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‘Ask Sam’ Features the Elder Law Clinic

The Elder Law Clinic at Wake Forest University was featured in the Winston-Salem Journal’s popular “Ask Sam” advice column here on Friday, January 27, 2017.

The Real Deal

Fall 2016 group photo - web

Fall 2016 Elder Law Clinic
Maria Collins, Rebecca Daddino, Casey Fidler, Monica Berry,
Dan Choyce, Cara Van Dorn, Lisa Roach, Cate Berenato, Reva Singh

“Nothing ever becomes real ‘til it is experienced.” - John Keats

In the Elder Law Clinic, law students gained hands-on legal experience with actual clients, under the supervision of Professor Kate Mewhinney.  The students prepared wills and powers of attorney, handled guardianship hearings, tackled consumer law issues and answered health law questions.  Below are some stories, with details changed to protect confidentiality.

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Stress from the IRS

Cartoon - hand in marriage floor

Michael Maslin/The New Yorker Collection/The Cartoon Bank

$870 per month from Social Security is not much to live on.  But Cate Berenato’s client was also anxious and depressed about an IRS debt.  Cate represented her client by filing an “Offer in Compromise” with the IRS, asking to reduce the debt.  She obtained a statement from the client’s doctor confirming that the IRS debt was negatively impacting the client’s mental health.

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The Right to Die

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Going over the details with Lisa Roach.

The right of terminally ill patients to end their lives through legal means is now the law in six states.  Lisa Roach is taking the lead to advance this initiative in North Carolina.  The non-profit organization Dying Right North Carolina is devoted to honoring life by allowing it to end with dignity and without suffering.

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Special Thanks

Monica client best

A mother and daughter consult with Monica Berry.

Thanks to Parkway United Church of Christ for making a donation to help the Clinic do community service.  Also, thanks to several local experts who gave their time to teach our students about long term-care insurance options: Ellen Atkins, Gerry Malmo and Ernie Osborn.  They are each Certified in Long-Term Care.

 Our Medical Teaching Partners: 

To better understand the needs of older clients, our students learned about medical issues such as mental capacity assessment, caregiver support programs, ECT and hospice and palliative care.  The clinic’s medical teaching partners, who generously share their time and expertise with the clinic students, are:

  • William Hazzard, M.D., Professor of Gerontology and Geriatric Medicine
  • Predrag Gligorovic, M.D., Associate Professor, Department of Psychiatry and Behavioral Medicine
  • Mark Corbett, M.D., Associate Medical Director, Hospice and Palliative CareCenter
  • Edward Shaw, M.D., M.A., Sticht Center for Healthy Aging, Caregiver Support Group.

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The Art of the Interview

Cara best home visit

Cara Van Dorn makes a home visit.

In this course, students get a lot of experience with interviewing clients, their family members and witnesses.  From the opening chitchat to the final summary, students learn how to conduct a thorough interview.

Maria Collins had some particularly challenging interviews.  She worked with a client who had had a stroke a few years ago and tended to get off track. Maria found it hard not to be overly deferential and to keep the discussion on the legal tasks at hand.  It helped, she found, to be direct about the time constraints and to not follow up when the client brought up new topics.

Interviewing requires getting and giving information while also clarifying misunderstandings, all while being empathetic.  It can sometimes be tough!

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Your Life A Mess? So Bad That Courts Should Step In?

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Casey Fidler discusses a case with Tyler McQueen, M.D.

Our students handled nine guardianship cases this semester.   Each student wrote a brief to the court, after many interviews and gathering evidence from physicians, social workers, neighbors and family members.  They thought about what it should take before society, through the courts, should step in.

Monica Berry was court-appointed to represent a retired woman who was living alone in an apartment.  The woman’s daughter said that her mother’s mental illness had progressed and that she wasn’t eating well.  There were no recent medical records to examine, but the woman’s relatives testified about her declining hygiene and physical health.  The court adopted Monica’s recommendation to appoint a guardian to make decisions for the woman.

Reva Singh is getting a Masters in Bioethics, in addition to a law degree, which she found useful in her guardianship case.    She writes: “Just because someone is weird, does that make them incompetent?  When  I asked my client’s family why he may need a guardian, they said  ‘He thinks he’s God,’ or ‘He thinks he can ask any woman to marry him if she smiles at him.’  While these details were worth considering, they did not determine his ability to take care of himself.  If outlandish behavior was all I’d found, I would be troubled, but not certain of his incompetence.”

Reva used both sides of her education to focus on the facts of the case and help the court decide what was best for her client.

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Avoiding the Double Whammy

Reva Best

Reva Singh explains the legal options.

Many people come to the Elder Law Clinic worried about losing their homes if they should ever need nursing home care.  Should they be worried?  Yes!  Once a person’s savings get down to the poverty level ($2,000 in savings for an individual), Medicaid pays for most nursing home residents.  The person can own a home while Medicaid pays the nursing home.

Here is the problem, though.  Medicaid law requires that the government be reimbursed out of the person’s estate. This means that first their savings are used up and then all or part of their house value goes to pay back the Medicaid program.  This is called “Medicaid estate recovery.”  It’s a double whammy that few families expect.  Often they will seek out an elder law attorney, to learn the rules and to see what assets they can protect.  Most folks want to hold onto what they have worked for in case they get better and leave the nursing home. They also want to leave something for their spouse, children and grandchildren.

Lisa Roach helped a woman who had been a cosmetologist for more than 25 years.  She wanted to ensure her home went to her three sons.  Like many people, she was confused about Medicaid and thought perhaps she should give her house to her sons now.  Lisa advised her against this, because it would actually make her ineligible for this valuable program.  She also explained that the son who the client appointed under a power of attorney could take steps to protect the home from “estate recovery” if – and only if – the client ever enters a nursing home on Medicaid.  Lisa advised her client to keep the home in her name for now.

There are cases where Medicaid does allow a person to give her home to a child, without causing ineligibility.  One example is the “caregiver child rule.”  Casey Fidler helped a woman whose son has been staying with her for several years.  The client wanted to be sure he could stay there after she passes away.  Casey explored different options with her client, including the possibility that the “caregiver child” rule would apply.  This required getting a physician to document that the woman needed a caregiver living with her and that her son had lived with her for at least two years before the home was transferred to him.

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Clinical Professor Kate Mewhinney

Walters grandkids (5)

Grandma’s helpers come with a client to her appointment at the clinic.

  • Co-authored a web-based training with physicians from the Mayo Clinic and Wake Forest School of Medicine.  The training is part of the only national geriatrics curriculum for medical students and other health professionals.
  • Published “The Protected Consumer Credit Freeze: A New Tool to Prevent and Stop Financial Exploitation of Incapacitated Adults,” in the newsletters of the NC Bar Association’s Elder Law and Special Needs Section and the Estate Planning and Fiduciary Law Section.
  • Organized a program on LGBT rights in health care settings with law students and medical students.  For resources on this topic, visit elder-clinic.law.wfu.edu/lgbt.
  • Was invited to be part of a strategic planning process on preparing our community for the growing senior population.  The process was initiated by the CEOs of BB&T, Reynolds American, Hanesbrands, Senior Services and Wake Forest Baptist Health.

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Alumni News

  • Jenna Coogle (’17), a clinic student in the spring, worked in Washington D.C. at the Securities and Exchange Commission (SEC).  She spent part of last summer assisting the Investor Advocate, Rick Fleming (’94).  Back in 1993, Mr. Fleming was a student in the Clinic.

    Maria best

    Maria Collins meets with Rebecca Omlor, M.D., at the Forsyth County Hall of Justice before a hearing.

  • Maria Collins (’17) worked with Sarah Randal Watchko (’08) last summer in Georgia.  Watchko is one of only ten Certified Elder Law Attorneys by the National Elder Law Foundation in her state.
  • Rebekah Garcia (’14) is now a staff attorney with Legal Aid of N.C.’s Senior Law Project.  She writes: “I provide legal assistance to victims and work with multi-disciplinary elder abuse task forces in eastern N.C.  Our project helps educate community members about how elder abuse/financial exploitation happens and how they can protect themselves.”
  • Marcus Fields (’16) joined the preeminent elder law firm of Ron M. Landsman, in Rockville, Maryland.
  • Jenica Cassidy (’14) presented at a Roundtable on Restoration of Rights in Adult Guardianship at the ABA Commission on Law and Aging.  This was the culmination of a yearlong research project funded by Borchard and The Greenwall Foundation.  Her findings and policy recommendations will be published in 2017.  Jenica practices elder law in Maryland.

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