Posted: 6:00 pm Sun, September 9, 2012
By Joe Surkiewicz
Special to The Daily Record
Would you or your family be ready if you were in a serious car accident or suffered a stroke and required nursing home care? Or what if a parent became incapacitated?
Did you know that you or that family member may need Medicaid, typically thought of as medical insurance for the poor?
?Most people don?t realize that unless they have long-term care insurance ? and most don?t ? that they will eventually run out of money and need Maryland Medicaid to pay for long-term care in a nursing home,? said Anne Haffner Hurley, director of Maryland Legal Aid?s Long Term Care Assistance Project. ?And that program, called ?Medical Assistance? in Maryland, has very complex rules that most people ? even very educated people ? are not familiar with.?
That?s not all: If you get the Medical Assistance rules wrong, you or your loved one could be facing an involuntary discharge from the nursing home for failure to pay.
Fortunately, those residents have a legal right to mediation and a hearing. But how can they pay for lawyers now that they have spent all their money on nursing homes?
Legal Aid?s LTCAP is usually the first stop for residents facing discharge. But with only two full-time attorneys on staff, LTCAP?s capacity can?t meet the need.
That?s why Legal Aid teamed with the Maryland Volunteer Lawyers Service to recruit private attorneys to take nursing home involuntary discharge cases.
?These are fantastic cases for pro bono attorneys,? Hurley said. ?It?s a discrete, but accessible area of the law. And the appeals process happens quickly ? a case typically takes about a month from the issuance of a discharge notice to the hearing date.?
Last spring, LTCAP and MVLS trained 15 volunteers and placed 22 involuntary discharge cases.
?The pro bono placement of these cases works particularly well because our partners at Legal Aid have expertise in elder law and provide support and mentorship to our volunteers. ?? MVLS executive director Bonnie Sullivan said. ?We can assure them that our friends at Legal Aid will help them every step of the way.?
Nursing home residents have robust rights when facing involuntary discharge.
?There are five major rights,? Hurley said. A resident can only be discharged if ?your needs can?t be met, your health has improved [to the point that care is no longer needed], you?re a danger to yourself or others, you haven?t paid your bill or the nursing home is closing or no longer is certified by Medicare and Medicaid.?
The cases are usually compelling. Many long-term residents consider the nursing home their home, where they live with their friends, consider staff as family and may have lived in the same rooms for years.
?Also, there?s ?transfer trauma,? which can trigger more health problems for medically fragile residents,? Hurley said. ?Private attorneys who take these cases can have a huge impact on their clients? lives. If you?re successful, you?re helping someone stay in their home ? and potentially extending their life.?
Volunteer attorneys get a wide range of support when they take an involuntary discharge case, including mentoring, an involuntary discharge manual, periodic trainings and access to previous trainings on video.
?Pro bono attorneys aren?t stepping into a void,? Hurley said. ?Our program attorneys always make themselves available to our pro bono partners for mentorship and advice.?
Jackie Byrd, a private elder law lawyer, has handled four involuntary discharge cases pro bono through MVLS.
?Seniors need so much help. And, in the whole scheme of things, so little is available to many of them,? said Byrd, a partner with Byrd and Byrd LLC in Bowie. ?I can?t take every case offered by MVLS, but I try to take ones fairly close to me.
?I get wonderful support from MVLS and Legal Aid, and have talked at length to different folks there,? Byrd said. ?They encourage me, especially if I have a case very difficult to win ? a person smoking in a nursing home, for instance.
?I definitely would encourage others to help. There is so much work, they offer free training and they are always available to assist.?
LTCAP helps in other ways, as well. For example, the program works with the state to encourage more options for people who need long-term care to receive that care in the community, not in a nursing home.
?We?re working with the Maryland Department of Health and Mental Hygiene as Maryland moves folks from nursing homes to community-based settings with funding from the Affordable Care Act,? said Jennifer Goldberg, Legal Aid?s assistant director of advocacy for elder law and health care.
?Maryland is receiving $106 million over the next three years to rebalance from nursing homes to communities,? Goldberg said. ?So many people want to get help at home and not move to a nursing home, and this rebalancing will go a long way toward making that dream a reality.?
For more information on pro bono opportunities or to volunteer, call MVLS deputy director Richard Chambers at (443) 451-4064.
Joe Surkiewicz is the director of communications at Maryland Legal Aid. His e-mail is jsurkiewicz@mdlab.org.
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