Life Planning

We have all heard and read about privacy laws in recent years. In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a major federal law that deals with a patient’s right to privacy with respect to medical records. An unfortunate side effect of this legislation, however, is that sometimes doctors, nurses, and other health care providers are reluctant to share medical information with a patient’s trusted loved ones. In some places, only a patient’s spouse—and not his/her children—will be allowed to see the records and/or speak with the professionals about the care plan. A HIPAA Release is a document that allows doctors and other health care professionals to share your medical information with anyone you designate in the document, such as (but not limited to) a child, spouse, unmarried life partner, relative, friend, or other loved one.

A Health Care Proxy is a legal document that gives a close, trusted person the power to make all health care decisions for you in the event you cannot communicate your wishes directly to your health care providers. Massachusetts law requires that only one person at a time be designated as your health care agent in order to avoid disagreement among family members in the event of an emergency.

Such documentation can be especially important for same-sex spouses (although such couples are now legally recognized in Massachusetts, they will not be in every state where they might travel). Having a properly executed health care proxy is imperative in such situations including access to these documents regardless of where you are and without having to carry them with you.

Many individuals have strong feelings about what they want to happen to them should they ever be in a persistent, irreversible vegetative condition at the end of life. The advance directive (also commonly known as a “Living Will”) is frequently used to address this situation. It can request that doctors not resuscitate you, or use extraordinary means to prolong your life, once certain critical irreversible milestones have passed, or provide whatever guidance you desire to communicate in these situations. Advance directive can help to alleviate the confusion and even extended, bitter disputes between loved ones and family members.

This document is meant to speak clearly to the family and doctors when the patient becomes incapable of speaking for him or herself. We build an automatic “check” into the advance directive document; by requiring that at least two doctors concur in the diagnosis of the patient, before acting in accordance with the instructions of the advance directive. This check can ensure that your interests are being looked after and acted upon, based upon objective diagnoses. Although these directives are not legally binding in Massachusetts, they provide substantial help to loved ones (and physicians) about what your wishes are in these circumstances.

A Durable Power of Attorney allows you to give someone whom you trust (often referred to as “the Attorney-in-Fact”) the authority to handle financial and other related matters for you (the “Principal”) in the event of your incapacity. This document is valuable in that it allows you to choose who shall act for you if you are incapacitated, rather than allowing a court to make this determination. The powers can be broad, and may even include gifting, especially if it is anticipated that that the Principal may want or need to transfer assets for tax or Medicaid planning purposes. It is for this reason that you should make sure that you have a power of attorney that is carefully crafted to your needs. This document is effective only during the lifetime of the Principal.

Studies show that 70% of Americans who create these very types of health care documents don’t use them! The most common reason is that the documents cannot be found at the actual moment of crisis. In order to address this problem, we have developed a system to store these documents electronically and which allows clients to retrieve their documents at a moment’s notice. Every client for whom we provide these documents receives a wallet sized card that has a personalized access code to an on-line, secure storage facility. Medical professionals can simply dial the number and 24/7 your documents will be sent via fax or pdf to the hospital or medical office where you are being treated. As part of this service, we also include certain emergency information you provide, such as who to call and in what order, whether you have any allergies or serious medical conditions, and the name and contact details of your Primary Care Physician. Clients find this an enormously helpful tool in time of need. It’s part of our way of creating estate plans that work!