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Guest Blog: Palliative Care and Palliative Care Laws in New York: What Patients Should Know

Friday, November 21st, 2014

Our guest blogger this week is David C. Leven, JD, Executive Director, Compassion & Choices of New York

Palliative care can help improve your quality of life. You should know what palliative care is and how two New York State laws effective in 2011can help you learn about your palliative care options and receive timely palliative care.  The Palliative Care Information Act (PCIA), Public Health Law Section 2997-c,and the Palliative Care Access Act (PCAA), Public Health Law Section 2997-d, define palliative care as “health Care treatment, including interdisciplinary end-of-life care, and consultation with patients and family members, to prevent or relieve pain and suffering and to enhance the patient’s quality of life, including hospice care.” The care provided can address not only pain and other symptoms but depression, anxiety, psycho-social and spiritual issues as well.

Palliative Care Access Act (PCAA)

The PCAA  requires that  hospitals, nursing homes, home care agencies and enhanced and special needs assisted living residences establish policies and procedure to provide patients with advanced, life limiting conditions and illnesses who might benefit from palliative care, with information and counseling regarding such options appropriate to the patient.. It also requires that they facilitate access to appropriate palliative care and pain management consultations and services including but not limited to referrals consistent with patient needs and preferences.

Palliative Care Information Act (PCIA)

Terminally ill patients now have a clearly defined right to receive information and counseling about their palliative care and end-of-life options, including hospice. This will enable them to make informed treatment decisions during the final months of their lives. The law states, in part:

“If a patient is diagnosed with a terminal illness or condition, the patient’s attending health care practitioner shall offer to provide the patient with information and counseling regarding palliative care and end-of-life options appropriate to the patient, including but not limited to: the range of options appropriate to the patient; the prognosis, risks and benefits of the various options; and the patient’s legal rights to comprehensive pain and symptom management at the end of life; and information regarding other appropriate treatment options should the patient wish to initiate or continue treatment.”

The information and counseling under both laws should be provided to those lawfully authorized to make decisions for patients who lack capacity to make medical decisions, such as a health care agent.

What You Can Do to Get Palliative Care and the Benefits Required Under the Laws 

If you are a patient and believe that you may qualify for the benefits of either law or both laws or if you are a health care agent or surrogate for a patient who you believe has or may have a terminal or advanced life limiting illness or condition, then you might consider discussing this with the appropriate health care practitioner. If you are a health care professional and you believe that a patient of yours has not yet benefitted by the requirements of the PCIA and/or PCAA, then you might consider discussing this with the appropriate health care practitioner responsible for compliance with the applicable law (s) after conferring with the patient.

Resource: The New York State Department of Health website, questions and answers and guidance.

 

Learn more about Palliative Care and the Palliative Care Laws in New York, by visiting  Compassion and Choices.

Learn more about our elder law services by clicking here,  www.elderlawnewyork.com.

 

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Understanding Asset Rules for Medicaid

Friday, August 17th, 2012

Many seniors take advantage of Medicaid for health insurance coverage, nursing home care, or, in the state of New York, home health care.  Because Medicaid is a joint program between the federal government and the states, it is important to understand the rules that apply where you live.  Here we will review the resource or asset rules that apply to the program for nursing home or home health care recipients, both generally and in the state of New York.

Individuals who have a disability, are blind or are age 65 or over, or who require nursing home care, must pass a resource test to be eligible for Medicaid.  In New York, in order to be eligible for Medicaid, a person’s assets must be $14,250 or less.  Income is restricted to $792 per month if the person continues to reside in the community.  Nursing home residents are permitted a small monthly income for personal needs.

Asset rules also apply to a nursing home resident’s spouse, known as the “community spouse.”  In New York, the Community Spouse Resource Allowance (CSRA) is $74,820, or half of the joint assets of the couple, up to $113,640 in countable assets.

The community spouse is also entitled to a small amount of income, what is known as a minimum monthly maintenance needs allowance (MMMNA).  For income in excess of the MMMNA, 25 percent may go to the cost of the nursing home resident’s care.

Assets that do not count against the resource limits are those defined as “noncountable,” including personal possessions like furniture and clothing.  A primary residence and an automobile can be considered noncountable, with certain restrictions.  Prepaid funeral arrangements, some life insurance, and assets that are “inaccessible” can also be considered noncountable.

For more information about New York Medicaid rules, visit http://www.health.ny.gov/health_care/medicaid/. For more information about our elder law services, visit www.elderlawnewyork.com.

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Free Wellness Services and Discounts Available to New Yorkers on Medicare

Wednesday, November 16th, 2011

More than 1.3 million New York state individuals have received free preventive services through Original Medicare this year so far. But only a little more than 113,000 people have taken advantage of its free annual wellness exam. With more than 1.77 million New Yorkers enrolled in Medicare Part B, these recipients should use these free services to better their health and longevity.

Along with these benefits through Medicare Part B, the average prescription drug premiums are not expected to rise in 2012. The U.S. Department of Health and Human Services reported that 900,000 Medicare recipients who are in the prescription drug donut hole had 50 percent discounts on their prescription drugs this year.

The Centers for Medicare & Medicaid Services notes that generic prescription coverage will not increase for those in the donut hole in 2012. Out-of-pocket costs will also be lower due to discounts on brand name prescription drugs. Individuals should still carefully review their Medicare plan elections for 2012 to see that their pharmacies, prescriptions, and preferred doctors are still available at reasonable prices as plans can fluctuate annually.

For those on Medicaid in New York, the program made a change earlier in the fall. Medicaid’s pharmacy benefit and the Family Health Plus pharmacy benefit is now part of the managed care benefit package. Each health plan has its own category of medicines, including prescription drugs, some over-the-counter drugs and medical supplies. It is important to make sure the plan has the medicines each individual needs. The New York health plans do allow a one-time only fill of a drug in the event that individuals cannot reach their doctor to get guidance to switch to a plan that does cover what they need.

Littman Krooks LLP counsels seniors and families to access government benefits as well as plan for health care needs and personal decisions. Our New York City, White Plains and Fishkill elder law attorneys and estate planning attorneys are accomplished in comprehensive planning for a senior’s golden years. To learn more about New York elder law, visit http://www.littmankrooks.com/elder-law/ or http://www.elderlawnewyork.com.

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