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From my discussions with estate planning attorneys, I know that many of you are always on the lookout for current stories to help clients understand the value of the estate planning you’re proposing.
‘The Descendants,” this year’s Oscar-winning film (best adapted screenplay) might serve just this purpose – at the very least vis-a-vis your clients’ healthcare directives.
First of all, just mentioning George Clooney to your clients might help get their attention. Second, the story conveys several powerful messages about the benefits of written advance directives and of making medical decisions in advance.
This film sets up George Clooney as a middle-aged husband whose vital, healthy wife has just been seriously injured in a tragic boat racing accident. She now lies in a coma on life support. The Clooney character, Matt King, reveals himself to us through his anguished, bedside pleadings with his wife, Elizabeth, to awaken from her coma. After three weeks of waiting, doctors tell Matt that she will never wake again.
Enter the living will. Elizabeth has completed one, and it states that she wants life support to be terminated in a medical situation like this one. (The film doesn’t mention an HCPOA.) During multiple scenes, we see King telling family and friends of her permanent condition and her medical wishes.
The film conveys, poignantly, the value that an advance directive can play for a family experiencing a devastating tragedy like this one.
The movie does this largely through what it doesn’t show us. Precisely because Elizabeth has a living will, we don’t see the added emotional difficulties the family might face if she had not completed an advance directive.
- We don’t see the doctor asking Matt King what he thinks his wife would have wanted, and King trying to decide himself, potentially agonizingly, whether to terminate her life support.
- We don’t see the compounded anger and resentments of their rebellious teenage daughter (who, beneath it all, still identifies with her mother) that might result from seeing her father put in the position of making this difficult decision.
- We don’t see the added confusion of their 10 year old daughter, who might perceive that her father has “chosen” to end her mother’s life.
- And while we do see Matt’s father-in-law blame Matt for his wife’s boating accident, we don’t see him blaming Matt for discontinuing the life support. Without the advance directive document, Elizabeth’s father, in his own grief, might not be able to resist the temptation to blame Matt for this, too.
What we do see clearly presented on screen is that advance care planning is actually a gift to one’s family in tragic situations. Indeed, when Matt King shows his wife’s father her living will and explains that she will be removed from life support, her father responds: “Elizabeth had the good sense to write this thing. She’s a strong girl. A thoughtful girl.”
P.S. “The Descendants” also has a strong plotline about other estate planning matters. See this Forbes article for a full analysis of the estate planning issues presented.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directives registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
A few weeks ago, the ABA Center for Law and Aging held a webinar: “Effective Advance Care Planning: Are Your Advance Directives Worth The Paper They Are Written On?” The purpose was to enhance attorneys’ client counseling skills on this topic and their drafting of more effective advance directives. Today I’ll share some state-of-the-art thinking from these leading advance care planning experts on one of the topics discussed: appointing the health care agent.
Choosing a Health Care Agent
Attorneys can add important value to the advance directive drafting process and to the clients’ thinking about advance directives. With the Health Care Power of Attorney, you have the opportunity to help clients be thoughtful about their choice of health care proxy. The guiding responsibility: to think about the best way for the clients’ wishes to be honored.
A. Share with clients the skills and qualities of the ideal healthcare proxy
The agent should be someone who can:
- advocate for the patient with doctors, hospitals, and the medical community generally;
- manage conflict within the family
And while there is no such thing as a perfect agent, there is always the “best-possible agent” from among the client’s options.
B. Counsel clients not to assume that their spouse is the best choice
While it is understandable that most clients do choose their spouse or significant other as their agent, sometimes spouses are simply not the best equipped to fulfill this role. A spouse may not be able to handle conflict, for example. If you recognize this, you should advise the client to select another party. But even beyond the obvious cases where the spouse is the wrong choice, you should broach this concept with clients in ways that will make the topic comfortable and safe for them to consider and discuss:
- Introduce the idea in the third person (e.g. “some of my clients find that their spouse actually isn’t the best person to make these decisions…)
- Use specific client examples – real or fictional stories war stories of clients who inappropriately chose the spouse
C. Do not appoint co-agents
While attorneys have differing opinions on this and states also vary, the experts who spoke to this point strongly recommended naming only one agent. Clients who want to appoint co-agents usually have multiple adult children whom they want to be involved.
Solutions for this include:
- Having an understanding that there is a single decision-maker but shared information between the agent and the other siblings
- Even including language in the HCPOA that the agent must reasonably consult with the other adult children – for instance before making an important decision
D. Help clients make the family comfortable with their choice of agent
As counsel, the attorney’s role is also to help clients think about how the family moves forward after the death of the client. It’s important that the adult children or the spouse who is not chosen as the agent feels OK about this decision. Counsel your clients to talk about their choice of agent with the loved ones(s) whom they didn’t name – and to explain their thinking. Often this can be done in very compassionate terms, e.g. “I knew it would be too hard for you to make these decisions…”
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directives registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
Each New Year, we talk about how to better ourselves ― eat well and exercise, watch less television, spend more time with family, etc. And while determining how to live a healthier and more personally fulfilling life is an admirable goal, there’s another question, I think, to ask ourselves at the New Year: what can we do to effect positive change not just in ourselves, but in others? How can we, individually, make the world a better place?
One of my friend’s family members was recently diagnosed with terminal cancer. She did not expect this, and she is not prepared. Her wishes have not been recorded. And it’s hard for her to even think, let alone plan, when she feels so sick from the chemotherapy. Her family is arguing about what is best for her, and how to make it happen. This has already led to serious clashes that may take years to fully heal, and this process is just beginning. And the fact that my friend is in a family business just makes the dynamics all the more charged.
I’d like to say my friend is alone in this challenging circumstance, but as we all know, she’s not. When someone passes away, or is diagnosed with a terminal illness, families may argue. And if that person hasn’t planned in advance, the process can become even more difficult, sometimes tearing families apart entirely.
Unlike many people, we have been granted the opportunity to help others, to improve the world through our work. As attorneys, you help create and execute people’s wishes for the ends of their lives and after their deaths, through their healthcare and estate planning documents. As a healthcare directives registry and electronic document repository, we help ensure that these wishes can be known, available, and followed when it counts. It can be easy to forget amidst the day to day, but with these acts, our efforts can help simplify the complications that arise toward the end of life and after. These actions can help hold families together at the most critical of moments, when they might otherwise split at the seams. What a blessing it is that we have the opportunity to help others, just by doing our jobs.
Self-betterment is a great goal for the New Year, but helping others is at least as important. Clearly, the volunteer activities that we engage in throughout the year are an obvious way to give back. But at this time of year, I think it’s also useful to take a moment to reflect on the fact that this work is not just a source of income; it’s also a service, a means of helping others. As we go forward into this New Year, let’s pledge to renew our efforts to offer good counsel in helping people make the difficult decisions, to support them with these documents when they are needed, and to prevent unnecessary pain for family members when the time comes.
Wishing you a Happy New Year and good works in 2012.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directives registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
Newly released online: a short video encouraging Americans to think about their health care wishes.
Accompanied by moving music, it aims to reach the viewer emotionally as well as intellectually ― more so than I’ve seen in other video pieces on this topic. In fact, its tone reminds me a bit of the emotional ASPCA ads similarly-produced with only music, text and photos.
You might find this 3-minute piece useful to share with clients. It could be viewed in your office while clients wait for their initial consult, as homework before clients complete their healthcare directives with you, or during an educational presentation you might give in your community.
This video might also be an interesting way to reach out to existing clients at the holiday season. While your clients have obviously already completed their directives, it’s just as important that they talk about their wishes with their loved ones. And while this can be hard for them to do, it can be a tremendously important gift to their families. A short video like this to share with loved ones might give them a tool to start the conversation.
The National Healthcare Decisions Day (NHDD) initiative is hosting this video on its website (on the homepage) and adapted it for national use, as another vehicle to encourage advance care planning.
If you have any tools or ideas that you use to help clients have this conversation with their loved ones, please let me know.
Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
Making decisions about medical care can be a daunting proposition – we know this from our own experiences. Start with the sophistication of diagnoses, add the complexity of medical procedures, and top it off with a menu of treatment options. Deciding what to do can be a recipe for anxiety, paralysis and/or self-doubt – even among those who are highly informed.
A new book takes on the task of helping people make the medical choices that are right for them. Your Medical Mind, by Drs. Jerome Groopman and Pamela Hartzband, begins with a fundamental assumption: there is often more than one correct decision for patients. It then tackles how patients can go about determining what care they want. In addition to coaching readers to gather the factual information about their options, the authors help people understand how their personal values – their goals, dislikes, and fears – can inform what medical decision is best for them.
Your Medical Mind helps people understand how they view medicine and medical treatment, whether as doubters (who tend to worry about the side effects or risks of treatment) or believers (who are convinced that the treatments or approaches will work and prefer to “do something”) or as a blend between these two extremes. They also suggest that patients look at the effect that the options will have on their lives and why these either matter or don’t matter to them.
Understanding and recognizing this can help patients make choices they are more comfortable with, and it can help doctors guide these patients to choices that are better suited for their beliefs and values. For instance, one patient didn’t want surgical thyroid removal for Grave’s disease because he didn’t want to be forced to take a pill every day. Another preferred the surgery because he wanted to “just get it over with” and move on with his life.
The significance of this book’s approach to decision-making is amplified when clients are faced with serious or end-of-life decisions about care. This is exactly the role that advance directives try to play. And it is also, I would argue, exactly the kind of conversation that’s particularly important for patients and health care surrogates to have. It is important for clients’ health care agent(s) to know, fundamentally, what the clients’ goals are when facing an end-of-life or other serious condition. And this includes even going that next step further – WHY is that the goal? Or WHAT does the person like or not like about that option? This will help clients communicate to their agent what’s really important to them. Is the goal to live without pain? To be able to tell jokes and watch Sunday afternoon football regardless of one’s physical abilities or limitations? To be able to take a Sunday afternoon stroll, even if one’s memory is lacking?
This book, and others like it that attempt to help clients dig below the surface level of their decision-making, may be useful tools for clients and their loved ones. It may be especially helpful to clients and their agents in talking about some of the big end-of-life treatment questions. Having additional language and another way to frame the conversation can only help.
Please let me know if you recommend any tools or resources that help clients and their surrogates improve their communication, complete more informed advance directives, or make better medical decisions. I am interested in learning from your experiences.
Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
An important new study about advance directives was just released October 5 in the Journal of the American Medical Association (JAMA). You and your clients may have already heard about this in the news.
The study’s findings are generally favorable (and certainly not unfavorable) toward advance directives. But — some of the press coverage has the potential to confuse clients or cause them concern about the purpose of the advance directives that you helped them create. Specifically, some of the coverage describes advance directives as a “cost-saving measure” or as “not effective.”
Here are some of the main points from the JAMA study that may be important for your firm and your clients to understand should clients ask you about this study:
- This study looked at patients who wanted less aggressive treatment at the end of their lives. It used cost of care as the proxy measure of the treatment received, hence the reporting focus on costs.
- The findings suggest that people with advance directives who wanted less aggressive end-of-life care did have their wishes met. Specifically:
- this group of patients did not have everything medically possible done for them, as measured by their lower costs of care.
- these patients had a higher rate of dying outside the hospital (a measure of less aggressive care)
- these patients had higher rates of using hospice and palliative care (comfort and pain management) services
- In certain areas of the country, advance directives helped patients achieve their goal of less aggressive treatment. In other areas, advance directives were not necessary for people to have their wishes met because of less aggressive treatment norms there.
- The study did not find or even suggest that advance directives were used as a cost-cutting measure. Nor does it suggest that patients received less care than they wanted for any reason. In fact, the study did not evaluate the care of patients who specifically stated in their advance directives that they wanted the most aggressive treatment possible (to determine if advance directives helped them achieve this goal).
In closing, this study suggests that having advance directives either helped or at worst had no effect on patients getting the less aggressive care that they wanted at the end of their lives. It did not find that advance directives were counterproductive to these patients receiving their desired care.
If you have any questions about this study or its meaning for your clients, please feel free to call me at 610-667-3524 or email me at rsiegel@docubank.com.
Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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
According to a recent study by the Mind Perception and Morality Lab at the University of Maryland, people view patients in a persistent vegetative state (PVS) as worse off than patients who have died. Published online in Cognition (http://www.sciencedirect.com/science/article/pii/S0010027711001752), the study consisted of three experiments. Here is the Abstract:
“Patients in persistent vegetative state (PVS) may be biologically alive, but these experiments indicate that people see PVS as a state curiously more dead than dead. Experiment 1 found that PVS patients were perceived to have less mental capacity than the dead. Experiment 2 explained this effect as an outgrowth of afterlife beliefs, and the tendency to focus on the bodies of PVS patients at the expense of their minds. Experiment 3 found that PVS is also perceived as “worse” than death: people deem early death better than being in PVS. These studies suggest that people perceive the minds of PVS patients as less valuable than those of the dead – ironically, this effect is especially robust for those high in religiosity.”
The complex views of PVS illuminated in this study further illustrate the importance for clients to be clear in advance about their medical wishes and to not assume that others will be able to infer what they would want. It also speaks to the possibility that people may hold simultaneously conflicting views about PVS when making decisions on behalf of a loved one in a persistent vegetative state.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directives registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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, CA 92123
Phone: (858) 453-2128
www.aaepa.com
Robert Ettinger, the father of cryonics, died a few weeks ago at the age of 92. He believed that an individual can achieve immortality by freezing one’s body upon death, until scientific advances allow them to be resurrected.
Having already frozen his mother and his 1st and 2nd wives, Mr. Ettinger became his Cryonics Institute’s 106th human patient. Last year, he described these patients to a New Yorker reporter as “not truly dead in any fundamental sense.”
So far, over 900 individuals have registered and paid a minimum of $28,000 to be frozen by the Institute upon their deaths. If you think that sounds steep, you’ll be surprised to learn that a competing organization charges multiples times more.
(You may recall the most famous cryonics customer, former major league ball player Ted Williams, and the legal dispute over his actual wishes for the disposition of his remains back in 2002.)
Of course, in addition to the enormous scientific obstacles to cryonics as yet unsolved, there are also interesting legal questions. For example, Ettinger himself would face a tricky situation of the family law variety, were cryonics ever to be successful. As he was a widow before marrying his 2nd wife, what would happen if both Mr. Ettinger’s wives were brought back to life? “That would be a high class problem,” he observed.
Are you likely to encounter a cryonics client? Probably not. But cryonics is just one example of how advances in science and medicine often come before the usefulness of these technologies has been determined. And how these developments may be challenging our familiar definitions of life, death, and the execution of our end-of-life wishes.
If you’ve encountered an unusual situation around clients’ estate planning or healthcare wishes, please let me know (no client names, of course) at rsiegel@docubank.com.
Randi J. Siegel, MBA, is the President of DocuBank (docubank.com), the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. 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, CA 92123
858-453-2128
www.aaepa.com
Last month, I wrote about how the U.S. Department of Health and Human Services has begun enforcing HIPAA by imposing large financial penalties against healthcare providers for HIPAA violations. (In the first case, a healthcare provider received a $4.3 million civil penalty for failing to provide timely personal health information to patients upon their request; in the other, a different provider agreed to a $1 million settlement for disclosing patients’ personal health information without their approval.)
What will be the fall-out for you and your clients from this new enforcement? If healthcare entities intensify their efforts to avoid HIPAA financial penalties, we may see a few things happen:
- Patients themselves may have an easier time gaining access to their own medical information. And some may even get it more quickly. At the same time;
- Patients’ family members — and others whom the patient wants to have access — may have a harder time getting the patients’ information.
What does this mean for your clients’ legal needs?
- Clients need a Health Care Power of Attorney (HCPOA) more than ever. This document may increasingly do double-duty. In addition to its primary function, the HCPOA also serves as a de facto HIPAA Release, even if you haven’t specified this in the document. The HIPAA law expressly authorizes the health care agent to receive the patient’s personal health information (called “PHI” under HIPAA).
- Clients may increasingly need a separate HIPAA Release designating individual(s) — in addition to the health care agent — who can receive their medical information. Why? Clients often rely on someone other than their health care agent to help them navigate the healthcare system. This might be another family member, a friend, or a neighbor. Healthcare providers may be increasingly apt to request written authorization from the patient to deal with any of these folks on your client’s behalf. (If you are getting feedback to this effect from your clients, please let me know.)
Alternatively, some firms are addressing this need within their HCPOA document itself, rather than drafting a separate HIPAA Release. They are creating a section in the HCPOA naming additional individuals to receive PHI under HIPAA, but who are not authorized as health care agents. (I’d like to report back on the trend in how attorneys are handling this. Please share your approach with me at rsiegel@docubank.com.)
The stricter HIPAA enforcement may also create heightened challenges particular to college students and other young adults. More on this in another post.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directives registry in the U.S., which ensures that the healthcare directives of its 190,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. Randi is an ongoing contributor to the Academy blog.
Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
6050 Santo Rd Ste 240
San Diego, CA 92124
858-453-2128
www.aaepa.com
Many of us have found ourselves complaining, or have heard clients complain, about HIPAA. Hospitals and doctors’ offices now require the completion of additional paperwork. Hospitals, doctors, and health insurers sometimes refuse to share information with patients or with family members, citing HIPAA as the barrier even when it isn’t.
But recent news reminds us why certain pieces of this law were enacted in the first place. In February of this year, in response to particularly egregious infractions, the U.S. Department of Health and Human Services (HHS) imposed its first civil monetary penalty against a healthcare provider for HIPAA violations. The penalty amount: $4.3 million. Shortly thereafter, HHS announced a settlement of $1 million with another provider for a significant HIPAA breach.
These cases illustrate two major types of personal privacy violations that HIPAA is designed to curtail. In the first, HHS found that a health care entity failed to provide timely personal health information (PHI) to patients upon their request. The organization essentially ignored patient requests for their medical records for months at a time. HHS also found that the healthcare provider did not cooperate with the HHS investigation, and that it did so out of willful neglect. This neglect resulted in an additional fine of $3 million, on top of the $1.3 million for the initial infractions.
Conversely, in the second case, a healthcare provider disclosed patients’ personal health information without approval. An employee lost documents from an Infectious Disease practice by leaving them on a subway while commuting (the employee intended to work on them at home). These documents, never found, included patients’ billing records with names, birth dates, medical record numbers, health insurers and policy numbers, and diagnoses. Some of these patients were being treated for HIV/AIDS. In addition to the $1 million settlement, the covered entity agreed to a three-year remediation plan to help it prevent future infractions.
By imposing these large financial penalties, HHS appears to be getting serious about enforcement of patients’ privacy rights. And while HIPAA may create administrative hassles that patients will continue to complaint about, patients can also take some comfort in knowing that there is now a greater deterrent to doctors and hospitals mistreating their personal medical information, either by disclosing too much or too little of it.
For more detail on these cases, see, among others: Pepper Hamilton LLP Health Law Alert, Baker Hostetler Health Law Alert, and the HHS Office of Civil Rights website at http://www.hhs.gov/ocr/privacy/hipaa/news/cignetnews.html and http://www.hhs.gov/ocr/privacy/hipaa/news/mghnews.html.
Randi J. Siegel, MBA, is the President of DocuBank, the largest advance directive registry in the U.S., which ensures that the healthcare directives of its 180,000 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. She is active in health policy pertaining to advance directives and serves as a Senior Fellow at the Jefferson School of Population Health in Philadelphia. Randi is an ongoing contributor to the Academy blog.
Academy Guest Blogger
American Academy of Estate Planning Attorneys, Inc.
6050 Santo Road Ste 240
San Diego, CA 92124
858-453-2128
www.aaepa.com
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