The Center for Elder Law & Justice is a non-profit civil legal services agency, providing free legal representation in Western New York. On this week’s episode, we welcome Lindsay Heckler, supervising attorney, to discuss the Center’s mission.
Schenk: Hey out there. Welcome back to the Nursing Home Abuse Podcast. My name is Rob. I’ll be your host for this episode. We from time to time like to highlight organizations, associations, places that are doing great work for people who have loved ones in nursing homes. So in the past, we’ve had on individuals from the National Center on Advancing Person-Centered Practices and Care. We’ve had on members of the AARP Litigation Group. We’ve talked to Senior Medicare Patrol, so groups that are doing good work for nursing home residents. Today is no different.
We wanted to highlight a particular state organization, state law firm essentially called the Center of Elder Law and Justice. This is a New York-based organization that does a lot of work for not just nursing home residents but seniors in general. They have a wide range of practice areas that they represent people for and they have a lot of resources for individuals living in their territory.
But we don’t do this alone. We’re going to have an attorney on as a guest and representative for the Center of Elder Law and Justice. Her name is Lindsay Heckler. Lindsay Heckler is actually a supervising attorney at the Center for Elder Law and Justice where she manages the agency’s response to nursing home, assisted living and long-term care policies and regulations as well as other issues that impact older adults and vulnerable populations. She is a legal liaison for the partnership between the Center for Elder Law and Justice and People Incorporated New York State Region 15 Long-Term Care Ombudsmen and is a certified ombudsman. In her role as legal liaison and ombudsman, Ms. Heckler is an advocate and resource for information pertaining to long-term care issues for residents and nursing homes, adult homes and their families. Lindsay was previously associate compliance counsel for a Medicare compliance company, assisting clients in navigating the CMS system, policy initiatives and appeals procedures. Again, we are so happy to have Lindsay Heckler on. Lindsay, welcome to the show.
Heckler: Thank you for having me.
Schenk: All right. Well Lindsay, I kind of gave a brief introduction as to you and your organization, but I wanted to hear it straight from the horse’s mouth. What is, because you’re right there on the front lines, what is the Center for Elder Law and Justice, and can you talk to us about what its mission is and what you guys kind of do on a daily basis?
Heckler: Sure, we are a nonprofit civil law firm, so we provide free legal representation in the 11 counties in Western New York, which is Buffalo, New York, Niagara Falls. We are not near New York City, which is a common misconception. We have been around since 1978, so for over 40 years, we have been advocating for our mission, which is to improve the quality of life for our clients through the provision of free legal advocacy services. And our primary goal through our advocacy and legal services is to ensure our clients and those living in the community may live independently and with dignity.
Schenk: Wow. So that’s something kind of – that’s an interesting kind of category of nonprofits. So it’s like a nonprofit law firm. It’s not like an ombudsman program. It’s not some type of informational place. You literally are a nonprofit law firm taking clients and their matters and pursuing them in court.
Heckler: Correct. And so for nursing homes, what we don’t do is lawsuits for neglect, personal injury, wrongful death. That’s really more of the private bar organizations. So what we do is we provide for nursing home residents, legal assistance with Medicare, Medicaid, whether it’s appeals, their hearings, inappropriate denials. We also provide legal representation for people who are facing involuntary discharge or transfers from their nursing home and we also engage in various systems advocacy initiatives to improve the quality of care in a nursing home but also in our adult care facilities, also known as assisted living and all the way to home care in the community.
Schenk: I see. I see. That makes sense. You kind of separate one thing from the other but it’s still like you’ll have – at least according to the website, you all do a whole bunch of stuff, like you mentioned, the Medicare appeals. It looks like – I’m looking at you guys fight improper evictions and discharges, foreclosure prevention, that type of stuff, consumer protection. You all are doing all kinds of stuff. And I guess, are you guys, are you limited to the Buffalo and surrounding counties? If somebody was listening to this in New Jersey or Pennsylvania somewhere, could they reach out to you? How would that work?
Heckler: We are specific to Western New York. However, we do have a statewide legal help hotline for all of New York state that people can call. We can, depending on the call volume, receive calls from other states, but the challenge with that is our help line is New York state legal-specific, so our attorneys who are licensed in New York state cannot provide brief legal support on other state issues. So I do caution folks who are in New Jersey that our services are New York state-specific.
Schenk: Right. And we talk about this pretty regularly on the program about how we live in a federal system, so how nursing homes are regulated at a federal level. Those are usually the most rigid – not rigid, but the most encompassing rules. But then each state has their own particular rule, which can be more strict. But everybody’s got their own difference sauce. And so we’ll get calls from whatever and we’ll say, “I’m an attorney, but I’m not an attorney in Hawaii, so I can’t advise you what’s specifically going on in Hawaii.” So it’s the same situation with you guys. So you actually have somebody – you have a phone line that people can call for advice even if it’s not necessarily, “I want you guys to help me with this discharge,” or whatever, but I can call for advice. Can you tell us a little more about that, the hotline?
Heckler: Sure. We had our help hotline even before the current pandemic situation. As a response to what is currently going on, we have opened it up to all ages and across the state. So our help line is meant for brief legal advice, so 15, 30 minutes on a phone call and we help with a variety of legal issues and concerns through the help line ranging from consumer protection, health insurance questions, unemployment, how to protect a loved one from abuse and neglect, resident rights, advanced directives and a lot more.
Schenk: Wow. That’s very impressive. I mean you couldn’t call the average law firm and get legal advice, 15 or 20 minutes, in that amount of wide-ranging subject matters, so that’s pretty impressive. Can you tell me about – so you mentioned earlier you had the hotline for a while and before the COVID-19, you’ve been around for 40 years – can you tell us about the organization, like the history of the organization and when you started, kind of the back story?
Heckler: Oh sure. So we started in 1978 and as time continued, the need for legal services that are free and encompassing to people who are 60 and older and goes way younger living with disabilities. The need is growing. And so back in 1978, we were known as Legal Services for the Elderly, Disabled or Disadvantaged of Western New York. Then in 2016, we decided to change our name to the Center for Elder Law and Justice, because we felt that it better reflected the work that we do and our mission. Our office is more than just a law office, so we go beyond just representing people in the standard legal capacity in court or administrative legal proceedings. We have a guardianship unit, for example, where we are court appointed, and we also have trustee services and we are part of the Western New York Coalition Pooled Trust, which helps people become eligible or remain eligible for Medicaid while still living in the community.
Schenk: I see. I see. Lot of great work up there. In your experience with the Center for Elder Law and Justice, is there a particular problem that you’re seeing more than others, especially in these times? Or is there something your office is like, “Oh my goodness, we’re dedicating a lot of resources to this problem,” for the clients you’re taking on?
Heckler: All our resources are equally dedicated to the areas that we serve. We are known for many areas, but especially our elder abuse and prevention unit and our participation in multi-disciplinary teams to focus on elder abuse prevention and revolution. And so our attorneys will represent older adults who are in abusive situations, whether its physical, mental or financial, and provide them with the legal support to get out of that extremely challenging, difficult situation on the road to living a good quality of life and independence and being free from abuse.
Schenk: And how many attorneys do you have on staff with the organization?
Heckler: Oh. That I’m going to have to look up real quick.
Schenk: Not to give you a pop quiz like that.
Heckler: We have about a staff of 50 employees made up of attorneys, paralegals and also social workers. And we have three officers in Western New York and the reason for that is to better reach our clients, whether they live in a city setting, suburban setting or more rural area. We can try to reach our clients where they are.
Schenk: Wow, that’s a big territory. So what are some – are you seeing yourself, are you seeing or involved in a particular case that you’re passionate about? In other words, do you have a particular category of cases that you handle?
Heckler: Sure, yes. I am a legal liaison to the New York State Regional Long-Term Care Ombudsman Program, specifically the Region 15 program, which is the Buffalo, New York, program and covers four counties. I have been the partner and the legal liaison to this program since October of 2015 and through that, I have many roles, one being I connect residents between our office and the regional ombudsman program for nursing home resident advocacy. So we work together to ensure that our clients, the resident, has the access to the legal services they need but also the advocacy they need to ensure their rights aren’t being violated. I also provide direct legal support to the program staff and volunteer ombudsmen, which means that their advocacy for a resident or for multiple residents, if they have a question on federal or state nursing home regulations or laws, they can contact me directly and I can walk them through on guide them on how to best advocate for that specific situation. We also have an uptick in inappropriate or involuntary discharges from nursing homes where myself and colleagues will represent residents at what’s called discharge hearings. And we will advocate or represent residents at these hearings to ensure they are either transferred back to the nursing home in the situation that they are left at the hospital or to ensure that they remain in the nursing home of their choice.
Schenk: Wow. So that’s really interesting that you say there’s an uptick in the improper discharge. We had an episode dedicated to that. We had an attorney with the AARP Litigation Group, and that’s one of their – I mean that’s a huge problem across the country, these improper discharges where the nursing homes aren’t going to get reimbursed after the 100 days, they find that they get discharged after the 100 days. So you mentioned that you can be a liaison with regard to providing advice to what the regulations require and how to advocate based on the regulations. Can you talk more about regulations, particularly about some of the changes from the previous presidential administration with today? What’s happened with federal regulations the past few years?
Heckler: Ah, for the past few years, in my opinion, the current administration compared to the prior administration has been actively rolling back nursing home residents’ rights at the federal level, and this is extremely problematic because the roles and regulations, these residents’ rights, they have been in place for many years and updated back in the President Obama administration to – they’re meant to protect residents, however there’s always been a problem or challenge of enforcing these basic residents’ rights and right to quality care. For an administration to come in and purposely say, “We’re not going to fine nursing homes for certain actions and we’re looking to work with nursing homes as our customer,” it’s really problematic when the customer, if you will, are nursing home residents and patients. The customer shouldn’t be viewed as nursing home operators who choose to provide, who choose to accept Medicare and Medicaid funding to provide care. It’s really frustrating to see what has gone on under the current administration, and even during the pandemic situation, which we’re living in now, it’s been frustrating to see the lack of support and protections for nursing home residents.
Schenk: Yes, I agree with that wholeheartedly. I mean just the – as it stands right now, that no nursing home is going to get cited for anything that isn’t an immediate jeopardy citation, not cited for not having appropriate PPE if it’s “out of their control,” these types of things, it’s just insane. And just to add on top of that, I’m not sure what the situation is in New York, but I know in Georgia, our governor just enacted a proclamation freeing nursing homes from liability from essentially anything during the crisis.
Heckler: Yes, our state and governor has done that as well. It was done through the New York state budget process, and the legislature passed what’s called the Emergency Disaster Treatment Protection Act, which states that any healthcare facility or professional, which does include nursing homes and their operators and administrators, they will have immunity from any liability, which is civil or criminal, for any harm or damages alleged during the pandemic so long as the care provided or the decisions were in response to or as a result of COVID-19. This is extremely concerning for obviously the residents, their families and advocates because our concern is with limited state survey agency oversight, so Department of Health in New York State’s case, the only legal action many residents and their families have to abuse and neglect are through the court system. And that’ll be determined how this plays out through litigation in the future, but understaffing, for example, in nursing homes has been a problem prior to the pandemic and it’s even worse now and it’s scary and horrifying to relieve nursing home operators of their legal responsibility to provide safe care to their residents.
Schenk: Agreed. Amen to that. So Lindsay, in the last couple minutes that we have, can you – if someone is in your area in Western New York, in the Buffalo area, and they wanted to find out more about your organization, what you guys do, and then if they wanted to reach out to you, can you talk us through what the best ways to do those things are?
Heckler: Oh sure. They can use our main office and call at area code 716-853-3087. They can also visit our website at elderjusticeny.org. And they can also call our legal advice hotline, which is 1-844-481-0973 at any time to leave a message or on Monday through Friday 9 a.m. to 11 a.m. to reach an attorney directly. And people are also welcome to email us at email@example.com with their name and number. Any messages that we receive through our help line, whether it’s a phone number or an email, will be returned by an attorney within one business day. I’m also happy to provide you all with some residents’ rights information, though no legal advice, to people who have called us with questions, and to direct them to resources if they would like them.
Schenk: Fantastic. I don’t know many attorneys or law firms who will call you back within 24 hours, so that’s a great policy that you have. Well and Lindsay, how did you get involved with the organization?
Heckler: This goes back to when I decided to pursue a career in law. I was lucky enough to pursue it the same my JD and my master’s in public health. And prior to working with the Center for Elder Justice, I worked with straight out of law school years ago now as a compliance counsel for a Medicare company. I was not happy with what I did. I was good at what I did but wasn’t meaningful. So a position opened up with the Center for Elder Law and Justice where I actually interned back in law school for the legal liaison position and a new partnership with the ombudsman program. I jumped at the opportunity, applied. I have been working with the Center for Elder Law and Justice and advocating for nursing home residents and people receiving long-term care services in the community since 2016. I love what I do and look forward to every day helping people quite frankly.
Schenk: That’s fantastic, Lindsay. Thank you for sharing that with us. And again, thank you so much for coming on the show and talking about the Center for Elder Law and Justice. We really appreciate that and we hope that our audience, if you’re in that area that is serviced, if you have questions for her, just give the organization a call at those numbers and we’ll have those numbers and information in the show notes as well. So Lindsay, again, thank you so much for coming on the show.
Heckler: Oh, you’re very welcome. Thank you for having me.
Schenk: Again, so great to have the different organizations that we highlight on the program. This one is no different. They’re doing a lot of great work so we’re so happy that they’re there, that they exist, because as she mentioned, I feel like there is a spectrum of people that have been hurt by nursing homes, and there is a gap where attorneys like myself are able to protect those residents and that’s where they fill in and they come in and they’re able to do things most attorneys that are injury attorneys cannot do. So we’re thankful for them.
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