I recently attended the Academy’s 20^th Anniversary Summit in our home base of Philadelphia.

First-off, it was wonderful to finally have the Academy in our own backyard. This is the first time in 20 years that a Summit has been held here, and I’ve been waiting for this for almost that long! And judging from the reaction of the attendees, I think it’s fair to say “what took you so long?”  In a shameless plug for my City of Brotherly Love, I’m happy to report that Academy members found Philly to be (surprisingly to them) clean, exciting, and obviously full of interesting history to explore. (If you are planning a professional or personal trip to Philadelphia, feel free to email me for the list of sites and attractions that we put together for the Academy’s visit.)

It was also great to be local because we were able, for the first time, to have Academy members visit our office (and feed them local fare). It was gratifying to us, and rewarding for them, to see firsthand how we protect their clients’ advance directives and emergency medical information (and eat Philly pretzels), observe the client registration process (Tastycakes), and witness the outstanding customer service we provide after that (cheese steaks).

Regardless of venue, it was terrific, as well, to be celebrating with the Academy on the occasion of its 20^th anniversary. As an affiliate of 17 years, we have seen the impact this organization has made on the lives of its Members and their clients. I have watched the Academy mentor new and transitioning attorneys into successful practitioners. I have seen established firms hire associate attorneys, who then develop into full-fledged partners. I have watched these Members retire, executing their succession plan just as they had intended, with their junior partner(s) taking over the firm.

In a culture that so often focuses on the negative and on failures, it’s nice to step back every once in a while to celebrate positives and successes.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the Center for Advocacy for the Rights and Interests of the Elderly, the International Society of Advance Care Planning, and the Coalition to Transform Advanced Care, she is active in health education and public engagement related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

First, a word of congratulations to the American Academy on its 20^th anniversary, to be celebrated later this month in my own home base – the City of Brotherly Love. (And now to the blog…)

All seniors, including your clients, might as well be walking around with targets on their backs. They are all prospects for Medicare fraud, which can rob them during their lifetimes of their money, their time, and the high quality products and services that they expect. (See this NYT piece for a recent story.) In addition, it bilks taxpayers of $65 billion a year.

Medicare beneficiaries have long been attractive scam targets for many reasons, including that health insurance can be so darn complicated and convoluted that fraud is hard to spot. Here are some examples of common types of fraud to warn clients about:

• They receive an official-looking letter informing them of changes to their Medicare plan.
  To receive more details they must send their personal information.

• They are offered a “free” health screening or massage if they provide their Medicare number.

• They are billed for services they never received.

• They receive the wrong medication or equipment via an internet purchase.

What can clients do if they suspect Medicare fraud? They can report it to their area Senior Medicare Patrol, where they will speak with a senior volunteer who has been trained to help them. This federally-financed program can help clients identify potential scams and actual fraud that has already occurred. Further, the Senior Medicare Patrol can cut through the red tape and connect clients with the organization that Medicare has contracted with to help beneficiaries rectify fraud. See this NYT piece for an example. (The DHHS Office of Inspector General and the FBI’s OIG also have Medicare fraud reporting systems.)

How can you help clients avoid being victims of Medicare fraud?

• Share with them a list of common fraud scams and how clients can protect themselves. Email me for a ready-to-use Client Tip Sheet.

• Share with them this Medicare anti-fraud video. (yes, Medicare has a you-tube channel)

• Contact your state’s Senior Medicare Patrol, which may also have pertinent information about local scams. A program member might even be available to speak at an event. (Marketing idea: Arrange a speaker as part of a community outreach session to attract prospects, an education session for existing clients and their adult children, or as part of your annual maintenance program or annual client appreciation day.) 

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the Center for Advocacy for the Rights and Interests of the Elderly, the International Society of Advance Care Planning, and the Coalition to Transform Advanced Care, she is active in health education and public engagement related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

As an attorney, you have particular potential to help folks think and talk about their health care goals and wishes. This makes you in synch with National Healthcare Decisions Day (NHDD), a grassroots initiative now in its 6^th year which encourages people to do just this. (April 16, the day after tax day, is designated as it’s in keeping with Ben Franklin’s adage that nothing is certain “except death and taxes.”)

National Healthcare Decisions Day (NHDD)

Given your busy schedule, here are some straightforward things to choose from to help others focus just a bit on advance care planning. Some are purely altruistic. Others have marketing potential built in.

1. Lead by example: Create or update your own advance directive. Talk with your family about your wishes if you haven’t. (Talking about theirs, too, is even better!)

2. Take your staff’s pulse. Have your staff take a quick, anonymous survey of whether they’ve done any thinking about their wishes or completed an advance directive and why or why not. For a short survey, email me. (Your staff may be a good barometer of what your clients are thinking.)

3. Encourage your staff to do basic advance care planning. Facilitate an informal conversation among staff about their own questions and their wishes. Maybe bring in lunch to help spur the talking. Have advance directive forms available and have a witnessing party when they sign.

4. Offer clients tools to help them talk to their families. The Conversation Project’s Starter Kit includes great ideas for how to open the conversation, along with guidance for talking with their doctor. To introduce a little levity, try suggesting a special deck of cards to spur the conversation. The best ones I’ve found are Heart2Hearts and Go Wish (also has an online version).

5. Pass this post on to your colleagues via the listserv of your bar association or estate planning council.

6. Engage one member of the media. Contact one health reporter from your local newspaper or TV station and offer yourself as an expert for a story. (The NHDD website has a media kit.)  Or, submit an article or op-ed to your local paper (use the NHDD standard template, or contact me for one specifically designed for estate planning and elder law attorneys).

7. Reach out to one religious leader in your community (perhaps your own, if relevant). Use the email template in the list of NHDD Tools. Provide links to: the Conversation Project to help parishioners/congregants get started; your state’s online advance directive form; and to the Faith Leader’s Initiative of the Coalition to Transform Advanced Care (C-TAC).

Let me know if I can be of any assistance.

Randi J. Siegel,MBA, is the President of DocuBank(docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the Center for Advocacy for the Rights and Interests of the Elderly, the International Society of Advance Care Planning, and the Coalition to Transform Advanced Care, she is active in health education and public engagement related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

I recently attended the first annual meeting of the national Coalition to Transform Advanced Illness Care (C-TAC). Most striking was this: amidst the high-level discussion about healthcare systems changes, public engagement and policy improvements, the over-riding theme was stories. The personal stories from the speakers and panelists about the death of a loved one.

Even the 3 U.S. Senators who spoke (both republican and democratic) began with how their personal stories motivated them to want to improve national policy on this issue. The stories were both of “good deaths” and “bad deaths.”

Everyone has these stories, whether about the death of a parent, a grandparent, a close friend. Which is why you should consider using their power when it comes to your clients’ health care directives and advance care planning. You can elicit their stories, but you can also share your own.

Telling your personal story to clients and prospects can be a good way to:

• Explain what healthcare directives are for

• Convey why it’s important to families to document one’s wishes and talk about them

• Create an emotional connection with clients and prospects

While it may not be appropriate to reveal to clients what sort of estate planning vehicles and decisions your own parents or grandparents made and what happened when they died, you can probably share what happened when they were hospitalized, whether their medical wishes were followed, and whether they were even known.

For some examples of how you might succinctly tell your own story about the death of a loved one, see The Conversation Project. It contains the stories of a number of leaders in medicine, clergy, and the media who came together to share their own stories about the deaths of their own loved ones. Founded by former syndicated columnist Ellen Goodman, this initiative helps people create a comfortable, safe way to talk about their goals for living with and dying from advancing illness

The Conversation Project also has great suggestions on how clients can start their own conversation with loved ones about their health care wishes and how to guide it. Tell them to read the “opening lines” suggestions from The Conversation Project. Tell them to use its guides for when and where they might like to have this conversation. Tell them they have to do it. Sooner or later, their adult children will thank you.

Randi J. Siegel,MBA, is the President of DocuBank(docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

Can the medium used to present medical information affect patients’ understanding and the decisions they make about their medical care?

Yes, according to a new study in the Journal of Clinical Oncology.

Researchers looked at different methods for presenting information about CPR (cardiopulmonary resuscitation) to advanced cancer patients. One group of patients listened to a verbal description of CPR and its chances of successfully resuscitating patients. The other group heard the same information, accompanied by a short (3-minute) video showing a simulation of a patient receiving CPR and being put on a ventilator.

The results: very different. Less than half as many people wanted CPR for themselves when they also saw the video (20%), compared to those hearing only the narrative (48%). Put another way, more than twice as many people wanted CPR when they hadn’t visually seen how it worked. The patients who saw the video were also better informed about CPR and their decisions. This study was conducted as a randomized controlled trial, the “gold standard” for medical research.

Inquiry about how patients — and people in general — process information and acquire knowledge is a burgeoning field of study, both in medicine and neuroscience. The latter has already demonstrated that individuals tend to process and understand information better when they receive it from more than one medium.

This raises a couple of questions for estate planning and elder law attorneys:

• As part of teaching your clients to be good medical advocates (for themselves or as a health care power of attorney), how might you counsel them about ways to better understand the information presented to them? You could advise them to ask for information in different modalities: they can ask for it in writing as well as just being “told.”  Or ask for a verbal explanation if they are only handed a piece of paper. This is important for follow-up instructions at a doctor’s visit or upon hospital discharge, as well as when making treatment decisions.

• Should we bring this approach (ie presenting information in multiple modalities) into the advance care planning process earlier on? Possibly even at the point of clients executing their advance directives?

And then there’s the broader question for your practice: As an attorney in an agency relationship with your clients, you possess a vast amount of complex, specialized knowledge that is guiding your counsel to them. Do you think it would help your clients, or your attorney-client relationship, if clients understood more about what you are advising them? (This is not a rhetorical question.)  Could it possibly even change their understanding of your questions and cause them to make different decisions? While clients presumably trust your professional expertise, would it nonetheless make some more comfortable to better understand what you’re creating for them? Would increased knowledge of or comfort level with your plan contribute to their willingness to pay a higher fee? To refer others to you?

If the answer to any of these is “yes,” what different, reasonably-priced media could you use to share information that you aren’t using now? If you are principally talking to clients presently, would it be helpful to have a written description also? What about pictures or diagrams — of the A/B Trust design of an RLT, for instance? (I know that those of you in the Academy have the latter already.)

Do you think anything works better than just talking with clients to help convey information and understanding? If so, what? I’d love to hear your thoughts. (And you don’t have to divulge your proprietary info.)

Randi J. Siegel,MBA, is the President of DocuBank(docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

Do your clients inform you when they have been diagnosed with an end-stage or terminal illness? Do you ask them to tell you? Even if you don’t, you might find this information useful for yourself and your loved ones.

Suppose your client learns that he/she has advanced cancer that isn’t curable. A recent study finds that your client will likely make different decisions about care if their doctor has talked with them sooner versus later about their treatment options for end-of-life care.

Specifically, the study finds that most patients make decisions for more “comfort care” and less aggressive care (like additional chemotherapy or ICU care) in their last month of life when they’ve talked with their doctor earlier, according to study author Dr. Jennifer Mack of the Dana-Farber Cancer Institute. Of course, some patients do choose more aggressive care regardless of the timing of this discussion. And that’s the point: earlier discussion can help patients get the kind of care that they actually want.

Why is it important to know this? Because oncologists are not good about initiating discussions about the patient’s wishes for care as they face the end of their life. In this study, doctors talked to patients about their wishes on average only 1 month before the patient died. Usually, this kind of conversation occurs only after all the chemotherapy options have been exhausted, according to Dr. Thomas Smith, director of palliative care for the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Why? It’s a “hard conversation” for doctors to have, Dr. Smith explains, but avoiding it “doesn’t serve as well to prepare the patients and families for what’s coming.”

Other studies have also found that near the end of life, less aggressive care can improve a patient’s quality of life, help patients stay at home, and can in some cases even help patients live longer. And — family members are actually less likely to develop depression after the patient’s death.

So the take-away is this: if a person is diagnosed with advanced cancer or other terminal illness, it’s up to the patient and the family – whether this person is your client, your loved one, or yourself – to initiate a discussion with the doctor about all treatment options. These options include comfort care and alternatives to all-out “aggressive” treatment. The patient and family can ask, for example: “what will my life be like if I do get the chemotherapy? What will my life be like if I don’t? How long might I live? What are my options for comfort care (including pain management and/or hospice)? What are my chances of staying at home?”  With this kind of information, patients and families can make treatment decisions that best matches their wishes.

Yes, it’s a travesty that many doctors don’t take the lead on this with their patients. But until medical training and medical culture change in this regard, we have to rely on ourselves and our families to do it. Don’t be bashful. Don’t feel that you’re challenging the doctor. In fact, many physicians will be relieved that you have raised it and were just waiting for a cue from you to talk about it.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

Acting as the health care proxy for a loved one who has been in the ICU for 5 days is stressful. No news here. But a new study finds that a surrogate’s confidence in their decisions can actually be increased and their stress decreased — if the patient and the surrogate had talked about treatment preferences in advance. This was true even if patients hadn’t written down their health care wishes.

So, you think you are “done” with your clients’ advance care planning when clients sign their advance directives? Nope.

The next step in proactive planning is to counsel clients to talk with their named health care agent about their wishes or goals. This is consistent with your role as a trusted advisor, not just a drafter of documents.

When talking together, loved ones can get a sense of the client’s preferences about what’s important to them. Maybe it’s certain qualities of life, or length of life, or thinking about potential tradeoffs between them. Yes, it’s true that all possible medical scenarios can’t be discussed in advance, but that isn’t the goal. (This is also why the living will is usually best used as guidance to the health care agent.)

Perhaps the scenario featured in this study could even be a catalyst for a discussion by clients who want to dig a bit deeper: Your client is in the ICU for 5 days on a ventilator. What’s important to them if they’re in the ICU because: they have a terminal condition? Are in an irreversible coma? Have had a stroke and may remain severely physically impaired? Or severely mentally impaired? The answers might be different.

Is this topic really necessary for you to advise your clients about? Consider this: on average, ¼ of your elderly clients will die in an ICU. Even more will die in situations requiring their health care agent to make decisions. What do you want to do to help your clients’ spouses, adult children, or other surrogates feel more confident that their decisions will be in your clients’ best interest?

PS  Thanksgiving is a great time for clients to talk with their families about healthcare wishes. Folks are relaxed and not in the midst of a medical crisis. This 2-minute video is a good inspiration for clients. Click here if you’d like a draft article for your client newsletter or e-blast encouraging clients to “have the talk” over Thanksgiving.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

A Missouri woman is being accused of 1^st degree murder and forgery. The murder weapon: her father’s power of attorney, allegedly forged, naming herself as the agent. The actual murder: directing that her father’s life-sustaining medical treatment be discontinued. The accused, Susan Elizabeth (“Liz”) Van Note has pleaded not guilty to the charges.

This case turns even more bizarre. Prosecutors allege that Ms. Van Note is responsible for the critical gunshot wound that landed her father in the hospital in the first place. They claim that she shot her father and his fiancé in their home shortly before their upcoming marriage. (The fiancée was killed. These charges are being handled separately.)

The prosecutor explains that the actual murder charge against Ms. Van Note stems from the document forgery and from her subsequent action as her father’s health care agent – not from the shooting itself – because it is the termination of medical treatment that directly led to his death.

One unfortunate and shocking detail: Ms. Van Note is actually an estate planning attorney. Presumably your clients and prospective clients are savvy enough to understand that case is an anomaly. And presumably they will understand that you truly are committed to, as Ms. Van Note’s own website states, empowering clients “to make a difference in the lives of [their] loved ones” by providing “honest and sincere legal counsel.”  Nonetheless, this case has been picked up by AP and might be appearing in your local paper, so it’s worth knowing that this news is out there.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

When should clients review their advance directives for updating?

The ABA Commission on Law and Aging offers an easy-to-remember guide: the “5 D’s.”  Per the Commission, a client’s directive should be reviewed when any of the following occurs:

• Death of family or friend

• Divorce

• Receive a new Diagnosis

• Experience a significant Decline in health

• Reach a new Decade

As the client’s estate planning attorney, you are unlikely to be aware when many of these triggers occur. And it’s just not realistic to expect clients to remember to contact you if one did. Clearly, clients will need some assistance.

Using the 5 D’s as a guide, here are a few ideas for helping clients keep their directives updated – that also help you keep in touch with them:

• Send an annual reminder to all clients about the 5 D’s. If any of the D’s applies to them, ask them to contact you and to review their directives. Consider scheduling this communication around National Healthcare Decisions Day, which occurs annually on April 16. Click here if you’d like to receive a sample 5 D’s graphic that doubles as a client reply card, along with a sample reminder letter.

• On a client’s birthday that begins a new decade of life, send a personalized reminder letter to review their advance directive. Or, invite them in for a quick update meeting to take care of this (consider having your paralegal handle it). If the client hasn’t been back to your office in the past 10 years, you might want to offer this update gratis to help renew the relationship.

• If you have a client maintenance program or annual updating program of any kind, you will certainly include a healthcare directives update. Most firms do the review every 1 or 2 years.

In the course of updating clients’ advance directives, you may discover other changes in their lives that result in additional client matters right then. And that’s all to the good. But regardless, this type of contact is part of providing ongoing counsel to clients. It communicates that you are primarily interested in a relationship with your clients for the long haul.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com

As your clients send their “babies” off to college, each one should each be armed with a HIPAA Release along with their comforter and laptop computer.

Steve Hartnett emphasized this in his June 6 post about the legal document needs of adult children: youngsters who’ve turned 18 are now legal adults are subject to HIPAA in their own right. If you still need convincing, consider this additional evidence from your colleagues:

• Two estate planning attorneys have told me their own PERSONAL STORIES about being denied information about their own 18-year old children, who were hospitalized unexpectedly at college without a HIPAA release or an HCPOA

• A few years ago, before we launched our Healthcare Directives Registry for college students (I.C.E.), we surveyed estate planning attorneys on this topic. They shared with us a number of stories about clients who have similarly been denied this information by hospital staff. One was a particularly harrowing story about a parent who couldn’t get information about her daughter for 2 days, until she was able to travel and show up in person at the hospital.

Here’s another real world suggestion: execute a separate HCPOA and a HIPAA Release. Yes, an HCPOA is legally sufficient for the parent who is named as the 18 year-old’s agent. But it’s worthwhile having a separate HIPAA release for one or both of these reasons:

• Your clients may want to grant permission to additional person(s) to talk to hospitals and doctors if their college students have a medical emergency. Maybe they have a relative or close friend living near the college whom they’d want to receive information in an emergency. Or perhaps your client has a relative who is a physician, whom they would want to consult with the student’s doctor. With a HIPAA Release, all of this can happen without the individual being named as the HCPOA.

• We have heard from a few of our enrollees that hospital staff occasionally refuses to honor the HCPOA and ask explicitly for a HIPAA release. Though erroneous, the staff person believes he/she is required to have this document. Again, in a time of emergency, you don’t want your clients to have to argue the law, or be stymied. (And you certainly don’t want to look like you didn’t provide your clients with the needed documents). You just want your clients to have whatever legal papers they might possibly need, so they can learn about their child’s condition as quickly as possible.

Are hospitals required to be this strict about guarding patients’ medical information that they must have a HIPAA Release or an HCPOA in all cases? Actually, no. HIPAA regulations allow hospital staff the leeway to share information if it is in the best interests of the patient. But, it’s a lot easier for hospitals to train staff with black and white rules rather than with nuance. And they are concerned about being fined for a HIPAA breach.

If you’d like to see a sample letter to send clients, inviting them to create a HIPAA Release and HCPOA for their college students, feel free to email me.

Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directives registry in the U.S., which ensures that the emergency information and healthcare directives of its 200,000 enrollees are immediately available 24/7/365. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the International Society of Advance Care Planning, she is active in health policy and health education related to advance care planning and advance directives and serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128
www.aaepa.com