Posts Tagged ‘Family Responsibility’

Singapore’s Legal Laboratory for “Family Responsibility”

SEPTEMBER 23, 1996 VOLUME 4, NUMBER 12

Faced with the high cost of nursing home care for a growing population of elderly residents, several states have flirted with the concept of “family responsibility” laws. Such laws, if enacted, would impose a duty on adult children to support their needy parents, and might be used to reduce both the frequency and cost of nursing home institutionalization.

A small number of states have adopted “family responsibility” laws, or have discussed reactivating old laws. Arizona does not have such a law, and no serious discussion has been heard on the issue. For the moment, federal rules prohibit states from enforcing such laws, but that may well change as Congress moves ahead with its pledge to “end welfare as we know it.”

How would family responsibility laws work in the real world? Would children be obligated to support even parents who had abandoned them? What about children of different means, or living in different states?

Some insight into how such a program might work comes from an unlikely quarter. The country of Singapore is presently conducting just such a socio-legal experiment, and the early results are interesting.

Singapore’s new law went into effect on June 1, 1996. Proponents of the law argued that it was needed for largely symbolic reasons, and that the specially-constituted courts should not expect to see very many cases. To everyone’s surprise, over 100 claims have been filed by (or on behalf of) parents against their children in the first three months.

According to a Wall Street Journal article, Singaporean legislators mostly wanted to provide legal support for traditional Asian values which encourage support of one’s parents. One couple making a claim before the new court, however, complained that their daughter “prefers paying for the living expenses of her dogs than for ours.” Another complainant is the daughter of an 85-year-old woman who argues that her brothers should help provide care for their mother; the two sons claim that the mother should simply be placed in a nursing home.

A third case described in the Wall Street Journal article involves the children from a second marriage seeking support from their father’s children from his first marriage. This case raises interesting legal and philosophical issues, since the support to which the father is entitled may be adjusted for the different treatment he accorded the two families when his children were young.

It is this latter issue which most troubles some Singaporean observers. Since the support to which parents may later be entitled is affected by the way in which they treat their young children, critics worry that parents will be encouraged to quantify every good thing they do for their children, just in case. Opponents argue that the legislation reduces the moral effect of traditional Asian values by converting them into a Western-style legal analysis of rights and responsibilities.

Will similar laws be in Arizona’s (or the country’s) future? It is too early to be certain, but Singapore’s experience may be an interesting precursor to our own.

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Medicaid Reform: “Family Responsibility” Laws

DECEMBER 18, 1995 VOLUME 3, NUMBER 25

One element of the Medicaid reform proposal recently passed by Congress (and vetoed by President Clinton) would, if adopted, have a dramatic effect on the way long term care is funded in the U.S. “Family Responsibility” laws, already on the books in some states, could become commonplace in the near future.

The Republican “MediGrant” proposal to replace Medicaid includes the following provision:

FAMILY RESPONSIBILITY.–A MediGrant plan may not require an adult child with a family income below the State median income (as determined by the State) applicable to a family of the size involved to contribute to the cost of covered nursing facility services and other long-term care services for the child’s parent under the plan.

What does this seemingly innocuous provision really mean? Under MediGrant, states would be free to adopt provisions requiring at least wealthy adult children to pay some or all of the costs of caring for their parents in nursing homes. The law would prohibit states from seeking contributions from children earning less than the median income for families of the same size; in Arizona, the median income for all families is just over $32,000.

While nothing in the MediGrant law requires states to adopt Family Responsibility laws, many already have such provisions on the books. Since current Medicaid rules prohibit Family Responsibility recovery, those laws have been unenforced for decades.

Little attention has been paid to the Family Responsibility (sometimes also called “Filial Responsibility”) provisions of the Republican proposal. Critics, however, note that the concept of charging adult children for the costs of their parents’ care is inconsistent with public notions of individual liability.

In addition, there are other concerns about the proposal. Since states would be free to adopt or ignore Family Responsibility laws, the costs of care would be treated differently in each state. Since states would have both legal and practical and practical problems pursuing out-of-state children, the effect of such laws would be to penalize only those children staying in their parents’ state. Furthermore, such laws would encourage children to leave the state and abandon parents.

Supporters of Family Responsibility laws point out that, as proposed, they would affect only wealthier children. As costs of long term care rise and federal funding is cut back, states insist that they must have as many alternatives as possible to meet potentially huge budget shortfalls.

Observers anticipate that the Family Responsibility provision may be removed in budget negotiations. A recent article on the subject syndicated in newspapers across the country notes that many Republicans view the provision as “political suicide” and expect to give up the issue in talks with President Clinton.

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