Senator Wyden, Housecall Provider, and Independence at Home are Aligned

Posted on August 10, 2010 by Victoria Blachly

 

As a board member for the non-profit Housecall Providers Inc. ("HPI") in Portland, Oregon, I recently had the good fortune to meet with Oregon Senator Ron Wyden when he was meeting with the organization to discuss the Independence at Home Act ("IAH").  

 HPI is living proof how in-home primary care can deflect ever growing medical costs.  As HPI explains, "In-home medical care allows for proactive management of chronic health conditions that would otherwise result in costly emergency care and hospital admissions."  

The federal governement is finally catching up with this non-profit, as IAH launches a new chronic care coordination benefit in a three-year demonstration project for primary in-home care of Medicare beneficiaries who have difficulty getting to and from a physician's office - which HPI has been successfully providing for 18 years.

The statistics evidence the need for such a program when Medicare beneficiaries with multiple chronic illnesses:

  • see an average of 13 different physicians
  • fill 50 different prescriptions a year
  • account for 76% of all hospital admissions
  • account for 88% of all prescriptions filled
  • account for 72% of physician visits
  • are 100 times more likely to have a preventable hospitalization than someone with no chronic conditions

It will be interesting to see how this new federal program develops.  Hopefully they learn from the efforts of the good people at HPI. 

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When Joint Bank Accounts Fail

Posted on August 4, 2010 by Victoria Blachly

 

Taufen v. Estate of Kirpes, 155 Wash App 598, 230 P2d 199 (2010)

Decedent’s estate included a joint checking account which named Decedent and Mr. Yochum as joint owners. Although Decedent made no mention of survivorship when she opened the account, the banker unilaterally elected to add a right of survivorship without discussing the matter with Decedent. Upon Decedent’s death, Mr. Yochum transferred the balance of the account to the estate after he was informed that the money in the joint account belonged solely to Decedent’s estate. Thereafter, he sued the estate for the account proceeds.

In recognizing that the essential issue before the court was whether Decedent intended to create the account with a right of survivorship, the court first acknowledged that there is a rebuttable statutory presumption that funds belonging to a deceased depositor which remain in a joint account with a right of survivorship belong to the surviving depositor unless there is clear and convincing evidence of a contrary intent. When the presumption is overcome, however, it ceases to exist and cannot be further considered.

The court determined that, although the signed account card created a rebuttable presumption of intent to create a right of survivorship, the estate met its burden of production by providing evidence that: 1) Decedent only instructed the banker that she wanted to open up a joint account, 2) Decedent never instructed the banker that there was to be a right of survivorship, 3) It was the banker who elected to create a joint account with a right of survivorship, and 4) the designation of a right to survivorship was never discussed with Decedent. Thus, the statutory presumption of intent disappeared, and judgment was entered in favor of the estate.

LESSON: The presumption of a joint bank account may be overcome with the right evidence.
 

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