Comprehensive Planning. Lifelong Solutions.

Medicare Actively Expanding MSP Compliance for Personal Injury Claimants

By Shannon Laymon-Pecoraro

On February 3, 2017, the Centers for Medicare and Medicaid Services (CMS) announced that they would be establishing two new Medicare Set-Aside (MSA) processes – one for Liability Medicare Set-Asides (LMSA) and the other for Non-Fault Medicare Set-Asides (NFMSA). As a result, CMS will begin rejecting claims for payment of Medicare expenses associated with an injury for which a personal injury payment has been made. Specifically, CMS will direct the Medicare claimant to use LMSA or NFMSA funds to cover injury-related medical expenses.

When an injured person receives or has a “reasonable expectation” of receiving Medicare, the client has a duty to take Medicare’s future interest into account. Medicare is prohibited from paying claims when payment “has been made or can reasonably be expected to be made under a workers’ compensation plan, an automobile or liability insurance policy or plan (including a self-insured plan), or under no-fault insurance” pursuant to the Medicare Secondary Payer Act (MSPA). Essentially, the MSPA states that, when there is a primary payer, such as a motor insurance or worker’s compensation insurance policy, then Medicare will not be responsible for the medical expenses associated with an injury. Instead, the claimant is expected to utilize the funds received from the primary payer to pay the medical expenses. The setting aside of settlement or verdict funds to pay for future medical expenses associated with the injury is a MSA.

It is important to note that the rule only applies to those payments that have been, or can be expected to be, paid by the primary insurer. In the context of personal injury settlements, primary insurers are expected to make a person whole against – which would mean payment for future medical expenses. As a result Medicare will not pay the medical associated with a settlement, judgment, award, or other payment because payment “has been made” for such items or services through use of an MSA.

Although Worker’s Compensation MSA rules have been established for some time, CMS has not implemented rules for LMSAs or NFMSAs. In May 2012, CMS issued an Advanced Notice of Proposed Rulemaking, which was withdrawn in October 2014. Many practitioners and advocates have anticipated the formal implementation of MSP compliance via LMSAs and NFMSAs for some time, but this is the first formal transmittal we have received.

Hook Law Center has been working with personal injury attorneys and their clients for a number of years to protect Medicare benefits. We assist attorneys and their clients in assessing whether a Medicare Set Aside is necessary, calculating the amount to be set aside, and options for administering the Medicare Set Aside.

Kit KatAsk Kit Kat – Blue-Footed Booby

Hook Law Center:  Kit Kat, what is a blue-footed booby?

Kit Kat:  Well, I have to tell you, when I first read about it, I thought there was a typing error in the title. However, that wasn’t the case at all. A blue-footed booby is a bird that lives on the Galápagos Islands which belong to Ecuador. They also can be found on Isla Isabel, south of the Baja Peninsula, Mexico and on certain Pacific Islands. It is thought that the name evolved from the Spanish word “bobo,” which means clown. Their feet really are a vibrant shade of blue, but they also have a distinctive wiggle to their walking, which can appear clown-like to the observer. They are about the size of large seagulls, with wingspans which can approach five feet. Females are about 20-30% bigger and stronger than males.

The booby has several interesting characteristics. 1) They feed like pelicans—taking a nosedive straight to the fish they eye flying high above the water. The booby hits the water at a speed of 60 miles an hour, its head protected by air sacs in the skull. 2) They live their lives close to where they were born, rarely straying beyond a range of a few dozen feet. 3) Their mating can be for life, but it is not always the case. Some select new partners every season. Those that do mate for life, however, tend to produce 35% more offspring than those that switch partners continually. Those mates which are most fertile are those where the mates are mismatched in age. It does not matter whether it is the male or female who is the older one of the couple. 4) It appears that the secret to longevity of a relationship is equal sharing of parental duties. In these long-term relationships, both males and females spend equal time nest sitting and feeding the young.

So perhaps we have much to learn from the blue-footed booby. Some of their traits are quite admirable. But one thing is certain—they are a good subject for research. Most birds would not tolerate the presence of humans in their midst—but not the booby! According to David J. Anderson of Wake Forest University, Winston-Salem, NC, ‘They let you move among them without minding too much. You try to do that with a continental bird or mammal—forget about it. But with these guys you see it all.’ (Natalie Angier, “On Galápagos, Revealing the Blue-Footed Booby’s True Colors, The New York Times, Science section, March 6, 2017)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, March 20th, 2017. Filed under Newsletter.

Predators and Creditors: How to Protect Your Family

By Elizabeth Boehmcke

Estate planning has come a long way from when I first began practice in 1993. At the time, estate planning was highly driven by a need to avoid or minimize estate taxes and the tax rules took precedence over many other considerations for many families. Now, with possibility of estate tax repeal again looming on the horizon and with the current estate and gift tax exemption amount equal to $5.49 million per person, estate planners can again turn our attention to addressing problems that families face in their everyday lives that have nothing to do with taxes. For instance, how do you address the fact that your beloved child has married a person who is unsuitable in some way? How do you protect a descendant from his or her own bad choices? Do you have the ability to stop the train wreck before it happens?

The answer to all of these issues can be addressed within a trust. A trust is tool that we can use to allow someone, the trustee, to control and manage property for the benefit of another, the beneficiary. Trusts can come in many different varieties, depending on the goals that you want to accomplish. However, all trusts that are meant to protect a beneficiary from his or her creditors or from his or her poor choices should have a few things in common. First, the trust should have a spendthrift clause. A spendthrift clause is a clause in the trust that prevents a beneficiary from assigning or selling his or her interest to anyone, including a creditor. In Virginia, such clauses are enforceable with a minor exception relating to child support (but not spousal support) owed by the beneficiary. Second, the trust should give the Trustee discretion to make distributions to the beneficiary rather than allowing the beneficiary to withdraw assets or to direct distributions to himself or herself. The more discretion that the Trustee has, the harder it becomes for a beneficiary’s creditors, including a divorcing spouse, to compel the Trustee to make a distribution that is attachable by the creditors. Of course, such absolute discretion also puts the beneficiary at the mercy of the Trustee. Thus it is important to balance the risk based on the known extent of the problem.

For instance, if the intended beneficiary is an addict, it might make sense to give the Trustee plenty of discretion to stop all distributions from the trust except for distributions for rehabilitation in the event that the beneficiary is, in the opinion of the Trustee, using addictive substances until such time as the beneficiary is again sober. If the intended beneficiary is in an unstable marriage or is a spendthrift, the Trustee may have the discretion to make distributions for the beneficiary’s health, education, maintenance and support. By giving the Trustee some standard by which to make distributions, it gives the beneficiary slightly more leverage against a Trustee who is not appropriately exercising his or her discretion without significantly increasing the danger that a creditor of the beneficiary can compel a distribution to the beneficiary. However, properly drafted, the Trust property itself would be considered the separate property of the beneficiary and not subject to division between the divorcing spouses as marital property. Furthermore, the Trustee could be given the direct discretion to purchase items for the benefit of the beneficiary directly rather than making a distribution directly to the beneficiary.

As knowledgeable estate planners, the attorneys at the Hook Law Center have also become creative trust drafters in an effort to meet our clients’ changing needs and concerns. Make an appointment with one of us to review your current estate plan to make sure your individual goals and concerns are being met.

Kit KatAsk Kit Kat – Robot Bees

Hook Law Center:  Kit Kat, are there such things as robot bees?

Kit Kat:  I know it sounds strange, but yes there are. They’re still in the experimental stage, but what we’re really talking about are small drones that do the work of bees in pollination of fruits, flowers, and other plants. As you may know, bees appear to be in decline due to a number of factors—pesticides, invasive species, and climate change. The rusty patched bumblebee, for example, was just listed as an endangered species in the month of January 2017, though the Trump administration has put a halt on that process for now.

The drone bees were developed by a Japanese scientist, Eijiro Miyako, a chemist at the National Institute of Advanced Industrial Science and Technology in Japan. He stumbled on his discovery somewhat accidentally 10 years ago when he was trying to create a fluid that could be used to conduct electricity. The resulting gel was extremely viscous. It wasn’t suitable for his purpose, so he stuck it in a cabinet uncapped in a bottle. Discovered 10 years later, the gel hadn’t changed at all. He also observed that when the gel was dropped on the floor, it was good at picking up dust. If it could do that, it might be good at picking up pollen. Then, he stuck the gel to the legs of ants, and with a control group as a comparison, he found that those with the gel were good at picking up pollen. The next step was to try it using drones. He and his colleagues outfitted the drones with horsehairs to approximate a bee’s body. They then slathered the horsehairs with the gel. It was very effective at picking up pollen from flowers—to the rate of 10x more effective.

More research needs to be done to make the drones more maneuverable and energy efficient, but it does offer a promising alternative to our dwindling bee population. (Amina Khan of the Los Angeles Times as it appeared in The Virginian-Pilot, February 11, 2017, pg.5)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, March 13th, 2017. Filed under Newsletter.

Events That Inspire Estate Planning

By Stephan A. Lipskis

Frequently clients call our office due to a perceived risk, such as an upcoming surgery or a long-distance vacation. The refrain is usually, “I need to update (or create) my will in case something happens!” Fear of one’s own mortality naturally arises prior to these events because there is always an inherent risk in certain activities. We do move quickly (often within the same day) to get documents in place for our clients when urgent changes are needed, but “Emergency Planning” like this has certain limitations.

Getting core documents in place is the bare minimum needed for estate planning. Doing so provides legal authority and clear direction for your incapacity or death. “Core documents” include a medical directive and general durable power of attorney, which allow for someone to make decisions on your behalf in the event of incapacity. Waiting until the last minute does not provide the time needed to address common issues beyond the core documents, such as correcting beneficiary designations or getting documents approved by financial institutions prior to the perceived emergency. For instance, if a general durable power of attorney is created for a client a day before surgery, there may be a lag in time for the bank to recognize the document in the event the client suffers an incapacity from the procedure. This could prevent the agent named from performing necessary functions. The inability to adequately consider and discuss proposed documents sometimes occurs when estate planning is rushed. Rather than being able to consider a significant amount of information over a period of several days or weeks, the time for contemplation is compressed into a period of hours or a couple of days.

The recent death at 61 of Bill Paxton, the actor famous for his roles in Apollo 13, Twister, Alien, Tombstone, among others, illustrates the very real risk of undergoing surgery. However, accidents consistently ranks in the top 5 causes of death in the United States and, given the way medical errors are reported, it is unlikely that those deaths are adequately represented in the number reported as accidents. Furthermore, the likelihood of a plane crashing is between 1 in 5,000,000 and 1 in 11,000,000 depending on who you ask. That is the likelihood of a “crash” and not the likelihood of incapacity or death due to a crash, which is slightly lower. The point of these figures is not to scare or prevent planning due to trip or surgery, but rather to promote planning before a perceived risk. Frankly, the “scary” things we hear about on the news are highly unlikely to be the things that result in our incapacity or death and each of us needs to have a plan for the risks we do not associate with an impending event.

Our goal in estate planning is legally coordinating your assets to go where you want them, but another goal is also to minimize risk from creditors, incapacity, probate, and other perils. Obviously, failing to plan avoids thinking about the risks bust does not actually avoid any risk. Knowledge of your personal risks empowers you to create a plan that can mitigate that risk. While planning is often seen as costly, the more significant cost is NOT planning. If a risk arises without a plan in place, then significant funds will be expended in a dispute, guardianship action, estate litigation, or other dispute that could have been avoided if planning had been undertaken. Please contact our attorneys to get your plan in place (or updated) so that we won’t be needed later to correct a major problem. If you are experiencing a problem due to a failure to plan, we can help address those concerns as well.

Kit KatAsk Kit Kat – Baby Gators

Hook Law Center:  Kit Kat, what can you tell us about baby alligators at the North Carolina Aquarium?

Kit Kat:  Well, this is a very interesting story! 4 baby alligators have been residing at the North Carolina Aquarium in Manteo for the last two years, but the exhibit with them opened in December 2016. They’re not sure where the alligators are from—probably Florida—because they were acquired after a sting operation on some illegal operators of exotic pet sales. While at the aquarium, they’ve doubled in size and measure 18 inches in length. Ironically, the baby gators have been named Cheese, Turkey, Ham, and Gravy after the diet that their captors fed them. We can laugh now, but if they had continued on such a regime, they would have died prematurely.

The gators are being trained to respond to their given names through the use of distinctive lures. Cheese’s is a yellow star on the end of a pole. Turkey’s lure is a blue-and-white oval on a pole. By combining the lure with calling their name, the gators are taught to touch the lure with their snout. If they do the task correctly, they are rewarded with a piece of fish. Being able to identify each gator correctly, even though they have unique markings, will help staff treat them should they need medical attention. They are also being accustomed to human interaction.

Alligators in North Carolina are beginning to be an issue. The state is their northernmost range, but as people get them as pets when they are only a few inches long, they have tended to release them in streams or ponds in rural areas once they become untenable as a pet. Jeff Hampton, staff writer for The Virginian-Pilot, says, “It is not unusual to see an alligator swimming in a dark roadside canal around East Lake in Dare County. Merchants Millpond State Park in Gates County is home to a small group.”

For now, the 4 baby alligators are doing fine. They’re eating well and being treated to live crickets, which serve as a tasty reward, and as practice for hunting prey. Time will tell whether they remain at the aquarium. Some adult males grow to be as large as 12 feet. Space is one of the prime considerations. Stay tuned for further updates. (Jeff Hampton, “What’s in a name?” NC Aquarium’s baby gators know,” The Virginian-Pilot, Feb. 6, 2017, pg.3)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Friday, March 3rd, 2017. Filed under Newsletter.

Beware Hospital “Outpatient” Observation Status

By Jessica A. Hayes

Picture this: You’re 80 years old and you suffer a fall that lands you in the hospital for a week. At the end of your stay, you are discharged to a rehab facility for three weeks of rehabilitation and skilled nursing care. The time you spend in the hospital and at rehab is stressful, but you rest assured knowing that you have Medicare coverage. Weeks later, the bills start pouring in, and you learn that Medicare has covered almost nothing. You now owe both the hospital and the rehab facility several thousand dollars. How did this happen?

Three words: Outpatient observation status. Hospital patients and their families are often blindsided by the effect of these words. Outpatient observation status is a billing code hospitals use to protect themselves from penalty by Medicare for admitting patients for treatment which Medicare believes should have been provided on an outpatient basis. Use of this code is on the rise, having doubled between 2006 and 2014, according to The Center for Medicare Advocacy. Unfortunately, this can result in Medicare patients who do not have Medicare Part B paying entirely out of pocket for their the full cost of their hospital stay, hospital prescriptions, and/or nursing facility (rehab) care following a hospital stay. The financial effects can be devastating.

Use of the word “outpatient” in this context is misleading. You may spend the night (or several nights) in a hospital and technically still be classified as outpatient. It has nothing to do with where you receive the care or what kind of treatment you receive.

To address the issue, Congress passed the Notice of Observation Treatment and Implication for Care Eligibility Act in 2015. The NOTICE Act requires hospitals to notify individuals who receive observation services as an outpatient for more than 24 hours with written and oral notification of the classification within 36 hours after they begin receiving the services. The notice must explain the individual’s status as an outpatient and the reasons for the classification. It must explain the implication of that status on services furnished, particularly the implications for cost-sharing requirements and subsequent coverage eligibility for services furnished by a skilled nursing facility. It must be written in “plain English” and be provided in the individual’s own language, and the individual or a person acting on his behalf must sign to acknowledge receipt of the notification. If the individual or his representative refuses to sign, the hospital staff who presents it must sign.

If you or a loved one is classified as outpatient observation status during a hospital stay, fighting the classification can be extremely difficult. The Center for Medicare Advocacy recommends the following:

  • At the BEGINNING of a hospital stay, have a proactive discussion with the hospital about your classification. Don’t wait to receive a written notice; try to prevent the use of outpatient observation status from the start.
  • Ask the hospital doctor to admit (or reclassify) you as an “inpatient,” based on needed care, tests, and treatments; then have your primary care physician call to support this request.
  • File an appeal with Medicare if your nursing home (rehab) coverage is denied.

File a complaint with your state health department if you did not receive a notice about outpatient observation status.

Kit KatAsk Kit Kat – Frog’s Secret Weapon

Hook Law Center:  Kit Kat, what can you tell us about the frog and its powerful tongue?

Kit Kat:  Well, this is a very interesting story. I had never thought much about how a frog catches its prey, but a Ph.D. student at Georgia Institute of Technology named Alexis Noel has done some research on the matter. The frog tongue can move quite rapidly; we’re talking milliseconds from time of sticking its tongue out and retracting its tongue back into its mouth. As helpful as this is, it’s not the secret to its prowess in hunting. That is attributed to its saliva or spit which is composed of a unique substance which can change in viscosity instantly. For instance, when the prey (usually an insect) is first on its tongue, the spit is very viscous, similar to the consistency of honey, only more so. Later, the spit can change into a thinner fluid as it closes its mouth. The spit can change rapidly from one state of viscosity almost instantaneously. As a result, they can “capture meals in the amount of time it takes a human brain to think of and speak a word,” according to Noel and her colleagues.

Another thing Noel discovered about frogs’ tongues is that they are much softer than a human’s tongue. When compared to human tongues and human brains, a frog’s tongue is “slightly softer than (human) brains and 10 times softer than human tongues.” The softness contributes to elasticity, which in turn allows the frog to keep its prey inside its wide mouth and not fall out. Then to swallow the prey, the frog pushes down its eyeballs creating pressure to move the prey from the tongue to the throat. In addition, Noel and her colleagues teamed up with the Atlanta Botanical Garden to discover that 7 species of exotic frogs also had the same characteristics of extremely soft tongue tissue and the changeable viscosity of spit of the ordinary frog. These small amphibians are marvels of efficiency in securing prey to ensure their survival. What an interesting world we live in! (Ben Guarino, “Scientist cracks mystery of the frog’s powerful tongue. It’s called spit,” The Washington Post, February 1, 2017)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Friday, February 24th, 2017. Filed under Newsletter.

Exceptions to Medicaid Estate Recovery

By Shannon Laymon-Pecoraro

A large number of clients worry about the consequences of utilizing Medicaid to pay for long-term care. Most importantly, they have received information from non-legal professionals that Medicaid will take their home or that the spouse will be impoverished. The good news is that with proper planning your entire estate may be free from estate recovery.

When an individual age 55 or older dies, states are required to seek recovery of payments from the individual’s estate. Since the assets of an individual must have countable assets valued below $2,000, collectability is often an issue. Good planning and inherent exceptions to estate recovery further complicate recovery.

Some estate will be exempt from Medicaid estate recovery. The most common exemption is the existence of dependents. The state is prohibited from initiating estate recovery if a spouse, a child under age 21, or a disabled child survives the beneficiary.

Another exception to Medicaid estate recovery exists when recovery would case an undue hardship on the heirs. Undue hardships include cases where the survivors make a living from the asset, such as a family farm or other family business, when assets are illiquid, when a home is of modest value, or when recovery would not be cost effective.

Additional exemptions may also apply depending on what type of planning was done. For example, savings bonds, which are governed by the regulations imposed by the U.S. Treasury, may be exempt from estate recovery under certain circumstances. Additionally, real property for which the recipient held a life estate, or real property that was transferred out of the recipient’s name, would not be included in the estate, and therefore would not be subject to estate recovery.

While not all estates will be completely exempt from Medicaid estate recovery,, knowing what will happen to your estate during the planning so that you can minimize potential consequences both during lifetime and after death is imperative. The staff of the Hook Law Center not only help address a family’s concerns related to the potential risk of losing assets, but also help families assess other consequences, such as the tax implications of transferring a home or low-basis investment.

Kit KatAsk Kit Kat – Misnamed Rat

Hook Law Center:  Kit Kat, what can you tell us about the origin of the Norway rat?

Kit Kat:  Well, this ubiquitous rat of the United States is incorrectly named. It is known as the Norway rat or brown rat, but oddly enough, it did not come from Norway. The mix-up occurred around 1769 (18th century) when the British naturalist, John Berkenhout, wrote of its arrival in England from Norwegian ships. However, this was incorrect. Other records show that the brown rat arrived in Europe at the start of the 17th century attracted to cities with its brick and stone construction. But, somehow, the name persisted. The Norway/brown rat then made its way to North America on boats with the legions of immigrants who would settle the new lands. Today, rats can be found on every continent except Antarctica. Its cousin, the black rat, is generally smaller and is sometimes known as the ‘roof rat.’

Other myths about rats are now being re-examined. The Norway rat seems to be in the clear as to its role in the bubonic plague. The black rat may have had a part to play in the plague, but not so much as previously thought. Current research into the matter leads us to the possibility that the plague was transmitted via gerbils and/or through the air. As merchants traveled to the East along the ancient Silk Road, they may have picked up the deadly disease through a combination of factors.

So let’s refer to this resourceful creature as the brown rat. It can reproduce quite easily. Females are fully mature at three months, and the gestation period is only three weeks long! So, they are quite numerous. They are very content to feast on garbage and other leftovers they find in their environment. They’re not out to hurt their fellow humans. Isn’t it interesting to know more about the creatures in our midst? (Dave Taft, “A Rat with a Bum Rap. And It Isn’t Even Norwegian,” The New York Times, NY Region, Jan, 31, 2017)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, February 20th, 2017. Filed under Newsletter.

Issues to Consider when Your Child Goes off to College

By Elizabeth Boehmcke

It’s February, folks. That means that college acceptance letters will soon be arriving via email, snail mail or however they get around these days. Once the initial euphoria has worn off and you know that your child is definitely going to college and you have made peace of a sorts with how you are going to pay for that, take a moment to consider some other items for your to-do list before your child packs up and leaves this summer. If your child is eighteen (18), he/she is now a legal adult. Believe me, I know it is hard to grasp sometimes when you look at your newly minted adult and try to comprehend how it is possible that he/she could be an adult while you are listening to the same implausible explanation that you have heard too many times to count for why they are late, why their homework is undone, or why they can’t manage to clean their room. While you may find it laughable that your child is considered an adult under the law, it is not so laughable when you think through the consequences. Legally speaking, you no longer have the right to control your child’s finances or make healthcare decisions for him/her. You have no right to speak with your child’s doctor to get information about his/her health conditions. This is downright frightening for most parents, especially when you consider that your child may be on his/her own hundreds of miles away and you know for a fact that he/she can’t remember the time of day, much less be able to recite his medical history for a doctor.

There is an answer to this problem. We recommend that young adults execute general durable powers of attorney, advanced medical directives and HIPAA releases, so that their parents have the power to act as surrogate decision makers while their children are off at college.

The power of attorney would allow a parent, acting as an agent, to assist his/her child with bill-paying to make sure that tuition is paid or that scholarship forms are appropriately filled out. It would allow the parent, as agent, to access the child’s bank and credit card accounts to help him/ her better manage money. Being an adult does not automatically confer wisdom about handling money and maintaining a budget. Being an involved parent, on the other hand, does allow you to guide and instruct your child and, if necessary, to jump in before a little problem becomes a huge problem. If you do not have access to your child’s accounts and financial information, you may not be able to assist your child when they hit that first, inevitable, bump in the financial road. Imagine your frustration at calling the bursar’s office to check on their receipt of an important check only to be told that they cannot tell you anything and you have to round-up your child to get the information or worse, get the child to appear at the bursar’s office to ask the question himself. Even the most responsible ones will be hard to find as they experience the freedom of college living.

An advance medical directive and accompanying HIPAA release is an important part of the equation as well. While many think of an advance directive as being limited to end-of-life decisions, this is only one part of a well-drafted advance directive. In the case of young adults, it serves a vital function of appointing an agent to make health care decisions for them if they cannot do so themselves. The HIPAA release authorizes a doctor to communicate with a parent about the child’s medical condition so that, even if the child is not wholly unable to make a decision, it allows a faraway parent the ability to participate with the doctor and the child in making important decisions. If the child cannot make his/her own decisions, either because the child has been seriously injured in an accident or has psychiatric or dependency issues, most parents and children would want the parents to be informed of the situation and to be involved in the decision-making process. Nothing could be scarier than calling a hospital only to be told that privacy laws prevent the doctor from speaking to you about your child.

By executing these documents on attaining the age of eighteen, young adults and their parents can feel secure in the knowledge that the safety net on which they have all relied since birth will remain in place until such time as the children are really ready to be totally on their own. The vast majority of children will likely leave these documents in place until they are ready to do some estate planning on their own. And that is not a bad thing. Come see the attorneys at the Hook Law Center – we can help you with all life’s transitions from the birth of a new baby to the baby leaving the nest, from marriage to divorce, from planning for retirement and long-term care to the death of a loved one. We’ve got you covered.

Kit KatAsk Kit Kat – Westminster Dog Show

Hook Law Center:  Kit Kat, what was new at the Westminster Dog Kennel Club Show that was held on February 13-14, 2017?

Kit Kat:  Well, a couple of things were new this year. In my opinion, the biggest news was that cats were included for the first time this year. The cats weren’t actually in the show, but they were part of a ‘Meet the Breeds’ event which took place on February 11, 2017 before the actual dog show. At this event, dogs and cats were featured in booths in which the owner could have them displayed with information about the animal—where they originated from, etc. Booths could be decorated any way the owner chose. It made for an interesting event with both cats and dogs dressed up in all their finery!

Also, new to the Westminster Dog Show were 3 new breeds. This helped expand the number of participants to nearly 3,000 dogs. Wow! Can you imagine that many dogs in one place? Anyway, the 3 new breeds were: the American Hairless Rerrier, the Pumi, and the Sloughi. Can’t tell you much about 2 of the breeds, but the Pumi looks to me like a miniature poodle with a squarer face. Actually, Wikipedia defines it as a herding terrier from Hungary of small/medium size. It definitely is a good-looking dog, who I am sure will increase in popularity due to its compactness and personality.

So, kudos to the Westminster Dog Kennel Club! They are showing an inclusiveness which animal lovers can’t help but enjoy! (http://www.usatoday.com/story/news/nation-now/2017/02/01/ westminster-dog-show-going-cats/97329506/)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, February 13th, 2017. Filed under Newsletter.

Commonly Overlooked Tools for Incapacity Planning

By Stephan A. Lipskis

Every individual should have a plan for when they can no longer make decisions for themselves effectively but most delay planning because it entails the confronting their fears about disability, death, and dying. As the U.S. population ages in greater numbers due to aging baby boomers and increased longevity, the marketplace has responded to the needs of such planning. Accordingly, here are a few tools that are currently available, but often overlooked, to assist in planning for disability, incapacity, or death.

Elder law attorneys are probably the most overlooked tool for incapacity planning. Beyond providing the legal documents and tools for effectively coordinating decision making and financial management, elder law attorneys provide an experienced concierge in areas most people have not confronted, such as coordination of benefits, hiring of supplemental providers, and coordinating financial planning. Furthermore, elder law attorneys focus on the effective implementation of their documents. Put simply, a power of attorney or other document is false comfort if the document cannot be used effectively when needed.

Aside from attorneys, financial advisors are underutilized as a tool to address incapacity and death. Building a solid relationship with a financial advisor can be an extremely effective way of coordinating assets at death, preventing or mitigating financial exploitation, and budgeting for medical expenses. If you have a financial advisor that you have been working with it is important that your advisor and your attorney are “on the same page” so that your legal and financial plans are coordinated effectively.

Age, dementia, and other issues can cause individuals to be more susceptible to scams or even result in a change in personality. While financial advisors used to limit their focus almost solely to investment return, most are realizing that placing alerts for unusual expenditures and regularly discussing budgeting and other matters with clients. The increased focus on these concerns provides an important service and some protection in the event of incapacity. Frequently, we meet with individuals who have only realized the extent of their cognitive decline due to issues brought up by their financial advisors such as unusual withdrawals, large expenditures, increased purchases, and other general changes in financial behavior.

A third overlooked tool is a trusted CPA. Many individuals think that their income picture in retirement is so simple, that they do not need a CPA to assist in preparing their tax return. However, having returns regularly filed with a CPA provides a quick and easy place for a substitute decision maker or executor to go in the event of incapacity or death, respectively. Furthermore, we frequently see individuals who self-file tax returns miss out on important tax benefits available to older clients, such as deductions for long term care premiums, deductions for healthcare expenses, and “catch-up” contributions to retirement savings. Sometimes we see families who fail to properly plan payments for the benefit of a medically needy family member in order to claim them as a dependent. These benefits quickly justify the cost of using a CPA experienced in income tax planning and filing.

A fourth overlooked set of tools are the multitude of services and applications that have proliferated to address coordination of banking, account, health, and other information. Most banks have created smartphone applications to manage accounts, which is a great help to any family caregiver. Mobile payment platforms for in-home care services prevents the need to trust new caregivers near cash or checkbooks, while delivering instant and direct payment for their services and keeping a clear record for tax and other reporting needs. Password applications provide a digital vault to keep your passwords so that they can be accessed by your substitute decision maker in the event of your incapacity or death (or by you, if you’ve forgotten a password). Other applications can help you (or a trusted loved one) keep track of your finances, health data, and other important information in an easily accessible location. While these services do come at an expense many of them quickly justify their costs in the security, comfort, and protection they provide.

As new products and services develop, we at Hook Law Center are constantly working to stay abreast of changes and trends. By specializing in elder law, our attorneys and staff can assist in more than coordinating your legal plan, we can help find ways for you and your family to smooth the inevitable transition that occurs during illness, incapacity, or death. If you are curious how some of these tools can be used to better serve you or your family members, please call our office to schedule an appointment to discuss your needs.

Kit KatAsk Kit Kat – Bao Bao Returning Home

Hook Law Center:  Kit Kat, what can you tell us about that adorable panda 3-year old who is currently at the Washington, DC National Zoo?

Kit Kat:  Well, sadly, Bao Bao, a female giant panda, will soon be leaving Washington, DC and returning to her home country, China. The zoo has not yet set an exact date for the trip, but they are scheduling some goodbye events before she goes. Though born in the United States on Aug. 23, 2013, she will be sent to her home country by the time she turns age 4. Bao Bao’s mother, Mei Xiang, is from China, and by agreement with the China Wildlife Conservation Association, any cub born at zoos in the United States must return to China around the time that they turn 4 years of age. Bao Bao was the first baby panda since 2005 to survive birth at the zoo and thrive. 4 years of age is when a panda is capable of breeding.

Bao Bao has been living an independent life at the zoo since March 2015. She is kept separate from her mother, Mei Xiang. This is to prepare her to lead a solitary life like she would be living, if she were in the wild. Separation usually occurs around the age of 18 months to 2 years.

Preceding Bao Bao was Tai Shan, another panda born on July 9, 2005 at the National Zoo. Tai Shan was returned to China in February 2010. Alas, for a little while, we can enjoy the company of Bei Bei, a male giant panda, born on Aug. 22, 2015. He’s only 1.5 years old now, so we still have time to watch him mature and grow to adulthood. ( Michael E. Ruane, “Bye Bye, Bao Bao,” The Washington Post, Local section, January 18, 2017)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, February 6th, 2017. Filed under Newsletter.

Will Medicaid Take My House?

By Jessica A. Hayes

We hear this question all the time: “If I apply for Medicaid, will they take my house?” The answer is no; however, there are certain situations in which your home may be counted against you in determining whether you have too many available resources to meet the financial qualifications for long-term care Medicaid.  If the home is counted against you, then you simply will not qualify.

To qualify financially for long-term care Medicaid in Virginia, you must have countable assets (“resources”) totaling $2,000 or less. If you are applying for Medicaid and you are married, your spouse who is not receiving Medicaid may retain countable resources valued at one-half of your collective countable resources, or $120,900 (in 2017), whichever is lower.  Countable resources include (but are not limited to) bank accounts, investments, retirement accounts, and real property other than your primary residence.  Non-countable resources include one automobile, certain types of savings bonds and irrevocable prepaid funeral contracts, household goods and personal effects, and your primary personal residence, if you or your spouse are living there.

If you are applying for Medicaid to help pay for long-term care services in your own home, your home will not count against you. If you are applying for Medicaid to help pay for long-term care services in a nursing facility, but your spouse is remaining in the home, the home will not count against you.  If you are single and applying for Medicaid to pay for long-term care services in a nursing facility, then the home will not count against you for a period of six months, beginning on the date you left the home.  After you have been out of the home for six months, if there is no spouse remaining in the home, it is considered a resource available to you and from which you should be paying for your long-term care expenses.  To avoid having the home counted against you at that point, you will need to make a good faith effort to sell the home, by listing it for sale at its tax assessed value.  Failure to do so will mean that your Medicaid benefits end, and you will be responsible for the entire cost of your care.

There are steps we can take to protect your home and avoid having to list it for sale, with a little pre-planning. In certain situations, it makes sense to transfer a home to an irrevocable trust as a part of five-year planning before the need for long-term care arises (the transfer is subject to Medicaid’s five-year lookback period).  In other situations, we may be able to use the “caretaker child” exception and transfer the home without penalty to a child who has lived with you and cared for you for at least two years, preventing you from requiring care in a facility during that time.  There are other exceptions and strategies we may use, as well – transfers to a blind or disabled child or to a sibling who has lived in the home for at least a year and who has some interest in the property, for example, may be made without penalty.

Medicaid’s rules and regulations are intricate and frequently misunderstood. For questions relating to Medicaid eligibility and how you may qualify, work with a professional who is well-versed in this complex area of the law.

Kit KatAsk Kit Kat – Fake or Real Fur

Hook Law Center:  Kit Kat, how can you tell if fur is fake or real?

Kit Kat: Well, I know all the rage now is fake fur, but you have to be careful, because some retailers are still using real fur and advertising it as fake or ‘faux fur.’ The word “faux” is French for false or fake. To tell the difference, separate the fibers, and look to the base of the item. If you see a weave backing, then it is fake or faux. Also, the ends of the fur will be more blunt, and not tapered, as they would with real fur. I am not sure what the motivation to use faux fur is, but the practice is continuing. Frequent sources of real fur are factory-farmed raccoons, dogs, and rabbits.

Thank goodness the Humane Society of the United States (HSUS) continues to monitor this situation. What they have found is not good news. All types of retailers from discount to high-end stores pass off real fur items as faux, when they are not. HSUS has alerted the FTC (Federal Trade Commission) that they have found 37 items sold by 17 retailers that are still using real fur. They make coats, footwear, purses, and keychains from the real fur. Up to now, the FTC has not fined any companies, but they have the power to do so. Pierre Grzybowski of HSUS says HSUS’ latest information is the result of 4 years of data collection. Until stronger action is taken by the FTC, the consumer can help by assuming that “anything that looks like animal fur might well be,” says Gryzbowski. Don’t fall for the fake products. Boycotting these items will speak volumes to retailers. (“Are you sure your fur is fake?” All Animals, November/December 2016, p. 9)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Tuesday, January 31st, 2017. Filed under Newsletter.

Maximizing Your Child’s SSI by Utilizing ABLE Accounts

By Shannon Laymon-Pecoraro

I see a large number of clients who have a child receiving SSI as a result of a disability. In many cases, the child is not receiving their full SSI check ($735 per month for the year 2017) as a result of in-kind support and maintenance provided to the child by the client. This reduction for in-kind support is premised on the idea that the purpose of SSI is to provide for a person’s basic need for food and shelter, and that if someone else is providing such food or shelter, then that individual does not need the full SSI benefit. The SSI benefit is accordingly reduced by the presumed maximum value, which equates to one-third of the full SSI benefit amount. A reduction of SSI due to in-kind support and maintenance is often the result of a parent’s desire not to charge their child rent, or the result of the SSI not being sufficient to cover the child’s share of the household’s food and shelter expenses. While the receipt of a full SSI check may not be important to parents while they are still able to care for their child, the benefit may become increasingly important as the parents start to age – when the parents start having health issues of their own and the child may be placed in a supportive living arrangement that is counting on contributions from the child’s SSI. As a result, we encourage families to correct the benefit reduction sooner, rather than later – thanks to ABLE Accounts, this problem has been much easier to resolve.

A person who had a disability prior to age 26 may now setup an ABLE Account, and anyone may contribute to such account; provided, however, that total contributions to the account may not exceed $14,000. The person with the disability may use the money for “qualified disability expenses,” such as housing and basic living expenses. The utilization of the ABLE Account funds for such purpose will not be considered in-kind support and maintenance. To demonstrate the value of these accounts, I am going to use two common examples:

Parents Did Not Charge Rent: Ron’s Case

Ron is a 19-year old with Down Syndrome who lives with his parents. Ron just started to receive SSI; but, because his parents do not charge him for food or shelter, he receives a 1/3 reduction of his full benefit amount due to in-kind support and maintenance. The monthly household food and shelter expenses total $2,175, and because Ron is one of three people living in the house, he is responsible for a total of $725. Because of the reduction in income, Ron is unable to start paying his parents his pro rata share of the household food and shelter expenses. An ABLE Account is established for the benefit of Ron, and Ron’s parents contribute $2,000 to the account. Ron will pay his parents his $725 share of rent (from a combination of his SSI check and his ABLE Account). The rent payments will be reported to the Social Security Administration, and the Social Security Administration will then increase Ron’s SSI check to the full $735. To continue to receive the full benefit amount, Ron must continue to pay his parents rent. (Bear in mind that earned and unearned income may also factor into Ron’s benefit amount, but this is for a later discussion). 

Household Expenses Too High: Jackie’s Case

Jackie is a 35-year old with Cerebral Palsy who lives with her sister. When Jackie moved in with her sister, her pro rata share of household expenses totaled $1,000 and the full SSI benefit was not sufficient to cover her pro rata share. As a result, Jackie received a 1/3 reduction in her benefit due to in-kind support and maintenance. Jackie established an ABLE Account and the Trustee of her Special Needs Trust distributed $5,000 to the account. Jackie can now pay her sister $1,000 to cover her pro rata share of the expenses (via SSI and her ABLE Account). The change in circumstances will be reported to the Social Security Administration who would then increase Jackie’s SSI check to the full $735 a month. From that point forward, Jackie’s Special Needs Trust will continue to distribute money into her ABLE Account so that she can continue to pay her pro rata share of household expenses and receive her full SSI check.

Kit KatAsk Kit Kat – All About Skunks

Hook Law Center:  Kit Kat, what’s the latest information about skunks, and what should you do if your pet has encountered a skunk?

Kit Kat:  Well, this can cause some problems you might not anticipate, though, generally, your pet’s encounter with a skunk can be quite harmless. Usually, the skunk gives some warning before employing its ultimate weapon—the spray. Initially, you may notice the telltale smell, but there may be other symptoms like drooling, sneezing, or vomiting. More severe symptoms can emerge a few days later like lethargy and pale gums. If the more severe symptoms appear, immediately take your pet to the vet to be checked. In most cases, the severer symptoms occur after a direct spray to the face.

Now, how to deal with cleaning your pet after a potent spray. Ordinary pet shampoo will not be strong enough. You will need to make your own mixture composed of 1 quart of 3% hydrogen peroxide, ¼ cup baking soda, and 1-2 tsps. of dishwashing liquid. Lather your pet well and let it sit for about 5 minutes. Then, thoroughly rinse with lots of water. If your pet has long hair, you may want to consider clipping them before shampooing, because a shorter coat will foster more effective results. There may be some bleaching of the fur with this procedure, but it is not harmful to them. Repeat as necessary.

To prevent your house/property from being attractive to skunks, there are several things you can do. First, if you store food in your garage/shed like bird seed or dry pet food, make sure it is in well-sealed containers. Second, make sure areas around decks are blocked, so they cannot make their home there. Third, keep exterior lights at night on or install motion-activated lights. Skunks do not like light. Fourth, discourage their nesting in your yard by sprinkling kitty litter in front of their den/hole or stuffing it with twigs and leaves. This will let them know, that they are not welcome.

Hopefully, with this knowledge, you will be well-equipped to handle your pet’s skunk encounter. If your pet is actually bitten, you should take your pet to a veterinarian right away. Skunks can carry rabies, and prompt medical attention could be crucial. (“Pets and Skunks: A Smelly Dilemma,” ASPCA Action, Issue #3, 2016, p. 8)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Friday, January 20th, 2017. Filed under Newsletter.

Intra-Family Conflict After Death – It’s Expensive

By Elizabeth Boehmcke

Within the confines of this office’s newsletters over the years are strategies designed to assist you in planning your estate to implement your decisions, your goals, avoid taxes and avoid probate. But were you aware that even the best laid estate plans can be torn apart by feuding family members after you are gone? Intra-family conflict can arise between siblings and between generations. It can arise when one child is favored over others or is perceived by the others to have been so favored. It can arise when a child who is named as the fiduciary has personal interests that are not in line with the interests of the other beneficiaries. It can arise over high value estate accounts and over low value tangible personal property that is loaded with sentimental baggage. When such conflict arises, it is not uncommon for the various parties to seek legal counsel and the conflict can land the family in court. Litigation is very expensive, and sometimes is unavoidable, such as cases where the fiduciary is in serious breach of his/her fiduciary duties.

On the other hand, there are things that you can do to avoid conflict in your family after you are gone. The first step, and perhaps the most important one, is to make sure that you know your family – both the good and the bad. You can love all your children and grandchildren very much and still recognize that one or more of them have serious financial or addiction problems that might not make them good choices as a fiduciary. You can love your family and recognize that some of your children do not get along and will not work together well. You may have a child who means well but really doesn’t understand the realities of financial planning or managing wealth and who needs a trust to protect his or her interests. You can have a child who is great with money but oblivious to the emotional interactions within the family. Once you have identified potential problems within the family, discuss with your attorney how to draft your documents to manage or avoid the potential conflicts you can already see.

For instance, if you have children who do not get along and you have determined that trust planning for them meets your goals, you might avoid making the children trustees of each other’s trusts. That way they do not have to be in conflict with one another over distributions from the trust and can focus, instead, on their relationship as siblings. This may be particularly true in instances where a trust is created for only one child as a result of an addiction issue. Depending on the circumstances, a professional trustee may even make sense. A no contest clause could also make sense in appropriate circumstances, especially where you are making an uneven distribution of your estate, or you have one or two descendants who like to cause trouble.

The second step is to know your assets and the relative importance and value that each member of the family places on such assets. For instance, if you have a family farm, it may be very important to maintain the farm as such while others may see it as a development opportunity. If your goal is to maintain the property as a family farm, you will want to take steps to ensure that this asset is controlled by family members who think as you do. If you have other assets that you can use to equalize bequests to your family, it may make sense to give the farm to one child who wants to maintain the farm, while giving the liquid assets to another who has no interest in farming. If you have multiple family members who value the farm or really any business, it may make sense to create a family LLC for the farm that you can run as a family while you are alive. Nothing, and I mean nothing, will pass on your values and traditions like incorporating your family into your business while you are alive. By doing so, you pass on your passions, your business strategies, your values in ways that make them truly alive for the next generations.

A similar issue arises with respect to tangible personal property. It is not uncommon for family members to fight over the distribution of tangible personal property. While most families ultimately work this issue out themselves, if only because the cost of legal help rarely makes sense, it can cause tensions within the family that may take a long time to clear up. By knowing the importance that your family members place on particular items of tangible personal property, you can alleviate these tensions in many cases while you are alive. You can give the tangibles away to particular people during your lifetime. This can be done one-on-one or at a family party where the children take turns choosing items. If you are concerned that the children may fight over things, you can even sell them and take a personal vacation.

The third step is to communicate with your family. It is rarely a good idea to keep your estate plan a secret from your family members. If you have decided that only one of your children should be a fiduciary or only one needs a trust or you have made some other uneven distribution of your estate, let all of the children know. Explain, while you can, why you have made your choices as you have. Usually, the family understands your decisions and, even if they do not like the decisions, they are willing to accept your decisions on the matter. After all, it is your money and you can do with it what you like. Secrecy in the family, especially where one family member has been favored by an ailing parent and the other family members feel isolated from that parent, is a leading cause of conflict that ultimately ends up resolved in court. Not just because one child feels left out, but because the trust within the family has been broken. Once you are gone, the opportunity is lost.

The fourth step is to encourage your named fiduciary to seek qualified legal counsel in connection with the administration of your estate. Some problems can be easily resolved with careful guidance of the fiduciary through the administration of the estate. It can also reduce conflict within the family to have a dispassionate third party communicate with the beneficiaries, explain the process etc., so that the focus of any disappointment or anger may not rest on the child named to act your fiduciary.

Addressing potential conflicts within the family before death with your attorney cannot guarantee that conflicts will not arise. However, an experienced estate planner like the attorneys at the Hook Law Center, can offer individualized advice and assistance to reduce the conflict while you are alive and to minimize the conflict after your death.

Kit KatAsk Kit Kat – Kitten Nursery

Hook Law Center:  Kit Kat, what can you tell us about the special kitten nursery in NYC?

Kit Kat:  Well, they are doing a wonderful job and performing a unique service to the feline population of New York City. Leave it to New York—a city of 8 million people also has an outsized population of kittens. Breeding season is April to November, and kittens proliferate. This particular nursery is located on the Upper East Side at East 91st Street and was opened in 2014, because the ASPCA needed some way to deal with the high number of kittens. It can handle up to 300 kittens at a time. Once they reach 8 weeks of age and are spayed, they are transitioned to one of the regular ASPCA locations.

It takes a horde of volunteers to handle these little darlings. They need individual attention to become accustomed to handling by humans. Some have come to the nursery as young as a day old. The volunteers act as surrogate mothers. They feed them individually with tiny bottles of formula. They mimic the mother cat’s grooming with the use of a toothbrush. The grooming act, in turn, stimulates the kitten to feed and take the bottle. The volunteers also rub the kittens’ tummies with warm water to get them to use the litter box. Bubbles are blown at them to foster their hunting skills.

In the nursery’s two-year existence, it has handled 3,500 kittens! Kitten euthanasias have declined by 20 percent, because the kittens are able to get the care they need at a critical time in their development. Kittens from the same litter stay together and are given names starting with the same letter of the alphabet. “Orion, Ozzy and Osbourne in one cage; Hallie, Hamlet and Hiro in the next.” It’s a great service to the feline population. Often the mother does as much as she can for her kittens, but if she has to move suddenly because she feels threatened, frequently a kitten or two get lost in the shuffle. Thank goodness this safety net is here to help! (Andy Newman, “Two Rooms, 300 Kittens,” The New York Times, New York Region, November 23, 2016)

Upcoming Seminars

Distribution of This Newsletter

Hook Law Center encourages you to share this newsletter with anyone who is interested in issues pertaining to the elderly, the disabled and their advocates. The information in this newsletter may be copied and distributed, without charge and without permission, but with appropriate citation to Hook Law Center, P.C. If you are interested in a free subscription to the Hook Law Center News, then please telephone us at 757-399-7506, e-mail us at mail@hooklawcenter.com or fax us at 757-397-1267.

Posted on Monday, January 16th, 2017. Filed under Newsletter.