Will you be able to help your college-age child in a medical emergency? HIPAA Privacy Rule can get in your way
Don't get stuck in an information vacuum if your son or daughter ends up in the ER.
Early one October morning, Sheri E. Warsh, a mother of three from Highland Park, Ill., stepped out of the shower to a ringing phone. On the other end, her 18-year-old son’s college roommate delivered terrifying news: Her son—270 miles away at the University of Michigan—was being rushed by ambulance to a nearby emergency room with severe, unrelenting chest pain. “I was scared out of my mind, imagining the worst,” Warsh said.
In a panic, she called the ER for details. What she got instead was a rebuff from the nurse. “She asked me how old my son was, and when I said 18, she told me I had no right to talk to the doctor,” Warsh said.
Was the nurse acting within her scope by shutting out the anxious mom? In fact, she was. The ER chose not to disclose the son’s medical condition due to the Privacy Rule of the Health Insurance Portability and Accountability Act, or HIPAA.
“Once a child turns 18, the child is legally a stranger to you,” said Jane F. Wolk, a trusts and estates attorney practicing in New York and New Jersey, referring to the legal age in almost all states (in a few it's older). “You, as a parent, have no more right to obtain medical information on your legal-age son or daughter than you would to obtain information about a stranger on the street.” And that is true even if the young-adult child is covered under the parents’ health insurance, and even if the parents are paying the bill.
A medical provider can chose to disclose protected health information to a family member, even without the patient's authorization, if, in her professional judgment, it serves the best interest of the patient. But providers often come down on the side of patient privacy, particularly if they have never met the family member.
In this case, Warsh’s son didn’t intend to keep his parents in the dark. In the midst of cardiac-care chaos, he was in too much pain to give authorization. But a simple, signed legal document (or two, in some states) would have smoothed the way.
“Nobody is talking about this, even after I went to so many college meetings and orientations,” Warsh said. The irony of her story is that Warsh is an attorney specializing in the practice of trusts and estates as a partner at a Chicago law firm. “Now in my practice I have made it my goal to educate parents on what they need to do,” she said.
Moms and dads who still think of themselves as protectors and advisers, even after their children become legal adults, often don’t consider the real-world implications of that milestone birthday. They and their young-adult children need to think about the unthinkable in advance. Three forms—HIPAA authorization, medical power of attorney, and durabe power of attorney—will help facilitate the involvement of a parent or other trusted adult in a medical emergency.
If a student attends college out of state, fill out the forms relevant to the home state and school state to avoid any challenges. If the school has its own form, sign that one too, Warsh said. “When the doctor or medical institution sees it, you want them to be familiar with it and recognize it,” she said.
Once the forms are completed, it’s a good idea to scan and save them so that they are readily available on a smart phone or home computer.
You don’t need a lawyer to do this. Many websites have downloadable forms. But a lawyer’s involvement can benefit in making sure you are using the right form, explaining it, and advocating on your behalf in case something goes wrong.
Thinking about the unthinkable: 3 forms that help
A signed HIPAA authorization is like a permission slip. It permits health-care providers to disclose your health information to anyone you specify. A stand-alone HIPAA authorization (not incorporated into a broader legal document) does not have to be notarized or witnessed. This document alone, signed in advance by her son, would have sufficed for Warsh to get information from the hospital treating her 18-year-old son. Young people who want parents to be involved in a medical emergency, but fear disclosure of sensitive information, need not worry; HIPAA authorization does not have to be all-encompassing. They can stipulate not to disclose information about sex, drugs, mental health, or other details they might want to keep private.
Medical power of attorney
In signing a medical POA you appoint an “agent” to make medical decisions on your behalf in case you are incapacitated and cannot make such decisions for yourself. Each state has different laws governing medical POA and, therefore, different legal forms. In many states, the HIPAA authorization is rolled into the standard medical POA form. Whether the medical POA requires the signature of a witness or notary varies state by state.
For the sake of clarifying often-used terms: A medical POA sometimes goes by other names, such as health-care power of attorney, designation of health-care proxy, or durable power of attorney for health care. It is one type of advance directive. The other type is a living will, which specifies your wishes with regard to interventions in life-or-death scenarios in case you are unable to do so. In many states, the language for the living will is also incorporated into a hybrid document that includes the medical POA and HIPAA release.
Durable power of attorney
As an additional step, young-adult children might consider appointing a durable power of attorney, enabling a parent or other designated agent to take care of business on the student’s behalf. If the student were to become incapacitated or if the student were studying abroad, the durable power of attorney would be able to, for example, sign tax returns, access bank accounts, and pay bills. Durable POA forms vary by state. In some states the medical POA can be included in the durable POA form. “The durable power of attorney is sweeping,” Wolk said. “You do not want to give it to someone who you do not trust.”
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Original Source: http://www.consumerreports.org/cro/news/2014/08/will-you-be-able-to-help-your-college-age-child-in-a-health-emergency/index.htm#
What is business succession planning? Business succession planning refers to the practice of using estate planning strategies to increase the chances for the survival of your family business when you retire or die unexpectedly.
Original Source: http://wealthcounsel.com/articles/2015/business-success-planning-checklist?utm_content=buffer24eec&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer
By Andrew Keyt
Mon, 2015-06-15 15:20
A person born into a family business is a person born into a story—one that’s ongoing and generations old. Like any good story, there are heroes: parents, grandparents and great-grandparents, whose legacy, mythologized over time, casts a long shadow. This shadow weighs heavy on the next generation. Do I have what it takes? Will I be a great a leader or will I fail? The expectation to succeed, to live up to the past and honor its heroes… even the most resilient successor can be crushed by the pressure.
There are other obstacles, too. The myths of leadership. Idioms and phrases that at first, sound wise but at heart are akin to nonsense. For example, “leaders are born and not made.” How shortsighted to think that there’s only one iconic style of leadership bestowed upon a lucky few. That leadership is what? Somehow given to a person at birth, like some fairy godmother’s spell? Myths like these slowly chip away at successors and, like the weight of the family shadow, can undermine their confidence, capability and talent.
The topic of succession is one I hold near and dear. For almost 20 years, I’ve watched graduates from our Next Generation Leadership Institute go on to become confident and successful leaders within their family business. I’ve also had the fortune of interviewing 28 family business successors, all chronicled in my book, Myths and Mortals: Family Business Leadership and Succession Planning. All of these experiences have brought me to this understanding: that while it’s true we’re all born with certain leadership traits, those we lack can be developed and strengthened through hard work and education.
When on the road to becoming a successor to a family business, here are some traits to consider.
A successful successor is aware of their strengths and weaknesses and leverages their strengths for the good of the family and the business.
Belief in Oneself
The family shadow can lead them to believe that credibility and worth comes from their family name rather than individuality and identity. Successful successors aren’t afraid to make mistakes. Nor are they afraid to learn from these mistakes. This process teaches them to believe in themselves, while at the same time, building a personal record of achievement. Credibility must be built on personal and professional actions, not a family name.
Credibility with Others
Belief in oneself isn’t enough to become a successful successor; others must believe in them too. They’ll recognize a successor’s credibility in the same way a successor recognizes it within themselves: through actions, ability to lead and track record. Christie Hefner described it this way, “True power is given by the people that you lead, not by the people who gave you the job.”
Clear Sense of Values
Successful successors reflect on their parents’ values and, in turn, establish their own set of values. Some may be shared with parents, while others may be unique to them. Think of values as a map; they keep the business on a set course. When we reach a fork in the road, values help us decide which path to follow.
Successful successors are skilled problem solvers. They know how to make difficult decisions and act decisively for the betterment of the family and the business. Laying off parts of the workforce, for example, can be an extremely difficult decision, especially when employees feel like part of the family. But it’s a decision that sometimes must be made to keep the family business afloat.
Commitment to the Family
Survival isn’t just about money. Research shows that centuries-old family businesses have survived for so long, not because of financial success, but because of strong relationships. Families enjoy being together and have a sense of pride and commitment to each other and the business. Successful successors come to know that “we” is more important than “me.”
Commitment to People
Successors shouldn’t let their family shadow diminish contributions by employees, trusted advisors and other family members. Successful successors aren’t blinded by the shadow; instead, they shine a light on the contributions of others. (S)he should commit to the growth and development of his/her employees. Give credit where it’s due, celebrate success, admit mistakes and take responsibility when things go wrong.
Commitment to Continual Learning
Successful successors are life-long learners. They enjoy discovery and new perspectives, taking some initiative to learn and be curious.
Ability to Deal with Ambiguity
Leading in a family business is often fraught with uncertainty and ambiguity. There’s often no clear right or wrong. Successful successors are comfortable in this middle-zone; while others are paralyzed with indecision, they seek clarity.
Successors face many challenges; from the family shadow to the myths of leadership, overcoming these challenges is no easy feat. A successor will need to make a concerted effort to strengthen their leadership traits over time so they can build a legacy larger than themselves.
Source URL: http://wealthmanagement.com/family-business/key-leadership-traits-family-business-successors