How is Dutiful Responsibilities Defined

Dutiful responsibility is a legal term for the obligations that must be carried out by an adult child to his parents for the necessities of life for his parents. This is usually a problem when older people need long-term health care but cannot afford it.

To fully explain filial responsibility, let’s take a closer look at an example, as well as the relevant legislation at the federal and state levels. We will also consider how children’s responsibilities play a role during the COVID-19 pandemic.

Low- and middle-income households rarely need to worry about these laws if parents have registered and are eligible for Medicaid. However, the situation may change when treatment is needed before the parents have eligible for Medicaidat least when the adult children are deemed to have enough income to pick up the tabs.

What is a Dutiful Responsibility?

Many states have laws requiring adult children to be financially responsible for their parents’ necessities of life when the parents do not have the means to pay for them themselves. The extent of this responsibility may vary by state. Nursing homes and other long-term care facilities can use this law as a means to seek reimbursement from adult children for unpaid bills.

Example of the Law of Dutiful Responsibility

Duties of responsibility laws were rarely enforced in previous years, but a 2012 case in Pennsylvania bucked that trend.

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The Pennsylvania High Court upheld the lower court’s decision in Health Care & Retirement Corporation of America v. Pittas to hold the adult son liable for nearly $93,000—a debt that resulted from the six months of skilled care and care his mother received at the Pennsylvania facility.

The court concluded that the state had no obligation to consider the woman’s other possible sources of payment, including her husband and two other adult children, or the fact that applications for Medicaid assistance were pending at the time.

The woman had left the country—and had left her debts behind—by the time the court first heard the case, and multiple reports suggested she had retirement income that resulted in her being rejected by Medicaid.

Instead, the court found that the facility had adequately met its burden of proof that this particular son had the means to pay the nearly $93,000 bill. The High Court ruled that the tribunal was right in holding the son responsible for paying for it.

The case of Pennsylvania demonstrates the importance of long-term care planning from the perspective of elderly parents and their children. Without proper planning and legal advice from an experienced senior legal attorney, some adult children may be in dire need of the thousands of dollars of care their aging parents need.

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States With Duties of Liability Laws

More than half of the states and Puerto Rico consider adult children to be financially responsible in some way by 2021. They include Alaska, Arkansas, California, Connecticut, Delaware, Georgia, Indiana, Kentucky, Louisiana, Massachusetts, Mississippi, Montana, Nevada, New Jersey, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Puerto Rico, Rhode Island, South Dakota, Tennessee, Utah, Vermont, Virginia, and West Virginia.

Maryland repealed its child liability law in 2017, and New Hampshire is taking steps to limit children’s liability.

Arkansas requires adult children to pay only for mental health care. Connecticut law only applies to parents who are younger than 65, and adult children in Nevada are only liable if they have signed a written promise to pay for care.

Most states take into account the ability of an adult child to pay. People who do not have sufficient income to pay are not liable for these debts.

Federal Law

Federal law prohibits care facilities from requesting guaranteed payment from third parties as a condition of entry, and patients cannot be “evicted” for lack of such coverage.

A Montana court dismissed the nursing home claim in 2013 under this federal law.

However, the federal Medicaid Plantation Recovery Program allows states to look into a patient’s estate for reimbursement of benefits after the beneficiary dies.

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How COVID-19 Can Affect Dutiful Responsibilities

Given that filial responsibility laws may require adult children to pay for their elderly parents’ medical expenses, it makes sense that the COVID-19 pandemic could bring these laws to the fore. The disease disproportionately affects older people, and people between the ages of 65 and 74 are five times more likely to be hospitalized than those between the ages of 18 and 29, according to the CDC. For people aged 75 to 84, the multiple is eight.

A simple doctor’s visit doesn’t seem enough to carry out filial responsibilities. “At least as far as parents are concerned, most have Medicare and supplements that cover their medical bills,” said John Ross, a senior attorney at Ross & Shoalmire and host of radio and TV show Aging Insight.

However, Ross sees greater potential for child responsibility issues when it comes to long-term care during the pandemic. “We’ve seen a number of people bill nursing homes because of the combination of patients being isolated, and families not having access to info to apply for Medicaid.” That creates a difficult situation where patient bills come in, but their family members may not have sufficient resources to pay them—and the debt continues to grow.

“This is the kind of non-reimbursable medical expenses where filial responsibilities usually arise,” Ross concludes.

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