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Mind over Matters New Rules for Medi-Cal

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Mind over Matters New Rules for Medi-Cal
8 ry
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07 ire TION
20 A D T SEC
U
CB LLO
LA PU
Special Issue: Elder Law
October 2007 / $4
E A R N MCLE CR E D I T
New Rules for
Medi-Cal
Eligibility
page 35
Mind over
Matters
Los Angeles lawyer Sherrill Y. Tanibata
discusses the factors determining diminished
capacity among elders page 28
PLUS
Mediation and the Elderly page 12
Financial Elder Abuse page 19
Litigating Civil Elder Abuse page 42
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F E AT U R E S
28 Mind over Matters
BY SHERRILL Y. TANIBATA
The standard for capacity among elders varies according to the legal context
35 Care Package
BY JAMES A. BUSSE JR.
New state and federal rules are tightening the eligibility requirements for
Medi-Cal aid to pay for nursing home costs
Plus: Earn MCLE credit. MCLE Test No. 163 appears on page 37.
42 Crossing the Line
BY BRYAN CARNEY
Emerging case law suggests that a finding of elder abuse requires deliberate
disregard of a patient’s condition over an extended period of time
D E PA RT M E N T S
Los Angeles Lawyer
the magazine of
10 Barristers Tips
Default judgment—dying without a will
BY ELIZABETH A. NIXON
The Los Angeles County
Bar Association
October 2007
Volume 30, No. 7
COVER PHOTO: TOM KELLER
23 Practice Tips
Mandatory reporting requirements for
financial elder abuse
BY JAMES P. BESSOLO
12 Practice Tips
The challenges of mediating disputes
involving elders
52 Closing Argument
The science of eyewitness testimony
BY CAROLINE C. VINCENT
BY ALEX YUFIK
19 Practice Tips
Litigating financial elder abuse claims
49 Classifieds
BY JULIA L. BIRKEL, JOHN M. BYRNE, AND DR.
50 Index to Advertisers
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T
hey are among us. You can see them everywhere, with
more appearing every day. Some of us have joined
their ranks, while others of us are not far behind. As
their numbers swell, so will our challenges and responsibilities as lawyers. They are elders, and increasingly we will be
called upon to represent them and practice elder law.
Whether or not we now practice in the area of elder law, we are likely to be touched
by it. About one in every eight Americans is a person age 65 or older. The number
of persons in the United States age 65 and over will rise from 35 million in 2000 to
40 million in 2010, a 15 percent increase, and then to 55 million in 2020. As the
population ages, many of us will be affected in some way by the myriad of issues
that arise in elder law. Many of us have already helped our parents or other family
members face challenging decisions involving healthcare, structuring finances, estate
planning, long-term care, illness, and, perhaps, even an unfortunate case of elder abuse.
Now we will be doing the same for a growing number of clients.
The elder law arena does not have a specific location. There is no universal point
for all purposes at which elder law begins and other substantive law ends. Like some
other general categories of law, such as entertainment law, elder law is not codified
and instead draws from various areas of the law. There is no precise marker for all
purposes at which a client becomes an elder. Even the identifying word sometimes
changes from “elder” to “senior” to whatever other term that causes baby boomers
to cringe. In California there are specific laws, such as those relating to various types
of elder abuse, that apply at age 65 and older and use the specific term “elder.”
Other legal issues often discussed as part of elder law apply to all types of representation, such as the capacity to retain a lawyer in the first place or to prepare
estate planning documents such as a will, trust, and an Advance Health Care Directive; to participate in a mediation and enter into a settlement agreement; and to obtain
public benefits.
Issues involving elders are receiving much well deserved attention in the media.
The Los Angeles Times, for example, in 2005 tackled the topic of professional fiduciaries in a series titled Guardians for Profit. The newspaper also recently addressed
the financial abuse of elders in an article on “Con Artists’ Old Tricks.” Given that
an aging American population will have a substantial impact on the legal profession,
the Los Angeles Lawyer Editorial Board embraced a proposal to examine the field
of elder law in a special issue. Although our readers practice in many areas of law,
we thought all would benefit from gaining some familiarity regarding elder law.
In the past, the future was often viewed as an extraordinary opportunity. Now,
the future is frequently seen as threatening and perilous—and the prospect of aging
is too often regarded through the same lens. But even as we grow older, with proper
guidance and planning, the future can be a time of hope. As we increase our knowledge and broaden our practice experiences to help the enormous population of elders,
we can strive to ensure that our shared future is one with more hope and fewer perils. In doing so we will be helping our clients and enhancing our profession.
■
THE HOLMES LAW FIRM
626-432-7222 (Phone)
626-432-7223 (Fax)
1-800-FAIR-ADR (324-7237)
[email protected]
www.TheHolmesLawFirm.com
Also available through the
Amercian Arbitration Association
213.362.1900 or www.adr.org
8 Los Angeles Lawyer October 2007
Steven Hecht practices transactional business law with offices in Los Angeles and Sherman
Oaks. Jacqueline M. Real-Salas is a partner at Calleton, Merritt, De Francisco & Real-Salas, LLP,
where she specializes in estate planning, trust administration, probate, and elder law.
Gretchen D. Stockdale is an associate with Hill, Farrer & Burrill, LLP, where she practices civil
litigation. Hecht, Real-Salas, and Stockdale are coordinating editors of this special issue.
/
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barristers tips
BY ELIZABETH A. NIXON
Default Judgment—Dying without a Will
THE COBBLER’S CHILDREN WHO GO SHOELESS have something in 1) half the community property to her husband and the balance to
common with the families of attorneys who forsake estate planning. her children, and 2) one-third of her separate property to her husband
Younger attorneys with new families may think: “I don’t have enough and the balance equally to her children. Lack of planning may result
money or assets to have an estate worth planning for.” While the value in a default judgment contrary to what she would have wanted.
If her children are minors, the court will usually appoint their father
of an estate is an important element of estate tax planning, with the
estate tax exemption rate rising, critical tax planning is not always as the guardian over their inheritance. This may not be her desire if
necessary. In 2007, individuals may have an estate of $2 million the couple is separated or divorced, because it puts an ex-spouse in
control of finances. Another consideration arises if the children have
without incurring any federal estate tax.
A young lawyer may think he or she is a long way from having attained majority. If the children are over 18, their inheritance will
a million dollars, let alone two, but it is important to remember sev- pass directly and outright to them. Even in a nontaxable estate, this
eral elements that are often overlooked. First
is the home. The value of homes in Southern
California generally continues to rise. Second,
If a single person with no children dies, the state will default
life insurance payouts are included in the value
of an estate. Third, retirement benefit packages,
IRAs, and 401(k)s are all part of an estate.
to the following people: 1) parents, 2) siblings, and 3) nieces and
Even individuals who feel (perhaps understandably) that they are living paycheck to
paycheck can often discover equity in their
nephews. The law continues with additional alternate heirs, but
home of $500,000 or more, that they have as
much as $1 million in life insurance, and that
their law firm is helping them build a sizeable
even the beginning of the list can be enough to create problems.
401(k). Whether they feel rich or not, they
may have a taxable estate. What is more, with
an estate tax rate of nearly 50 percent, not plancould put large lump sums in the hands of 18-year-olds. For most parning can really hurt those left behind.
Aside from estate tax, what is the importance of estate planning ents, that is a situation certainly worth avoiding. To prevent it, a will
for young attorneys? Without a will or a trust, an individual permits or trust can establish a plan that distributes an inheritance in stages.
Aside from establishing heirs, a will should also designate guardians
the state to choose his or her heirs. An attorney’s job is to prevent
default judgments against clients, and thus when an attorney dies with- for minor children. If a parent fails to make this designation, the court
out a will or trust, he or she has done a poor job of self-representa- will. The court is required to make a determination based on the best
interests of the child, but parents are much more qualified to exertion. The court steps in and enters a default judgment.
If a single person with no children dies, the state will default to cise this judgment. The internal family struggles that can result as parthe following people: 1) parents, 2) siblings, and 3) nieces and ents, in-laws, grandparents, and siblings fight over who should be
nephews. The law continues with additional alternate heirs, but even appointed, serve only to deprive the children of a cohesive family unit.
the beginning of the list can be enough to create problems. Consider, Having already suffered the loss of parents, ensuring a safe family envifor example, a young, single, childless woman attorney who earns a ronment for minor children may be the most important element of
high salary at a law firm, which also provides life insurance based on estate planning. A final pragmatic point is that without a will, the court
her salary and contributes toward a 401(k). Like many, she has two can take two to three years to finalize a probate. With a trust, your
fathers. One is her biological father, with whom she has had little con- personally selected representative can wrap it up much faster, with
tact. Her second father is her stepfather, the man she calls her “real less expense and without exposing your personal affairs to the pubdad” because he raised her and will walk her down the aisle at her lic record.
There are many other default judgments that lurk within the
wedding. If this single attorney dies without either a will or trust, a
default judgment will be entered to award half her estate to her bio- Probate Code. Whether an attorney feels like a multimillionaire or
logical father and the other half to her mother. Therefore, even those not, the government may take an alternate view. The attorney who
who do not have enough wealth to warrant an estate plan but do have wisely counsels clients to avoid default judgments should also take
■
stepparents would be prudent to avoid the state’s default estate plan. steps to avoid default judgments regarding his or her estate.
Or take the example of a woman attorney who is married with
two children. The Probate Code’s default succession plan might not
Elizabeth A. Nixon is the founder of Nixon Law, a boutique estate planning firm
prove contrary to her wishes. If she dies without a will, the code directs
in Santa Monica and counsel to Pepperdine University.
10 Los Angeles Lawyer October 2007
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practice tips
BY CAROLINE C. VINCENT
The Challenges of Mediating Disputes Involving Elders
ELDERS COME TO THE MEDIATION TABLE in a wide range of civil and
probate disputes. In these cases, mediators and lawyers must keep several considerations in mind. While the term “elder” may be statutorily defined for some purposes as a person over 65 years of age,1 an
elder in the mediation context is simply an older adult who may be
demonstrating certain mental and physical debilities that naturally
occur with advancing age.
Elders have varying degrees of capacity to participate in the mediation process and make informed decisions affecting their financial
affairs and physical well being. They may have no impairment whatsoever and be able to competently make binding decisions concerning their affairs. Or, they may participate with a court-appointed conservatorship or an appointed agent pursuant to a power of attorney.
Elders may be capable of protecting their own interests but may
need support persons—such as relatives, caretakers, or professional
advisers—who can provide emotional support, serve as sounding
boards, and assist with special needs.
The mediator and counsel should be alert to the issue of whether
an elder party requires some form of legal or court-supervised representation. For example, while many aging parents with serious physical or mental impairments are cared for by their children, without
any form of legal representation an elder parent may lack the capacity, and children the requisite authority, to proceed on the elder’s behalf.
Maximizing the ability of an impaired person to participate and
helping the parties focus on the special needs of the elder is the special charge of the mediator in elder disputes.
The Los Angeles Superior Court routinely orders cases to mediation under the court-supervised mediation program that was established pursuant to Code of Civil Procedure Section 1775.5 as an alternative to judicial arbitration.2 The court’s ADR office administers a
pro bono panel of qualified mediators for civil cases through which
a mediator serves for three hours without charge and charges agreedupon hourly rates thereafter. Parties are always free to select their own
private mediator or one from the court’s party-pay panel.3 The court
adopted a special set of probate mediation rules for ordering contested
estate, trust, and conservatorship disputes to mediation, which
include a special private-pay probate mediation panel administered
by the court’s ADR office4 and the express power to order parties to
mediation on a repeated basis.5 However, since the recent California
appellate decision in Jeld-Wyn v. Superior Court, the probate court
has reportedly refrained from ordering participants to mediation
under its special rules, successfully encouraging the use of mediation
on a voluntary basis or referring participants to the court’s regular
pro bono mediation panel.6
California Rules of Court 3.850 et seq. set forth the minimum rules
of conduct for mediators who serve on panels in court-connected mediation programs. The rules are intended to guide the conduct of mediators in these programs, to inform and protect participants, and to
promote public confidence in the mediation process and the courts.7
The rules apply to attorney mediators on the court’s panels for either
12 Los Angeles Lawyer October 2007
general civil or probate cases.8 The rules are not applicable to retired
judges, but retired judge mediators are encouraged to follow them.9
Private mediators not serving through the court panels are not subject to the Rules of Court but are guided by the widely used standards
of practice for mediations upon which the Rules of Court are based.10
Counsel can expect good mediators to employ these rules and can insist
upon their implementation in appropriate circumstances. Mediator
conduct rules that are especially pertinent to elder cases include
those that involve the principles of voluntary participation, selfdetermination, and a procedurally fair and balanced process.
Capacity
Determining whether an elder who appears at a mediation session has
the legal capacity to enter into a settlement agreement raises several
interesting issues for the mediator and counsel. For example, consider
an action in which the elder is the intestate beneficiary of a son’s estate,
but a friend of the son is the designated beneficiary in a contested holographic will offered for probate. The attorney for the elder takes the
mediator aside and confidentially asks for help to assess whether the
attorney’s elder client has the requisite capacity to settle the matter.
Counsel is concerned because the client seems to be overly influenced
by a live-in caretaker, and the elder’s mind sometimes wanders.
Counsel questions whether the elder can make good decisions.11
What should the mediator do?
California Rules of Court 3.853 provides that “a mediator must
conduct the mediation in a manner that supports the principles of voluntary participation and self-determination by the parties.”12 The
mediator thus has an obligation to make sure that the elder party is
capable of participating. This obligation is bolstered by Rule
3.857(i)(2), which permits a mediator to terminate the mediation when
he or she believes that a participant is unable to participate meaningfully in negotiations.13 It is quite possible that the mediator and
a party’s counsel could determine that the elder party is capable of
participating meaningfully in the mediation, yet lack certainty that
the elder has the capacity to enter into a binding contract.14 Elders
may freely and fluently participate, artfully articulating their wants
and needs, all the while masking diminished mental functioning.
Whether or not a person has capacity depends upon many facts
and circumstances. An assessment by a geriatric psychiatrist or other
medical professional may be required. The court has the power to
determine the issue of legal mental capacity under Probate Code
Sections 810 through 813. A finding of lack of capacity requires evidence of one of the deficits in mental functions set forth in Probate
Code Section 811, and the particular deficit must correlate to the decision to be made.15
In particular, Probate Code Section 812 provides that:
Caroline C. Vincent, an attorney mediator and arbitrator with ADR Services,
Inc. in Los Angeles, specializes in probate, complex business, real estate, professional liability, employment, personal injury, and family business disputes.
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[A] person lacks the capacity to make
a decision unless the person has the
ability to communicate verbally, or by
any other means, the decision, and to
understand and appreciate, to the
extent relevant, all of the following:
(a) The rights, duties, and responsibilities created by, or affected by the
decision.
(b) The probable consequences for the
decision maker and, where appropriate, the persons affected by the decision.
(c) The significant risks, benefits, and
reasonable alternatives involved in the
decision.
The parties and their lawyers, not the
mediator, should make the threshold determination that the elder has the requisite
capacity to proceed. The mediator’s primary
role is as a facilitator to assist the participants
in jointly, or separately, determining that
issue. Mediator standards of conduct suggest that the mediator refrain from giving
legal advice or forming legal opinions.16 On
the other hand, if the mediator strongly suspects or reasonably believes that the elder
party cannot either meaningfully participate
or make a binding decision, the court rules
would suggest that the mediator terminate the
mediation.17
To begin to address the capacity issue,
the mediator may initiate a separate conversation with the elder client and the elder’s
counsel to help the participants obtain a sense
of the elder’s ability to comprehend the nature
of the proceedings, discuss the issues, and
make informed decisions about the subject
matter of the dispute. This assessment may
include a conversation with the elder’s livein caretaker and the elder about how they customarily interact. Many times, other support
persons can assist in the decision-making
process.
If the mediator (or attorney and elder)
feels that the elder is capable of meaningfully participating in the process, but there is
still an issue of capacity, the next step is to
consider whether the other party needs to
be advised that there is an issue as to the
elder’s ability to enter into a binding contract. The mediator should encourage disclosure to the other party because of Rule of
Court 3.857(b), which requires that the mediation process be conducted in a procedurally
fair manner. “Procedural fairness” means a
balanced process in which each party is given
an opportunity to participate and make uncoerced decisions.18 Proceeding without informing the other party could cause harm to the
other party, who might later find out that the
settlement agreement obtained through arduous negotiations was unenforceable. Rule
857(i)(3) provides that a mediator may ter14 Los Angeles Lawyer October 2007
minate the mediation when the mediator suspects that continuation of the process would
cause significant harm to any participant or
third party.19
Whether the mediator raises the issue of
capacity in the presence of the elder or in a
sidebar with both counsel is an issue of discretion. If either or both counsel agree that the
elder party has the requisite capacity to make
a binding decision, then a writing should be
created to memorialize that fact. This could
be as simple as a statement of agreement that
all parties have assessed the elder’s capacity
to enter into the settlement agreement. If this
conclusion was based upon observations,
counsel may record their observations in a
separate memorandum that could be lodged
in the file or presented to the court for a
determination of capacity or for court
approval of the settlement agreement.
The documented assessment of capacity
protects the interests of all parties, because it
helps preclude a party from alleging that the
elder party’s lack of capacity is a ground for
nullification of the mediated agreement. It is
important that the written capacity assessment
contain an express agreement making it
admissible. Evidence Code Section 1122(a)(1)
provides that a written document (such as the
capacity assessment) prepared during the
course of a mediation is admissible if an
express written agreement to admit it is signed
by all mediation participants, including the
mediator. Otherwise, the provisions of Evidence Code Sections 1115 et seq. make mediation communications, including writings
made in the course of mediation, inadmissible. Alternatively, the capacity assessment
could be contained in the settlement agreement itself and made admissible by Evidence
Code Section 1123, if the settlement agreement is made expressly admissible by its
terms or contains words to the effect that it
is binding or enforceable.
A lawyer who believes the elder client
lacks the requisite capacity to enter into a settlement agreement should take measures that
may include seeking appointment of a
guardian ad litem20 or conservator or creation
of a special needs trust.21 The lawyer should
be mindful that the client’s consent to these
steps may be needed, lest the lawyer violate
the ethical rules prohibiting the divulgence of
client secrets.22
Participants and Process
Considerations
When the representative, a conservator, or the
agent under a power of attorney attends the
mediation, the lawyers and the mediator
should assess whether the represented party
elder has sufficient knowledge, interests, or
understanding of the situation that he or she
should also attend. New Probate Code Section
2113 requires a conservator to “accommodate
the desires of the conservatee, except to the
extent that doing so would violate the conservator’s fiduciary duties to the conservatee
or impose an unreasonable expense on the
conservatorship estate.” This suggests that the
conservatee, as well as the conservator, should
be at the mediation when the conservatee is
capable of providing input to the process. In
these situations, the mediator should be aware
of the inherent tension between the expressed
wants of the conservatee elder and the conservatee’s needs or best interests, which the
conservator must consider in making a decision on behalf of the conservatee. A mediator can often facilitate a dialogue between
conservator and conservatee that provides
meaningful participation by the elder.
Other support persons—such as a relative,
significant other, or financial advisor—may
need to be present to assist the elder. And,
prior to convening a joint session, the mediator should assess whether a joint session is
desirable. In abuse cases, putting the alleged
abuser into the same room with the alleged
victim-elder can create or exacerbate feelings of discomfort and vulnerability.
Lawyers who are overprotective of their
clients present a challenge to the mediator
when they make it difficult for the mediator
to interact with the client. In the case of an
elder who is claiming abuse under the Elder
Abuse Act,23 the elder’s special vulnerability
does not render the elder incapable of making good decisions or participating in a mediation. While the lawyer may use his or her
legal judgment to assist the elder in making
an informed choice, the attorney must respect
the client’s right to make informed decisions;
the final settlement terms are within the control of the client.24
Does the mediator have an obligation to
insist on speaking with the client or abort the
process if the mediator cannot speak with the
client? The mediation conduct rules regarding voluntary participation and self-determination25 would so dictate. The mediator
can ensure compliance with this rule of conduct by announcing at the beginning of the
process that the mediator will be speaking
with the parties as well as their counsel.
The Elder Abuse Act provides that certain
defined persons, or mandated reporters, must
report instances of elder abuse to the appropriate authorities. A mandated reporter is
“any person who has assumed full or intermittent responsibility for the care or custody
of an elder or dependent adult, whether or not
he or she receives compensation, including
administrators, supervisors, and any licensed
staff of a public or private facility that provides care or services for elder or dependent
adults, or any elder or dependent adult care
custodian, health practitioner, clergy member,
VICE CHANCELLOR, LEGAL AFFAIRS, UCLA AND
ASSOCIATE GENERAL COUNSEL
The University of California, Los Angeles and the Office of the General Counsel of The Regents of the
University of California invite inquiries, applications and nominations for the position of Vice Chancellor,
Legal Affairs, UCLA and Associate General Counsel.
This position reports jointly to the UCLA Chancellor and to the General Counsel of the University of
California, and is a member of the University’s Office of General Counsel. The Vice Chancellor, Legal Affairs
and Associate General Counsel is chief legal counsel at UCLA and heads UCLA’s Office of Legal Affairs. He/she
provides legal counsel to the UCLA Chancellor, as well as legal services to academic and administrative units at
UCLA. He/she also advises the General Counsel for the University on the legal trends and needs of the UCLA
campus and assists the General Counsel in advocating and representing the interests of The Regents, the
governing board of the University.
The Vice Chancellor, Legal Affairs and Associate General Counsel also oversees the campus Sexual Harassment
Prevention Office and the Ombuds Office at UCLA. In addition to his/her lawyering and management
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collaboratively with – and serving as advisor and counselor to—the Chancellor and Executive Vice Chancellor/
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UCLA is an affirmative action/equal opportunity employer with a strong institutional commitment to the
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There is no substitute for experience.
■
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Over 1,200 Successful Mediations
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LEE JAY BERMAN, Mediator
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BUSINESS VALUATION • LOSS OF GOODWILL • ECONOMIC DAMAGES • LOST PROFITS
16 Los Angeles Lawyer October 2007
or employee of a county adult protective services agency or a local law enforcement
agency….”26
There is no indication that a mediator is
required to report, but a party who is a mandated reporter would be required to report if
he or she learns facts of abuse during the
mediation. Even though mediation communications and writings prepared for mediations are inadmissible in a subsequent adversarial proceeding, facts that are discoverable
independent of the mediation are not rendered
inadmissible solely because of their introduction at the mediation.27
The mediator and counsel should be aware
that confidentiality provisions in settlement
agreements in which there is evidence of elder
abuse under the Elder Abuse Act are generally not enforceable, except to the extent of
prohibiting disclosure of the monetary
amount of the settlement.28
The Needs and Interests of the Elder
A common elder mediation dispute involves
the proper care of an elder and management
of the elder’s assets. This might arise under a
trust or power of attorney, contested estate
planning documents recently changed by an
elder’s child, or a contest for appointment of
conservator. For example, one sister may
charge that an in-home care situation is insufficient for her mother who has declining mental functioning and mobility and that another
sister who possesses the power of attorney
over the mother’s assets is unnecessarily
spending money on home improvements and
expensive 24-hour individual nursing care.
Communications break down as demands
are made and responses stop coming. The
mediation briefs are filled with incendiary
allegations of improper care, breach of fiduciary duty, failure to account, and the like.
The mediator has an opportunity to
address the relationship between the sisters
and refocus the discussion, reminding them
that their mother is still alive with ample
financial means for her care, as well as two
daughters to look after her. Refocusing the dispute into a problem-solving session, the mediator can help the parties find common ground
by agreeing that the care of the elder is their
common goal, and identifying the underlying
needs and interests of all concerned. This
focuses the dialogue on what the sisters can
accomplish collaboratively. A joint care and
financial management plan might be
arranged, with a method to ensure future
communications. Often a family member,
such as another sibling, a cousin, niece, or
nephew is the natural peacemaker and can be
appointed to serve as mediator.
A powerful mediation technique in family disputes involves the use of acknowledgements and thank yous. In this sibling
dispute, the mediator can coach each sister in
a private caucus to tell the other that she
appreciates the efforts and contributions
made. The parties may balk at this, but coaching them is the right strategy, because the
making of the statement to the other, whether
heartfelt or not, almost always breaks the
ice, if not melts it completely. The shift in
energy in the room is usually palpable. The
mediator uses the acknowledgement to build
a series of agreements, keeping the parties
focused on the interests of the elder and creating the opportunity for the sisters to rebuild
their fractured relationship around their common cause. The repair of their relationship
alone can be sold as a powerful dose of medicine for the elder, whether known by the
elder or not.
Another powerful technique in family
squabbles is the nonadmission apology. The
mediator coaches each party to say to the
other, “I’m sorry if any of my actions in managing our mother’s monies caused you concern, but my intentions were good, and I am
here at this mediation to help resolve our
differences.” Said directly to each other, or
conveyed by the mediator, statements such as
this often soften the parties and break
impasses.
Mediators and lawyers will benefit from
awareness of a variety of special issues applicable to elders. These include assuring maximum participation of the elder, addressing and
documenting capacity issues, dealing with
confidentiality and reporting issues for disputes under the Elder Abuse Act, and employing collaborative problem solving techniques
to aid the parties in addressing the needs and
interests of impaired elders.
■
Seeking an Experienced
Arbitrator/Mediator?
HONORABLE
LAWRENCE W. CRISPO
(RETIRED)
STEVEN
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COUNSELOR AT LAW • SINCE 1974
Resolving matters involving:
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Wrongful Death, Nursing
Home & Hospital Abuse.
323.933.6833 TELEPHONE
Mediator
Arbitrator
[email protected] E-MAIL
4929 WILSHIRE BOULEVARD, SUITE 740
LOS ANGELES, CALIFORNIA 90010
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213-926-6665
www.judgecrispo.com
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Prepare and File Articles
1 For
example, under the Elder Abuse and Dependent
Adult Civil Protection Act, W EL . & I NST . C ODE
§§15600 et seq., elders are defined as persons over 65
years of age. Id. at §15610.27.
2 CAL. R. OF CT. 3.871, 3871(a).
3 See ADR processes: How Much Does It Cost?, available at http://www.lasuperiorcourt.org/courtrules.
4 L.A. SUP. CT. R. 10.200 et seq.
5 L.A. SUP. CT. R. 10.205, 10.208.
6 Jeld-Wyn v. Superior Court, 146 Cal. App. 4th 536
(2007). In Jeld-Wyn, the court held that a case management order requiring parties in complex cases to
attend and pay for mediation was not authorized
because it was not encompassed by the statutory
scheme set forth in CODE CIV. PROC. §§1775 et seq. and
the accompanying Judicial Council rules.
7 CAL. R. OF CT. 3.850(a).
8 CAL. R. OF CT. 3.851(a); L.A. SUP. CT. R. 10.209(b).
9 CAL. R. OF CT. 3.851(d) and Advisory Committee
comment thereto.
10 See Standards of Practice, available at http://www
.cdrc.net (a set of guidelines published by the California
Dispute Resolution Council (CDRC) based upon a
collaborative effort of major California dispute resolution providers and mediators); Model Standards of
Conduct for Mediators, available at http://www.aba.org
(a set of guidelines jointly developed by the American
Arbitration Association, the American Bar Association
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Section of Dispute Resolution, and the Society of
Professionals in Dispute Resolution).
11 Counsel for the elder may be breaching the ethical
obligation to keep secrets of the client confidential. In
practice counsel often confidentially seek the mediator’s
assistance in helping resolve internal issues with the
client. See discussion at n.22 infra. The capacity issue
could be raised as well by opposing counsel or by the
mediator during the course of the mediation.
12 CAL. R. OF CT 3.853(1) and (2) specifically provide
that a mediator must inform the parties that any resolution will be by voluntary agreement of the parties
and must respect the right of each participant to decide
the extent of his or her participation in the mediation, including the right to withdraw.
13 See also CAL. R. OF CT. 3.852(3) and (4). A “participant” includes a party as well as a lawyer for a party.
CAL. R. OF CT. 3.852(3).
14 See also PROB. CODE §2113 and discussion in text
infra about including the wishes of conservatees in
decisions affecting them.
15 PROB. CODE §811.
16 A mediator should refrain from giving legal advice
or legal opinions, although weighing in and assisting
the parties in determination would be part of the facilitation role. See CDRC Standard 3, available at
www.cdrc.net. See also CAL. R. OF CT. 3.856(d) (“A
mediator must decline to serve or withdraw from the
mediation if the mediator determines that he or she does
not have the level of skill, knowledge, or ability necessary to conduct the mediation effectively.”).
17 CAL. R. OF CT. 3.857(i)(2).
18 CAL. R. OF CT. 3.857(b).
19 See also CDRC Standard 3, available at
www.cdrc.net (“If a Mediator believes that the continuation of the process would harm any participant or
a third party (such as children in a marital dissolution
matter), or that the integrity of the process has been
compromised, then the Mediator shall inform the parties and shall discontinue the mediation, without violating the obligation of confidentiality.”)
20 PROB. CODE §1003(a)(2).
21 PROB. CODE §3604. Note that a lawyer does not have
authority to act on behalf of someone who lacks capacity. Sullivan v. Dunne, 198 Cal. 183 (1926).
22 See State Bar Formal Opinion No. 1989-112 (1989)
(providing that it is unethical for an attorney to institute conservatorship proceedings contrary to the wishes
of the client because to do so would be to reveal client
secrets, including observation of the behavior of the
client leading to the lawyer’s conclusion of incapacity;
withdrawal may be necessary). For a contrary result,
see ABA MODEL RULES OF PROF’L CONDUCT R. 1.14
(providing that a lawyer may seek a guardian, conservator, or take protective action when the lawyer
believes that the client cannot adequately act in his or
her own interest, but the lawyer must be careful in
divulging only the observation of the client’s incapacity).
23 Elder Abuse and Dependent Adult Civil Protection
Act, WEL. & INST. CODE §§15600 et seq.
24 Decisions affecting client’s substantive rights must be
made by the client. See Blanton v. Womancare, Inc., 38
Cal. 3d 396, 403-05 (1985); Steward v. Preston
Pipeline, Inc., 134 Cal. App. 4th 1565, 1581-82 (2005).
See also ABA MODEL RULES OF PROF’L CONDUCT R.
1.2(a).
25 CAL. R. OF CT. 853.
26 WEL. & INST. CODE §15630(a).
27 See EVID. CODE §1120(a); Rojas v. Superior Court,
33 Cal. 4th 407 (2004).
28 CODE CIV. PROC. 2017.310. If there is evidence of
elder abuse under the Elder Abuse Act, a confidentiality
provision could still be enforceable if the information
is privileged or there is a showing of a substantial
probability of prejudice. Id.
practice tips
BY JULIA L. BIRKEL, JOHN M. BYRNE, AND DR. SUSAN I. BERNATZ
Litigating Financial Elder Abuse Claims
UPON TURNING 65 YEARS OLD, a resident of California qualifies for
the dubious honor of becoming one of the more than 200,000 victims of financial elder abuse each year,1 no matter whether that 65year-old is suffering from dementia or other mental or physical infirmities. Statistics indicate that people over 65 are more heavily targeted
by would-be financial predators. In fact, over 70 percent of people
over the age of 50 have been approached fraudulently, with no less
than $3.8 billion lost by seniors to financial scams.2
As the California Legislature has recognized, “elder and dependent adult abuse is…indiscriminate…and factors such as one’s socioeconomic status, gender, race, ethnicity, educational background and
geographic location do not provide an impregnable barrier against
its broad, horrible reach.”3 Financial abuse is estimated to account
for 40 percent of all forms of reported abuse against seniors.4 The statistics become more alarming when one considers estimates that as
few as one in five elder abuse cases of any type is reported5 and only
one in 25 incidents of financial elder abuse is reported.6
California’s elderly population is substantial and growing.7 In
response to rising levels of crime against elderly persons and the
underreporting of such crimes, the California Legislature has, over
the last 17 years, repeatedly strengthened statutes to protect the
elderly from self-serving relatives and cunning salespeople. One such
law is California’s financial elder abuse statute, Welfare and Institutions
Code Section 15610.30.
The phrase “financial elder abuse” underscores its seriousness, yet
the phrase remains misunderstood. To many people, the term “abuse”
equates with physical abuse. Moreover, California’s financial elder
abuse law does not raise the issue of mental or physical capacity. If
you are 65 or older and incur financial loss due to fraud or other bad
faith conduct, you are the victim of financial elder abuse. You or someone acting on your behalf may bring a claim under Section 15610.30.
Jurors and even judges (particularly since these cases do not necessarily get tried in Probate Court, where judges are more familiar with
elder law) may not recognize the abuse element and lose sight of the
wrongfulness of the taking.
To properly present a case, it is helpful to be knowledgeable
about the background of California’s financial elder abuse statutes
and to understand the procedures and issues common to litigating a
financial elder abuse case, including the use of expert testimony.
Financial elder abuse also interplays with issues of competence,
capacity, and undue influence. By understanding the nature of a
financial elder abuse claim, more attorneys will be able to properly
identify cases of elder abuse when dealing with elderly clients and
become empowered to advocate on their behalf.
Definition
Financial elder abuse occurs when a person or entity takes, secretes,
appropriates, or retains (or assists in taking, secreting, appropriating,
or retaining) “real or personal property of an elder or dependent adult
to a wrongful use or with the intent to defraud, or both.”8 It covers
any appropriation or retention of property made in bad faith.9 If the
party knew or should have known that the elder had a right to possess the property, he or she will be deemed to have acted in bad faith.10
The financial elder abuse statute is relatively new. Unlike other statutory protections benefiting the elderly, such as provisions regarding
capacity and undue influence in the creation of wills or the intervivos
transfers that are found in the Probate and Civil Codes, the financial
elder abuse statute was designed for the protection of the elderly
regardless of capacity. In creating the statute, the legislature acknowledged the special vulnerability of elders to financial predators.
In its inception in 1994, the financial elder abuse statute imposed
liability only on those who stood in a fiduciary relationship to an
elderly person. Labeling the violation “fiduciary abuse,” the original
law made it a violation for anyone standing in a position of trust with
an elder to take or appropriate money or property for any use outside the purpose for which the money or property had been entrusted.11
The legislative intent behind the statute was to improve the reporting and processing of elder abuse claims and to encourage attorneys
to take elder abuse cases. According to the Assembly Floor Bill
Analysis, statistics in 1994 indicated that only one in 14 incidents of
elder abuse were reported, amounting to half a million instances of
abuse going unreported each year.
Three years later, the legislature expanded the statute to allow
recovery of attorney’s fees in an effort to encourage more attorneys
to take on financial elder abuse cases. It also expanded the definition
of fiduciary abuse to include any person who takes advantage of the
elderly and refuses without good faith to disgorge the property.12 The
following year, the statute was broadened again and redefined as financial abuse. The legislature focused on financial crimes as a general category of harm faced by elders.13 The 1998 amendment made the first
attempt to inject the intent required to constitute financial abuse, stating that financial abuse occurred wherever a person in a position of
trust took the money or property of an elder with the intent to
defraud.
Additionally, mandatory reporting was expanded under the 1998
law to include instances of financial exploitation, and minimum
standards of investigation were established. The legislature expressed
a strong need for these revisions, identifying a sharp increase in incidents of elder abuse since the late 1980s.14 According to the legislature, financial abuse was a factor in roughly a third of cases of elder
abuse and was more commonly experienced than either physical or
mental abuse among the elderly population.15
The current version of the statute was adopted in 2000 as part of
a bill sponsored by California Advocates for Nursing Home Reform,
Julia L. Birkel is a partner with Hill, Farrer & Burrill, LLP, whose litigation practice includes probate disputes. John M. Byrne is also a partner with the firm
and specializes in trusts and estates. Dr. Susan I. Bernatz is a forensic neuropsychologist and a member of the Los Angeles County Elder Abuse Forensic
Center at County/USC Medical Center.
Los Angeles Lawyer October 2007 19
which asserted that the then-existing and
proposed laws did not “sufficiently address
the daily financial abuse problems faced by
the elderly.”16 The Assembly Floor Analysis
heralded the bill as “a comprehensive
approach to address the problems of financial abuse and misrepresentation directed
against seniors.” The analysis continued:
California seniors are losing millions
of dollars by purchasing unnecessary
financial products from [persons] who
have a financial stake in the sale.
Current statutes designed to protect
seniors are weak and ambiguous and
need to be strengthened. This bill’s
multifaceted approach will combat
elder abuse through strengthening protections and assisting in the prosecution
of perpetrators.17
The 2000 amendment strengthened the
definition of financial elder abuse by providing that financial abuse occurs wherever
a perpetrator “takes, secretes, appropriates,
or retains real or personal property of an
elder” to a wrongful use or with intent to
defraud or assists in the taking, secreting,
appropriating, or retaining of such property.18 Again, a use is wrongful if conducted
in bad faith—that is, if a person or entity
knew or should have known that the elder
had a right to have the property transferred
or made readily available, and it is obvious
to a reasonable person that the elder maintained that right.19 The amendment loosened
the intent requirement. It is not necessary
under the present statute that the taker maintain an intent to defraud; rather, a person is
guilty of committing financial elder abuse so
long as it would be obvious to a reasonable
person that the taker is not entitled to the
elder’s assets.20
Capacity Not an Issue
The legislature has recognized the special
vulnerability of elders regardless of capacity
and has created a statute that applies to any
affected elder, while acknowledging that elders
with developmental disabilities, mental or
verbal limitations, or in poor health are more
at risk.21 The statute is still evolving. For
example, one bill will provide a right of
attachment in cases involving financial elder
abuse.22 Recently passed by both houses and
signed by the governor, this modification will
incentivize attorneys to handle financial abuse
cases. Presently, one of the difficulties facing
an attorney deciding whether to take a case
is collecting from the perpetrators, who are
often wasteful or irresponsible with the assets
they take. Allowing for attachment would
provide a more promising outlet for recovery
and encourage efforts to recoup funds wrongfully taken from the elderly.
In addition to still being in evolution, the
20 Los Angeles Lawyer October 2007
statutory scheme is of recent creation, and
there is a lack of case law interpreting what
constitutes financial elder abuse. Most elder
abuse cases have not reached an appellate
level and are therefore usually not reported.23
The dearth of case law is also explained by
the fact that most financial elder abuse cases
never make it to court. The elderly are not
often in a financial position to pay for litigation or may not want to disrupt their relationships with their caretakers. Often, an
elder simply does not know that he or she has
a case.24
In dealing with elderly clients, it is important to have a good understanding of the relevant documents and donative intentions.
Moreover, to properly investigate a financial
elder abuse claim, it is important to meet the
elder separately from other family members
to ascertain whether the elder truly consents
to the intervivos transfer, modifications to
testamentary documents, or other affairs
affecting the estate. For example, two different
elderly women may seek to transfer ownership of their houses to their adult children.
One sees this as a potential tax break for
herself or her family, while the other has
been led to believe by her daughter that she
would be better off living in a small apartment
and selling the house at a below-market rate.
The transfers may be the same, but in the latter case undue influence may have a role.
Some incidents will be clear-cut cases of abuse
(a son changes the locks on a house while his
aged father is hospitalized, or a daughter
trustee of her mother’s life estate does not provide enough money for her mother’s monthly
upkeep). An attorney with elderly clients
must be alert to the distinctions that turn
simple transactions into situations of abuse.
Under Section 15610.30, financial abuse
of an elder occurs when someone obtains
property of an elder for a wrongful use or
with intent to defraud. The legislature recognized that old age by itself renders people
vulnerable to financial abuse, irrespective of
whether they are legally mentally sound.25 In
addition, Probate Code Section 850 allows a
personal representative to bring a case on
behalf of a decedent holding a claim to real
or personal property that is possessed or held
in title by another. By utilizing Section 850,
a personal representative may make a claim
of undue influence on behalf of a decedent
under Civil Code Section 1575, which defines
undue influencing as: 1) the use, by one in
whom a confidence is reposed by another, or
who holds a real or apparent authority over
him or her, of such confidence or authority for
the purpose of obtaining an unfair advantage,
2) taking an unfair advantage of another’s
weakness of mind—i.e., the elder lacked the
mental vigor to protect against impositions,26
or 3) taking a grossly oppressive and unfair
advantage of another’s necessities or distress.27 Undue influence occurs when people use their role and power to exploit the
trust, dependency, or fear of others. They
use this power to gain control over the weaker
decision-making abilities of another person.28
Case law is more developed in the area of
undue influence than with elder abuse. Like
Section 15610.30, undue influence under
Section 1575 does not require a showing of
mental incapacity. A grantor can be of sound
mind and considered legally mentally competent yet still be subject to undue influence.29 Indeed, the concept of sound mind,
typical to an inquiry regarding testamentary
instruments, is not essential in determining
whether an intervivos transfer is invalid.30
Because of the similarity of rights under
the undue influence and financial elder abuse
statutes, there will often be an overlap in
factual circumstance leading to two separate
claims. This presents interesting procedural
challenges. The undue influence claim under
Civil Code Section 1575 is asserted as part of
a petition brought under Probate Code
Section 850, typically accompanied by an
effort to seek damages under Probate Code
Section 859. This cause of action is equitable and will be tried by the court.
On the other hand, the financial elder
abuse cause of action, which is outside the
Probate Code, is triable by a jury. There will
likely be two simultaneous trials if the facts
significantly overlap—one before the court
and the other before the jury. Generally, the
court first resolves the equitable issues.31
Procedurally, the trial court may try the equitable issues first, without a jury. The court
may, in this phase, dispose of the legal issues
so that nothing further remains to be tried by
a jury.32 Or, alternatively, the court may
choose to have an advisory jury.33 The court
is also within its discretion to wait to rule on
the equitable issues until after the jury’s decision, either guided by special verdict findings
or not. The trial court has great discretion to
set the procedures.
One significant difference between pursuing financial elder abuse claims and causes
of action for undue influence is that in financial elder abuse litigation, the burden of proof
rests on the petitioner. In undue influence
cases, however, if the respondent is in a “confidential relationship” with the victim, the
burden of proof shifts. The respondent who
holds a confidential relationship will be presumed to have taken undue advantage of the
victim’s trust, unless the victim had independent advice and acted of his or her own volition and with full comprehension of the
results of his or her action.34 This shows the
importance of conducting pretrial discovery
directed to what the elder knew, what other
advisers he or she had, and whether the per-
petrator sought or suggested independent
advice for the elder.
This more easily met burden makes undue
influence a significant factor for an attorney
to consider. A confidential relationship can be
established with or without a technical fiduciary relationship, although a fiduciary is
most certainly considered to be in a confidential relationship. Both exist whenever
trust and confidence is reposed by one person
in the integrity and fidelity of another.35 A
confidential relationship is found when one
party gains the confidence of the other and
purports to act or advise with the other’s
interest in mind.36 Typically, when a stranger
abuses a confidential relationship with an
elder, he or she does so in a deliberate, predatory fashion. In contrast, a family member
tends to be more opportunistic, for example
taking funds “just once,” discovering no one
is watching, and then taking more. This family member may argue that he or she “would
have been there” for the elderly person if
need arose. However, the spending patterns
of the person committing financial abuse
generally belie that argument.
Elder Law & Nursing Home
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2) Financial Abuse (Real Estate, Theft, Undue Influence)
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Presumptive Disqualification
Recent case law has made a caretaker a prima
facie suspect if he or she becomes the beneficiary of a testamentary instrument, and the
scope of who is considered a caretaker is
being expanded. Care custodians are presumptively disqualified from receiving testamentary transfers,37 and this includes longtime friends who assume a healthcare role.38
Under these conditions, in which courts and
juries may be sympathetic to a wrongdoer for
having performed at least some minimal care,
expert testimony can substantiate a financial elder abuse claim. The requirements for
expert testimony are that it relate to a subject
sufficiently beyond common experience so as
to assist the trier of fact, and that it be based
on matter that is reasonably relied upon by
an expert in forming an opinion on the subject to which his or her testimony relates.39
An expert can explain the particular vulnerabilities of the victim with a depth outside the
normal experience of a lay person.40 For
example, while everyone is influenced and
persuaded in various ways, vulnerability to
influence varies. The elderly are, under the
financial elder abuse statutes, presumed to fall
into a vulnerable category. Some of the factors that contribute to their vulnerabilities
include mental and physical infirmities, dependence on others for help with finances and
daily needs, loss of a spouse, lack of financial
sophistication, and isolation. These factors
underscore why, typically, the person who
takes advantage is a family member or caretaker. An expert witness is critical to explaining how a seemingly competent and self-suf-
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Los Angeles Lawyer October 2007 21
ficient elder can nonetheless get fleeced by a
son or daughter, salesperson, or neighbor.
California courts have deemed such an opinion “virtually indispensable” to understanding the relationship between the facts and
the results.41
As the population of elderly Californians
continues to grow, financial elder abuse is an
increasing concern. Knowing how to recognize
financial elder abuse requires an understanding that anyone over the age of 65 can be the
target of abuse. Situations of abuse may not
always be readily apparent, and a good attorney will investigate any transaction affecting
the financial affairs of an elderly client.
Moreover, as the legislature continues to
improve upon the recovery avenues available
in financial elder abuse cases, such as through
attachment or reimbursement of attorney’s
fees, the likelihood of a positive outcome in
any financial abuse case should improve dramatically and encourage more attorneys to
come to the aid of elderly clients.
■
1 See Elder Financial Abuse Task Team Report to the
California Commission on Aging, available at
http://ccoa.ca.gov/pdf/Elder_Financial_Abuse.pdf (last
accessed June 26, 2007) [hereinafter Task Team
Report].
2 See id.
3 2005 CA A.C.R. 8.
4 See
Task Team Report, supra note 1.
National Center on Elder Abuse, National Elder
Abuse Incidence Study (1998), available at
http://www.aoa.gov/eldfam/Elder_Rights/Elder_Abuse
/ABuseReport_Full.pdf [hereinafter NCEA Study].
6 See John F. Wasik, The Fleecing of America’s Elderly,
CONSUMERS DIG., Mar./Apr. 2000.
7 The 2000 census reported nearly 3.6 million
Californians over age 65, and it is estimated that by
2010 the number of Californians over 65 will approximate 4.5 million. See Census Tables 83 and 121,
available at http://www.aging.ca.gov/html/stats
/2000Census_aging_data.html (last accessed June 26,
2007).
8 WELF. & INST. CODE §15610.30(a).
9 See id. §15610.30(b).
10 Id. §15610(b)(1)-(2).
11 WELF. & INST. CODE §15610.30, added by 1994 Cal.
Stat. ch. 594 (S.B. 1681).
12 See WELF. & INST. CODE §15610.30, amended by
1997 Cal. Stat. ch. 724 (A.B. 1172).
13 WELF. & INST. CODE §15610.30, amended by 1998
Cal. Stat. ch. 946 (S.B. 2199).
14 See WELF. & INST. CODE §15610.30(1)(a), amended
by 1998 Cal. Stat. ch. 946 (S.B. 2199).
15 See id.
16 Senate Judiciary Committee Bill Analysis of A.B.
2107, 2-3 (Aug. 9, 2000).
17 Assembly Floor Analysis of A.B. 2107, 2 (Aug. 29,
2000).
18 WELF. & INST. CODE §15610.30, as amended by 2000
Cal. Stat. ch. 442 (A.B. 2107).
19 See id.
20 See id.
21 See WELF. & INST. CODE §15610.30, added by 1994
Cal. Stat. ch. 594 (S.B. 1681).
5 See
22 See
2007 Cal. S.B. 611 (Steinberg).
See Brisk & Flynn, No Bad Deed Should Go
Unpunished: Evaluation and Discovery of Cases of
Financial Elder Abuse of Elders, 16 Fall NAELA Q. 8,
9 (2003).
24 See id.
25 See WELF. & INST. CODE §15600.
26 See O’Neill v. Spillane, 45 Cal. App. 3d 147, 155
(1975).
27 CIV. CODE §1575.
28 See Margaret Thaler Singer, Ph.D., Undue Influence
and Written Documents: Psychological Aspects, 10
THE CULTIC STUDIES J. 1, 19-32 (1993).
29 See Balassi v. Balassi (Estate of Gelonese), 36 Cal.
App. 3d 854 (1974); see also Potter v. Coleman (Estate
of Baker), 131 Cal. App. 3d 471 (1982); Jamison v.
Johnson, 41 Cal. 2d 1 (1953).
30 See O’Neill, 45 Cal. App. 3d at 155.
31 See Connell v. Bowes, 19 Cal. 2d 870 (1942).
32 See Raedeke v. Gibraltar Savs. & Loan Ass’n, 10 Cal.
3d 665, 671 (1974).
33 See id.
34 See Sparks v. Sparks, 101 Cal. App. 2d 129, 135-36
(1950).
35 See Sime v. Malouf, 95 Cal. App. 2d 82, 98 (1949).
36 See Kudokas v. Balkus, 26 Cal. App. 3d 744, 750
(1972).
37 See PROB. CODE §21350.
38 See Bernard v. Foley, 39 Cal. 4th 794 (2006).
39 See People v. Olguin, 31 Cal. App. 4th 1355, 1371
(1994); EVID. CODE §801.
40 See Estate of Duhaney, 246 Cal. App. 2d 653, 657
(1966).
41 Natural Soda Prod. Co. v. City of L.A., 109 Cal. App.
2d 440 (1952).
23
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practice tips
BY JAMES P. BESSOLO
RICHARD EWING
Mandatory Reporting Requirements for Financial Elder Abuse
FINANCIAL ELDER ABUSE may be the crime of the twenty-first century, which should not be shocking news, given America’s aging
population. It is estimated that 40 million Americans will be 65 and
over in 2010, increasing to 55 million in 2020.1 In California, the state
with the largest population of older Americans, the U.S. Census
Bureau projects that the elderly population will increase from 3.7 million to more than 6.4 million within the next 20 years. These projections, coupled with the baby boomers’ wealth concentration, lay
the groundwork for significant potential financial elder abuse.
In an effort to combat financial abuse, California law requires individuals in certain positions, who are known as mandated reporters,
to report incidents that reasonably appear to constitute elder or
dependent adult abuse. The reports are generally made to the local
Adult Protective Services (APS) agency or to local law enforcement.
Effective January 1, 2007, officers and employees of financial institutions became mandated reporters of suspected financial abuse of
an elder or dependent adult.2 The Elder Abuse and Dependent Adult
Civil Protection Act defines “financial abuse” as occurring when a
person or entity takes, hides, appropriates, or retains real or personal
property of an elder or dependent adult for wrongful use and/or with
the intent to defraud, or assists in doing so.3
Abuse of elders can take many forms, such as physical abuse, financial abuse, emotional abuse, neglect, isolation, abandonment, and
abduction.4 The California Department of Justice estimates that
approximately one of every 20 elders is a victim of abuse every year.
The number of incidents of elder abuse is difficult to determine
because it is often unreported. According to one source, only 1 in 14
cases of elder abuse is reported to authorities.5 Reasons for nonreporting can include a victim’s fear, embarrassment, or lack of capacity. Sadly, a majority of the perpetrators of elder abuse are adult children or other family members.
An “elder” is a California resident age 65 or older.6 A “dependent
adult” is a California resident between the ages of 18 and 64 who has
physical or mental limitations that restrict his or her ability to carry
out normal activities or to protect his or her rights.7 Under California
law, certain individuals who, in their professional capacity or within
the scope of their employment, observe or have knowledge of an incident that reasonably appears to constitute the abuse of an elder or
dependent adult are legally required to report the incident.8 These individuals include persons who assume responsibility for the care or custody of an elder or dependent adult, whether or not compensated;
administrators, supervisors, and licensed staff of a public or private
facility that provides care or services for elders or dependent adults;
physicians and medical professionals; clergy; and employees of APS
agencies and local law enforcement.
The report must be made by telephone immediately or as soon as
practicably possible, followed by a written report sent within two
working days. Subject to certain exceptions, the report is made to either
the local APS agency or local law enforcement.9 One exception is that
if the purported abuse occurred in a long-term care facility other than
a state mental health hospital or a state developmental center, the report
is made either to the local ombudsman or to local law enforcement.10 The report is confidential and may generally be disclosed only
to certain persons and government entities. Violation of the confidentiality requirement constitutes a misdemeanor.11 Failure of a
mandated reporter to comply with his or her reporting obligations
under the act is also a misdemeanor.12
A mandated reporter who reports a known or suspected instance
of abuse of an elder or dependent adult as required or authorized by
the act is protected from civil and criminal liability with respect to
the report. A person who is not a mandated reporter who knows or
reasonably suspects that an elder or dependent adult has been the victim of abuse may report the abuse in the same manner as a mandated
reporter.13 The act protects nonmandated reporters from civil and criminal liability for making reports unless it can be proven that the
report was false and that the nonmandated reporter knew the report
was false.14
Advocates for elder abuse victims have advanced the position that
employees of financial institutions can help prevent financial elder
abuse by reporting known or reasonably suspected financial abuse
to government authorities. Advocates have noted the devastating
James P. Bessolo is a senior attorney with Northern Trust, N.A., in Los Angeles.
The author wishes to thank Raymond M. Lynch, associate general counsel,
Greater Bay Bank N.A., for his permission to use the warning signs checklists
that appear in this article.
Los Angeles Lawyer October 2007 23
harm that financial abuse can cause an elderly
victim. By the time the abuse is discovered, the
abuser often will have dissipated the victim’s
assets and elderly victims are often unable to
financially recover from their losses, which
can lead to increased reliance on public welfare programs, greater physical problems,
and a higher mortality rate. Advocates believe
that financial institutions have the potential
to be the first line of defense against financial
elder abuse. Nonetheless, while supporting
efforts to prevent financial elder abuse on a
voluntary basis, many in the financial industry opposed efforts to impose mandatory
reporting obligations on financial institutions or their employees. For example, the
California Bankers Association opposed previous legislative attempts to impose mandatory reporting obligations because of concerns about such issues as whether a financial
institution could be liable for a false report
and whether criminal penalties could be
imposed on an employee or financial institution for failing to report. However, these
concerns have now been substantially
addressed.
Employee Reporting Obligations
Employees of financial institutions became
mandated reporters effective January 1, 2007,
but only of suspected financial abuse of an
elder or dependent adult.15 For reporting
purposes, “suspected financial abuse of an
elder or dependent adult” occurs when an
employee observes or has knowledge of
behavior or unusual circumstances or transactions, or a pattern of behavior or unusual
circumstances or transactions, that would
lead an individual with like training or experience, based on the same facts, to form a reasonable belief that an elder or dependent
adult is the victim of financial abuse.16
The act defines “financial institution” to
include national banks, savings and loans,
state banks and trust companies whose
deposits are not limited solely to funds held
in a fiduciary capacity, and federal or state
credit unions.17 A financial institution does
not include a subsidiary or affiliate of a financial institution that does not itself come within
the definition of a financial institution. The
definition does include an “institution-affiliated party,” which encompasses directors
of and agents for an insured depository institution; certain shareholders or other persons
who participate in the conduct of the affairs
of an insured depository institution; and
attorneys, accountants, and other persons
who knowingly or recklessly participate in
certain conduct that caused or is likely to
cause more than a minimal financial loss to,
or a significant adverse effect on, an insured
depository institution.18 The inclusion of an
institution-affiliated party in the definition of
24 Los Angeles Lawyer October 2007
financial institution is somewhat confusing.
For example, since mandated reporter status
is imposed on employees of financial institutions, would employees of a bank director,
if any, be mandated reporters of suspected
financial elder abuse, or is the intent that the
director be the mandated reporter?
The obligation of an employee of a financial institution to report arises in two situations. 19 The first situation involves an
employee who observes or knows of an incident through direct contact with the elder or
dependent adult that reasonably appears, or
that the employee reasonably suspects, to
be financial abuse. The act does not expressly
limit the direct contact to in-person contact,
and therefore the term presumably includes
contact by oral or written communication.
The second situation involves an employee
who reviews or approves the elder or dependent adult’s financial documents, records,
or transactions, and by doing so the employee
concludes that there reasonably appears to
be, or reasonably suspects, financial abuse.
The employee may rely solely on the information before him or her at the time of
reviewing or approving the documents,
records, or transactions; there is no duty to
further investigate.
In both situations, an obligation to report
may apply only if the employee’s knowledge
or observation arises “in connection with
providing financial services with respect to an
elder or dependent adult” within the scope of
the employee’s “employment or professional
practice” and the incident is “directly related
to the transaction or matter that is within that
scope of employment or professional practice.” Therefore, if an employee of a financial
institution observes an incident outside the
confines of his or her employment that could
reasonably constitute financial abuse of an
elder or dependent adult, the employee is
not a mandated reporter and has no duty to
report the incident. Also, the act does not distinguish between customers and noncustomers, so if the reporting requirements are
otherwise satisfied a report must be filed
whether or not the elder or dependent adult
is a customer of the financial institution. For
example, if in connection with an application
for a loan that is ultimately denied an
employee reasonably suspects financial elder
abuse, the employee is required to report.
An allegation by an elder, dependent adult,
or other person that financial abuse has
occurred is not sufficient to trigger the reporting requirement if two conditions are met: 1)
The employee is not aware of any other corroborating or independent evidence of the
alleged financial abuse (without any duty to
investigate any accusations), and 2) in the
exercise of the employee’s professional judgment, the employee reasonably believes that
financial abuse did not occur.20
A required report must be made by telephone immediately, or as soon as practicably
possible, with a written report sent to the
agency that received the oral report within
two working days thereafter. When two or
more employees jointly have knowledge or
reasonably suspect that financial abuse of
an elder or dependent adult has occurred,
with the mutual consent of the employees
the report may be made by a designated
member of a reporting team.21 The California
Department of Social Services has issued a
form for use by employees of financial institutions to make a written report. This is different from the form used by other mandated reporters.22 The form requests personal
information about the elder or dependent
adult, the location of the incident, the
reporter’s observations, information relating
to the targeted account (although only the last
four digits of the account number are disclosed on the form, the form’s instructions
provide that the full account number will be
requested in the oral report), information
about the alleged abuser, and whether any
other persons are believed to have knowledge
of abuse against the alleged victim. The original and one copy of the form must be submitted to the appropriate agency. The oral and
written report must be made to either the
APS agency in the county where the apparent victim resides or to a law enforcement
agency in the county where the incident
occurred. If the mandated reporter knows
that the apparent victim resides in a long-term
care facility, the report must be submitted to
either the local ombudsman or the local law
enforcement agency. The identity of all persons reporting suspected financial abuse is
confidential and may generally be disclosed
only to certain persons and government agencies. Since the government agency’s investigation is confidential, a financial institution
will not be able to obtain further information
on the reported matter unless the elder or
dependent adult consents to the disclosure.
A question arises whether copies of documentation referenced in the report may be
disclosed as part of the report without violating federal and state financial privacy laws.
For example, if a suspected abuser attempts
to transact business under a power of attorney purportedly executed by an elder, could
a copy of the power of attorney be submitted to APS with the report? The act does not
expressly authorize the disclosure of documentation as part of a report. Nonetheless,
there appears to be support under California
law for disclosure of documentation, at the
time the report is filed, that is directly related
to the incident and referenced in the report.23
A report of suspected financial abuse of an
elder or dependent adult made by an
employee of a financial institution is a privileged communication under Civil Code
Section 47(b).24 The Section 47(b) privilege
immunizes the reporter against all tort actions
except for malicious prosecution.25 In addition, the act protects a mandated reporter
from civil and criminal liability for any report
required or authorized by the act.26 Although
the liability protections afforded to employees of financial institutions under the act do
not expressly reference the financial institution itself, presumably financial institutions
are also protected by the absolute privilege
under Section 47(b) with respect to an
employee’s report of suspected financial abuse
of an elder or dependent adult.27
If an employee of a financial institution
fails to report an incident that should have
been reported, the financial institution, and
not the employee, is subject to a civil penalty
of up to $1,000, or up to $5,000 for a willful failure. The penalty can be recovered only
in a civil action brought against the financial
institution by the attorney general, district
attorney, or county counsel.28
When a report of suspected financial abuse
is made by an employee of a financial institution, the financial institution must consider whether to file a Suspicious Activity
Report (SAR) with the federal government.
The filing of a SAR may be required if there
are one or more financial transactions conducted through the financial institution
involving known or reasonably suspected
financial abuse of an elder or dependent adult
that aggregate at least $5,000. A SAR must
usually be filed within 30 days from the date
of the initial detection of the suspicious activity. Federal law provides complete protection from civil liability for the filing of a
SAR.29
In anticipation of the January 1, 2007,
effective date, training programs were implemented to educate employees of financial
institutions on their reporting responsibilities,
and financial institutions established procedures for determining whether and how to
report incidents of suspected financial elder
and dependent adult abuse. Some financial
institutions, particularly the larger institutions, have established a centralized group to
assist employees with the reporting process.
Warning Signs
A common factor in financial abuse cases is
the presence of a third party during transactions. This individual may be a relative, friend,
caregiver, or even an apparent casual acquaintance. This third party is often someone in
whom the elder or dependent adult has placed
trust and confidence. The following are some
possible warning signs of financial abuse in
a financial institution setting.
Unusual account activity can indicate that
Los Angeles Lawyer October 2007 25
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an elder or dependent adult is being financially
abused. Common examples include:
• Large cash withdrawals.
• Activity inconsistent with the person’s physical ability, such as ATM use by a physically
impaired person.
• Activity inconsistent with a person’s normal
banking habits, such as ATM use by an elder
or dependent adult with an established pattern of client service representative transactions.
• Frequent new withdrawals, usually in round
numbers.
• Increased activity on credit/debit cards.
• Withdrawals made from savings or certificates of deposit despite penalty assessments
or loss of interest.
Account changes may also indicate that an
elder or dependent adult is a victim of financial abuse. Examples may include:
• New use of power of attorney to gain
access to financial accounts.
• Change in account beneficiaries.
• New authorized signers on accounts.
• Change in receipt of account statements.
• Recent change of physician, attorney, or
accountant.
• Change in property title, or new or refinanced loan.
• Recent change in power of attorney.
• Recent change in a will or trust, when the
elder or dependent adult seems incapable of
managing his or her affairs.
• Recent change in a will or trust to favor a
new or much younger “friend.”
Elders and dependent adults who are being
financially abused may also display significant
changes in their behavior as customers.
Examples may include:
• Withdrawn, tired, confused, or depressed.
• Confusion about recent financial arrangements.
• Reluctance to discuss matters that were
previously routine.
• More apprehensive of the outside world.
An elder or dependent adult who is being
financially abused may also demonstrate that
he or she is being influenced or directed by
someone in a position of trust (e.g., caregiver, relative, adviser, or friend). Examples
may include:
• Comes to the financial institution accompanied by a third party, whereas he or she previously came alone.
• Appears to depend on the input or direction
of another to conduct a transaction.
• Stops coming to the financial institution.
• Employee is told that elder or dependent
adult is not willing or able to accept visits or
telephone calls.
• Another person is overly concerned about
the elder’s or dependent adult’s finances.
• Another person speaks for the elder or
dependent adult, even when the elder or
dependent adult is present.
• Another person appears dependent on the
elder or dependent adult for financial support.
• An individual accompanies the elder or
dependent adult and encourages him or her
to withdraw money.
• An individual accompanies the elder or
dependent adult and pressures or coerces
him or her into a transaction.
The above behaviors are all signs of possible financial abuse. However, these behaviors may have legitimate explanations, and
therefore it is important for an employee of a
financial institution not to jump to conclusions
but to make a reasoned determination, after
receipt of appropriate internal assistance,
about whether a report should be filed.
Preliminary indications are that the new
reporting obligations imposed on employees
of financial institutions will result in a significant increase in the number of financial
abuse reports filed. According to information
provided by a representative of Los Angeles
County APS, financial abuse reports filed
with APS in Los Angeles County during the
first four months of 2006 numbered 1,062,
with most reports submitted by financial
institutions voluntarily. For the first four
months of 2007, the filings increased to
1,485, with most reports derived from financial institutions. This represents a 40 percent
increase in financial abuse reporting. Hopefully, the increased reporting will result in a
reduction of actual losses incurred by elders
and dependent adults and an increase in assistance to those who have been victimized. ■
1
ADMINISTRATION ON AGING, U.S. DEPARTMENT OF
HEALTH AND HUMAN SERVICES, A PROFILE OF OLDER
AMERICANS: 2005.
2 Elder Abuse and Dependent Adult Civil Protection
Act, WELF. & INST. CODE §§15600 et seq., as amended
by the Financial Elder Abuse Reporting Act of 2005 (SB
1018).
3 WELF. & INST. CODE §15610.30.
4 WELF. & INST. CODE §15610.07.
5 House Select Committee on Aging (1994).
6 WELF. & INST. CODE §15610.27.
7 WELF. & INST. CODE §15610.23.
8 WELF. & INST. CODE §15630. See also WELF. & INST.
CODE §15610.65 (defining “reasonable suspicion”).
9 APS is a state-mandated program that assists elders
and dependent adults who are unable to meet their own
needs or are victims of abuse. Each county in California
has an APS agency. Upon receipt of a report, an APS
social worker will typically meet with the alleged victim to investigate and assess the situation and, when
appropriate, work with local law enforcement agencies
in an attempt to eliminate any apparent abuse. For more
information on APS and a contact list of APS agencies
for each county, see www.dss.cahwnet.gov/cdssweb
/AdultProte_175.htm.
10 See WELF. & INST. CODE §15610.47 for the meaning of “long-term care facility.” Ombudsmen are persons who advocate for the protection and rights of residents in long-term care facilities. See WELF. & INST.
C O D E §15610.50. For more information, see
www.la4seniors.com/ombudsman.htm.
& INST. CODE §15633.
12 WELF. & INST. CODE §15630(h).
13 WELF. & INST. CODE §15631.
14 WELF. & INST. CODE §15634.
15 WELF. & INST. CODE §15630.1.
16 WELF. & INST. CODE §15630.1(h).
17 WELF. & INST. CODE §15630.1(b).
18 See 12 U.S.C. §1813(u) for a definition of “institution-affiliated party.”
19 WELF. & INST. CODE §15630.1(d)(1).
20 WELF. & INST. CODE §15630.1(e).
21 WELF. & INST. CODE §15630.1(d)(2).
22 The financial institution form, SOC 342, as well as
the form for other mandated reporters, SOC 341, may
be obtained from the California Health & Human
Services Agency Web site.
23 The California Right to Financial Privacy Act
§7471(c) (codified at GOV’T. CODE §§7460 et seq.)
authorizes a financial institution to disclose a customer’s financial records to a state or local agency
concerning suspected violation of any law. Also, the
California Financial Information Privacy Act
§4056(b)(8) (codified at FIN. CODE §§4050 et seq.), also
known as SB1, authorizes the disclosure of a customer’s nonpublic personal information (as defined in
FIN. CODE §4052) when reporting a known or suspected
instance of elder or dependent adult financial abuse.
24 WELF. & INST. CODE §15630.1(i).
25 See Silberg v. Anderson, 50 Cal. 3d 205 (1990).
26 WELF. & INST. CODE §15634.
27 See Hagberg v. California Fed. Bank FSB, 32 Cal. 4th
350 (2004). See also PENAL CODE §368, which makes
financial abuse against an elder or dependent adult a
crime, and WELF. & INST. CODE §15656.
28 WELF. & INST. CODE §15630.1(f), (g)(1).
29 31 U.S.C. §5318(g)(3).
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Los Angeles Lawyer October 2007 27
SPECIAL ISSUE
ELDER LAW
by Sherrill Y. Tanibata
Mind over
Matters
Determinations
and decisions
regarding capacity, diminished capacity, and incapacity are at
the heart of elder law, which addresses the ramifications of mental and physical impairment due to age. However, while elder
law has recently been viewed as a separate substantive area of
law, a variety of lawyers have grappled with the issues at its
core for years. For example, trust and estates practitioners have
always dealt with questions of capacity in numerous circumstances, including when they assess a client’s ability to make
a trust, will, or gift; plan for a client’s future disability; or litigate in probate conservatorship proceedings or in evidentiary hearings on the validity of documents and transactions.
These practitioners have done so without the help of special
legislation for their elderly clients. So why is elder law now nec28 Los Angeles Lawyer October 2007
essary to address capacity issues that have traditionally been
resolved by applying time-tested principles familiar to many
lawyers, especially trust and estates practitioners?
A possible answer to this question lies in the California
Legislature’s 1996 findings as presented in Welfare and
Institutions Code Section 9001. In 1996, persons over 60
represented 14 percent of California’s population, but by
2020 older individuals will represent 21 percent of California’s
population. In 2010, the first wave of baby boomers will constitute 29.2 percent of California’s over-60 population—and
Sherrill Y. Tanibata is a senior associate at Sullivan, Workman &
Dee, LLP, where she is responsible for the firm’s probate and estate
planning department.
JONATHAN BARKAT
The question of an elder’s legal capacity
nearly always involves issues of fraud and
undue influence
in 2020, baby boomers will comprise 70.2
percent of California’s over-60 population.
While dementia affects only 1 percent of 60year-olds, that percentage jumps to 30 percent
to 45 percent for 85-year-olds.1
The aging of the baby boom generation in
the coming years will put all traditional methods of dealing with diminished capacity and
incapacity to the test by the sheer numbers in
that group. All lawyers, no matter what their
area of specialization, increasingly will be
asked to resolve issues of capacity and will
find themselves, like it or not, becoming elder
law practitioners in two basic ways: 1) determining the capacity of their elder clients, or
2) determining whether a specific document
or transaction is tainted by the possible incapacity of an elder or is the product of possible undue influence exerted upon an elder.
While these capacity determinations have in
the past arisen nearly exclusively in the
province of trusts and estates law, due to the
increasing numbers of aging clients, attorneys in every area of the law will find themselves grappling with these issues.
In determining an elder client’s capacity,
attorneys are required, practically and ethically, to resolve a series of critical questions:
• Is my client competent, or does my client
suffer from diminished capacity?
• How does my client’s diminished capacity
affect his or her ability to execute a will or
trust? A durable power of attorney? A deed?
A pay on death contract with a bank? Any
other document or transaction?
• Is my client susceptible to undue influence?
Is my client being unduly influenced?
In determining whether a specific document or transaction is invalid because it was
executed or entered into by a principal who
lacked capacity or who was subject to undue
influence, an attorney is required to make an
analysis based upon the following criteria:
• Statutory provisions on capacity.
• Presumptions and burdens of proof.
• Decisional law.
• The facts particular to a case.
• The availability of evidence to prove or
disprove capacity or undue influence.
Basic Guidelines and Definitions
The capacity of elders is addressed in the
Probate Code and in Welfare and Institutions
Code sections on special treatment of elders
and on elder abuse. Testamentary capacity
and contractual capacity are addressed in
the Civil Code as well as in Probate Code sections enacted pursuant to the Due Process in
Competence Determinations Act. 2 Fundamental to any discussion of capacity within
the elder law context are a few key statutory
guidelines:
1) An elder is anyone age 65 or older.3
2) All persons are presumed to have the legal
30 Los Angeles Lawyer October 2007
capacity to take action and make decisions on
their own account. The presumption of capacity is a rebuttable presumption affecting the
burden of proof.4
3) A determination that a person is of
unsound mind or lacks the capacity to do an
act or make a decision must be supported by
evidence of the existence of at least one of the
deficits listed at Probate Code Section 811 as
well as evidence that the deficit correlates
with the act or decision in question.
4) A person lacks capacity to make a decision
if he or she cannot communicate the decision
verbally or by any other means and cannot
appreciate the rights, duties, consequences,
risks, benefits, and alternatives involved with
the decision.5
5) Persons lack testamentary capacity if they
are unable to understand the nature of the testamentary act, unable to understand and recollect the nature and extent of their assets, or
unable to remember and understand their
relationship to their living relations and those
whose interests would be affected by their
will. Testamentary capacity is also lacking if
a person suffers from a mental disorder that
causes the person to make a disposition of
property that he or she would not have made
were it not for the mental disorder.6
6) A conservator may be appointed for persons who are unable to properly provide for
their personal needs or are substantially
unable to manage their financial resources or
resist fraud or undue influence. The standard for the showing required for the appointment of a conservator is clear and convincing evidence.7
7) A spouse’s capacity to deal with community property is measured by the same standards of capacity applicable to noncommunity property transactions. The spouse with
legal capacity has exclusive management and
control of community property, including
the power to dispose of the property.8
Against the backdrop of these fundamental principles, practitioners must be cognizant that each act or decision by an elder
may have a different legal standard for capacity. The applicability and meaning of terms
used in statutory and decisional law—such as
“unsound mind,” “lack of capacity” or
“understand and recollect”—will depend on
the nature and complexity of the act or decision in question and on the elder’s mental and
physical condition at the time of the act.
Similarly, the term “ability to resist fraud or
undue influence” may have different meanings in different fact situations: “In one case
it takes but little to unduly influence a person;
in another case much more….”9
Threshold Assessment
Prior to determining whether a client has the
capacity to engage in the transaction for
which the client has consulted the attorney,
the attorney must make the important threshold evaluation regarding the client’s competence to retain an attorney. The ease or difficulty with which an attorney makes this
initial evaluation will depend to a large extent
on whether there is a preexisting relationship
with the client. If the attorney has, for example, prepared estate planning documents for
the client in the past, the capacity assessment
will be easier because the attorney will be able
to gauge whether the client’s behavior and
cognitive skills seem the same as they were or
have changed.
If the attorney has no history with the
client, greater reliance must be placed on the
client interview and possibly on conversations with the client’s family and friends.
With new, unfamiliar clients, the attorney
must be alert not only regarding the potential client’s capacity but also the identity and
relationship of the person or persons bringing the elder to the attorney’s office. Perhaps
the elder was brought to the attorney’s office
by a “disqualified” person as defined in
Probate Code Section 21350.10 If so, the
attorney must ascertain whether the elder is
planning a testamentary devise to the disqualified person and whether a Certificate of
Independent Review pursuant to Probate
Code Section 2135111 is required. Someone
besides the elder may be paying for the legal
services. In that circumstance, the attorney
must obtain the informed written consent of
the elder prior to accepting that payment
arrangement.12
Furthermore, present California Rules of
Professional Conduct and state ethics opinions strictly construe an attorney’s duties of
loyalty and confidentiality to a client without
making any special provision for a client
with diminished capacity. The duty of loyalty
strictly prohibits an attorney from initiating
conservatorship proceedings regarding a client
with diminished capacity without the client’s
consent. The duty of confidentiality constrains an attorney from disclosing confidential information to individuals, institutions, agencies, and even family members
who might help a client with diminished
capacity.
The American Bar Association directly
addresses an attorney’s duty to a client with
diminished capacity in its Model Rules of
Professional Conduct. Model Rule 1.14 provides three general guidelines for attorneys
dealing with these clients:
1) An attorney shall maintain a normal
lawyer-client relationship insofar as is reasonably possible.
2) If an attorney believes that a client with
diminished capacity is at risk of substantial
physical, financial, or other harm, an attorney may take reasonably necessary protective
action. This includes consulting with individuals and entities that have the ability to
take action to protect the client, such as seeking the appointment of a conservator.
3) An attorney taking protective action for a
client with diminished capacity may reveal
otherwise confidential information about the
client, to the extent necessary to protect the
client’s interest.
to the caveat that an attorney may not initiate conservatorship proceedings without the
client’s consent.14
It is important to note that even though the
probable issuance of a new ethics rule and the
possibility of upcoming statutory enactments
seemingly offer guidance to attorneys in their
future dealings with a client whose capacity
is questionable, attorneys must always pro-
Supporting evidence of the client’s capacity is
particularly critical when acts or documents
are challenged after the client can no longer
speak on his or her behalf because the client’s
condition has drastically deteriorated or the
client has died. The most common forms of
supporting evidence are videotapes and a
clinical capacity assessment report prepared
by a doctor, psychologist, or other profes-
Even when an attorney makes a determination that the client clearly knows
what he or she is doing, the practitioner would do well to take precautionary
steps to document an elder client’s present physical and mental state.
The ABA model rule was adopted by a
majority of states, but not by California. In
fact, the State Bar of California’s Formal
Opinion No. 89-112 specifically rejected the
model rule provision allowing an attorney to
seek a conservatorship. However, beginning
in 2004 the State Bar proposed the adoption
of a rule similar to the model rule. This
effort was paired with a proposal for a new
Business and Professions Code Section
6068.5 that would not only codify the new
rule but also thereby create exceptions to
Business and Professions Code Section
6068(e)’s duty for attorneys to “maintain
inviolate the confidence and preserve the
secrets of [the] client.”
Section 6068.5 has not yet become law,
but the new California Rule of Professional
Conduct is scheduled to be published this
year—and it will be substantially the same as
ABA Model Rule 1.14, with the exception
that an attorney in California may not seek
appointment of a conservator. The new rule,
and proposed legislation if enacted, will
relieve the attorney to some extent from the
conflict that naturally arises from the duties
of loyalty and confidentiality to the client and
the duty to question and assess the capacity
of a client.
Until—or whether—these proposed
changes in the law become official, practitioners confronted with a client whose capacity is questionable or whose capacity could
be subject to question in the future must
assume that they will be held to the strictest
duty to represent the client’s interest even
when that interest diverges from what practitioners believe to be the client’s best interest.13 Thus, if an attorney makes an initial
determination that the client lacks capacity
to engage in the transaction for which the
client consulted with the attorney, then the
attorney must decline to act and permit the
client to seek other representation. The attorney may make a recommendation to the
client for a conservatorship, always subject
ceed with caution in taking action or violating a confidence to protect a client. Language
in the proposed legislation refers to clients that
are “significantly impaired” and also states
that the new law would be applied to cases
in which a client is “completely unable to
make decisions.”15
Capacity for Specific Acts and Decisions
In addition to making a determination that a
client has the capacity to retain counsel, a
determination regarding the client’s capacity
to engage in the transaction for which the
client is consulting the attorney must be made.
In the end an attorney is usually left to make
his or her own determination of capacity
using common sense, the Probate Code
Section 811 “unsound mind” deficit criteria, the Probate Code Section 812 “capacity
to make a decision” criteria, the Probate
Code Section 6100.5 “testamentary capacity”
criteria, and a general knowledge of existing
case law.
Even when an attorney makes a determination that the client clearly knows what he
or she is doing, the practitioner would do well
to take precautionary steps to document an
elder client’s present physical and mental
state. Keeping meticulous notes regarding
the client’s demeanor and verbal communications during the client interview and, if
there is a past history of dealings with the
client, preparing a memorandum to file outlining how the present action differs from or
conforms to the client’s past actions, will be
effective means for maintaining the integrity
of an elderly but competent client’s actions
and documents in the face of subsequent
attack during litigation.
If an attorney suspects that an elder client’s
actions might be subject to question because
of advanced age; diagnosis of a debilitating
illness; or simply because the elder’s actions
are eccentric, whimsical, arbitrary, or cruel,
additional documentary evidence might be
desirable to preempt future litigation.
sional expert in assessing capacity.
These tools should be used deliberately
and with caution, because tapes and clinical
assessment reports are double-edged swords.
Sometimes, in cases involving a client of
advanced age or marginal competence, a
videotaped interview of the client or the
client’s execution of documents can backfire
and make the client appear to be less competent then he or she actually is. It is not
uncommon, for example, for an elderly client
to quickly and accurately name all of his or
her children and their birth dates off camera
and then, when asked to name the children
on camera, forget to mention one or two.
This captured performance may demonstrate
nothing more than nerves or stage fright or
a momentary mistake, memory lapse, or lack
of concentration. But none of these explanations will overcome the deleterious impact
of the videotape in subsequent litigation over
the client’s capacity. The videotape will provide opposing counsel with a classic “gotcha”
moment.
If a decision is made to use videotape, the
attorney should follow a general script or
outline. Counsel should avoid even the
appearance of asking excessively leading
questions. Also, practitioners should not try
to ask the kind of yes-or-no questions that not
only reveal nothing about the client’s competence but also invite accusations that the
attorney is acting in the interest of someone
other than the client. For example, consider
this question and answer: “Is it true that
you have disinherited Child A because he has
not visited or called for 10 years?” “Yes.”
This is an example of an exchange to be
avoided. It reveals little or nothing about
the client’s capacity to understand the nature
and consequences of the act involved and
gives the impression that the attorney might
favor another child or beneficiary. However,
asking clients to state the reasons for their
actions might result in a rambling, disconnected narrative that could undermine an
Los Angeles Lawyer October 2007 31
argument for their capacity.
Similarly, a clinical capacity assessment
report can result in formal documentation of
a client’s shortcomings rather than his or her
strengths. Moreover, these reports are discoverable if the clinician is designated an
expert in future proceedings. There are two
methods of using clinical opinions:
1) An informal consultation between the clinician and attorney, in which the client’s name
is not disclosed and the attorney obtains the
clinician’s opinion on capacity based upon
information provided by the attorney.
2) A referral for a formal assessment, in
which the client consents to an examination
by a clinician for a formal assessment of
capacity to perform a certain act.16
Even when a formal assessment is used, it
is important to remember that a clinical
assessment of capacity is merely one factor in
establishing a legal determination regarding
capacity. Indeed, the clinician’s assessment
is not the final determination of legal capacity. The attorney and the trier of fact, not the
clinician, must arrive at a conclusion on legal
capacity.
In most cases, attorneys will find that
their client’s capacity is good and proceed
with the transaction. In close cases, or in
cases that might be litigated when the client
is no longer competent or alive, attorneys
must be mindful when they create and execute legal documents with their client of the
varying standards of capacity and undue
influence by which the legal documents will
be evaluated and scrutinized.
While attorneys owe no duty to third parties to document an assessment of client
capacity,17 California law requires attorneys
to be satisfied that their client is competent
to sign a document or participate in a transaction and is not acting as a result of fraud
or undue influence.18 Also, attorneys owe
duties of competence and loyalty to their
client to assist in the accomplishment of the
client’s objectives. In cases of borderline
capacity, an inherent conflict exists between
the prohibition against an attorney’s preparation of a will or other dispositive instrument
if the attorney believes the client lacks capacity and an attorney’s duty to assist a client
whose testamentary capacity appears to be
borderline. The court in Moore v. Anderson
Zeigler Disharoon Gallagher & Gray, P.C.
articulated this conflict in dicta:
Because of the importance of testamentary freedom a lawyer may properly assist clients whose capacity
appears to be borderline….
It may be that prudent counsel
should refrain from drafting a will for
a client the attorney reasonably believes
lacks testamentary capacity or should
take steps to preserve evidence regard32 Los Angeles Lawyer October 2007
ing the client’s capacity in a borderline
case.19
Attacking or Defending Acts and
Documents
Determinations regarding the validity or invalidity of a document or transaction due to lack
of capacity are made after the fact of their creation and execution, with a few exceptions—
such as at evidentiary hearings on a conservatee’s ability to enter into a transaction or
make a decision. These determinations are frequently accompanied by questions of fraud
and undue influence.
Most often issues concerning capacity
come under scrutiny by courts in the context
of litigation over wills, trusts, and other testamentary documents. The Probate Code
Section 6100.5 criteria provide that an individual is not mentally competent to make a
will if he or she is unable to understand the
nature of the testamentary act, understand
and recollect the nature of his or her assets,
or remember and understand his or her relationship to family members, friends, and
those whose interests are affected by the will.
Further, the individual lacks mental competence if he or she suffers from a mental disorder with symptoms such as delusions or hallucinations that cause an individual to devise
property in ways that the individual would
not otherwise have done. Notwithstanding the
seemingly straightforward provisions of
Section 6100.5, however, endless litigation has
resulted in case law interpretations that create a standard for testamentary capacity that
is extremely low.
One of the most oft-cited cases regarding
the standard for testamentary capacity is
Estate of Selb.20 This 1948 case is still good
law and ably encapsulates California case
law regarding testamentary capacity:
It has been held over and over in this
state that old age, feebleness, forgetfulness, filthy personal habits, personal eccentricities, failure to recognize
old friends or relatives, physical disability, absent-mindedness and mental
confusion do not furnish grounds for
holding that a testator lacked testamentary capacity.
The Selb court lists and cites no less than
18 cases in which courts validated wills under
attack because of the testator’s alleged lack of
capacity.21 Each case adds to Selb’s litany of
facts that are insufficient to establish lack of
testamentary capacity, including delusions
and hallucinations not related to the provisions of the will or act,22 the testator being
subject to a conservatorship,23 continual
drunkenness,24 and a medical diagnosis of
mental derangement and insanity.25
So what constitutes sufficient evidence to
rebut the presumption of testamentary capac-
ity? One criteria consistently referred to in
case law is evidence of the testator’s incapacity, delusion, confusion, insanity, or drunkenness coupled with evidence of the Probate
Code Section 6100.5 criteria for lack of testamentary capacity at the time of the execution of the will. Successful attacks based on
lack of testamentary capacity are also often
accompanied by allegations of fraud or undue
influence. For example, in Estate of Martin,26
the decedent’s will left his estate to an attorney who had probated the decedent’s predeceased wife’s will and a bank official at the
decedent’s bank. The will omitted the decedent’s nephew, who was the primary beneficiary in the prior will. Evidence showed that
at the time the will was executed, the decedent—who died in a mental hospital—suffered from unsoundness of mind and insanity sufficient to establish mental incapacity
and was also the victim of delusions that
directly affected the testamentary act.
Testimony established that the beneficiaries
of the will had told the decedent that his
nephew was attempting to put him in an asylum and take all of his money and that the
beneficiaries would protect the decedent from
these actions.27 The court invalidated the
decedent’s will based on his lack of testamentary capacity.
The standard for the capacity to contract—which is the same as the standard for
the capacity to convey, to create a trust, to
make gifts, and to grant powers to an attorney—is higher than the standard for testamentary capacity. This is to be expected.
Bluntly stated, a decedent will not suffer the
havoc wreaked by capricious or pernicious
testamentary documents. However, a living
individual will be affected by the negative
consequences of an inappropriate inter vivos
conveyance, an inadvisable lifetime gift, or a
foolish grant of a power of attorney.
In addition to the criteria in Probate Code
Sections 811 and 812 for unsound mind and
the legal capacity to make a decision, the
Civil Code also contains guidelines for determining the capacity to contract. Civil Code
Section 39(b) provides that if a person is
“substantially unable to manage his or her
own financial resources or resist fraud or
undue influence,” a rebuttable presumption
of unsound mind exists. The standard is the
same as that in Probate Code Section 1801
regarding the showing required for establishment of a conservatorship. Once the Civil
Code Section 39(b) presumption arises, the
burden is placed on the party claiming capacity to contract to prove that while he or she
may be unable to manage his or her financial
resources or resist fraud or undue influence,
the party is nevertheless still of sound mind
pursuant to Probate Code Section 811 and
therefore capable of contracting.
Additionally, under Civil Code Section
38, a person “entirely without understanding”
cannot contract. According to Probate Code
Section 810(c), “[a] judicial determination
that a person is totally without understanding” should be based on evidence of a deficit
in one or more of the mental functions listed
in Probate Code Section 811. Thus, a determination of capacity to contract appears to
depend upon an analysis of the facts pursuant to Probate Code Section 811. If an
individual had the capacity to contract at
the time of the act, then that individual also
had the requisite capacity to create a trust, to
execute a deed, or to make conveyances,
including those intended as gifts. Civil Code
Section 2296—which governs the appointment of agents—and Probate Code Section
4120—which governs the appointment of
an attorney in fact—both use identical language to state simply that any person with the
capacity to contract may appoint an agent or
attorney in fact.
As with testamentary capacity, however,
the clear statutory language can be obscured
by the complex facts of cases. In spite of
statutory provisions and guidelines, California
cases have held that the rules governing capacity to execute and deliver deeds are generally
the same as those governing testamentary
capacity.28 In the 1947 case of Hughes v.
Grandy,29 which was decided prior to the
enactment of Probate Code Section 811, the
court struggled to define capacity to execute
a valid deed:30
It is difficult to formulate any rule
determining the degree of mental
weakness which will destroy a person’s capacity to convey property….Old age alone does not render
a person incompetent to execute a
deed. Nor will sickness, extreme distress or debility of body affect the
capacity of the grantor to make a conveyance if sufficient intelligence
remains. Therefore, the issue of competency must be determined from all of
the circumstances surrounding the
transfer.
The standards for capacity that are
required for the valid execution of deeds,
contracts, and powers of attorney are not,
according to statutes and codes, as low as
those for testamentary capacity. Nevertheless,
the courts often analyze the validity of deeds
and transactions along the same lines as the
analysis used for testamentary capacity,
because a party’s acts in the last stage of his
or her life are being questioned, and all the
disputed acts thus take on a type of testamentary significance.
In Allen v. Samuels,31 a grantor executed
a deed with a mark that was made with the
assistance of another holding and guiding
the grantor’s hand. The grantor had suffered
a stroke that paralyzed him and made him
incapable of speech. The court voided the
deed based on the grantor’s lack of capacity.
Similarly, in Reiger v. Rich,32 the grantor
executed a deed the day before the grantor’s
death, while the grantor was under heavy
medication for extreme pain. The court held
that the deed was invalid because of the
grantor’s lack of capacity. The court also
found invalidity based on undue influence,
because it found that the grantees were in a
confidential relationship with the grantor
and unduly profited from the procurement of
the deed at a time when the grantor was
incapacitated.
Undue Influence
Cases in which the validity of deeds, contracts, powers of attorney, and the making of
gifts are disputed on the basis of lack of
capacity nearly always involve allegations of
fraud and undue influence. The Civil Code,
Probate Code, and Welfare and Institutions
Code are replete with use of the phrase “substantially unable to manage his or her own
financial resources or resist fraud or undue
influence”—language that links the issue of
capacity with undue influence.33
Civil Code Section 1575 provides that
undue influence can be found:
1. In the use, by one in whom a confidence is reposed by another, or who
holds a real or apparent authority over
him, of such confidence or authority
for the purpose of obtaining an unfair
advantage over him;
2. In taking an unfair advantage of
another’s weakness of mind; or,
3. In taking a grossly oppressive and
unfair advantage of another’s necessities or distress.
This section is drafted to include all manner of undue influence, not only undue influence of an incapacitated elder. Individuals
with substance abuse problems or physical
handicaps that make them dependent on others come within the scope of Section 1575.
There is a large body of California probate
case law that addresses issues arising out of
an elderly person’s susceptibility to undue
influence. In Campbell v. Genshlea34 and a
subsequent long line of cases, California
courts have held that the burden to show
that there was no undue influence in a transaction falls on the person who will benefit
from the transaction being declared valid, if
a set of conditions exist:
• The parties to the transaction are in a confidential relationship.
• There is a transfer for no consideration.
• There is an opportunity to exert undue
influence.
• One party to the transaction is susceptible
to having his or her will overcome by the will
of another for an undue benefit.
• One party receives an undue benefit and
was an active participant in the procurement
of the deed, contract, or gift.
The law of undue influence involves the
operation of a presumption or its lack. Once
the basic facts of a confidential relationship,
opportunity, participation, and undue or
unnatural profit are established, a presumption of undue influence arises, and the burden then is on the proponent of the deed or
gift to establish that the questioned document or transaction was an act of an individual with capacity:
In every transaction of this kind, one
who holds such confidential relation
will be presumed to have taken undue
advantage…unless it shall appear that
such person had independent advice
and acted not only of his own volition
but with full comprehension of the
results of his action.35
In the absence of a presumption of undue
influence, the burden rests on the individual
disputing the validity of a document or transaction to establish the elements of undue
influence:
• The grantor has a propensity to have his or
her free will usurped.
• The disputed action was inconsistent with
the grantor’s voluntary actions.
• The person exerting influence on the grantor
gained something that he or she ordinarily
would not have received.36
The influence exercised must effectively
destroy the grantor’s free agency and substitute another’s will for the will of the grantor.37
It is not enough that a person profits as a
result of a confidential relationship; there
must also be a showing that the person has
unduly or unnaturally profited because the
grantor’s execution of a deed or other document was not an expression of the grantor’s
wishes. For example, if a child—who is presumptively in a confidential relationship with
a parent—is deeded the family home to the
exclusion of other children, it must be proved
that the gift was contrary to, or not an expression of, the parent’s wishes. A parent may
favor one child over another without being
subject to undue influence. Affection by a
parent for one of his or her children or a
wish to please that child does not amount to
undue influence, and so a gift to one child
would not be rendered void.38
Attorneys must be aware of their duty to
a client with diminished capacity. An understanding of California case law on capacity
and undue influence is essential to the practice of elder law. There is perhaps no other
area of law in which an attorney’s documents
are so often subject to the unforgiving scrutiny
of a client’s friends and family and by triers
Los Angeles Lawyer October 2007 33
Daniel A. Plotkin, M.D.
Diplomate, Psychiatry and Geriatric Psychiatry American Board of Psychiatry & Neurology
Clinical Professor of Psychiatry UCL A
Distinguished Fellow American Psychiatric Association
Past President Southern California Psychiatric Society
Geriatric psychiatrist with over 20 years experience providing expert services:
conservatorships, diminished capacity, undue influence, elder abuse.
West Los Angeles
310 477 7855
1823 Sawtelle Blvd.
Los Angeles, CA 90025
THE LAW
OFFICES OF
Sherman Oaks
818 986 8824
15300 Ventura Blvd. Suite 525
Sherman Oaks, CA 91403
STUART D. ZIMRING
Helping to promote the means and methods for our clients to age in
place and to provide maximum guidance and assistance to persons
with special needs.
(818) 755-4848 • www.elderlawla.com
12650 RIVERSIDE DRIVE, SUITE 100, NORTH HOLLYWOOD, CA 91607
34 Los Angeles Lawyer October 2007
of fact. Knowledge of the standards promulgated by decisional law and statutes can
enable attorneys to prophylactically prepare
an effective defense against attacks on
intended documents and gifts and to assist
rightful beneficiaries and heirs in voiding
unintended documents and gifts.
■
1 AMERICAN
BAR ASSOCIATION COMMISSION ON AGING,
A SSESSMENT OF O LDER A DULTS WITH D IMINISHED
CAPACITY: A HANDBOOK FOR LAWYERS [hereinafter
ABA HANDBOOK) (citing National Institute on Aging,
National Institute of Health, U.S. Department of Health
and Human Services) (1999).
2 Due Process in Competence Determinations Act,
PROB. CODE §§810-813, 1801, 1881, 3201, 3204.
3 W ELF . & I NST . C ODE §15610.27; P ROB . C ODE
§2951(b).
4 PROB. CODE §810(a).
5 PROB. CODE §812.
6 PROB. CODE §6100.5.
7 PROB. CODE §1801.
8 PROB. CODE §§3012, 3051, 3071.
9 Estate of Sarabia, 221 Cal. App. 3d 599, 607 (1990).
10 Probate Code §21350 provides that provisions in an
instrument for donative transfers to seven categories of
individuals—including, among others, care custodians, the drafter of the instrument, and the drafter’s relatives by blood or marriage—are invalid. However,
Probate Code §21351(b) establishes the requirements
for review by an independent attorney of an instrument
making a donative transfer to a care custodian or the
instrument’s drafter. Meeting these requirements validates the instrument and the transfer.
11 See PROB. CODE §21351(b).
12 CAL. RULES OF PROF’L CONDUCT R. 3-310(F).
13 Linsk v. Linsk, 70 Cal. 2d 272, 278 (1969).
14 Moore v. Anderson Zeigler Disharoon Gallagher &
Gray, P.C., 109 Cal. App. 4th 1287, 1306 (2003).
15 Sept. 9, 2005, Report on the Board Referral of Trust
and Estates Section Legislative Proposal 2005-02 (re:
Impaired Clients) and Proposed Section 6068.5,
Legislative Proposal (T&E-2006-07): Mentally
Impaired Clients: Attorney Authority to Protect &
Confidentiality Exception.
16 See ABA HANDBOOK, supra note 1, for a detailed and
helpful exposition of the use of capacity assessment
reports by attorneys.
17 Disharoon, 109 Cal. App. 4th at 1303.
18 San Diego County Bar Ass’n Op. 1990-3 (1990).
19 Disharoon, 109 Cal. App. 4th at 1307.
20 Estate of Selb, 84 Cal. App. 2d 46, 49 (1948).
21 Id. at 50-53.
22 Estate of Chevallier, 159 Cal. 161, 169 (1911).
23 Estate of Mann, 184 Cal. App. 3d 593, 605 (1986);
see also Estate of Swetmann, 85 Cal. App. 4th 807
(2000).
24 Estate of Arnold, 16 Cal. 2d 573 (1940).
25 Estate of Shay, 196 Cal. 355, 359 (1925).
26 Estate of Martin, 270 Cal. App. 2d 506 (1969).
27 Id. at 509.
28 Hemenway v. Abbott, 8 Cal. App. 450, 461 (1908).
29 Hughes v. Grandy, 78 Cal. App. 2d 555, 564 (1947).
30 9 CAL. JUR. 117, §21.
31 Allen v. Samuels, 204 Cal. App. 2d 710 (1962).
32 Reiger v. Rich, 163 Cal. App. 2d 651 (1958).
33 PROB. CODE §§259, 1801, 2952; CIV. CODE §§38, 39.
34 Campbell v. Genshlea, 180 Cal. 213 (1919).
35 Ross v. Conway, 92 Cal. 632, 635 (1892).
36 Estate of Mann, 184 Cal. App. 3d 593, 606-14
(1986); Estate of Sarabia, 221 Cal. App. 3d 599, 60709 (1990).
37 Goldman v. Goldman, 116 Cal. App. 2d 227, 234
(1953).
38 Id. at 235.
MCLE ARTICLE AND SELF-ASSESSMENT TEST
By reading this article and answering the accompanying test questions, you can earn one MCLE credit.
To apply for credit, please follow the instructions on the test answer sheet on page 37.
SPECIAL ISSUE
ELDER LAW
by James A. Busse Jr.
Care
Package
The Deficit Reduction Act makes estate planning
for the needs of an ill spouse and a well spouse
more difficult
Arrangements
for uncovered medical costs is an often overlooked aspect of estate planning.
Many clients find out, too late, that their medical costs,
especially those involving nursing home care, can quickly consume even a sizeable estate. Estate planning attorneys have
been able to preserve a significant portion of a client’s estate
by seizing opportunities within the Medicaid program (MediCal in California) to make the client eligible for state benefits. These benefits have been used in various ways: to pay
the $5,000 to $6,000 monthly cost for institutionalized
nursing home care, to pay for a client’s disability care before
he or she becomes eligible for Medicare, or as a supplement
to Medicare payments.
The federal government took notice of the success achieved
by estate planners in preserving the assets of individuals
with large estates whose medical costs are uncovered.
Congress enacted the Deficit Reduction Act of 2005,1 a
comprehensive law designed to not only reduce benefits
heretofore available but also to increase taxes. The DRA—
signed by President George Bush on February 8, 2006—will
have a profound impact on Medicaid and Medi-Cal by:
• Implementing stricter requirements for those seeking benefits and claiming to be U.S. citizens.
• Instituting the Income First Rule, which may reduce a
stay-at-home spouse’s income forever.
• Changing the treatment of annuities.
• Limiting the home equity exclusion amount for eligibility
James A. Busse Jr. is a probate and estate planning attorney with
offices in Long Beach, California, and Gardnerville, Nevada.
Los Angeles Lawyer October 2007 35
purposes to $750,000.
• Extending the look back period. Prior law
was 30 months from the date of a gift. The
DRA designates the look back period as 60
months from the date the applicant is otherwise qualified.
The DRA will make it more difficult for
an individual to qualify for state aid to pay
disability or nursing home costs, may disqualify some already receiving benefits, will
increase the cost a recipient of state aid will
pay (the share-the-cost fraction), and will
eliminate many methods currently used to
reduce the amount a recipient’s estate will
have to repay the state for benefits received.
Clearly, the enactment of the DRA makes
careful and thoughtful estate planning more
important than ever. Moreover, any planning strategies for the possibility of a disability—a task that all too often was done, if
at all, late in a client’s life—will now have to
become an early priority in the estate planning
process.
The implementation of the DRA in
California is complex and piecemeal. Some of
the provisions of the DRA are effective nationwide as of the date of the legislation’s enactment, which was February 8, 2006; others
have later effective dates. The DRA provisions
that have an impact on Medi-Cal rules require
conforming state legislation and the promulgation of state administrative rules.
Current law in California—the rules implemented by the state Department of Health
Services (DHS)—is derived from historic
Medicaid law that has been slightly modified
by the mandates of the Omnibus Budget
Reconciliation Act of 1993. These rules
include share-the-cost rules, in which the
state seeks ways to lower its cost by, for
example, requiring an individual receiving
Social Security to apply those funds to medical care before Medi-Cal picks up the rest of
the bill. Some post-DRA rules have already
been promulgated, most notably the DHS’s
All County Welfare Directors Letter
(ACWDL) 06-12, the Administrative
Procedure for Increase in Spousal Allowance;
and ACWDL 07-12, the Proof of Citizenship
Requirement. However, full implementation
of the DRA in California is not expected
until after January 1, 2009.2
Income First Rule under the DRA
When a married person applies for and
receives Medi-Cal benefits for nursing home
care, he or she moves into an institution that
provides food, clothing, sundries, and most
living expenses. The institutionalized spouse
is allowed to keep a small amount of his or
her own spending money for various items.
This amount is currently $30 per month.
The spouse who lives at the married couple’s
home is known as the well spouse or the
36 Los Angeles Lawyer October 2007
community spouse. He or she is allowed to
keep a Minimum Monthly Maintenance
Needs Allowance (MMMNA)—which is currently $2,571 per month—and a Community
Spouse Resource Allowance (CSRA) of
$101,640 in cash and other nonexempt assets.
The CSRA may be increased to generate the
allowable MMMNA. This can be accomplished by one of two methods: a “fair hearing” by the DHS or a superior court Probate
Code Section 3100 proceeding.
For example, a retired husband receives a
pension of $2,000 per month and will do so
for the rest of his life. After his death, his surviving spouse will receive only $750 per
month. His wife has not worked outside the
home throughout their 45-year marriage and
thus has no pension of her own. The couple’s
investment portfolio contains $400,000, with
a return of 5 percent ($1,666 per month). To
qualify for Medi-Cal, the husband and wife
will have to disperse $298,360 to reach the
CSRA so that the husband can qualify for
Medi-Cal payments for the nursing home
care he needs. This leaves the wife with only
$423.50 per month ($101,640 at 5 percent
per year).
The wife’s income is below the allowable
MMMNA of $2,541.50. In order to generate the additional $2,147.50 per month to
reach the MMMNA, the husband and wife
will have to invest $515,400 at 5 percent. At
present, the couple may argue that $515,400
is needed so that the wife will receive the
MMMNA.
Under current law, using a Probate Code
Section 3100 hearing, the court will allow the
wife to keep the $400,000 because it is necessary to generate her MMMNA. This will
result in $1,095 of the husband’s retirement
income being paid to the nursing home as his
share-the-cost portion of the $6,000 per
month nursing home cost. When the husband dies, his wife is left with the $400,000
in the investment account. That amount is
required to generate her monthly income
plus the surviving spouse retirement income
of $750 per month—that is, the return from
the portfolio ($1,666) plus $750 per month,
for a total monthly amount of $2,416—and
she still has the $400,000.
Under the DRA’s new Income First rule,
at a fair administrative hearing, states are
required to allocate to the community spouse
any available income from the institutionalized spouse before any additional assets are
allocated. This means that the husband’s
entire retirement income of $2,000 per month
is first allocated to his wife. After a fair hearing, she can only keep $137,040 in investments. Thus, the couple will have to “spend
down” $262,960 for the husband to qualify
for benefits. When the husband dies, the wife
is left with a $750 survivor’s benefit and
$137,040 in investments that generate $571
per month.
To summarize the differences between the
new Income First rule as applied by ACWDL
06-12 at a fair hearing and a Probate Code
Section 3100 petition: Under the current law,
in a 3100 proceeding, the husband qualifies
immediately for Medi-Cal, the husband and
wife can keep $400,000, pay $1,095 per
month toward the husband’s healthcare, and
give the wife $2,541 per month as the
MMMNA. When the husband dies, the wife
will be left with $400,000 and $2,416 per
month ($400,000 invested at 5 percent fixed)
income for life.
Under the DRA and the new rule, after a
fair hearing, the husband will not qualify for
Medi-Cal, and the couple must spend down
$262,960, leaving $137,040. They pay nothing toward the husband’s healthcare when he
does qualify for nursing home care, because
his retirement income of $2,000 added to
the investment income of $541 makes up the
MMMNA amount. The wife receives the full
MMMNA of $2,541 per month during the
husband’s life, but when he dies, the wife is
left with only $137,040 in investments and
$1,321 per month in income.
The new Income First rule is designed to
deplete the Medi-Cal applicant’s cash and to
delay acceptance into the program. Once the
applicant is in the program, the government
cost is increased, because the income that
used to go to the share-the-cost fraction (the
money used to offset government costs) goes
instead to the spouse.
The Income First requirement—now
implemented under ACWDL 06-12 for applications effective on or after March 1, 2006—
only has an impact when the applicant
appears at a fair hearing by an administrative
law judge. It does not modify or change 42
USC Section 1396r-5(d)(5) or (f)(3) pertaining to court-ordered increases in the community spouse monthly allocation or transfers. Therefore, the rule does not apply to a
hearing regarding a Probate Code Section
3100 petition. The estate planning attorney
should weigh carefully such factors as the
anticipated life spans of a couple and the
extended support system available before
choosing which method to use.
Other Eligibility Issues
The major DRA changes to eligibility under
Medi-Cal involve the look back period, accumulation of gifts, computation of the start
date for benefits, and excludable home equity.
Also, with few exceptions, the DRA requires
proof of citizenship for an individual declaring to be a U.S. citizen to receive Medicaid
benefits. ACWDL 07-12—released on June 4,
2007—contains the requirements,3 including the applicable documentation. In the past,
MCLE Test No. 163
The Los Angeles County Bar Association certifies that this activity has been approved for Minimum
Continuing Legal Education credit by the State Bar of California in the amount of 1 hour.
MCLE Answer Sheet #163
CARE PACKAGE
Name
Law Firm/Organization
1. Only U.S. citizens are eligible for Medi-Cal.
True.
False.
2. The current look back period for eligibility is 60 months.
True.
False.
3. Annuities purchased after September 1, 2004, are
subject to Medi-Cal recovery when the beneficiary dies.
True.
False.
4. Annuities purchased after March 1, 2006, treat deferred
and balloon payments as exempt assets.
True.
False.
5. The current Average Private Pay Rate is $5,101.
True.
False.
6. A Probate Code Section 3100 petition guarantees the
well spouse will be able to keep more than the Community
Spouse Resource Allowance.
True.
False.
7. George transfers his home to his brother, retaining a
life estate. George is receiving Medi-Cal benefits. When
he dies, the state can lay claim to the entire value of his
home to recover the cost of his care.
True.
False.
8. Wanda checked the box on her Medi-Cal application
for nursing home benefits that showed her intention to
return to her residence when she was able to do so. She
proceeds to give her home to her niece as a gift with a note
stating her intention not to return to the residence and
her desire that the state will be prevented from taking the
home after she dies. A nurse copies the note. With this
evidence, the state may consider the home a nonexempt
asset and refuse Medi-Cal payments.
True.
False.
9. Harriet is admitted to a nursing home. She owns a fourunit apartment building and occupies one unit. The case
worker correctly states that the apartment building does
not qualify as a home and is therefore nonexempt.
True.
False.
10. John has a living trust, and his home is titled to the trust.
He is admitted to a nursing home after a stroke and receives
Medi-Cal benefits because his only real asset is his home.
John resides in the nursing home for about a year before
his death. Medi-Cal paid $75,000 in benefits. Since John’s
home was exempt, it is not subject to recovery.
True.
False.
11. The Deficit Reduction Act of 2005 is not yet fully
implemented in California.
True.
False.
12. A reverse mortgage is the best method to conserve
the estate of a person who will be in a Medi-Cal nursing
home for at least two years.
True.
False.
13. A client says that he is starting to have bouts of disorientation. He adds, “This happened to my dad, and he
ended up with full-blown Alzheimer’s in six years.” He
would like to fund a living trust with his $600,000 in
mutual funds. Will this plan avoid the look back period?
Yes.
No.
14. The state may seek reimbursement from the estate
or transferee of property from the estate for disability payments or for nursing home costs paid for by the state for
services rendered to an individual at any age.
True.
False.
15. The state may not deny benefits if a hardship waiver
is granted.
True.
False.
16. Placing all of a client’s assets into an irrevocable
trust so that the client has no access to the principal and
only $5,000 per year of income will create a hardship and
qualify the client for Medi-Cal.
True.
False.
17. The state can recover its costs from a trust established
and funded by a Medi-Cal recipient’s cousin to pay for the
recipient’s special needs.
True.
False.
18. Transferring a disability recipient spouse’s funds to
an irrevocable trust created by the recipient’s spouse will
trigger a look back period.
True.
False.
19. Payback language in special needs trusts documents
should be excised prior to the trust being used to pay for
the special needs of a Medi-Cal recipient.
True.
False.
20. The California Department of Health Services has
already promulgated some post-DRA rules.
True.
False.
Address
City
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ANSWERS
Mark your answers to the test by checking the
appropriate boxes below. Each question has only
one answer.
1.
■ True
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2.
■ True
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3.
■ True
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4.
■ True
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5.
■ True
■ False
6.
■ True
■ False
7.
■ True
■ False
8.
■ True
■ False
9.
■ True
■ False
10.
■ True
■ False
11.
■ True
■ False
12.
■ True
■ False
13.
■ Yes
■ No
14.
■ True
■ False
15.
■ True
■ False
16.
■ True
■ False
17.
■ True
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18.
■ True
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19.
■ True
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20.
■ True
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Los Angeles Lawyer October 2007 37
a claimant needed only to affirm his or her
U.S. citizenship to collect Medi-Cal benefits.
Now claimants must provide proof. Specified
categories of applicants are exempt from the
proof-of-citizenship requirements.
The DRA increases the maximum look
back period from 30 months after a disqualifying transfer of assets to 60 months
after the applicant is otherwise qualified.
Currently, if the applicant gives available
resources away within 30 months of the date
of application for benefits, that person is disqualified from the date the money was given
away for a period calculated by dividing the
amount gifted by the Average Private Pay
Rate (roughly the average cost per month
for nursing homes that accept Medi-Cal).
This amount is currently $5,101 per month.
For example, under the current rules, if an
applicant gave $40,000 away, the applicant
is disqualified from receiving Medi-Cal for
nursing home care for $40,000 divided by
$5,101, or almost 8 months. If the applicant
gave away $40,000 in September 2006 and
applied for Medi-Cal in February 2007, the
period of disqualification would only be 1 to
3 months (depending on what day in each
month the triggering event occurred).
When the DRA is fully implemented, the
period of disqualification will start from the
date the applicant was otherwise eligible for
Medi-Cal benefits and run for a period of 7
months and 25 days from that date. The
DHS has acknowledged that it does not plan
to implement the 60-month look back rule
retroactively.4
The DRA eliminates the current law’s
unlimited home equity exclusion.5 Applicants
are disqualified from receiving nursing home
and other long-term care assistance when
their home equity exceeds $500,000, unless
the applicant’s spouse, or the applicant’s
minor child, or a blind or disabled child is
residing in the home. Questions remain
regarding how home equity will be determined. Also, there is a clear trend for raising
the amount of excludable home equity. State
Senator Sheila Kuehl has introduced SB 483
to increase the home exclusion cap to
$750,000. The bill has cleared the Senate
and awaits action in the Assembly.
Currently, to qualify for nursing home
care, a single person is allowed to have $2,000
in cash or securities, up to $1,500 cash or securities set aside for burial expenses, a life insurance policy with a face value of $1,500 or less,
jewelry valued at less than $100, a home, a car
of any value, household goods, personal clothing, and possibly a business if it is the sole
method of the individual’s support or if there
are business partners who will not agree to
divest the property or business.
When implemented, the DRA will classify
money used to purchase a life estate interest
38 Los Angeles Lawyer October 2007
in the home of another individual as a transfer that causes a period of ineligibility unless
the purchaser lives in the home for one year
after the date of purchase.6
Annuities
The impact of the DRA on annuities, particularly regarding eligibility, is substantial and
comprehensive. The new annuity rules, which
affect annuities purchased after March 2006:
1) Mandate the state to require applicants to
disclose any interest they or the community
spouse has in any annuity.
2) Require the application or recertification
form to include a statement that the state
becomes a remainder beneficiary under the
annuity. If a regular payment annuity is established for the expected life of the patient and
the patient dies early, the state takes possession of the remainder.
3) Treat the purchase of a deferred or balloon
payment annuity as a transfer of assets.
4) Exempt work-related pension funds, annuities, and qualified IRAs.
Under the DRA, if the applicant spends
$100,000 to establish an annuity that makes
regular periodic payments over his or her
expected life, the annuity payments are considered income and taken for the share-thecost reimbursement. Additionally, the applicant will experience a period of ineligibility
equal to the amount spent on the annuity
divided by the Private Pay Rate. This is converted to months of ineligibility from the
date the applicant otherwise qualified for
care—unless the state is the remainder beneficiary of the annuity. Under the current
rule, the remainder does not revert to the
state.
Annuities purchased before March 2006 pose
a different set of Medi-Cal eligibility issues.
• For annuities purchased prior to August 11,
1993, the balance is considered unavailable if
the applicant is receiving periodic payments—
in any amount—of interest and principal.
• Annuities purchased between August 11,
1993, and March 1, 1996, will continue to be
treated under the pre-August 11, 1993, rules
if the annuities cannot be restructured to
meet the post-March 2006 requirements.
• If the annuities were purchased on or after
March 1, 1996, the applicant or the applicant’s spouse must distribute periodic payments of interest and principal to exhaust
the balance of the annuity at or before the end
of the annuitant’s life expectancy. Annuities
purchased by the applicant on or after
September 1, 2004, are subject to Medi-Cal
recovery when the beneficiary dies.7
After the DRA is fully implemented, an
effective planning technique will involve purchasing the annuity early in life for care later
in life. This approach may increase the sharethe-cost fraction, but the state will not have
to be the beneficiary, nor will the look back
period interfere with eligibility and qualification. An individual could buy a delayed benefit annuity for another that commences payments to a nonrelated beneficiary if the
purchaser is ever institutionalized. The third
party may be able to use the money to benefit the institutionalized person. The money
would be drawn from the institutionalized
person’s estate and would not be available for
the share-the-cost reimbursement. The only
requirement is that the payments must be
dispersed more than 60 months before the
institutionalized person would be otherwise
qualified for Medi-Cal.
The somewhat predictable path of dementia and Alzheimer’s disease allows a party to
do some planning. It is important to consider and calculate the time span from the
onset of symptoms to the inability of a family to care on their own for the person who
is ill. Often this path takes more than five
years. So for a person with a family history
of these diseases, if there is enough money
available, the delayed annuity method might
be a good way to reduce the estate, prevent
disqualification, and lower the share-the-cost
fraction.
Home Equity Rules
California defines home equity two ways.
The California Code of Regulations and the
Welfare and Institutions Code define the
owner’s equity in the property as “the net
market value which is determined by subtracting the encumbrances of record from
the market value.”8 But another section of the
Welfare and Institutions Code states that
“[i]f the holdings are in the form of real property, the value shall be the assessed value,
determined under the most recent county
property tax assessment, less the unpaid
amount of any encumbrance of record.”9 It
is obvious some reconciliation is required,
given the difference between the assessed
value of many homes under Proposition 13
and their current market value.
Probably in deference to the banking sector, Congress mentions in the DRA that home
equity loans and reverse mortgages may be
used to reduce home equity. Care must be
taken regarding these vehicles.
The borrower may use the cash from a
home equity loan to reduce the value of the
home, but the cash disqualifies the borrower
for Medi-Cal benefits. If the borrower uses the
cash from the loan to improve the home with
permitted work or to improve another asset,
the borrower’s assets and home value are
increased, which may disqualify the borrower. The equity exclusion amount will most
likely be based on the lower of the appraised
or assessed value, so a home previously
assessed under the lower range scheme of
Proposition 13 may find its equity disproportionately increased by an improvement
that increases the assessed value of the home.
This is especially true if, in the past, the
owner exercised the Proposition 8 assessment reduction option. Therefore, the cash
generated from a home equity loan should be
used to purchase an exempt asset, such as a
car, furniture, or burial plot.
Reverse mortgages provide funds to either
without a writing reserving the right to live
in the home for the remainder of the applicant’s life, and this occurs before the applicant
is accepted into the Medi-Cal system, the
home is no longer the applicant’s home and
is not exempt. One tactic for an applicant is
to check Item 51, get accepted into the system, and then gift the home for the love and
affection of the person receiving it. That
series of steps will prevent recovery.
spouse, an Intentionally Defective Grantor
Trust (IDGT) (sometimes referred to as an
Intentionally Defective Irrevocable Trust
(IDIT)) may be used. An IDGT is a trust for
the benefit of another, in which the settlor
pays the income and property tax. An IDGT
can remove assets from the institutionalized
person’s estate so that at death, there is nothing left for the state to collect.
Under the current rules, share-the-cost
Spending money for a house takes advantage of the rule that makes the
applicant’s home an exempt asset if the applicant states it is his or her desire
to return to that home when his or her stay in the nursing home is over.
improve the home or use as regular income.
Thus reverse mortgages by nature are counterproductive, because they increase the sharethe-cost fraction. They also consume an estate
at an alarming rate because the borrower is
now paying compound interest on the original amount borrowed. Some reverse mortgages even share the equity buildup but do not
share equity loss. The owner is in effect selling the house and paying a compound interest premium to do so. Moreover, most if not
all reverse mortgages require the borrower to
live in the home. If the borrower does not, the
loan is called. The net result may be loss of
equity, loss of the home, and loss of Medi-Cal
benefits when the home is foreclosed upon
and the borrower/Medi-Cal recipient receives
a cash settlement from the sale of the home.
Planning Techniques
Traditionally, planning techniques revolve
around the applicant’s qualifying for benefits;
minimizing share-the-cost charges; and delaying, minimizing, or eliminating the state
recovery of money dispersed to the MediCal recipient. Under the current rules, a customary approach for Medi-Cal estate planners
involves turning nonexempt assets into
exempt assets. For example, an applicant
may spend money for a home to which he or
she intends to return as a residence after the
nursing home care is no longer needed.
Money may be spent for an addition to the
home. The applicant may also purchase a
car for transport to and from the nursing
home.
Spending money for a house takes advantage of the rule that makes the applicant’s
home an exempt asset if the applicant states it
is his or her desire to return to that home
when his or her stay in the nursing home is
over. The applicant declares this desire on the
Medi-Cal application by checking Item 51. If
Item 51 is not checked, the home is not exempt.
If the applicant’s home is gifted to another
Transfers for value do not trigger the look
back period and can be used to reduce the size
of an individual’s estate. One example is a
contract for care in which the institutionalized spouse contracts with a family member
for services. For example, the institutionalized
person pays a set amount to the family member for the performance of specified services
for the rest of the institutionalized person’s
life. If the amount paid is equal to the market value of the services to be provided over
the institutionalized person’s expected life,
the transfer will reduce assets without triggering the look back period.
The estate planner often devises
approaches in anticipation of the institutionalized spouse’s death. Under the current
rules, qualifying the institutionalized spouse
for Medi-Cal may require all of that spouse’s
assets to be transferred to the well spouse as
his or her separate property. If this occurs, the
assets are considered unavailable after the
look back period. If the well spouse dies first
and his or her will transfers property to the
institutionalized spouse, the institutionalized
spouse may be disqualified from receiving
benefits.
Once Medi-Cal eligibility has been established for the ill person, the well spouse will
often want to create a living or revocable
trust to hold his or her property. It is essential that this trust not make the ill spouse a
beneficiary, since that would terminate the ill
spouse’s eligibility. Many well spouses understandably want to provide for the ill spouse
in the event the well spouse passes away first.
One way to accomplish this is to have the well
spouse’s living trust “pour back” the assets
into the well spouse’s probate estate if the well
spouse dies first, coupled with a will by the
well spouse that creates a testamentary trust
for the ill spouse. Since current Medi-Cal
rules do not cover testamentary trusts, there
is no ineligibility risk for the ill spouse.
For institutionalized persons without a
planning techniques may involve purchasing
annuities that do not make fixed payments.
The recurring payments are low, but there is
a remainder or balloon payment at the end of
the annuity that is paid to another person after
the patient dies. These payments technically
are not allowed, but existing policy is not to
recover them due to the high cost and marginal benefit of doing so.
These approaches have allowed families to
keep some of their assets when one family
member requires placement in a nursing home
or becomes disabled. Further, special needs
trusts may be used to fund certain comforts
for the institutionalized person without the
value of the gift being included in the sharethe-cost fraction.
When the Medi-Cal recipient dies, the
state recovers the money spent on the institutionalized person under Welfare and
Institutions Code Section 14006. This section
allows the state to seek reimbursement for disability services rendered when the decedent
was over age 55 and for nursing home care
received at any age. The state cannot claim
reimbursement during the lifetime of a surviving spouse, when there is a surviving child
under the age of 21 or when the surviving
child is blind or is permanently and totally disabled within the meaning of the federal Social
Security Act.
Under the Welfare and Institutions and
Probate Codes, the personal representative,
successor trustee, or surviving spouse of a person who may have received Medi-Cal benefits must inform the DHS within 90 days of
the date of the recipient’s death.10 The DHS
may then place a lien on the decedent’s property—and if the property has been given
away, the fiduciary is personally liable. MediCal recovery funds are recycled back into
the benefits system, so the recovery concept
is an important component of the total MediCal program.
Recovery, under current rules, may be
Los Angeles Lawyer October 2007 39
minimized or avoided by reducing the assets
of the institutionalized person at his or her
death. An irrevocable life estate is a method
of doing this. Life estates without the right to
revoke leave so little in the estate that the DHS
has stated that the cost to collect these funds
exceeds their value. Therefore, the agency
will not pursue collection against an irrevocable life estate.11 California currently only
penalizes transfers to purchase life estates
when the transfer is for an item of lesser fair
market value—except when the life estate
method remains an option. It will still be
possible to transfer funds to others by contracting for care over the expected life of the
institutionalized person. Planners must ensure
that the contract uses cost information that
is reasonable for the services provided and the
actuarial life expectancy of the institutionalized person. Otherwise, the contract is at
risk of being deemed a transfer of assets
invoking the look back provisions.
A delayed annuity to a trusted third party
or parties will reduce assets and might pro-
court. These trusts require the trustee to
notify the state upon the death of the beneficiary and pay any claims made by the state.
These trusts are subject to the control and
reporting requirements enumerated in Rule 7903 of the California Rules of Court, unless
the value of the trust is less than $20,000.15
An IDGT may be still be an appropriate
choice after the DRA is fully implemented.
With an IDGT, the applicant transfers an
exempt asset, such as a home, irrevocably to
the trust, reserving the right to live in and
The CSRA cap may be increased—allowing assets to be transferred
without qualification or recovery penalty—to provide the necessary
principal for the well spouse.
involves the institutionalized person’s home,
an exempt item.
A Probate Code Section 3100 petition
may be used in Medi-Cal planning. The petitioner uses this method for a court-ordered
transaction transmuting the separate and
nonexempt community property of the institutionalized spouse to the separate property
of the well spouse to satisfy the specific needs
of the well spouse. The order increases the
CSRA and MMMNA limits. The MMMNA
cap may be reasonably increased to meet the
recurring needs of the well spouse, including
high prescription drug costs, home loan payments, and the like. The CSRA cap may be
increased—allowing assets to be transferred
without qualification or recovery penalty—
to provide the necessary principal for the
well spouse.
Remaining Options
Once the DRA is fully implemented, the
estate planner must focus on the techniques
that will remain available. One involves the
transfer of the institutionalized person’s residence to his or her spouse or to an IDGT or
IDIT to reduce recovery. A transfer will only
be valid if it was not made for the purpose of
qualifying for Medi-Cal.
A donative transfer of the home does not
invoke a period of ineligibility under the
Medi-Cal regulations if the donor retains or
is given a legal right to return to the home.12
The homeowner receiving Medi-Cal benefits may decide to give away the house during his or her lifetime so that the house is protected from a Medi-Cal estate recovery claim
at the homeowner’s death. Placing a home in
an IDGT in which the owner retains the right
to live in or return home and the owner pays
the tax on the property allows the owner to
remain in or return to the home and removes
the property from the owner’s estate upon
death, thereby reducing recovery.
The acquisition-of-services-for-value
40 Los Angeles Lawyer October 2007
vide funds to that third party or parties so that
they can provide some comforts to the institutionalized person. One method to transfer
assets would be to gift the annual exclusion
amount, now $12,000 per person, earlier in
life to another person who is not a spouse.
That person then establishes a third party
special needs trust for the benefit of the potential Medi-Cal recipient. A third party special
needs trust is exempt from recovery and may
provide funds for items that improve the
quality of life of the institutionalized person.
This method thus offers an opportunity to
reduce the estate and provide care.
Probate Code Section 3100 petitions are
not affected by the DRA. So a court action is
still available to protect the well spouse’s
future and the cash and securities left in the
well spouse’s estate.
An irrevocable life estate remains a viable
alternative to avoid recovery. The caveat for
planners is to be sure the transfer is irrevocable and that the applicant has lived in the
home for at least one year before applying for
Medi-Cal.
Special needs trusts are available but
require careful consideration. A special needs
trust established by a third person with the
third person’s funds is not subject to recovery. The most popular form of special needs
trust, a D4A trust, is sometimes called a payback trust.13 It is a trust funded with assets
belonging to the beneficiary. The D4A trust
is established for a disabled beneficiary under
65 by a court, parent, grandparent, or legal
guardian. A D4A trust must pay back the
state for all medical assistance received at
any time up to the full amount of the principal in the trust on the date of the beneficiary’s death. Another form of special needs
trust is the first-party trust established under
Probate Code Sections 3600 et seq.14 This
type of trust is usually funded with judgment
money owed the beneficiary and is subject to
review by the DHS before approval by the
return to the home and retaining the obligation to pay the property and income taxes on
the property in the trust. This transfer is
excluded from the look back period and
removes the property from the applicant’s
estate for recovery purposes.
Estate planners should consider whether
a hardship waiver of the recovery is viable for
a client. The state will not be able to deny benefits to a person who has applied for and
received a hardship waiver in accordance
with DRA Section 1917(c)(2)(D). According
to the DRA, an undue hardship exists when
the application of a penalty for a transfer of
assets would deprive the individual of 1)
medical care, without which the individual’s
health or life would be endangered, or 2)
food, clothing, shelter, or other necessities
of life. California has not yet codified specific
criteria for eligibility for this waiver. A commentator to a draft rule stated that a hardship
should not qualify for waiver if the hardship
is created by estate planning methods.16
Finally, one method that does not save
the estate but may bring comfort to a person
requiring care would be for that person to
borrow on his or her own property to generate funds for in-home care—which is not
covered in any way by Medi-Cal. If the person has children, they could provide the
house payments as a gift to their parent,
knowing that when the parent dies they will
receive the property and can repay themselves. All parties would have to strike a balance between the expected duration of inhome care and the amount of money
borrowed. This family-funded care would
keep the ill person at home, which is usually
a far better place to be than even the best nursing home. This approach reduces the estate
but is more cost-effective than a reverse mortgage. The result is that the children receive
more for their inheritance than they would if
the ill parent chose a reverse mortgage, and
the ill parent will be able to remain in famil-
iar surroundings.
Among the purposes of the DRA is the
reduction or elimination of the estate planning
methods that have been widely used to conserve taxpayers’ estates for their families.
Although the DRA rules in California have not
yet been fully devised or promulgated, the
estate planner must keep in mind the potential for future changes when working with
clients. California rarely implements laws
retroactively, but the DRA’s enactment date of
February 8, 2006, does trigger some mandatory transfer rules involving real property and
transfer of assets to purchase annuities.
■
1 Deficit Reduction Act of 2005, Pub. L. No. 109-171
(Feb. 8, 2006), 42 U.S.C. §1396.
2 Estate planners must carefully watch legislation and
rule proposals for their effect on individual clients.
Numerous advocacy organizations provide updates
on proposed changes and platforms for comments.
See, e.g., the California Advocates for Nursing Home
Reform (CANHR) Web site, at http://www.canhr.org
/medical/medical_changes092006.html.
3 See http://www.dhs.ca.gov/mcs/mcpd/MEB/ACLs.
4 See CANHR, Legal Network News, vol. 18, no. 2,
Summer 2007, at http://www.canhr.org.
5 DRA §6014 adds new subsection (f) to 42 U.S.C.
§1396p.
6 42 U.S.C. §1396p(c)(1)(J).
7 WELF. & INST. CODE §§14006.41, 14009.6.
8 22 CAL. CODE REGS. §50415; WELF. & INST. CODE
§14006.
9 WELF. & INST. CODE 14006(e)(1).
10 WELF. & INST. CODE §14009; PROB. CODE §§215,
9202, 19202.
11 See CANHR Web site, at http://www.canhr.org
/medical/medical_changes092006.html. On June 12,
2006, the state Department of Health Services released
a statement regarding recovery against life estates and
enforcement of the May 10, 2006, regulations:
After the filing of R-32-00 with the Office of
Administrative Law, the Department of Health
Services (Department) continued to review and
analyze the numerous public comments that
had been received during the second public
comment period for the package. As a result of
that analysis, a policy decision was made to
amend a portion of R-32-00 through regulations package R-14-04. The amendment will
result in the removal of recovery efforts against
the value of life estate only interests. The
Department has now determined that during
the short period of time in which R-32-00 as
currently enacted will be in effect, it will not
be cost effective for the Department to initiate
or pursue recovery against life estate only interests. This decision is based on balancing the
anticipated small dollar value associated with
recovery for the few months R-32-00 would be
in effect prior to the filing of R-14-04, against
information obtained from advocates that the
legality of life estate only interest recoveries
would be challenged in the courts.
12 DHS, All County Welfare Directors Letter (ACWDL)
No. 90-01, Jan. 5, 1990, at 5, Questions and Answers
Nos. 7 and 8, available at http://www.dhs.ca.gov
/mcs/mcpd/MEB/ACLs.
13 See 22 CAL. CODE REGS. §50489.9.
14 See CAL. R. CT. 7-903 for trust requirements.
15 CAL. R. CT. 7-903(D).
16 Proposed changes to CAL. CODE REGS. §50961,
11/1/06 Draft Rule R-14-04.
MEDI-CAL PLANNING FOR LONG TERM CARE
LAW OFFICE OF SEAN D. ETHINGTON
MEDI-CAL PLANNING
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• Representation
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• Court proceedings and
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Hearings to increase
• Asset protection
planning to minimize or
potentially eliminate
estate recovery
TEL 800.852.1239
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SPECIAL ISSUE
ELDER LAW
by Bryan Carney
Crossing
the Line
Struggling
to define obscenity, Justice Potter
Stewart stated famously, “I know it when I see it.”1 Today, an
equally uncertain definition exists in the area of elder law: What
is elder abuse, and what separates it from professional negligence? In 2005, the California Court of Appeal published a previously unpublished opinion on that question, acknowledging
that numerous requests for publication were “well taken
because attorneys and trial courts in elder and dependent
abuse cases have struggled with the distinction between neglect
and professional negligence.”2
The distinction carries profound implications for elders, their
attorneys, and the healthcare facilities that serve the elderly.
If the lawsuit is for professional negligence, the panoply of
restrictions and conditions on causes of actions and remedies
directed at healthcare providers under the Medical Injury
42 Los Angeles Lawyer October 2007
Compensation Reform Act apply. On the other hand, if the law
suit is for elder abuse, MICRA is not in play,3 and an elder
abuse plaintiff may recover unlimited noneconomic damages.
Furthermore, his or her estate may recover up to $250,000 in
noneconomic damages, and the attorneys prosecuting (but
not defending) the elder abuse case may recover their fees.4 With
so much at stake turning on the difference between professional
negligence and elder abuse, one would assume that the line
between the two is clear. It is not.
Sixteen years after the California Legislature shifted the
focus of the elder abuse statutes from merely reporting abuse
and neglect to private enforcement stimulated by enhanced civil
remedies, courts and practitioners still struggle with basic
Bryan Carney is with Morris Polich & Purdy LLP.
HADI FARAHANI
Litigation of elder abuse claims hinges on the
distinction between professional negligence and
actual abuse
Los Angeles Lawyer October 2007 43
definitions in this highly emotional area of the
law. Not even the 1999 landmark opinion of
the California Supreme Court in Delaney v.
Baker put the question to rest.5
Some argue that judgments won under
the Elder Abuse and Dependent Adult Civil
Protection Act over the years have improved
the care that elders are receiving in healthcare
facilities.6 Others argue that the Elder Abuse
subdivision (b) of Section 3333.2 of the Civil
Code [limiting recovery] of non-economic
damages to $250,000.” Physical abuse and
neglect each have detailed statutory definitions.8
Although the majority of case law refers
to a claim made under the Elder Abuse Act
as a cause of action, some decisions view the
act as an enhanced remedy provision that
litigated) species of elder abuse. More importantly, courts are using nonstatutory markers
to draw the line between elder abuse and
professional negligence—namely, the length
of time that the elder is exposed to abuse or
neglect and what the healthcare provider
knew about the elder’s condition during that
time. No opinion expressly claims these two
factors are dispositive, but a fair reading of
published and unpublished cases strongly
suggests that these two factors decide the
difference between statutory elder abuse and
simple, common law negligence.
Begin with Delaney
Act has created unforeseen consequences for
the healthcare industry that ultimately undermine the legislature’s goal in ensuring that the
state’s growing elder population is protected.
Notably, insurance premiums for healthcare
providers have skyrocketed in California,
forcing many healthcare facilities into bankruptcy.7
More immediate consequences stem from
the triggering language of the Elder Abuse Act
that sets forth its enhanced remedies. Section
15657 provides, in pertinent part: “Where it
is proven by clear and convincing evidence
that a defendant is liable for physical
abuse…or neglect [of an elderly or dependent
adult], and that the defendant has been guilty
of recklessness, oppression, fraud or malice
in the commission of this abuse, the following shall apply, in addition to all other remedies otherwise provided by law.…(a) The
court shall award to the plaintiff reasonable
attorney’s fees and costs…[and] (b) The limitations imposed by section 377.34 of the
Code of Civil Procedure [forbidding a decedent’s estate from obtaining pain and suffering damages] shall not apply. However, the
damages recovered shall not exceed the damages permitted to be recovered pursuant to
44 Los Angeles Lawyer October 2007
comes into play if the plaintiff can prove the
statutory elements of the act in addition to the
elements of an underlying tort. Most recently,
for example, the court of appeal in Berkley
v. Dowds stated, “The Act does not create a
cause of action as such, but provides for
attorneys fees, costs and punitive damages
under certain conditions.”9
The uncertainty of whether a claim made
under the Elder Abuse Act is a separate tort
is surpassed by the uncertainty of what constitutes elder abuse under the act. In the
shadow of the act’s enhanced remedies provision, the legislature added a clause exempting professional negligence actions against
healthcare providers.10 Predictably, the first
order of judicial business was to discern the
difference between professional negligence,
which is exempt, and elder abuse, which is
not. In Delaney the California Supreme Court
tried to define that line. It still vexes courts
and practitioners.
A series of published and nonpublished
opinions since Delaney have begun to give a
judicial gloss to the term “elder abuse.” After
16 years of experience with enhanced remedies for elder abuse, “reckless neglect” has
become the favorite (and the most frequently
The facts of Delaney were clear. The facility
left the elder lying in her own urine and feces
for what the court described as “extended
periods of time.”11 The elder developed stage
III and stage IV decubitus ulcers, leading to
her death. The plaintiff repeatedly complained
of the elder’s deteriorating condition, yet the
defendants failed to timely respond to these
complaints.12 Not surprisingly, the plaintiff
prevailed at trial.
Legally, Delaney turned on the exemption clause for “professional negligence” contained in Section 15657.2 of the act. The
defendants argued that the language “based
on…professional negligence” as used in
Section 15657.2 of the Elder Abuse Act covers all conduct directly related to the rendition of professional services.13 A reading of
the act in this way would have broadly
exempted healthcare providers from the
enhanced remedies of Section 15657. The
supreme court disagreed with the interpretation of the defendants and held that “reckless neglect” under Section 15657 is distinct
from causes of action “based on professional
negligence.” Delaney’s lesson is that “[r]recklessness, unlike negligence, involves more
than inadvertence, incompetence, unskillfulness or a failure to take precautions but rather
rises to the level of a ‘conscious choice of
action…with knowledge of the serious danger to others involved in it.’”14 On the facts
before it, the supreme court in Delaney had
little difficulty affirming the jury’s finding of
reckless neglect.
Delaney’s articulation of recklessness is a
helpful but not definitive yardstick for distinguishing between elder abuse and professional negligence. Its facts are deplorable,
but not many cases lie at that end of the
spectrum. Most cases fall somewhere in the
middle, and Delaney does not indicate what
facts are needed, either at the pleading or
summary judgment stage, for a case to cross
the line separating elder abuse from professional negligence. That middle ground is
being defined by the courts of appeal. With
increasing frequency, inquiries concerning
“What did they know?” and “When did they
know it?” are being used to draw the line
between professional negligence and elder
abuse.
Time
The elder in Delaney was neglected for
“extended periods of time.” According to
an unpublished opinion, five days may be
enough. In Trujillo v. Superior Court, the
court of appeal reinstated an elder abuse
claim that had been dismissed on demurrer.
Relying almost exclusively on Delaney, the
court in Trujillo found that even though the
allegations before it were not as egregious as
those of Delaney, they were sufficient to state
a cause of action for elder abuse.15
The Trujillo complaint alleged that the
elder had developed decubitus ulcers on her
hips and feet and that the defendant, a home
health agency, was retained to provide home
care. According to the complaint, the defendant’s nurse missed a visit and, when called
two days later, claimed the agency was shortstaffed. After several more days passed without a visit, the plaintiff’s mother developed a
fever. The plaintiff took her mother to a hospital, where she died of sepsis.16
Two justices saw this as a pattern of indifference manifested over a period of approximately five days. One justice disagreed. In her
dissenting opinion, Justice Grignon wrote:
“[The] patient was under the care of Home
Health Agency for five days only. These are
allegations of professional negligence not
elder abuse.”17 Like the majority, Justice
Grignon focused on the issue of time. She
found that the facts alleged did not show
that the plaintiff’s mother had been left to
deteriorate over an extended time but rather
that the defendant missed a single at-home
visit.18
The split decision in Trujillo underscores
how, on the same record, reasonable minds
can reach different conclusions as to whether
the case is one for professional negligence or
elder abuse. In contrast to Trujillo, a different court of appeal unanimously saw elder
abuse but, like the Delaney court, used the
imprecise phrasing of “extended period of
time” to describe the temporal window
through which the allegations would be
viewed.
In Klinkner v. Alta Vista Health Care
Center, the elder was admitted to the skilled
nursing facility with “significant problems”
and stayed there for three months.19 Toward
the end of her stay, the elder’s family noticed
a number of problems with the elder’s care.
The elder became dehydrated, was immediately taken to a hospital for emergency treatment, and returned to the facility the same
day, apparently with instructions not to be
taken out of bed. The next day, the elder
was lifted out of bed and fell, dislocating her
hip. The dislocated hip was diagnosed and
appropriate care provided within 24 hours of
the fall.20
The court in Klinkner held that the allegations in the plaintiff’s complaint were insufficient to plead elder abuse. In language reminiscent of Delaney, the court wrote: “There
is no indication that any of Alta Vista’s alleged
failures to provide Isabelle with timely or
appropriate care occurred over an extended
period of time.”21 As in Delaney, an “extended period of time” is left undefined.
In many cases, the plaintiff attempts to
portray a lengthy period of time by citing
prior administrative citations. This type of evidence, however, typically falls short of showing elder abuse. In Klinkner, for example,
the facility had been cited 38 times by the
Department of Health Services (DHS) in the
two-year period preceding the elder’s admission to the facility, and the facility never told
the elder’s family about this two-year citation
history. But this was legally irrelevant to the
court’s analysis because no facts were alleged
relating the administrative citations to the
care of the elder or other residents.22 Other
cases hold that while the administrative regulations governing healthcare providers define
the duty of care, regulatory violations show
only a breach of that duty, i.e., neglect. On the
additional element of culpable knowledge—
recklessness, malice, oppression, or fraud—
the administrative citations are irrelevant.23
Klinkner and Trujillo are unpublished,
but they offer some insight into how the
courts look at the period of alleged mistreatment to determine whether the lawsuit
is one for elder abuse or negligence.
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The courts of appeal also emphasize what the
defendant knew about the elder’s condition
in determining whether or not the conduct
crosses the line from negligence to elder abuse.
Two published cases illustrate how concealing or ignoring an elder’s condition may constitute elder abuse. But no published case
defines the goalpost at the opposite end of the
field—namely, when will a defendant’s knowledge (or lack of knowledge) of an elder’s
condition not be sufficient to support a claim
of elder abuse? On that side of the question,
little guidance exists. The cases are unpublished.
Much like Delaney, Mack v. Soung has
facts so egregious that a finding of elder
abuse is not surprising. In Mack, the complaint against a treating physician alleged
that the elder had resided at a nursing and
rehabilitation center and that, despite the
center’s assurances to the elder that steps
were being taken to prevent her from getting
bedsores, the elder developed an untreatable
stage III bedsore after being left in a bedpan
Los Angeles Lawyer October 2007 45
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for 13 consecutive hours.24
According to the plaintiff, the center and
the elder’s treating physician concealed the
existence of the bedsore until the following
month. The physician affirmatively opposed
hospitalization during the next two months,
representing that the center’s care was “appropriate.”25 After the plaintiffs complained to
the DHS, the physician abandoned the elder
without notice and refused to respond to
staff requests to permit her hospitalization. At
the end of those two months, the elder died.26
Relying on Delaney, the Mack court
wrote, “We have no trouble concluding that
a doctor who conceals the existence of a serious bedsore on a nursing home patient under
his care, opposes her hospitalization where
circumstances indicate it is medically necessary, and then abandons the patient in her
dying hour of need commits neglect within the
meaning of the Act.”27
Sababin v. Superior Court involved a
skilled nursing facility resident who was suffering from Huntington’s chorea, a terminal
condition that subjects the sufferer to skin
deterioration.28 At the facility, the elder’s
care plan called for daily monitoring of skin
condition. Over the course of three years,
the skin checks were sporadic. Predictably, the
elder’s condition deteriorated, and she was
transferred from the skilled nursing facility to
a hospital. The hospital observed that the
elder had lacerations on her toes and feet
and had poor skin condition on both buttocks, which were dark red and squishy. The
skilled nursing facility had no documentation
of these conditions, nor had a physician been
notified.29 Sababin held that “a trier of fact
could find that when a care facility’s employees ignore a care plan and fail to check the
skin condition of a resident with Huntington’s
chorea, such conduct shows deliberate disregard of the high degree of probability that
she will suffer injury.”30
The defendant in Sababin argued that
elder abuse differs from professional negligence because elder abuse is a complete deprivation of care and not merely insufficient
care. The Sababin court disagreed, holding
that elder abuse can be found when a care
facility knows it must provide certain care on
a daily basis and yet only provides this care
sporadically, or when multiple types of care
must be provided and the care facility only
provides some types of care.31 But what if the
defendant’s awareness of the elder’s condition
is not as obvious as in Delaney, Mack, or
Sababin? In other words, what state of mind
by the defendant will not rise to the level of
recklessness, malice, oppression, or fraud?
Three decisions offer some answers, but they
are unpublished.
Renko v. Northridge Care Center, Inc.,
faced the question of whether recklessness can
be established by the defendant’s constructive
knowledge. The plaintiffs alleged that the
healthcare defendants failed to provide treatment to the elder and failed to promptly
transfer the elder to a hospital, which resulted
in the development of pressure sores, infection, and, ultimately, death.32 The elder abuse
theory was the defendants knew or should
have known that the elder required hospitalization to avoid further injuries. Neither the
trial court nor the court of appeal agreed. It
was not at all clear when the facility should
have known that emergency treatment was
required. Rejecting a constructive knowledge
theory of recklessness, the court in Renko
declared that there is “no indication in the
elder abuse statutes that constructive knowledge suffices to establish recklessness.”33
If constructive knowledge of an elder’s
needs cannot support an elder abuse claim,
what about a complete lack of knowledge of
the elder’s needs? Furlong v. Catholic
Healthcare West is illustrative.34 In Furlong,
the elder abuse claim against the hospital was
that it had wrongfully resuscitated the elder
in violation of her advanced healthcare directive. Hospital staff was unaware of the directive, which expressly contained “Do Not
Resuscitate” and “Withhold CPR” orders.
The hospital, according to the complaint, had
failed to determine and document the elder’s
healthcare wishes and participated in her
wrongful resuscitation, all in violation of federal and state law. But those allegations rose
only to the level of negligence, not elder abuse,
the Furlong court concluded. While hospital
staff had no knowledge of the elder’s advanced
healthcare directive, this lack of knowledge
stemmed from the failure of emergency room
personnel to ascertain that information in the
first instance. The “hospital’s alleged failure
to take any steps to ascertain her wishes does
not show a conscious or deliberate course of
action, undertaken with knowledge of the
dire consequences.”35
In Reyome v. Sunrise Senior Living Services, Inc., the facility faced an unpredictable
situation. Confronted with a combative resident, nurse assistants decided to use a wheelchair-to-bed transfer method that differed
from the facility’s policies and procedures.36
As a result, the elder fell forward and hit her
head on the side rail of the bed. Paramedics
arrived and took the elder to the hospital,
where she died the next morning.37
The facility’s written policy and procedure for wheelchair-to-bed transfers was key
to the plaintiff’s opposition to the facility’s
motion for summary judgment. The plaintiff
argued that it was undisputed that the policy
was ignored.38 The trial court and the court
of appeal agreed but concluded that it was not
enough to show elder abuse. Even though
there was sufficient evidence that the defen-
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Los Angeles Lawyer October 2007 47
dant’s staff did not comply with policies and
procedures, there was no evidence to establish
that the deviation constituted a deliberate disregard for the elder’s safety resulting in a high
degree of probability that an injury would
result.39 The modified transfer technique had
been successfully and safely used on prior
occasions when the elder was combative. In
addition, unlike Delaney and Trujillo, the
elder’s family made no prior complaints to the
facility about the transfer technique. Thus, the
state of the defendant’s knowledge could not
fairly be characterized as showing a conscious
choice of a course of action that would seriously endanger the elder.
From these cases, the distinction between
elder abuse and professional negligence
appears to turn on whether or not the case has
certain telltale signs. If the elder was subject
to abuse or neglect for an extended period of
time, courts are likely to find elder abuse, at
least at the pleading stage. If the defendant
conceals or ignores the elder’s deteriorating
condition, or fails to follow a treatment plan,
a finding of elder abuse is equally likely. But
perfect care is not the standard. Not knowing an elder’s wishes, not following procedures
when circumstances dictate a deviation, and
not taking emergency steps when it is not at
all clear that emergency steps are needed will
not likely rise to the level of elder abuse. An
understanding of the supreme court’s rationale in Delaney is the first step in finding a
distinction between elder abuse and professional negligence, but Delaney is only a starting place.
■
1 Jacobellis
v. Ohio, 378 U.S. 184, 197 (1964).
v. Superior Court, 144 Cal. App. 4th 81, 83,
n.4 (2005).
3 In 1975, citing serious problems that had arisen
throughout the state as a result of a rapid increase in
medical malpractice insurance premiums, the legislature enacted the Medical Injury Compensation Reform
Act of 1975. MICRA comprises several statutes that
limit damages for lawsuits against a healthcare provider
based on professional negligence. See Young v. Haines,
41 Cal. 3d 883 (1986).
4 WELF. & INST. CODE §15657.
5 Delaney v. Baker, 20 Cal. 4th 23 (1999).
6 Darmiento, Nursing Homes Facing Limits on
Insurance for Elder Abuse, LOS ANGELES BUS. J. (July
5, 2004).
7 Id.
8 WELF. & INST. CODE §§15610-15610.65.
9 Berkley v. Dowds, 152 Cal. App. 4th 518, 529 (2007),
petition for rev. filed Aug. 1, 2007; see also ARA
Living Ctrs. Pac., Inc. v. Superior Court, 18 Cal. App.
4th 1556, 1563-64 (1993); Smith v. Ben Bennett, 133
Cal. App. 4th 1507, 1524 (2005).
10 WELF. & INST. CODE §15657.2.
11 Delaney v. Baker, 20 Cal. 4th 23, 26 (1999).
12 Id.
13 Id. at 30-31.
14 Id. at 31 (quoting RESTATEMENT (SECOND) OF TORTS
§500, com.(g) ¶550 (1995)).
15 Trujillo v. Superior Court, No. B155860, 2002 WL
2 Sababin
1558830 (Cal. App. 2d Dist. July 16, 2002) (unpublished).
16 Id.
17 Id. at *7.
18 Id. at *8.
19 Klinkner v. Alta Vista Health Care Ctr., No.
E037164, 2005 WL 3344801 (Cal. App. 4th Dist.
Dec. 9, 2005) (unpublished).
20 Id. at *6.
21 Id. at *7.
22 Id.
23 Reyome v. Sunrise Senior Living Servs., Inc., No.
B174986, 2004 WL 2749811, at *8 (Cal. App. 2d
Dist. Dec. 2, 2004) (unpublished).
24 Mack v. Soung, 80 Cal. App. 4th 966, 969 (2000).
25 Id.
26 Id.
27 Id. at 973.
28 Sababin v. Superior Court, 144 Cal. App. 4th 81, 85
(2005).
29 Id.
30 Id. at 90.
31 Id.
32 Renko v. Northridge Care Ctr., Inc., Nos. B173512,
B175474, 2005 WL 2045352, at *1 (Cal. App. 2d
Dist. Aug. 25, 2005) (unpublished).
33 Id. at *22.
34 Furlong v. Catholic Healthcare West, No. B172067,
2004 WL 2958274 (Cal. App. 2d Dist. Dec. 22, 2004)
(unpublished).
35 Id. at *10.
36 Reyome v. Sunrise Senior Living Servs., Inc., No.
B174986, 2004 WL 2749811, at *2 (Cal. App. 2d
Dist. Dec. 2, 2004) (unpublished).
37 Id. at *3.
38 Id. at *3-*4.
39 Id.
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■ SOUTH CENTRAL HEALTH CENTER
4721 S. Broadway
Los Angeles, CA 90037
(323) 234-3100
■ ONTARIO HEALTH SERVICES
602 N. Euclid. Ave., Suite B
Ontario, CA 91764
(909) 395-5598
■ HIGHLAND PARK HEALTH CENTER
5421 N. Figueroa St. (Highland Park Plaza)
Highland Park, CA 90042
(323) 478-9771
■ WHITTIER HEALTH SERVICES
13019 Bailey Ave. Suite F
Whittier CA 90601
(562) 698-2411
■ MONTEBELLO WELLNESS CENTER
901 W. Whittier Blvd.
Montebello, CA 90640
(323) 728-8268
1.800.624.2866
Personal Injury and Worker’s Comp. cases accepted on lien basis.
Los Angeles Lawyer October 2007 49
50 Los Angeles Lawyer October 2007
American Immigration Lawyers Association, p. 2
Tel. 202-216-400 www.aila.org
Lexis Publishing, p. 1, 9
www.lexis.com
Aon Direct Administrators/LACBA Prof. Liability, Inside Front Cvr
Tel. 800-634-9177 www.attorneys-advantage.com
MCLE4LAWYERS.COM, p. 41
Tel. 310-552-4907 www.MCLEforlawyers.com
Arbitration and Mediation Group, p. 16
Tel. 818-790-1851 www.mediationla.com
Mesriani Law Group, p. 18, 34, 45
Tel. 310-826-6300 e-mail:[email protected]
Ballenger, Cleveland & Issa LLC, p. 26
Tel. 310-873-1717
Metrocities Mortgage Inc., p. 8
Tel. 800-464-2484 www.metrociti.com
Lee Jay Berman, p. 16
Tel. 213-383-0438 www.leejayberman.com
Noriega Clinics, p. 49
Tel. 323-728-8268
Coldwell Banker p. 4
Tel. 310-442-1398 www.mickeykessler.com
Charles Pereyra-Suarez, p. 6
Tel. 213-623-5923 www.cpslawfirm.com
Commerce Escrow Company, p. 47
Tel. 213-484-0855 www.comescrow.com
Peachtree Pre-Settlement Funding, p. 27
Tel. 866-476-2029 www.presettlementfunds.com
Cook Construction, p. 26
Tel. 818-438-4535 e-mail: [email protected]
Personal Performance Group, Inc., Inside Back Cover
Tel. 866-968-6711 www.commandingpresence.com
Devon Self Storage Holding, LLC, p. 18
Tel. 213-784-4440
Daniel A. Plotkin, M.D, p. 34
Tel. 310-477-7855 e-mail: [email protected]
Dixon Q. Dern, P.C., p. 46
Tel. 310-557-2244 e-mail: [email protected]
Premier Business Centers, p. 45
Tel. 1-877-MYSUITE (1-877-697-8483) www.pbcenters.com
Law Office of Sean Ethington, p.41
Tel. 800-852-1239 www.sean.elderlawsite.com
Law Office of Alice A. Salvo, p. 41
Tel. 818-887-3333 e-mail: [email protected]
First Indemnity Insurance Services, Inc., p. 48
Tel. 800-982-1151 www.firstindemnity.net
Steven R. Sauer APC, p. 17
Tel. 323-933-6833 e-mail: [email protected]
Forensic Construction Defect & Engr., Inc./Exp. Witness, p. 41
Tel. 213-632-1310 e-mail: [email protected]
Stephen Sears, CPA-Attorney at Law, p. 25
www.searsatty.com
G. L. Howard CPA, p. 46
Tel. 562-431-9844 e-mail: [email protected]
Anita Rae Shapiro, p. 46
Tel. 714-529-0415 www.adr-shapiro.com
Steven L. Gleitman, Esq., p. 4
Tel. 310-553-5080
Steven Peck’s Premier Legal, p. 21
Tel. 866-999-9085 www.premierlegal.org,
Greg David Derin, p. 46
Tel. 310-552-1062 www.derin.com
Stonefield Josephson, Inc., p. 5
Tel. 866-225-4511 www.sjaccounting.com
Marcia H. Harber, p. 26
Tel. 310-377-7624 e-mail: [email protected]
Tenrec, Inc., p. 26
Tel. 415-543-6600 x101 e-mail: [email protected]
Higgins, Marcus & Lovett, Inc., p. 16
Tel. 213-617-7775 www.hmlinc.com
UCLA Extension Conferences, p. 22
www.uclaextension.edu/taxcon, www.uclaextension.edu/realestate
The Holmes Law Firm, p. 8
Tel. 626-432-7222 www.theholmeslawfirm.com
UngerLaw, P.C., p. 17
Tel. 310-772-7700 www.ungerlaw.com
ImmigrationHouseCall.com, p. 18
Tel. 214-329-1265 e-mail: [email protected]
Union Bank of California, p. 11
Tel. 310-550-6400 (B.H.), 213-236-7736 (L.A.) www.uboc.com
Jack Trimarco & Associates Polygraph, Inc., p. 6
Tel. 310-247-2637 www.jacktrimarco.com
Vision Sciences Research Corporation, p. 34
Tel. 925-837-2083 www.contrastsensitivity.net
Lawrence W. Crispo, p. 17
Tel. 213-926-6665 e-mail: [email protected]
Walker Advertising Inc., p. 25
Tel. 800-409-0909 e-mail: [email protected]
Law Offices of Rock O. Kendall, p. 6
Tel. 949-388-0524 www.dmv-law.com
West Group, p. 13, Back Cover
Tel. 800-762-5272 www.westgroup.com
Jeffrey Kichaven, p. 4
Tel. 213-996-8465 www.jeffkichaven.com
Witkin & Eisinger, LLC, p. 26
Tel. 310-670-1500
LACBA LRIS, p. 21
Tel. 213-896-6440 www.smartlaw.org
Wolfsdorf Immigration Law Group, p. 47
Tel. 310-570-4088 www.wolfsdorf.com
Lawyers’ Mutual Insurance Co., p. 7
Tel. 800-252-2045 www.lawyersmutual.com
Law Office of Stuart Zimring, p. 34
Tel. 818-755-4848 www.elderlawla.com
Avoiding Electronic Discovery Mistakes
ON TUESDAY, OCTOBER 9, from noon to 1 P.M., the Los Angeles County Bar
Association will host an online program addressing the most common
errors made by attorneys, corporate IT staff, paralegals, record managers,
and even law firm litigation support technology staffs and vendors when
dealing with electronic discovery. Learn how to avoid sanctions and
adverse inference rulings by not spoiling metadata, running afoul of
reasonable retention policies, causing client data to be deemed
inadmissible, failing to file appropriate motions in support of or in
opposition to e-discovery techniques, going over budget, and breaking the
all-important chain of custody. Alex Lubarsky, a practicing attorney and
electronic discovery consultant, will share the top 10 errors that result in a
weakening (or destruction) of the case in chief of those who err. Learn from
others’ mistakes before you make them yourself. Registration for this
program closes on October 5, 2007. Early registration and an e-mail
address are required for this webinar. The registration code number is
009737.
$45—CLE+PLUS members
$85—LACBA members
$125—all others
1 CLE hour
International Arbitration
and Litigation Strategies
On Tuesday, October 30, the International
Law Section will present a program on
disputes involving multinational parties and
the laws, procedural rules, and judicial
systems of different nations. An everincreasing number of international
arbitration tribunals are also available to
resolve disputes, many with their own
procedural rules and fee structures. This
symposium will provide useful strategies
and insights for any lawyer, novice or
experienced, representing clients involved in
disputes, actual or potential, arising from
cross-border commercial transactions. The
program will include a luncheon with a
keynote speaker, Dean A. Peroff,
international defense counsel for Mikhail
Khodorkovsky in the ongoing criminal
prosecutions regarding Yukos Oil. Peroff will
speak on the challenges of representing
clients in countries with varying degrees of
judicial and/or political corruption. The
TAP: Expert Witness Workshop
ON MONDAY, OCTOBER 8, Trial Advocacy and the Litigation Section will host
an expert witness workshop providing introductory and advanced instruction
on how to use expert witnesses, with special emphasis on expert testimony.
Topics covered in the lecture portion of the program include evidentiary rules
regarding expert opinions, taking and defending expert depositions, how
experts can help and hurt a case, direct and cross-examination of expert
witnesses, establishing and challenging expert qualifications, and advanced
expert testimony techniques. In the workshop portion, participants conduct
direct and cross-examination of an expert witness. The workshop will take
place at the LACBA/Executive Presentations Mock Courtroom, 281 South
Figueroa Street, Downtown. Reduced parking with LACBA parking validation
at the Figueroa Courtyard parking garage costs $10. On-site registration will
begin at 8:30 A.M., with the program continuing from 9 A.M. to 1 P.M. The
registration code number is 009776.
$350—LACBA members
$500—all others
3.75 CLE hours
program will take place at the Omni Los
Angeles Hotel, 251 South Olive Street,
Downtown. Hotel valet parking costs $10.
On-site registration and the meal begin at 8
A.M., with the program continuing from 9 A.M.
to 4:30 P.M. The registration code number is
009733. The prices below include the meal.
$125—CLE+PLUS members
$230—LACBA members (price includes a
free half-year section membership)
$175—International Law Section members
(among others)
$260—all others (price includes a free halfyear LACBA membership and a free half-year
section membership)
$270—all at-the-door registrants
7.25 CLE hours
The Los Angeles County Bar Association is a State Bar of California MCLE approved provider. To register for the programs listed
on this page, please call the Member Service Department at (213) 896-6560 or visit the Association Web site at
http://calendar.lacba.org/. For a full listing of this month’s Association programs, please consult the County Bar Update.
Los Angeles Lawyer October 2007 51
closing argument
BY ALEX YUFIK
The Science of Eyewitness Testimony
One possible explanation is the firm belief held by many judges
ON NOVEMBER 10, 2000, POLICE ARRESTED Rachel Jernigan for
allegedly robbing three banks in Arizona. Jernigan became a suspect that because the information about eyewitness fallibility is so ubiqin the case after an FBI agent investigating the robberies had a chance uitous, nothing an expert can say can benefit the jurors in deciding
conversation with a postal inspector who had been investigating a case. On the contrary, recent studies have documented that lawyers
unrelated shoplifting incidents at a local post office. The postal agent and judges continue to remain ignorant about the empirical psynoted that Jernigan fit the description of the previously unidentified chological findings that explain human memory and behavior as
bank robber. After the conversation, the FBI agent created a photo- they relate to legal proceedings. As the Jernigan case shows, jurors
graphic lineup that included Jernigan and showed the pictures to one often underestimate the frequency of errors present in testimony
of the victim bank tellers. The teller identified Jernigan as the woman based on memory, and they remain unaware of the degree to which
who robbed her. Five or six months later, the pictures were shown to recall of past events is often subject to distortion.
other eyewitnesses who also identified Jernigan
as the robber. At trial, the government relied
entirely on the accounts of five eyewitnesses
As the Jernigan case shows, jurors underestimate the frequency
and an unclear bank surveillance video.
No physical evidence tied Jernigan to the
robbery, and throughout her trial Jernigan
of errors present in testimony based on memory.
asserted her innocence. Unbeknown to the jury,
the government knew that other nearby banks
were being robbed by another woman—fitting
The result has been that judges may feel that the scientific evidence
the same description as Jernigan—while Jernigan was in custody
but failed to provide this information to her counsel. The jury con- is unnecessary because the information is within common knowledge
victed Jernigan, and the court sentenced her to 168 months in jail. of the jurors. In addition, attorneys may not know how or when to
While in jail, Jernigan learned from her fellow inmates of the other employ experts in these situations. Science has clearly and definitively
woman with similar features who was arrested for robbing the same identified that the intuitive notions about memory, cognition, and eyebank on a different day. She then petitioned the court for a new trial. witness identification that are often held by judges and juries are
On July 9, 2007, the Ninth Circuit overturned her conviction in United wrong. For example, a study published in the Journal of Applied
Cognitive Psychology2 found that judges have very limited underStates v. Rachel Jernigan.1
Psychologists have long questioned the seemingly blind faith standing of eyewitness factors. In the study, more than half the
courts place in eyewitness testimony. Over the last 30 years researchers judges surveyed mistakenly believed that an eyewitness’s ability to recall
have documented extensively the many factors that affect the accu- peripheral details about a crime indicates that the witness has a betracy of eyewitness identification. The research information has been ter memory than a witness who cannot recall peripheral details.
As a result of these discoveries, California has made a landmark
used to make recommendations to change the manner in which eyewitness evidence is used in court as well as to make practical rec- effort to institute change in our legal system. In 2004, the legislature
ommendations for law enforcement officials to change the manner created the California Commission on the Fair Administration of
Justice with the task of reviewing the state’s criminal justice system
in which they conduct eyewitness lineups.
Forensic psychologists have also made significant contributions in and to make recommendations to ensure the fair and accurate adminclearly and dispassionately educating fact finders about eyewitness istration of justice. As part of its work, the commission has suggested
memory, recall, and other factors that are relevant in properly eval- a number of empirically supported changes to the rules guiding eyeuating eyewitness testimony. For example, one such recommended witness identification. As members of the legal system we can ensure
change is the use of experts in preventing false convictions based on the fair administration of justice by supporting and encouraging
unreliable eyewitness testimony. Many studies have shown that using such change, especially when it is based on sound, scientific, psyexpert testimony is the only legal safeguard that is effective in alert- chological principles. Only by continuing to question and examine
ing jurors to the perils of eyewitness identification, and that neither our system of justice and its methods can we prevent a case like
Jernigan’s from occurring in California.
■
jury instructions nor cross-examination is sufficient.
Despite the available studies, courts continue to preclude expert
testimony, and the police refuse to change their procedures. As the 1 United States v. Jernigan, No. 05-10086 (9th Cir. July 9, 2007).
Jernigan case illustrates, and as other cases continue to surface in the 2 18 J. APPLIED COGNITIVE PSYCHOL. 427-43 (2004).
press, the need to change the system is strong. Despite the available
data there is still a great deal of resistance to implementing changes.
Alex Yufik is a licensed forensics psychologist and an attorney in private pracWhy?
tice in West Hollywood.
52 Los Angeles Lawyer October 2007
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Limited number of seats available:
Location: LACBA Conference Center,
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Prices:
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All others with meal:
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