Grace Care Management works very closely with fiduciaries to be sure our clients have secured and well planned futures. We have had the pleasure of working with Susan Fox and Liberty Fiduciary Services directly and are pleased to feature her this month. In her interview, Susan shares more about fiduciaries and most importantly goes into detail about the Advance Health Care Directive, what it is and why it is so important to have in place.
As patient advocates, we are always looking for the best for our clients and are proud to introduce you to some of our most trusted associates each month. Thank you Susan for your time in educating our readers more about the valuable services you offer. We encourage you to reach out with any questions or if you need help getting important documents in place.
Susan K. Fox, the Principal and Founder of Liberty Fiduciary Services, Inc. has more than fifteen years of experience in providing direct services to vulnerable individuals, including those with Parkinson’s Disease. Susan is a University of Michigan graduate and holds certificates from Cal State Fullerton in Professional Fiduciary Management, Trusts, and Conservatorships. She also earned certificates from UCSD Extension in Gerontological Counseling and Program Management, Counseling and Interpersonal Skills, and Geriatric Activities. She studied Reality Therapy and attained the Advanced Certificate from Dr. William Glasser of the William Glasser Institute.
Susan is an active member of the community, both with regard to professional organizations and multiple volunteer activities. Susan raised two children who are college graduates. She studied Japanese flower arranging (Ikebana) for twelve years, was president of a local Ikebana organization and attained an advanced certificate granted to few foreigners. She enjoys bicycling, reading biographies and learning new things. Below we have captured our recent up close interview with Susan.
What influenced you most to become a fiduciary and serve vulnerable individuals?
The combination of seeing a video of Mother Teresa’s work with the homeless and forgotten along with the knowledge that approximately one in four people over 65 years old in San Diego County have no one that they can trust to speak for them or manage their affairs when they cannot do so. This statistic includes people who have millions, of dollars to the people who are on welfare and might receive as little as $600 per month to live on. There is a humanitarian need that can be filled by licensed, trustworthy and responsible professionals.
As a fiduciary, I work under the authority of legal documents in which I am named. Thus I work closely with estate planning attorneys, tax and insurance professionals, and others.
You offer a very important service, which is serving as an Agent under Advance Health Care Directive. We find many people are not aware of what an Advance Health Care Directive is and why it is so important. Can you please describe this service in more detail for those who are unfamiliar and inform us when one should get this in place?
I am licensed as a fiduciary to serve in the role of Agent under an Advance Health Care Directive. This is sometimes called a Power of Attorney for Healthcare. Both roles have a legal document whose directions must be followed by the Agent or Power of Attorney.
When an individual appoints an Agent under Advance Health Care Directive, they are giving that person legal authority to speak to healthcare professionals on their behalf when they cannot. Most people think this means that the Agent must decide when to “pull the plug”, but the responsibility goes much further. The Agent also has the authority to participate in all aspects of the appointer’s healthcare and medical needs. When the individual cannot speak for him or herself – due to an accident, stroke, Alzheimer’s, or some other debilitating physical or mental condition – the Agent communicates the appointer’s healthcare wishes to others.
The Agent, or POA for Healthcare, may also serve in many other capacities such as: making sure that the person is living in a safe environment with care management in place and quality caregivers, accompanying them to doctor visits, monitoring their medication supply, coordinating insurance benefits, or even advocating for a move to a different place where they could receive a more appropriate level of care.
The Agent has the health authority for a person who cannot make their wishes known. However, they have no authority over the individual’s financial affairs. The Trustee and/or Power of Attorney for Finances has the legal authority to make financial decisions, but no authority over healthcare. Sometimes, the same person fulfills both the financial and the healthcare roles. At other times, the individual names two different people in their estate planning documents to fill these roles. Either way, the Agent and the Trustee must be able to work together for the welfare of the vulnerable individual.
Otherwise, a scenario could arise in which the Agent says, “I want mother to live here,” and the Trustee might say, “No, that is not possible; there is not enough money for her to live there.” The result could be an argument and an impasse. Speaking from experience, my advice is to give careful consideration as to who you name as your Health Care Agent (and all legal roles) so that you can feel secure that your medical needs and wishes will be met. The Agent is a very important position and should not be taken lightly. This person has to have the time and be mature enough to put their interests aside, and to make decisions based on what you have told them, written down for them or expect them to decide based on knowing what you like. They have to withstand possible criticism from other well-meaning people who are not legally charged with your welfare. Severe disability or approaching death generally prompts a degree of irrational behavior in observers. The Agent needs to be the rational one, the anchor in the situation. A licensed fiduciary can do that.
In my opinion, everyone over the age of 18 should have an Advance Health Care Directive with an Agent named. If you end up in the ER, the staff will often ask you if you have one, and if not ask you to fill one out as part of the admission process. However, the best action is to be ready before the need arises. If you don’t already have an Advance Heath Care Directive, your doctor can provide you with the document. Fill it out, make copies of it, keep the original and give a copy to your Agent and your healthcare professionals. Seeking legal advice, if needed, and making that document part of your estate planning documents will ensure that your wishes are communicated adequately.
There are many local fiduciaries here in San Diego. What makes you different from others and what type of clients are generally drawn to you?
I am the licensed fiduciary at Liberty Fiduciary Services, Inc. I have a staff of five who assist me in making sure that my clients’ needs are met while they are living and that their wishes after their death as expressed in their will and/or their trust are carried out. We have the ability to communicate directly with each of our clients whenever they call us, 24/7. We make sure that our active client base feels included and valued. This takes time, manpower and interest. Our mission statement is: we protect the vulnerable by providing compassionate and fully accountable fiduciary services. We live that statement every day through outreach and detailed accounting practices. We respect our clients, we protect our clients and we are committed to every aspect of their welfare for the long term.
Clients who value relationships and want peace of mind when they can no longer manage their affairs are drawn to us. They know that they will need a fiduciary who is personally interested in their welfare, the welfare of their beneficiaries, as well as the welfare of their assets.
We have seen first-hand the special things you do for your clients, including bringing in live music therapy compliments of Grace Care’s very own talented staff! Any other special moments you’ve shared with your clients that you’d like to tell us about?
I have given birthday parties for my clients, inviting friends from the days when they were active members of their community. I have stood in for parents when they could not attend a special celebration for their child. I have arranged for vacation trips for my clients with their trusted friends and caregiver accompanying them. I have also reconnected one of my clients with his long-lost brother. The best reward was seeing the look of delight on my client’s face.
What benefit do you see in working with Grace Care’s Geriatric Care Management team?
The fact that Grace Care Management recognizes that hands-on geriatric care management is an integral part of their caregiving services raises the organization to the top echelon of personal care services in San Diego. Having a nurse who is trained in recognizing the health issues long before they become a threat to the well-being of my client can prolong the life and comfort of my vulnerable individual. At Grace Care, the care managers supervise and give individualized direction to their care giving staff regarding the ongoing needs of their clients. The communication is two way – the caregivers communicate with the care manager to let them know of a changing situation that needs their attention too. As a fiduciary, this close attention to detail is what I need because my legal responsibility is to be totally loyal to my client and to assess and fulfill their needs constantly. I need a team who is as committed to my client as I am. Grace Care goes the extra mile to be sure that I am informed and my client is comfortable be it day or night.
What is the best way for someone to contact you if they were interested in scheduling a consultation?
The best way is to either call my office at (858) 505-9156 or email me at [email protected] I would be pleased to respond to questions regarding service in any of these fiduciary roles: Trustee, Agent under Advance Healthcare Directive, Power of Attorney for Finances, Executor, Personal Representative, Conservator and Probate Administrator.