Wading into Deep Water

Sharing concerns with Sara Player.

One of the trickiest aspects of elder law is Medicaid.  Few firms have expertise in this area and many people want advice about it.  These clients see the little bit they own disappearing to pay for long-term care costs.  The Elder Law Clinic students learn the fundamentals of Medicaid and meet with several clients who have questions.

Sometimes, the issues result from “self-help” Medicaid planning.  Parker Smith had a client who owned two homes – his own home and his elderly father’s home.  Why?  Because the adult children (including Parker’s client) thought it would be a good idea for their dad to re-title his home.  They thought they were “protecting” it. Now, the second home makes Parker’s client ineligible for Medicaid.  And the father will also be denied Medicaid due to a transfer of assets.

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The Managing Attorney

Besides supervising the students, Clinical Professor Kate Mewhinney gave several talks:

  • “Long Term Care Insurance,” for the N.C. Bar Association’s elder law program.
  • “Advising Aging Clients with Diminishing Capacity,” for the Winston-Salem Estate Planning Council.
  • “Legal Issues for Geriatricians,” for the medical school geriatrics section.

She is also working on a local project to assess the needs of older LGBT people, as part of the Aging Friends Initiative of the Adam Foundation.  In the spring, Professor Mewhinney will teach a new doctrinal course called “Law and Aging” and will serve on an ABA accreditation team reviewing a California law school.

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Learning the Role of Counselor

Getting answers from Mitra Tashakkori.

Knowing the law is just one part of being a good lawyer.  Imparting advice to a client is a skill that takes a while to develop.

“Am I free to leave?” is a question we are sometimes asked by clients in long-term care facilities.  Sara Player had a client who came in with his son.  The gentleman wanted to know if he had to stay in the assisted living facility that his daughter had chosen.  Even though he liked the people where he lives, he wanted to leave to go live with his son.  After investigating, Sara determined that there was no legal impediment to the man’s leaving.  However, the son’s living situation is unstable.  Sara counseled her client that, while he could leave, she advised him not to.  Why?  He was risking his safety and could face a guardianship case brought by a social service agency.  Sara also explained how the the long-term care ombudsman could be of help.

Michael Levine’s client wanted a will leaving her house to just one child.  As we often hear, she said, “My daughter will know what I want her to do.”  Essentially, the client trusts that this one child will divide assets as the parent wishes.  The risk is, of course, that the child decides to keep it all!  Michael diplomatically explained this and talked to his client about having this “responsible child” as executor.  This way, her wishes would be carried out under a court’s supervision.

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Ethics from Inside

Checking the details with Michael Levine.

What is the right thing to do?  Families and health care providers sometimes disagree about what is the best choice for a patient, especially regarding end-of-life care.  The health care team itself may have disputes among its members.  These issues can be taken to an ethics consultation committee.

At Wake Forest Baptist Medical Center, a multi-disciplinary group meets regularly to provide input on ethical conflicts brought before it.  As a member of this group for many years, Clinical Professor Kate Mewhinney was able to invite Laura Esseesse along.  Laura has a good background, having interned in the hospital’s legal department last summer.  Laura will bring her understanding of the ethics consultation process into a career in health law.

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Debts x 3 = Stress

Will Peete verifies details with his client.

Will Peete had several clients with debt problems.  One client had paid off a mortgage only to find that the lender had failed to cancel the lien or mark the debt satisfied. Will contacted the lender to notify them of this oversight.

Another of Will’s clients had many bills she simply could not pay.  She did not realize that her modest home and her Social Security income were fully protected under state and federal laws.  Debts are a common source of significant stress, particularly for single, older women who live alone.  Will’s advice to her about legal protections was reassuring.  He reviewed the process for protecting her income and assets in a counseling session and a follow-up advice letter.  His calm manner was as helpful as his legal knowledge.

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Illustrious Alumnae

E-Clinic alumnae Kristin Burrows (‘05) and Natalie P. Miller (‘04) were elected by the N.C. Bar Association Elder Law Section to two-year terms on the Section’s executive council.

Good news from Vermont! Devon Green (‘06) has been handling elder law cases for Vermont Legal Aid.
She writes: 

Now I’m going to work as a health care policy analyst for Vermont’s director of health care
reform. Vermont is moving towards a universal health care system within the next few
years, and I am excited to be a part of this process. I hope to bring some of my experience
with Medicaid and Medicare to the table. I think this health care reform effort will help
innovate health care delivery for the population in general and seniors in particular.

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Good News for Mountain Communities

Kathleen Rose is heading to Asheville to the Van Winkle Law Firm and will practice estate planning and elder law.  There, she joins E-Clinic alumna Caroline Knox, who is a partner in the firm and certified as an elder law specialist by the N.C. State Bar and the National Elder Law Foundation.

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Ethics Fundamentals

Going over the details with Andrew Dixon.

Ethics are emphasized in the Elder Law Clinic.  Law students learn the diplomatic skills involved in representing older clients.  They meet one-on-one with  the older person, and only involve adult children with the client’s consent.  The clinic students document to whom the client has authorized disclosures of information.  They let the client know how they will proceed if the client becomes incapacitated during our representation.  Elder law ethics resources can be found on the Clinic’s website, in the Resources section.

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The Managing Attorney

Clinical Law Professor Kate Mewhinney recently:

  • Became an accredited attorney by the U.S. Department of Veterans Affairs.
  • Completed a book chapter, “State-of-the-Art Problem-Solving:  Mediation of Guardianship Disputes,” for Comparative Perspectives on Adult Guardianship, Kimberley Dayton, ed. (Carolina Academic Press) Forthcoming 2012.
  • Sponsored a multi-disciplinary program to train health care providers how to spot elder exploitation.  The training is part of a national initiative, handled here by the North Carolina Secretary of State.  It is called the Elder Investment Fraud and Financial Exploitation Prevention program (EIFFE).  Co-sponsors of the event included the N.C. Bar Association Elder Law Section and the Section of Geriatrics of the Wake Forest School of Medicine.
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Grateful Clients

A warm welcome from Scott Villarreal.

  • Will Peete explained things well to me.  He was patient and prompt, too.
  • Kathleen Rose was friendly, polite and professional.
  • Danielle Stone was very pleasant and gentle with my father.  She was knowledgeable about what needed to be done.
  • Julia Gravely explained everything well, on my level of understanding.  I don’t think she could have been better.

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