Healthcare / Disability

The world of health care is becoming more and more complex. To meet the demands of this changing field, when you create your integrated Estate Plan with us, we help you also prepare the following documents: HIPAA Release, Health Care Proxy, Advance Directive (sometimes known as a 'Living Will') and a Power of Attorney. Each is explained in more detail below. For people in the LGBT community, we have learned that these documents may be even more important to ensure that a same-sex partner or loved one who is not a biological family member can have access to clinicians and the legal authority to decide important issues, particularly in the event of an emergency.

Although President Obama issued a Memorandum to the Secretary of HHS in 2010 directing regulations be adopted which affirm rights of patients to choose visitors and explicitly mentioned that hospitals should not discriminate based on sexual orientation or gender identity, much work is still needed in implementing these regulations. It is our view that everyone still needs these basic documents in place and readily available in the event of an emergency.


We have all heard and read much about privacy laws in recent years. In 1996, Congress enacted the Health Insurance Portability and Accountability Act (HIPAA). HIPAA is a major federal law that deals with a patient's right to privacy with respect to medical records. An unfortunate side effect of this legislation, however, is that sometimes doctors, nurses, and other health care providers are reluctant to share medical information with a patient's trusted loved ones. For instance, in some places, only a patient's spouse - and not his/her children - will be allowed to see the records and/or speak with the professionals about the patient's care plan. But you may want your spouse, children, and/or even in-laws, who may be health care professionals themselves, to be able to participate in these conversations.

A HIPAA Release is a document that allows doctors and other health care professionals to share your medical information with anyone you designate in the document, such as (but not limited to) a child, spouse, unmarried life partner, relative, friend, or other loved one.


A Health Care Proxy is a legal document that gives a close, trusted person the power to make all health care decisions for you in the event you cannot communicate your wishes directly to your health care providers. Massachusetts law requires that only one person at a time be designated as your health care agent in order to avoid disagreement among family members in the event of an emergency.

Such documentation can be especially important for same-sex spouses (although such couples are now legally recognized in Massachusetts, they will not be in every state where they might travel). Having a properly executed health care proxy is imperative in such situations.



Many individuals have strong feelings about what they want to happen to them should they ever be in a persistent, irreversible vegetative condition at the end of life. The advance directive (also commonly known as a "Living Will") is frequently used to address this situation. It can request that doctors not resuscitate you, or use extraordinary means to prolong your life, once certain critical irreversible milestones have passed, or provide whatever guidance you desire to communicate in these situations. Advance directive can help to alleviate the confusion and even extended, bitter disputes between loved ones and family members.

This document is meant to speak clearly to the family and doctors when the patient becomes incapable of speaking for him or herself.  We build an automatic "check" into the advance directive document by requiring that at least two doctors concur in the diagnosis of the patient, before  acting in accordance with the directives of the advance directive. This check can ensure that your interests are  being looked after and acted upon, based upon objective diagnoses. Although these directives not legally binding in Massachusetts, they provide substantial help to loved ones (and physicians) about what your wishes are in these circumstances.



A Durable Power of Attorney allows you to give someone whom you trust (often referred to as “the Attorney-in-Fact) the authority to handle financial and other related matters for you (the “Principal”) in the event of your incapacity. This document is valuable in that it allows you to choose who shall act for you if you are incapacitated, rather than allowing a court to make this determination. The powers can be broad, and may even include gifting, especially if it is anticipated that that the Principal may want or need to transfer assets for tax or Medicaid planning purposes. It is for this reason that you should make sure that you have a power of attorney that is carefully crafted to your needs.  This document is effective only during the lifetime of the Principal. 



Studies show that 70% of Americans who create these very types of documents don't use them! The most common reason is that the documents cannot be found at the actual moment of crisis. In order to address this problem, we have developed a system to store these documents electronically which allows clients to retrieve their documents at a moment's notice. Every client for whom we provide these documents receives a wallet-sized card that has a personalized access code to a secure, on-line storage facility. Medical professionals can simply dial the number at any time of day or day of the week, and your documents will be sent via fax or pdf to the hospital or medical office where you are being treated. As part of this service, we also include certain emergency information you provide, such as who to call and in what order, whether you have any allergies or serious medical conditions, and the name and contact details of your Primary Care Physician. Clients find this to be an enormously helpful tool in times of need. It's part of our way of creating Estate Plans that Work!

If we can help you with your Health Care and Disability, please do not hesitate to contact us at (617) 716-0300 or

The premiere law firm of Squillace and Associates serves the gay and lesbian community in the Boston Massachusetts area including Allston, Brighton, Back Bay, Bay Village, Beacon Hill, East Boston, Roxbury, South End, Dorchester, Roslindale, Jamaica Plain, Hyde Park, West Roxbury, Mattapan, and Charlestown and all of the Boston Metro areas including Cambridge, Somerville, Brookline, Chelsea, Medford, Everett, Watertown; South Shore areas like Quincy, Braintree, Milton, Hingham, and Cape Cod: Metrowest areas like Lexington, Concord, Wayland; and North Shore areas like Melrose, Stoneham, Reading, Andover.

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