In re DiCecco

173 Misc. 2d 692, 661 N.Y.S.2d 943, 1997 N.Y. Misc. LEXIS 346
CourtNew York Supreme Court
DecidedJuly 21, 1997
StatusPublished
Cited by1 cases

This text of 173 Misc. 2d 692 (In re DiCecco) is published on Counsel Stack Legal Research, covering New York Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re DiCecco, 173 Misc. 2d 692, 661 N.Y.S.2d 943, 1997 N.Y. Misc. LEXIS 346 (N.Y. Super. Ct. 1997).

Opinion

OPINION OF THE COURT

Edwin Kassoff, J.

This is a proceeding pursuant to article 81 of the Mental Hygiene Law seeking the appointment of a guardian for the personal needs and property management of the alleged incapacitated person (hereinafter AIP) Betty Gersten. Petitioner is the son of the AIP. The petition asks that the guardian be given the authority to transfer the AIP’s residence located at 17 West 12th Road, Broad Channel, New York, now owned solely by the AIP, to petitioner with a life estate to be retained for the life of the AIP, to transfer certain assets to the AIP’s children, and to allow reimbursement of certain funds to the petitioner from funds held jointly by the AIP and the petitioner.

The AIP is a 76-year-old woman who currently resides at the Ocean view Nursing Home in Far Rockaway, New York. Petitioner instituted this proceeding by an order to show cause seeking to be appointed the personal needs and property management guardian for his mother. The petition alleges that the AIP suffers from severe dementia, is not oriented as to time and place, and needs assistance with the activities of daily living. The petition also states that the AIP broke her hip in a fall that occurred in 1996. The AIP’s physician, Ave-lino S. Rosales, submitted an affidavit, which is attached to the petition, that states that the AIP suffers from severe dementia, is unable to make any decision regarding her personal property and medical needs, and that the AIP is not expected to recover from her ailments. At the hearing held before this court on January 27, 1997, the presence of the AIP was waived by the court as the court found that the AIP could not understand, or meaningfully participate in, the proceedings (see, Mental Hygiene Law § 81.11 [c] [2]).

Article 81 creates a guardianship system that is tailored to meet the specific needs of the individual (Mental Hygiene Law § 81.01). Under the statute, the guardian is given only those powers which he needs and no more. In this way, article 81 seeks to foster the least restrictive form of intervention consistent with an individual’s self-determination (Mental Hygiene Law § 81.02 [a] [2]). Article 81 provides a two-prong test for determining whether a guardian should be appointed for an in[694]*694dividual. Under Mental Hygiene Law § 81.02 (a) (1), the court can appoint a guardian for a person if it first determines that the appointment is necessary to provide for the personal needs and property management of the person. To satisfy the second prong, the individual must agree to the appointment or be incapacitated (Mental Hygiene Law § 81.02 [a] [2]; Matter of Ehmke, 164 Misc 2d 609, 613; Matter of Kustka, 163 Misc 2d 694, 698).

Under section 81.02 (b), a determination of incapacity must be based on clear and convincing evidence that the person is likely to suffer harm because he is unable to provide for his personal needs and/or property management and he cannot adequately understand and appreciate the nature and consequences of his inability. Article 81 further requires the court to give "primary consideration" to one’s functional level and functional limitations in making a determination of incapacity (Mental Hygiene Law § 81.02 [c]). This functional evaluation considers how an individual manages his activities of daily living, such as eating, shopping, dressing, toileting, housekeeping, and money management (Mental Hygiene Law § 81.03 [h]).

Applying these principles to the matter at hand, the court finds that there is clear and convincing evidence that the AIP is likely to suffer harm because she cannot provide for her personal needs and property management and is unable to adequately understand and appreciate the nature and consequences of this inability. The AIP suffers from severe dementia and cannot make any decision with regard to her personal or financial affairs. She is unable to communicate intelligently, and her condition is not likely to improve. Therefore, the court will appoint petitioner as guardian for the personal needs and property management of the AIP.

Petitioner seeks the authority to transfer the residence owned by the AIP to the petitioner, but retain a life estate for the life of the AIP, and to engage in Medicaid planning by transferring some of the AIP’s assets to her children. Petitioner argues that notwithstanding section 217 of the Health Insurance Portability and Accountability Act of 1996 (Pub L 104-191 [the Act]), which makes it a crime to transfer assets in order to qualify for Medicaid under certain circumstances, the transfer of the AIP’s residence and some of her other assets, if done properly, should not result in the imposition of criminal penalties nor affect the AIP’s eligibility to receive Medicaid.

Medicaid is a joint Federal-State program established in 1965 with the passage of title XIX of the Social Security Act, [695]*695to pay the medical expenses of individuals who can demonstrate financial need (see, 42 USC § 1396 et seq.). The purpose of the Medicaid program was to provide medical assistance to the poor aged, blind and disabled persons and families with dependent children (42 USC § 1396; Kassoff and Robert, Elder Law and Guardianship in New York § 7:4, at 217 [1996]). There are strict eligibility requirements for Medicaid, and an applicant bears the burden of establishing eligibility (18 NYCRR 360-2.2 [f] [1] [i]). In 1996, a Medicaid applicant was not permitted to have more than $4,850 in savings.

In 1972, Congress imposed criminal penalties for the making of false representations or statements for acts involving Medicare or Medicaid (42 USC § 1320a-7b [a] [l]-[5]). These provisions provide the basis for prosecuting anyone who makes or causes to be made any false statements or representations that conceal or fail to disclose material facts with the intent to fraudulently secure either Medicaid benefits or payments for services provided to the program (Kassoff and Robert, op. cit., § 7:114, at 254). The statute also provides that criminal penalties can be imposed on providers of Medicare and Medicaid services who knowingly or willfully solicit or receive illegal remunerations (42 USC § 1320a-7b [b]), who knowingly or willfully make false assignment of payment provisions (42 USC § 1320a-7b [e]).

On August 21, 1996, the Kassebaum-Kennedy Health Insurance Portability and Accountability Act of 1996 was signed into law. This legislation, which became effective on January 1, 1997, added a new section to the above statute imposing criminal penalties for acts involving Medicare or Medicaid. Section 217 of the Act, codified at 42 USC § 1320a-7b (a) (6), criminalizes certain transfers of assets made for the purpose of qualifying for Medicaid benefits to pay for nursing home care. The statute specifically provides, in pertinent part, that:

"Whoever * * *

"(6) knowingly and willfully disposes of assets (including by any transfer in trust) in order for an individual to become eligible for medical assistance under a State plan under [title] XIX, if disposing of the assets results in the imposition of a period of ineligibility for such assistance * * * shall (i) in the case of such a statement, representation, concealment, failure, or conversion by any person in connection with the furnishing (by that person) of items or services for which payment is or may be made under the program, be guilty of a felony and upon conviction thereof fined not more than $25,000 or impris[696]

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173 Misc. 2d 692, 661 N.Y.S.2d 943, 1997 N.Y. Misc. LEXIS 346, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-dicecco-nysupct-1997.