GOLF TOURNAMENT BENEFITS LSED

The tenth annual golf tournament to benefit Legal Services for the Elderly raised nearly $29,000 for the agency. A total of 212 golfers took part in the tournament which was held on two courses at Legends on the Niagara. In addition to 37 tee sponsors and everyone who contributed to the raffle, the tournament organizers extend their sincere appreciation to the following corporate sponsors:

The M&T Charitable—Platinum Sponsor

Kavinoky Cook LLP—Gold Sponsor

Phillips Lytle LLP—Gold Sponsor

The Barnes Firm—Silver Sponsor

Gibson, McAskill & Crosby—Silver Sponsor

Jaeckle, Fleischmann & Mugel—Silver Sponsor

Plesh Industries—Silver Sponsor

Puleo & Puleo/Capital Abstract—Silver Sponsor

Shari Jo Reich, Esq.—Silver Sponsor

Injured Workers Pharmacy—Cart Sponsor

Cleve-Hill Tire & Auto—Dinner Sponsor

Willcare—Cocktail Hour Sponsor

Hodgson Russ LLP—Lunch Sponsor

An 83-year-old woman contacted our office after she was denied reimbursement for the purchase of a lift chair her doctor had prescribed. Client had severe arthritis and was wheelchair-bound. Our office successfully represented her at a hearing.

CATTARAUGUS COUNTY SUCCESS STORY

In January, 2005, the United States Office of Personnel Management (OPM) notified our 78 year-old client that it was terminating her monthly $1500.00 surviving divorced spouse’s pension benefits. The stated reason was that the 1990 Domestic Relations Order entered in her divorce proceeding did not specifically refer to “_survivor benefits payable under Federal law after the annultant’s death.”

We requested reconsideration on her behalf, researched the Federal regulations governing pension benefits and uncovered a transcript of the 1989 Court hearing on her divorce settlement. The transcript clearly indicated the parties’ intention that she collect the federal pension benefit.

We submitted the transcript and legal argument to OPM and that office withdrew its initial determination, finding her eligible for her deceased former husband’s pension benefits.

A TYPICAL CLIENT COMMENT

“I could offer no improvements. The staff was most superior, understanding and helpful. Mrs. Furnette Williams was wonderful to me. She eased my concerns, kept me posted and I thank God your group was there to help us.”

LSED IN CHAUTAUQUA COUNTY

The Chautauqua Office for the Aging (OFA) contracts with Legal Services for the Elderly to provide representation for seniors who are 60 years of age and older. In Chautauqua County, we represent clients with: Social Security issues, Medicare and Medicaid denials/appeals, health insurance problems, home health care matters and nursing home issues, landlord/tenant disputes and subsidized housing issues, Power of Attorney and Revocation of a Power of Attorney.

Staff Attorney, Bill Berry, and Paralegal, Brenda Symans, work on the Chautauqua contract. Referrals come from OFA, adult care facilities, non-profit agencies and from the general public.

The following is an example of a typical case we handle. A nursing home social worker had contacted our office to assist a resident who was facing a possible 30-day eviction notice. The resident’s daughter, who was Power of Attorney, had not paid any rent. The resident had been living at the nursing home for six months. It was extremely difficult for the resident to accept that her daughter was withholding her money and not paying the rent. The daughter went so far as to withhold money from the client’s personal account. The nursing home was very sympathetic and made sure the resident got her hair done and secured other personal care items.

After looking into the matter, we discovered due to the Power of Attorney’s actions, our client had incurred over $600.00 in bounced check fees. We assisted the client in revoking the Power of Attorney. On our client’s behalf, we met with the bank and put a restriction on her checking account since her social security and pension checks were direct deposit.

Because we were able to obtain this information, our client was able to remain at the nursing home.

Grandparents’ Rights Project

Legal Services for the Elderly is able to represent grandparents who seek custody of grand, great-grand and/or great-great grandchildren. The agency has a full time attorney who devotes all her time to the project. The agency may be retained in a case prior to the filing of a Petition seeking custody. In many instances, however, a referral from Dorothy Hawkins, a Kinship Services Facilitator with the GAP program, occurs after a Petition has been filed or a temporary placement with the grandparent has occurred in a neglect action. The agency advocates on behalf of the grandparent and works with counsel for the parents and the Guardian Ad Litem for the child(ren) to fashion a resolution to the custody/visitation issue. The agency represents grandparents who are sixty (60) years of age or older. If you would like more information about the program, you can contact the agency and ask to speak with Helen Ferraro-Zaffram, the attorney handling these cases.

SOCIAL SECURITY AND FLEEING FELONS

By: Beata Banas, Esq.

The harsh "fleeing felon" policy implemented by the Social Security Administration (SSA) is affecting those who are among the most vulnerable - the elderly and /or disabled.

The 1996 fleeing felon provisions, restricting Supplemental Security Income (SSI) payments to those who have a warrant for their arrest as felons or probation or parole violators, were extended to Title II effective January 1, 2005. The Title II (old age, survivorship, and disability) beneficiaries with an outstanding arrest warrant for a crime which is a felony, or for violating a condition of probation or parole can have their benefits suspended by SSA. In addition to benefits suspension, they can also be charged with an overpayment for the time that they were receiving their benefits incorrectly according to the new law.

This office was able to help such fleeing felons by having the warrant that prompted the benefit suspension vacated by the court, or other authority, in the jurisdiction that the warrant was issued. This is not always easy, though, particularly, in cases where the warrant is for violation of probation or parole. The suspension or denial of Social Security benefits because of a warrant for alleged violation of probation or parole will be the issue in a class action suit soon to be filed in the federal district court in the Second Circuit as a sequel to the victorious Fowlkes v. Adamec litigation. This case was brought by the National Senior Citizens Law Center (NSCLC) on the issue of suspending or denying SSI when there is an outstanding felony warrant. A LSED client is going to be one of the plaintiffs in the upcoming litigation.

Please call our office if you know of a person whose SSI or Social Security benefits were discontinued because of the existence of an arrest warrant. This is not only a criminal problem. It is also a matter that requires representation before SSA in addition to the court or agency that issued the warrant.

CONRAD CASE

On Wednesday, December 6, 2006, Judge Curtin gave preliminarily approval for a settlement of Attorney Anthony Szczygiel’s long running case, Conrad v, Perales. The case challenged the MOP II program, under which the DOH allowed nursing homes to double bill (Medicare and Medicaid) in 1989. This meant that residents had to pay a Medicaid client share even when Medicare had covered their nursing home care in full. The State DOH agreed to put $11 million into an escrow fund. We will use the money to find the heirs of those nursing home residents.

With expert help from the Center for Medicare Advocacy’s Data Unit we are in the process of identifying the class members from computer and paper records. We are almost done and expect to have about 12,000 class members, with full refunds amounting to about $15 million.

We have hired a class action administrator to do the heir search and handle the claim process. They have set up a website:http://www.ccsforms.com/nursing home/. with background information and claim forms.

A special thanks to attorneys Anthony Szczygiel, Henry Killeen and Peter Dellinger who have volunteered thousands of hours over the last 17 years to make this settlement a reality.

MEDICAID WRAP ENDS IN 2007 By: Frank R. Vavonese, Esq.

Since January 1, 2006 Medicare’s Part D program has offered prescription drug coverage to Medicare Parts A and/or Part B beneficiaries. Additionally, Medicare Part D coverage is mandatory for Medicare recipients that are also enrolled in Medicaid (“dual eligibles”), who do not have prescription coverage that is as good as, or better, than Medicare Part D.

If dual eligibles do not select a plan on their own, they will be automatically and randomly enrolled into one of sixteen Part D plans that meet the minimal coverage requirements. While these plans meet basic requirements by providing coverage for various drug classes, they do not provide identical drug coverage. Each plan’s drug formulary is unique and dual eligibles are inevitably enrolled into plans that do not cover the drugs they require. This oversight occurred during the initial enrollment period last year and despite preventative efforts by the Center for Medicare and Medicaid Services, some dual eligibles will again find themselves without proper Medicare Part D coverage next year.

The lack of intelligent plan selection has not been a significant problem for dual eligibles in the past because Medicaid was always the payer of last resort for drugs that were denied coverage by Medicare Part D plans. This process is referred to as the “Medicaid Wrap” because Medicaid coverage wraps around that of Medicare Part D. As of January 1, 2007, the Medicaid Wrap will be ending but for a small class of drugs: atypical antipsychotics, antidepressants, antiretrovirals used in the treatment of HIV/Aids and anti-rejection drugs used in the treatment of organ and tissue transplants.

In 2007 all dual eligibles who are faced with a coverage denial from their Part D Plan will be forced to either chose a new plan or navigate a sometimes tedious appeals process in order to access to medically necessary prescriptions. Should you find clients or loved ones faced with this issue or any prothis issue or any problem relating to Medicare Part D, you should contact attorney Frank R. Vavonese at the LSED office for assistance.

FUNDING

LSED receives the bulk of its funding through the federal Older Americans Act, which is distributed to the New York State Office for the Aging and finally to the county Departments of Senior Services. LSED contracts with several Western York counties. Erie County Department of Senior Services is the single largest provider. Each year we must ask the local community to support the work we do. We run both a golf tournament and a direct mail drive each year. In addition, we use staff to handle all administration, so that all of the funds raised can go back into our program.

Funding from government and private foundations does not come close to the level necessary for LSED to meet the needs of needy seniors in Western New York. Your donation is tax deductible. Please help support the work we do!