Before the onset of the Covid-19 pandemic, many of our clients were already assisting elderly or disabled family member and friends with such things as meals, medications, medical visits and shopping. Regular visits just to check in were also part of many folks’ normal routines.
COVID-19 restrictions have had a large negative impact on many of these activities. So, how can you continue to assist under these new circumstances? Here are a few thoughts:
Under a federal law commonly referred to as HIPAA, various medical services providers may be barred from communicating with persons other than the patient. If the provider is not set up to video conference, you may not able to get information concerning their condition or treatment plan.
However, with an effective and appropriate Advance Health Care Directive and HIPAA authorization form, you will be able to communicate more easily with your loved one’s health care providers.
An Advance Health Care Directive authorized a third party to make health care decisions for the patients. It can also set forth instructions for dealing with such decisions as end of life care, anatomical gifts and disposition of remains. The HIPAA authorization gives medical personnel the ability to communicate with third parties and to allow them the power to access the medical records of the patient.
It’s a good idea to have the Advance Health Care Directive and HIPAA authorization form in place ahead of time. They are normally included in any estate planning package prepared by a competent and comprehensive law firm.
If these documents are not in place, now is the time to get them. Once a person has lost their mental faculties, such as from dementia or Covid-19 complications, it may be necessary to
If you have been helping someone to pay bills and manage their finances but can no longer visit with them personally, it would be best to get some form of online access to their accounts. While, technically, the bank or financial institution may not permit anyone other than the account holder to have online access, nothing prevents someone from providing their username and password to someone else whom they trust.
It might also make sense to have your loved one’s mail forwarded to you for the time being, or work on having regular bills, such as for utilities, either sent to your address or turned into e-bills to make it easier for you to pay them on-line.
For the future, make sure you already have online access to the accounts you need to use to pay bills, preferably doing so under the financial institution’s rules, whether being named as an agent under a durable power of attorney, or preferably as co-trustee of a revocable trust. This is recommended even in the absence of a pandemic and even if your friend or family member can still take care of their finances themselves right now. These steps will allow you to seamlessly step in if and when necessary and it gives you the ability to see what’s going on with your parents’ accounts. Since older Americans are prime targets of scams. Having this oversight ability can help identify any unusual disbursal from in their accounts and for timely intervention as appropriate, while still permitting your them to continue to handle their own finances.
Virtual assistance with health care is more difficult than with finances. Doctors, their offices, and pharmacies may be barred by HIPAA restrictions from communicating with you. They are probably not set up to video conference with you when your parent visits for a check-up or medical or dental procedure. The one silver lining in this regard, is that in all likelihood all of your parents’ non-emergency medical visits have been cancelled for the duration of the pandemic.
Many medical providers now are expanding their ability to offer telehealth visits so they can meet with patients by video conference. It’s an open question whether these systems are equipped to offer small group meetings. While such sessions must be HIPAA compliant, your parents’ authorization to include you should do the trick.
In general, you will be able to communicate more easily with your parents’ medical providers if you have both a health care proxy and a HIPAA release. While the health care proxy is more comprehensive and gives you the power to make health care decisions for your parent, technically it’s only effective when a doctor has found your parent to be incapable of making their own medical decisions. It may be of little or no help in the current situation.
A HIPAA release can be effective any time, giving medical personnel the ability to communicate with you and giving you the power to access the medical records of homebound parents. In addition, while your parent can name only one agent at a time on a health care proxy, they can name any number of agents on a HIPAA release.
While it’s good to have both documents in place ahead of time and they are normally included in any estate planning package prepared by a law firm, downloadable forms are available and do not have to be notarized, though the health care proxy requires two witnesses.
You can take these steps now in this emergency and when it’s over, make sure you and your parents have everything in place for the next one (while still hoping there isn’t a next one).