Articles Tagged with manhattan elder law

The New York Assembly health committee recently held the first of two meetings on a proposed legislation that would allow some terminally-ill individuals with less than six-months to live the option to use medication to die in their sleep in cases where their suffering is unbearable. The committee members heard testimony from a variety of individuals including patients and their families, health care providers, legal experts, medical ethicists and religious leaders.

The committee’s exploration comes in the wake of a ruling by the New York Court of Appeals last year that ruled against three terminally-ill patients asserting they had a Constitutional right to die under their own conditions. The petitioners asked the Court of Appeals to shield their doctors from criminal charges in cases where physicians prescribe patients a lethal medication to end their lives.

New York’s Medical Aid in Dying Act, sponsored by Assemblywoman Amy Paulin and Sen. Diane Savino, would permit terminally-ill patients deemed mentally fit to end their lives by using medication provided to them by a physician. Proponents of the law assert that doctor-assisted dying is oftentimes the only alternative to a long and agonizing death, during which the patient may experience complete loss of their bodily functions and mental faculties.

A recent report by Fidelity Investments indicates that couple’s may need to put away even more in their retirement over the coming years to cover the cost of their health care. According to the report, a married couple retiring this year at the ages of 65-years old would need a staggering $280,000 saved away to pay for the cost of their health care over the remainder of their lives, a 2 percent increase over the previous year and a 75 percent increase from Fidelity’s first estimate of retirement health care costs in 2002.

Fidelity estimates that on average, men will need a total of $133,000 for healthcare expenses in retirement, while a woman would need about $147,000 because of their longer life expectancies on average. The company’s estimates are based on calculations that may shift due to fluctuations in the economy as well as changes in how the federal and state governments regulate the healthcare market.

“Despite this year’s estimate remaining relatively flat, covering health care costs remains one of the most significant, yet unpredictable, aspects of retirement planning,” said Shams Talib, executive vice president and head of Fidelity Benefits Consulting. “It’s important for individuals to educate themselves and take steps while working to ensure they are prepared to address these costs. Otherwise, people risk having to dip into more of their savings than originally anticipated, potentially impacting their overall retirement lifestyle.”

If you have a beloved elder who currently needs or will eventually need long term, in-home health care, you need to know about new changes to federal labor laws that may not only raise the cost of these services but potentially alter quality aspects. In addition to federal labor and wage laws, state and even local laws may impact what you pay for in home health care and who provides it.

When a person suffers from dementia, alzheimer’s, or or another cognitive health condition, he or she will likely need the aid of a home health care aide to provide even the most basic of care needs. For many years, home health care providers who also lived in the patient’s home were subject to different portions of the federal Fair Labor Standards Act (FLSA) which made them exempt from overtime and would essentially earn less than minimum wage because the individual was expected to be on call even during the evening.

However, a recent legal decision determined these in-home health care workers were not overtime exempt and must be paid one and a half times their average hourly wage when working more than 40-hours per week. This meant that it became economically feasible for many families to maintain constant care to their loved one from a familiar person that could be counted on to provide attentive, individualized service to the patient.

Retirement is a time to relax and enjoy the things you have worked hard for all of your life. For many people, that means spending more time at the golf course or spoiling grandchildren. For others, it means adventure and traveling to places they have always wanted to go. In many cases, a person or couple’s objectives in retirement can best be met by retiring abroad. Whether you are doing so for the cost of living, to be closer to family, or just because you want to there are important considerations to keep in mind when it comes to your comprehensive estate plan.


No matter what country they live in, citizens of the United States are still required to pay taxes to Uncle Sam. If you maintain residence in a state, that state may also continue to impose taxes on you. While you would likely be paying those taxes if you remained in the United States, living abroad could also subject you to taxes in the host country. That means you may face issues of double taxation, and that can have a significant impact on the assets you retain within your estate.

The New York Department of Financial Services recently published a proposal to add a “best interest” standard to insurance regulations that imposes suitability requirements on annuity recommendations by producers and insurers in New York. The move comes soon after the National Association of Insurance Commissioners (NAIC) suitability working group issued its own proposed guidelines for best interest standards for the NAIC Model Suitability Regulation which seeks to create a national standard for insurance regulations.

The proposals would require that an annuity purchase and replacement recommendation not only be suitable but also be in the best interest of the consumer at the time the recommendation is made. The proposal defines “best interest” as “acting with reasonable diligence, care, skill and prudence in a manner that puts the interest of the consumer first and foremost” and does not necessarily mean the cheapest policy available.

Although the proposed NAIC models are only recommendations to state regulators overseeing their respective insurance markets, they are nonetheless important because many professional organizations rely on these private interest groups for guidance on how to conduct their business. New York is one of the majority of state that already have adopted laws requiring insurance producers to make “suitable” annuity purchase recommendations and require insurers to maintain supervision systems designed to ensure compliance with regulations.

The new tax laws taking effect in 2018 give both individuals and couples even more flexibility to plan for their estates and ensure the largest possible part of their estate goes to beneficiaries on a tax-free basis. While the changes will remain in effect until 2025, families should start formulating estate plans now in order to take the greatest advantage possible of the reforms and craft the best possible plan for the future.

The tax reform bills substantially increases the individual estate and gift tax exemption from $5.6 million to approximately $11.2 million and up to $22.4 million for a married couple. After December 31, 2025, the numbers will revert back to their 2017 numbers adjusted for inflation. However, law makes no changes to the 40 percent tax rate currently imposed on transfers in excess of the exemption amount.

With the new changes, wealthy individuals and couples should consider immediately making large gifts or create trusts to maximize their federal estate and gift tax exemptions. Having the ability for married couples to transfer up to $22.4 million can benefit multiple generations of family members and avoid any future additional wealth transfer taxes. Furthermore, those who have already expended their gift tax exemptions prior to the end of 2017 will now have an additional $11.2 million to work with.

Promising statistics recently came out early this year indicating the mortality rate for older Americans is down from 2015 to 2016, perhaps due in part to the greater access to healthcare our elders enjoy now that insurance companies cannot deny individuals with pre-existing conditions. For Americans age 75 to 84, the mortality rate improved by 2.3 percent between 2015 and 2016, or twice the rate of improvement seen between 2011 and 2016. The figures come from the Society of Actuaries and is based on data provided by the Centers for Disease Control.

Mortality also improved for those 85-years and older by 2.1 percent, which is more than three times the rate of improvement between 2011 and 2016, according to new analysis from the Society of Actuaries. However, Americans aged 25 to 34-years old saw their mortality rates increase by 10.5 percent in 2016 which represented the highest of all age brackets.

The Society of Actuaries believes the uptick in mortality rates for younger Americans is due to a spike in accidents and the nationwide opioid epidemic. According to the report, opioid deaths are up almost 25 percent across the country in 2016, which constituted the highest increase for any single type of death.

The White House recently announced it planned to scale back initiatives put in place by the previous administration to reduce wasteful spending created by the complexities of the country’s healthcare system. As a result, officials from the Center for Medicare and Medicaid Studies (CMS) said they will no longer be operation on an aggressive timeline put in to place which sought to link increases in Medicare payments based on the quality of care patients received from hospitals which received the funding.

The objective of the direction taken by the Obama administration was to overhaul the nation’s largest health care program by altering payments to doctors and hospitals so that these providers would be incentivized to reduce unnecessary services that can put a drain on resources. The hope was that doctors would coordinate patient care, resulting in lowering healthcare costs while still maintaining vital revenue streams from Medicare that providers rely upon to do business.

To reach that goal, officials announced back in 2015 that in just three-years, half of Medicare payments to hospitals would be tied to standards on patient quality of care. However, White House officials recently told some news outlets that the new administration would instead conduct a review of how well the plan did or did not work at achieving this goal. While the Trump administration is not likely to fully do away with the initiatives, it is unlikely the proposed timeline will remain in place.

A recent audit conducted by the Social Security Office of the Inspector General found that the program has failed to fully pay the overwhelming majority of surviving spouses entitled to receive survivor benefits in addition to the regular Social Security benefits. According to the report, the Social Security Administration shorted $131 million to over a combined 9,000 widows and widowers aged 70 and older, or about 82 percent of those eligible.

The issue stems from a provision passed in the Bipartisan Budget Act of 2015 which ended the so-called “file and suspend” strategy which activates one spouse’s monthly benefit and suspends the other’s in order to increase payments on the delayed account after the individual reaches 70-years old. The members of Congress who passed the bill did so under the assertion those types of provisions constitute loopholes that unfairly increase payments to married couples.

However, the law was never meant to impose restrictions on couples filing a restricted application for survivor benefits where beneficiaries elect to claim their survivor benefits and delay taking their own Social Security benefits until the age of 70. This allows the widow or widower to grow their own Social Security benefits by 8 percent annually up until he or she reaches the age of 70. For those who are aware of the opportunity and take advantage of it, the increased benefits can make a tremendous difference in quality of life.

When someone passes away, he or she typically designates an individual as the executor of the estate in a last will and testament. As the executor of the estate, that individual has tremendous responsibility to fulfill his or her duty to the deceased and carry out that person’s final wishes to distribute property as desired. Unless executors fully embrace their responsibility to act as the representative of an estate and gather all the necessary documentation, complications can arise that may delay what should otherwise be a relatively simple process.

One of the most important primary steps the executor of the estate will have to take is filling the estate with the appropriate probate court in New York State. The proper venue is in the probate court of the county where the deceased lived or intended to return to if he or she was away from their residence at the time of death. If the will is filed with the wrong probate court, the judge hearing the case will likely be forced to reject the will’s entrance to probate.

If the deceased had more than one home, the proper county would be the one where the individual primarily lived or intended to live before passing away. Often times, older people live out their final days in nursing homes or assisted living facilities in counties outside of where there home actually is. Again, the proper jurisdiction to file probate would be where the person lived or would have lived had he or she not been a resident at the nursing home or assisted living facility.

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