution to electronic Estate and Trust Administration.

He showed how case information or financial transactions can be entered with codes or into a form, and then flow into each of the six modules -- federal estate tax, federal gift tax, state death (inheritance) tax, fiduciary income tax (federal & state), accountings, or court forms (including probate petitions, inventory, & reports). He also demonstrated the software's customization, "help" facilities, and output, including an accounting compliant with the new requirements.

The characteristics of this program are summarized in a 2-page listing found on The Lackner Group's website.

These two integrated software packages are noted by Donald H. Kelley, Esq. in his 24-page outline, with live Internet links, entitled "Electronic Practice Leverage -- A Trusts and Estates Desktop", which was reprinted into the 3-volume materials provided to attendees by PBI. See: PA EE&F Law Blog posting "Estate Planning & Drafting Software" (12/11/07). There are a few other such software systems that should be considered.

Preparation of probate documents & death tax returns was the original impetus for creation of such professional-level software. These remain complicated programs, because the laws they address are technical & overlapping.

Since PA courts require that accountings be filed to resolve issues in fiduciary administrations, and since such accounting forms are extensive & standardized, software such as this is more important than ever to the trust & estates practitioner or to the professional fiduciary.