You may be aware that October is National Breast Cancer Awareness Month. However, fewer people realize that before October, is September: National Ovarian Cancer Awareness Month.  More than 15,000 women will die from ovarian cancer this year, slightly less than half the number who will die from breast cancer (about 39,000).  The prevalence of all forms of cancers reminds me to remind my readers of the importance of Incapacity Planning and Asset Protection Planning.

According to HealthNews.com citing the American Cancer Society, “every year almost 22,000 American women are diagnosed with ovarian cancer and more than 15,000 die from the disease.”  According to government statistics, 207,090 women are diagnosed [with breast cancer annually] . . . and 39,840 die [from the disease].

Ovarian cancer affects women in their middle-to-later years.  9 out of 10 women who get ovarian cancer are over the age of 40, and the greatest numbers of ovarian cancers are discovered in women aged 60 years or older, according to the Centers for Disease Control and Prevention.

Asset Protection Planning and Incapacity Planning are the vital legal services where an Elder Law attorney guides the individual (or couple) through the complex Medicaid qualification, application, and approval processes.   It may be necessary to employ a complex set of asset protection strategies, saving hundreds of thousands of dollars in many cases.

Proper planning can protect the assets from nursing home creditors, allowing Americans from all walks of life to legally and ethically qualify for Medicaid and Veterans Benefits, passing on an inheritance if they so choose, and enjoy the standard of living and quality of life they prefer.

This September and October, remember the acronym, “RAP:” Recognize the risks, including your family history; Abstain from cancer-causing behavior like smoking and chronic inactivity; and Plan for the future, regardless of your current state of health.

More ovarian cancer articles you may be interested in:

Breakthrough in Ovarian Cancer Research Brings Hope
Do all contraceptives lower ovarian cancer risk?
National Ovarian Cancer Coalition
Advance Care Plan Explained

Virginia, the 27^th state to challenge the constitutionality of President Obama’s health care law, appears to have been unsuccessful (at least for the time being) in an effort to convince the Supreme Court to elevate the case so that it may proceed faster.

Attorney General (Virginia) Ken Cuccinelli “asked the court to resolve questions about the law quickly, without usual consideration by federal appellate judges and over objection of the Obama administration,” according to PilotOnline.

The Pilot reports that since the case was scheduled for private discussion late last week, and based on the fact that no news broke about the case today, that some debate may be going on behind closed doors.

Our National Elder Law Blog, Everything Elder Law, raised awareness of this (then impending) showdown late last year. You may review that article, entitled “Obama v. GOP: Healthcare showdown,” here.

Evan H. Farr, Certified Elder Law Attorney

“Getting old is not for sissies” goes the quote. Perhaps one of the biggest challenges people face as they age is a seemingly inevitable and impending change to their living situation, whether it be due to health concerns, financial circumstances or both. This feared transition may not be so inevitable after all.  With the right plan, seniors can qualify for Medicaid, take advantage of today’s latest elder care technologies, and protect the assets which otherwise could be drained by the catastrophic costs of long-term care.

Most people are familiar with care options such as In-Home Care, Assisted Living, and Nursing Homes.   But now, a fourth option is gaining popularity: Aging-in-Place . . . a care option that allows individuals to continue living independently in their own home without the need for a live-in caregiver.

TabSafe

Drug compliance is the most common issue for those living alone. For those with memory issues, pill-reminder services and gadgets can issue daily visual and audio alerts to take medication, dispense the correct pills at the right times, and can even send a confirmation message to a caregiver once the medication has been dispensed. If a dosage is missed, an alert is sent to the caregiver and appropriate action can be taken.  The  TabSafe is one such product; you may visit their website here.

Falling is the leading cause of injury and death among those ages 65 and older.[1] For those with a high fall risk, monitoring devices like eNeighbor use unobtrusive sensors to monitor a resident’s daily routine. If the resident were to fall and not be able to get up or reach the phone for help, the device would trigger a phone call to a list of contacts as well as a 24-hour call center.

HomMed Genesis

“Remote monitoring” is an in-home technology that measures vitals such as heart rate, body weight, blood pressure, and blood glucose levels–making it useful to patients with a variety of health concerns, from cardiovascular disease to diabetes.  Check out the HomMed Genesis.

These latest technological advancements are not necessarily cheap.  One of the goals we at the Farr Law Firm seek to accomplish through our Level 4 Planning is to protect assets from the disastrous expenses of long-term care, so that some of those assets can be used to enhance the standard of living with goods and services not covered by government financial assistance, such as the ones I’ve described.  Of course, if Aging-In-Place is not the ideal option for you, we can help you prepare for and decide on your other long-term care options.

If long-term care planning is a relatively new subject area for you or your family, I suggest you take a few moments to watch this segment from the National Business Series.

If you have been contemplating you or a loved-one’s long-term care options, we can provide the solutions that you may be looking for. Achieving long term peace of mind is an invaluable asset that we are honored to assist you with. Please do not hesitate to call us at 1-800-399-FARR to schedule a free, initial consultation.

UPDATE: The Farr Law Firm would like to extend a special thanks on behalf of the Muscular Dystrophy Association to our first two donors!

Thank You Ana A. and Mark R!

We still have a long way to go, as you can see from our Barometer

Please consider making a small donation by visiting our Firm’s MDA Fundraiser page.

The Farr Law Firm is participating in the MDA Fundraiser Walk on Saturday, April 2. We need your help!

Muscular Dystrophy is a group of genetic disorders that weakens muscles, makes it difficult to perform routine tasks like climbing stairs or playing with friends, and seriously limits what many children can do to enjoy life.  The Greater Washington Muscular Dystrophy Association funds research, cares for patients, and even sponsors summer camps for children with the disease. 

The Farr Law Firm supports organizations such as the MDA; our Firm takes great pride in helping families with Special Needs Children.  For more information, please visit our site for Special Needs Planning, located here.

In addition to the children who suffer from Muscular Dystrophy and need our support, an increasing number of adults under the age of 65 are entering nursing home facilities as a result of neuromuscular diseases.  Our recent article, posted on our National Blog, highlighted the fact that the number of young adults in nursing home facilities has increased 22% in just the last 8 years.

If you would like more information on how, when, and why to plan for the future in light of difficult life circumstances, please feel free to call us at 1-800-399-FARR and our team will be happy to assist you.  If you would like to review our four levels of Family Protection Planning, we have made this information available for easy access on our website, located here.

Please click here to make a small donation!

PS: We will post all donors’ first name and last initial in a later posting to say thanks!

While it may be true that the Supreme Court is often tasked with the daunting assignment of deciding the most controversial and divisive of issues, last Tuesday’s unanimous ruling was a little different.

Most who are familiar with the facts of Henderson v. Shinseki would probably agree that the decision “felt right;” especially to the elder law attorneys and senior-serving professionals who help U.S. Veterans on a daily basis.

The Court reversed a decision by the U.S. Court of Appeals that ruled Veterans Court judges could not extend the deadline to appeal, even when a Veteran’s mental illness procured the delay.

Justice Samuel Alito explained the Courts’ rationale in reversing the decision of the Court of Appeals;

The (Dep’t of Veterans Affairs) is charged with the responsibility of assisting veterans in developing evidence that supports their claims, and in evaluating that evidence, the VA must give the veteran the benefit of any doubt. … Rigid jurisdictional treatment of the 120-day period for filing a notice of appeal in the Veterans Court would clash sharply with this scheme.

For an interesting look at how the case developed in the headlines over the course of the past several months, read the first Washington Post article I referenced late last year, Court hears appeal from veteran who missed deadline, here.  Then, read Supreme Court eases benefit deadline for vets, the recent article from USA Today, available here.  The latter link also includes a photo of the late Mr. Henderson.

Last year I called attention to Henderson on my National Elder Law News Blog, in the article, Veteran Misses Filing Deadline Due to Mental Illness: Fair? a case about a Veteran with Schizophrenia, whose illness prevented him from meeting a deadline imposed by the government.

Mr. Henderson’s lawyer argued in front of the Court that his client’s disability – which developed as a result of years in the service – prevented him (Mr. Henderson) from meeting a deadline to appeal the government’s denial of his request for home care by the Veteran’s Administration.  The argument was that it would be an injustice to strictly enforce the deadline against Mr. Henderson.

Veterans’ disability compensation is paid to Veterans who are injured as a result of their service to the country.  If denied a request for benefits, there are 120 days to file a notice of intent to appeal.  Mr. Henderson was denied home care by the Veteran’s Administration, after which he filed his notice of appeal 15 days late.

The case really boiled down to inquiries of fairness and Congressional intent.  Henderson argued that Congress intended for Veterans to be treated fairly, and that the 120-day time limit was meant to be flexible; a permeable deadline, should the interests of justice require an extension.

The loser in this case (The Secretary of Veterans Affairs) argued that the time period was meant to be strictly applied and that any change to the deadline must come from Congress itself and not from the discretion of the bench (a judge).

Various veterans groups followed this case from its inception.  With the traumatic stress and psychological scars evident in many soldiers who have returned from the wars in Iraq and Afghanistan, groups like the National Organization of Veterans’ Advocates, the National Veterans Foundation, and Paralyzed Veterans of America are undoubtedly happy with how Henderson turned out.

For information on Aid & Attendance benefits, you can check out our Firm’s links to frequently asked questions below:

What Is the Amount of the Aid and Attendance Benefit?

Who Is Eligible for the Aid and Attendance Pension Benefit?

Is Aid and Attendance Only for Low Income Veterans?

How is the Aid and Attendance Benefit Calculated?

Filing a Claim

The Asset Test

Image Credits: Photograph uploaded by FreeDigitalPhotos.net Admin

Today’s  women are decision makers.  For some couples, the woman is THE decision maker, and there’s nothing wrong with that.  For example, in nearly 8 out of 10 cases where married couples purchase a vehicle, it is the woman who makes the final decision.  And because women outlive men by 5.4 years on average, women frequently make decisions that have long lasting effects upon their children, their spouse, and even their parents.

Today, I want to offer 3 tips to help open the lines of communication between parent and child when it comes to the difficult subject of long term care.

Tip 1: Explain that Elder Law Attorneys are Passionate About Their Clients – Elders!

Elder law attorneys have deliberately chosen a career in a specialized area of law to serve elders.  Moreover, Virginia Rules of Professional Conduct require lawyers to act in the best interests of their clients.  The client of an elder law attorney is the elder.  Not the child. 

Elder law attorneys are equipped to facilitate familial harmony; they place the client’s concerns at the forefront of any discussion, and they orchestrate a plan that can protect a nest egg from the catastrophic expenses of long term care and improve quality of life.  An inheritance is nice – and usually a much larger inheritance is a by-product of the plan devised by an excellent elder law attorney – but the first thing I explain to families I meet with is that the inheritance is not the focus.  My client’s quality and dignity of life is priority #1.

Tip 2: Gather Information with Parents in No-Pressure Environment

Parents love to do things with their kids, and adult children likewise value the time they have with their aging parents.  One easy way to spend time with your parents while gathering information is to attend a free seminar hosted by a local elder law attorney.  Don’t be afraid to research, communicate and explain important statistics to your parents.

Tip 3: Use Easy to Understand Statistics to Convey Your Message:

Did you know that if you are over age 65:

• you have a 7.2% chance of having an auto accident every year;
• a 6.15% chance of needing to file a homeowner’s insurance claim; and
• a 70% chance of needing long-term care?

Over half of those who need long-term care will require a nursing home.

Here is the statistic you must be concerned with:

• 13% of drivers are uninsured;
• 15% of homeowners are uninsured; but
• 90% of senior citizens are uninsured and unprotected against long term care needs.

This means;

1. 87% of people insure themselves against an event that has a 7.2% annual probability;
   

2. 85% of individuals protect themselves against an event with a 6.15% annual probability; but

3. Only 10% protect themselves from an event with a 90% probability!

Why is it important to plan for long term care?  Primarily because the expenses of long term care are catastrophic and can wipe out a nest-egg in less than a year.  50% of couples and 70% of singles are impoverished (broke) after one year of entering a nursing home.

Medicaid is a government program meant for those who plan for it.  I encourage you to attend a free seminar on the subject, as it is shocking that so many smart people do not realize that Medicaid – not Medicare – can be used to pay for long term care.

One common misconception is, “We don’t need to plan for our long term care yet, we’re only 65.”  Almost half of all long-term care claimants are under age 65 at the time of disability.  Every day that goes by without a plan, the family is risking possible delay or even forfeiture of government benefits that are meant to pay for catastrophic long term care costs.

Talking to your parents about their long term care options can be understandably difficult, and no other generation has had to simultaneously balance so many familial responsibilities at one time.  But there is a new breed of estate planning and elder law that takes a family-friendly, solution-based approach making it easier to discuss difficult subjects.

While it’s no secret that Alzheimer’s Disease can cause confusion in the estimated 5.1 million Americans directly affected by the disease, both researchers and the general public have spent years perplexed by the disease as well.  For a look at some of the most common misconceptions about Alzheimer’s Disease, see the Alzheimer’s Association‘s list of the top 8 Alzheimer Myths.

The Alzheimer’s Association, which calls Alzheimer’s Disease “the defining disease of the baby boomers,” points out that “too many of America’s baby boomers will spend their retirement years either with Alzheimer’s or caring for someone who has it.”  The Alzheimer’s Association also points out that although death rates for other major diseases — HIV, stroke, heart disease, prostate cancer, breast cancer — are declining, “Alzheimer’s is the only top 10 cause of death without a way to prevent, cure or even slow its progression.”

There is no question that Alzheimer’s Disease is a growing concern, especially as the number of America’s baby boomer and elders continues to rise.  But despite the disease’s prevalence, there are already two positive developments in 2011.  First, researchers seem excited about a new means to predict — and perhaps one day to diagnose — the disease with certainty in the living.  Second, an unlikely team of players  has unified on the front lines…from an NFL superstar to some of America’s largest pharmaceutical companies.

Three Recent Studies Suggest ‘Biomarkers’ Could Play Pivotal Role in Predicting Alzheimer’s Disease

What is a biomarker? AstraZeneca defines the term as:

“a characteristic that is objectively measured and evaluated as an indicator of normal biological processes, pathogenic processes, or pharmacological responses to a therapeutic intervention.”

In essence, a biomarker is an identifiable variable that can be measured in humans.   While this may sound like a very broad definition, the breadth of the concept is what makes it so promising.

A recent study, published in the Journal of the American Medical Association (JAMA) and reported by Senior Journal,  aimed to investigate a potential relationship between “plasma beta-amyloid 42 and 42/40 levels and cognitive decline in a large group of community-dwelling older adults without dementia.”

The study found that older individuals who do not suffer from dementia, but have lower levels of “blood plasma and biomarkers beta-amyloid 42/40 (protein fragments),” may be at an increased risk for experiencing cognitive decline later in life:

“[The use of] biomarkers to identify elderly persons at risk of developing dementia could be useful for early prevention, if and when such interventions are available, and treatment.”

In a different study, three specific proteins in cerebrospinal fluid were found to potentially “spot” Alzheimer’s disease.  That study appeared in The Archives of Neurology.  The BusinessWeek article on this study is available here.  Of note, the Senior Director of Medical and Scientific Relations at the Alzheimer’s Association had this to say:

“This just reinforces the recommendation by [Alzheimer's working groups] saying that biomarkers can actually be incorporated today into clinical practice in order to add a certain piece to the diagnosis if patients are already presenting with something that looks like Alzheimer’s.”

Still another study carried out by the Texas Tech University Health Sciences Center and the Texas Alzheimer’s Research Consortium, reported by Ivanhoe Newswire, found that blood serum biomarkers PLUS other clinical information could be used to more accurately classify patients with Alzheimer’s.  Commenting on the importance of such studies, the authors say:

“There is clearly a need for reliable and valid diagnostic and prognostic biomarkers of Alzheimer’s disease, and in recent years, there has been an explosive increase of effort aimed at identifying such markers.”

The Texas Tech study authors are optimistic:

“With the rapidly evolving technology and the analytic techniques available, Alzheimer’s disease researchers now have the tools to simultaneously analyze exponentially more information from a host of modalities, which is likely going to be necessary to understand this very complex disease.”

Pharmaceutical Companies are Uniting to Fight Alzheimer’s Disease

CNN reported recently on Big Pharmaceutical companies uniting to share data in an effort to better understand the disease:

Numerous Celebrities Help Raise Awareness of Alzheimer’s Disease

Dozens of national celebrities have been helping to raise awareness of the devastating toll that Alzheimer’s Disease takes on our society.   Here’s a “Behind the Scenes” look at some of the Alzheimer’s Association’s Celebrity Champions:

This CNN story (and the video below) highlights the emotional toll that Alzheimer’s disease has had on one such Celebrity — NFL star Terrell Owens.  Mr. Owens’ battle against the disease on behalf of his mother has touched hearts and inspired many:

Recognizing Early Symptoms is Important: Top 10 Signs

The Alzheimer’s Association provides 10 ways to spot early-onset symptoms here.  Summarized by MayoClinic, you will find them listed them below for your convenience:

Memory loss that disrupts daily life

Challenges in planning or solving problems

Difficulty completing familiar tasks at home, at work or at leisure

Confusion with time or place

Trouble understanding visual images and spatial relationships

New problems with words in speaking or writing

Misplacing things and losing the ability to retrace steps

Decreased or poor judgment

Withdrawal from work or social activities

Changes in mood and personality

Have you Heard of Alzheimer’s Planning?

Many people are unaware that Alzheimer’s Planning is a sub-specialty of Elder Law.  It involves a unique and complex combination of estate planning, long-term care planning, asset protection, Medicaid planning, and nursing home planning, and requires a specialized knowledge of the legal and financial problems and issues that are unique to families dealing with this devastating illness.  We at the Farr Law Firm routinely assist clients with all of the financial and legal issues surrounding Alzheimer’s Disease.

One of the primary goals of Alzheimer’s Planning is to ensure the highest possible level of personal dignity and quality care for the remaining lifetime of the Alzheimer’s patient. To achieve this goal, it is often necessary to protect assets as quickly as possible, so that if the Alzheimer’s patient  must enter a nursing home, Medicaid can be obtained as soon as possible. Money that is protected through Alzheimer’s Planning can often be used to provide the Alzheimer’s patient with an enhanced level of care and a better quality of life while in the nursing home and receiving Medicaid benefits.

Conclusion

There is still a long way to go in predicting, diagnosing, and ultimately preventing Alzheimer’s disease.  But with help coming from all directions – the steady fight of the Alzheimer’s Association in leading the global fight for a world without Alzheimer’s, new research methods and tools, consolidated efforts from Pharmaceutical Companies, and the increased awareness created by dozens of celebrities who have been personally touched by this destructive disease — hopefully greater strides for combating this disease are in store in 2011 than ever before.

The Alzheimer’s Association, mentioned several times in this article, is the leading voluntary health organization in Alzheimer’s care, support and research. The Association’s mission is to eliminate Alzheimer’s disease through the advancement of research; to provide and enhance care and support for all affected; and to reduce the risk of dementia through the promotion of brain health.  If you have a question about Alzheimer’s disease, if you’re providing care for someone with memory loss, or if you’re experiencing memory loss yourself, the highly trained and knowledgeable staff of the Alzheimer’s Association can assist you at any time — just call their 24/7 Helpline at 1-800-272-3900.

Lastly, don’t overlook the quality of life and dignity that can be preserved through Alzheimer’s Planning.  Until there is a cure or vaccine for Alzheimer’s disease, the focus for many families is on ensuring the quality of life and dignity of those suffering with this disease.  For more on Alzheimer’s Planning, please visit us at http://AlzheimersPlanning.com.

Struggling to make sense of the status of health care reform in America? Don’t worry; neither can Congress, the White House, nor the Courts say with certainty whether The Patient Protection and Affordable Care Act (the Act) will ultimately be considered successful legislation, whether it will be repealed, or if certain contested provisions are constitutional. The goal of this article is one of education and not political persuasion.

Last year, I discussed how the health reforms will help Medicare recipients and early retirees in my article entitled, Health Reform: Changes in Store for the Elderly.  This year, I want to briefly reiterate the most important 2011 changes.  As you may know, the sweeping health reform law passed last year is designed for long-term implementation.

Two Important 2011 Reforms for Seniors

There are two monumental changes worth mentioning briefly.  First, preventive services (including annual physicals and cancer screenings) will now be free for most beneficiaries, including people who enrolled in private plans as of last September.

Second, a 50% discount on brand-name medicines will be available for people in the Medicare Part D “donut hole.” Seniors on the Medicare Part D drug plan subject to the donut hole pay out-of-pocket when their annual drug costs are between $2,840 and $4,550.

Illustrating the likely unpopularity of health reform repeal, US News quoted Kenneth Thrope, Head of the Department of Health Policy and Management at Emory University:

“If you do repeal the law, you’ll have to start charging people for preventive benefits.  You’ll have to increase what seniors pay for prescription drugs . . . . [n]either one of those would be very popular.”

My goal is not to convince my readers to support or oppose the Act, nor is my goal to explain it: consisting of over 1,000 pages of law and policy reform, it is becoming increasingly clear that top lawmakers do not even fully understand or agree on the law.  Instead, I seek to enlighten my readers on the law’s current status.  Paradoxically, the same principle that ensures Democracy in America is the source of the maddening confusion, delay, and uncertainty: “the Separation of Powers.”

If you are interested in a summary of the Act, you can view the bill on OpenCongress here.  For information on related legislation that will modernize America’s health system, you may want to read my recent article on the HI-TECH Act, How New Health Information Technology Will Save Money and Lives.

For those who may feel lost, allow me to quickly bring you up to speed

Obama signed the Act in March of 2010

The Act was introduced September 17, 2009, passed both the House and Senate by late December, 2009, and was later signed into law by the President on March 23, 2010.  Republicans vow to repeal the law, while Democrats dismiss repeal of reform as an impossibility.  One thing is certain; this is a major piece of legislation that implicates millions of lives and billions of dollars.

Virginia Attorney General Ken Cuccinilli and 13 other states sued the federal government shortly after the law took effect. Presently, more than 20 states have filed suit against the federal government over the legislation. Virginia Governor Bob McDonnell said the new laws would have “a significant and unavoidable impact on the bottom line of [Virginia’s] state budget,” reported Richmond Times-Dispatch.  The Virginia Interfaith Center for Public Policy has voiced its opposition to Cuccinelli and McDonnell’s challenge, proclaiming, “[T]he political actions of Attorney General Ken Cuccinelli may simply allow health-insurance industry abuse of small business, seniors and children to continue.”

Sources of Confusion

Opposition from state Governors and their Attorney Generals is a major source of the public confusion.  The New York Times criticized such efforts and said these state suits “create confusion among the public and further destabilize political support for legislation that is under fierce attack from Republicans in Congress and in many statehouses.” The media’s undivided attention to the individual mandate provision has been broad, as opposed to the seemingly jaded level of concentration allocated to the other stories related to the law.  For example, beginning September 23, 2010, a key provision took effect prohibiting insurance companies from denying coverage to children based on health status.  But America is divided, as evidenced by a recently introduced state law in California: According to NewAmericaMedia.org, the backlash from insurance companies started in California when large insurers announced that they would no longer offer “child-only” policies.  Only after a law was introduced that would penalize these insurers for such behavior by banning them from the individual market for five years did the insurers reconsider their policy.  This is but one example of how important news stories are being overshadowed by the “individual mandate” debate.

What Role does Virginia Play in Shaping America’s Health Care Reform Debate?

Fast-forward to the present day, and Republicans in the House vow to repeal the law, while Democrats insist it isn’t possible (because they control the Senate).  On the other hand, there is speculation that it would be possible for the House to “de-fund” the legislation because they control the “purse strings.”  It is no wonder that the American public is confused.  Meanwhile, states are challenging provisions of the law in Federal Courts, and there is likely a Supreme Court case in the making, because Federal Courts can’t seem to agree on the constitutionality of a key provision – the “Individual Mandate.”

The "Individual Mandate" of the Act has been challenged in Federal District Courts

Henry Hudson, a federal judge for the United States District Court for the Eastern District of Virginia, recently found, this key provision of the Act to be unconstitutional.  Hudson did not undermine the Act and even refused to suspend its implementation pending appeal … he referred to Congress’s enactment as laudable but disagreed that the Commerce Clause granted the powers contained in the Act.  The New York Times provides the full opinion here.  Judge Hudson is the third federal district court judge to decide one of these cases on the merits; more than 20 other judges have cases pending which seek to challenge the law.

Demonstrating the “tit-for-tat” nature of the debate, the Obama administration responded just one day after the Virginia decision in an op-ed piece posted on the Washington Post website.  U.S. Attorney General Eric Holder along with Health and Human Services Secretary Kathleen Sebelius are of the belief that Americans who are presently insured are paying too much for their insurance, because of an inequitable burden placed upon them by those who don’t have health insurance. “Every insured family pays an average of $1,000 more a year in premiums to cover the care of those who have no insurance,” they said, reported CNN.

Though analysts agree that there may be a Supreme Court case in the making, it will most likely take some time before winding its way up to our nation’s highest court.  Illinois State University Political Science Professor Bob Bradley commented on the aftermath of the Virginia case, stating, “The Supreme Court [is] not going to hear this for awhile…what they’re going to do is let this play through all the other federal district court challenges.” Lawyers involved say it could take two years for the Supreme Court to hear the case.

“The problem is that if [state challenges succeed], they’ll all be left high and dry with half-baked reform plans that won’t work.”  Bnet offered this interesting take on the irony of state-developed reform plans, which would provide more state-autonomy but could do so at the expense of federal grant money.

An American tragedy has delayed the Republican effort to repeal.

Because of the recent shooting of Rep. Gabrielle Giffords (D-Ariz) that left six dead, the vote to repeal the Act has been postponed.  Scheduled to take place this week, the vote was delayed by House majority Leader Eric Cantor (R-Va.), along with the rest of the legislative agenda.

Major Groups that Support and Oppose Health Reform.

Of the groups that  support the Act, OpenCongress lists health professionals, consumer groups, elder groups, the U.S. military, and various trade unions.  The opposition is composed of groups such as accident and health insurance companies, construction companies, security brokers, investment companies, and milk and dairy producers.

To conclude this article, I would like to reiterate that you should not feel bad if you are still confused about the status of the U.S. health reform law. Every day, the mainstream media plasters headlines across its networks and they can be very misleading.  Some headlines I have seen could lead a casual reader to assume the Act never became law.  Still others may perhaps lead one to think the Act is doomed.  Whether you support health reform or not, and no matter what your political philosophy may be, something everyone can agree on is that patience is needed as Congress, the White House, and the Courts sort it out.  Here is the bottom line: the Affordable Care Act is currently law.  Any potential attempt at repeal or prospective landmark Supreme Court case is pure speculation at this point.

Image Credits:

Image: renjith krishnan / FreeDigitalPhotos.net

Image: renjith krishnan / FreeDigitalPhotos.net

Image: Hubpages.com/hub/inauguration-day-clip-art

Evan Farr, CELA

As the recent WikiLeaks disclosures continue to make headlines across the globe, I can not help but reflect upon what this means for healthcare privacy.

Why are these classified documents so “sensitive” in nature, that the White House believes their dissemination will risk the cause of human rights? There are at least two obvious reasons: First, the disclosures are embarrassing from a public relations standpoint, because they chronicle communications which were meant to remain confidential indefinitely. Second, some of the disclosures are substantively sensitive from a national defense perspective.

The White House is pulling no punches when it comes to how it feels about the organization, and made the following statement earlier this week regarding the disclosure of the diplomatic cables:

“By releasing stolen and classified documents, WikiLeaks has put at risk not only the cause of human rights, but also the lives and work of the individuals. We condemn in strongest terms, the unauthorized disclosure of classified documents and sensitive national security information.”

In light of the WikiLeaks disclosures, Dr. Westby G. Fisher, Clinical Associate Professor of Medicine at University of Chicago, summed up his concerns about healthcare privacy earlier this week: “While a single individual’s private healthcare information may not carry the gravitas of wartime communiqués, each of us deals with famous patients who might not want their diagnosis, HIV status, or drinking history spread far and wide.” Dr. Fisher makes a valid point, but I am not so quick to panic. While I think the privacy concerns extend beyond “famous patients,” I have faith that the HI-TECH Act will promote safeguards to effectively protect healthcare data. You can read my recent article on Electronic Health Records and the HI-TECH Act here. As I will explain later in this article, the Pentagon’s data-sharing network was grossly flawed and too easily accessible. It is my hope that the “takeaway” from this entire WikiLeaks issue will be a lesson learned by our Nation’s IT professionals. In other words, this “fiasco” will hopefully lead to an increased focus on Healthcare information technology and security in the future.

With roughly 250,000 documents released by WikiLeaks and with the aid of some popular media outlets, the ramifications of the diplomatic cables will be far-reaching. My initial thoughts were mixed:  perhaps this latest WikiLeaks embarrassment will sound the alarm bells for governments and private industries to protect sensitive information more closely; perhaps it will lead to the development of more sophisticated information technology tools and training methodologies. On the other hand, it is impossible to ignore the obvious – that the United States government failed to prevent a massive theft of classified data. As a result, the logical question raised is “how we can expect, in the future, government agencies (federal, state, or local), or even private industries, to keep sensitive data confidential?”

In my recent article on the importance of Electronic and Personal Health records, I discussed why the electronic storage of medical information is beneficial to patients, and how the use of smart health information technology can save money and lives. There is no denying that we are living in the “information age,” and to resist this transition would be counterintuitive and counterproductive. But, we also are living in the post-9/11 era. Thus, we must strike a balance between our privacy rights & expectations, and our safety.

Many Americans are wondering how hundreds of thousands of classified documents could be released in such a fashion. The answer seems to be that the security measures in place were rooted in good faith, albeit somewhat reckless in hindsight. Following 9/11, the government sought to implement a more free-flowing data network so that federal agencies could exchange information more quickly.  Analysts quoted by VOA News say, “the WikiLeaks disclosures can be traced in part to changes instituted in the aftermath of September 11, 2001 …The 9/11 Commission sharply criticized intelligence agencies for failing to share critical information with each other that, when combined, might have revealed and perhaps thwarted the plot.” As a result, the Pentagon created a network called the Secret Internet Protocol Router Network (SIPRNet). Although the network limited information to persons with a security clearance from either the State or Defense agencies, the threshold was too low. According to officials, a 23 year-old Army Private First Class (PFC) downloaded the documents and later transferred them to WikiLeaks. The rank of PFC is the third lowest in the Army; thus, the “Wikileaks fiasco” may be an example of the balance between privacy and safety having been too far skewed towards notions of the latter.

Below is a chart that represents the sources of the leaked cables. As you can see, they all came from U.S. agencies and Embassies.

Origin of Cables by Percentage

With almost every media outlet reporting on the recent WikiLeaks disclosures, it is my hope that, after all is said and done, America will emerge with a new-found appreciation for data security. In light of the WikiLeaks disclosures, it is vital that our federal and state governments institute laws, security measures, and protocols that will ensure that private medical records are kept out of the hands of thieves, extortionists, organized criminal enterprises, and non-government political groups. Most of us would have probably thought that a 23 year-old private first class officer would not have access to the documents released this week. Perhaps it is time to start asking questions, the goal being to learn from this unfortunate situation and hence pay more attention to safeguarding our data in this “post-9/11, information age.”

Evan Farr, CELA

Why is it that our most sensitive, personal data is often in an unorganized state of disarray? Most of us probably could more quickly pull a given DVD or book from our collections than proffer to a doctor a condition or illness we may have suffered 1, 2, 5,  or 10 years ago!

The electronic consolidation of health information is finally coming to fruition, as States, entities, and individuals are being presented with incentives (including common-sense!) to upgrade health information exchange technology. Absent privacy concerns, the benefits patients will receive are astonishing. Money will be saved, as will be lives. For example, we can eliminate duplicative and/or unnecessary tests. They will be a burden of the past. Doctors will be enabled to more accurately diagnose and treat patients.

I want to distinguish between two common terms that are sometimes incorrectly used interchangeably. An Electronic Health Record (EHR) is maintained by a person’s provider, whereas a Personal Health Record (PHR) is a consolidated electronic record of information, derived from numerous sources, and controlled by the individual. Both are essential to the dignity of healthcare in the wireless age moving forward.

EHR’s are useful; they document medical progress, treatment, and records rendered by a given provider. If you would like more information on EHR’s, Centers for Medicare & Medicaid Services provides an informative online overview here.

According to the Center for Medicare and Medicaid Services, approved hospitals and healthcare professionals will begin receiving incentives (payments) if they implement a “meaningful use of certified EHR technology.” This phrase is the standard established by the “HITECH” Act (the Health Information Technology for Economic and Clinical Health Act).  The Incentives Program begins in January 2011 and is scheduled to run for 10 years. The proposed timeline, in my opinion, correctly includes a generous “buffer” period (when incentives will no longer be provided) for the Medicare and Medicaid programs to initialize IT overhauls. This period of time should be more than enough for entities that lag behind the trends; once the efficiency of EHR technology is realized and in full-swing, I find it hard to believe that any state or eligible and able organization would forego the receipt of incentive payments to utilize technology they would otherwise need to implement to stay competitive and viable.

As I alluded to earlier, privacy concerns are real. In fact, medical conditions and diseases have historically been treated as among the most confidential of all personal information. I am happy to see that CMS has worked alongside the Office of the National Coordinator for Health Information Technology, with the purpose of instilling standards and criteria for EHR technology. In addition, CMS is working with the Office for Civil Rights to focus on privacy-related concerns. As the year draws to a close, I will update my blog with developments within the realm of EHR’s and privacy. For now, I will refer you to The Office of the National Coordinator for Health Information Technology Privacy and Security Page.

It appears that 2011 will be a year of important decision-making at the State level. I will continue to update my blog with developments and my thoughts. I would like to shift to another concept – the PHR – which I mentioned earlier.

I want to touch on three aspects of PHR’s that I believe are important – Control, Security, and Consolidation.

As I noted above when distinguishing EHR’s from PHR’s, a PHR is within (almost) complete control of the individual. This feature alone is what I believe will bring the American public on board to the entire electronic health information idea. I use the word “almost,” because sometimes a health plan provider will automatically create and maintain PHR’s, while others require the individual actually enter the information manually. Whatever the case may be, “Notices of Privacy Practices” generally require disclosure of the measures in place to keep the information safe and secure.  Moreover, companies have correctly realized that PHR’s should be readily accessible by allowing for unique user ID and password protection.

Consolidation is the key. It’s the key to saving money and saving lives, as my title indicates. The information consolidated by a PHR can vary, but may include important data such as emergency contacts, medication dosage and history, previous surgeries, allergies, hereditary conditions, and more. For information on selecting a PHR, visit Medicare online.

We have come a long way. I am happy to live in a proactive country with a government that insists on promoting advances that can save lives. We have the legislation (The HITECH Act), but now we need the participation. States and Medical providers will ultimately decide whether to take advantage of the incentives to put health technology in place.

At the Farr Firm, we have always taken your health and privacy concerns seriously. For many years, we have used the most advanced measures available to ensure that our clients (and their healthcare providers) have private access to their healthcare records.  For instance, for over a decade we have offered to register the Advance Medical Directives (AMDs) of our clients (and more recently, the Child Protection Plans (CPPs) of our clients), with an electronic registry, at no cost to our clients, to make these documents available in an emergency or simply for convenience.  DocuBank is the registry we currently use – an organization that has been trusted for many years with electronic storage of medical records. These records can be retrieved online by hospitals. The benefit of registering PHR’s in the context of an AMD or CPP is enormous. AMD’s are critical in emergency situations. According to their site, “a study in the Journal of the American Medical Association, living wills are not accessible in 74% of cases when needed in hospitals.”  Although this study was performed in 1998, I don’t think we have advanced tremendously since then. With the HITECH Act, I do think that America is finally on the cusp of revolutionizing healthcare information technology.

Whether you have a young family, or a family with seniors who are contemplating long-term care options, we can provide the solutions that you may be looking for. Achieving long term peace of mind is an invaluable asset that we are honored to assist you with.  Please do not hesitate to call us at 1-800-399-FARR to schedule a free, initial consultation.