Every April 16 since 2008 National Healthcare Decisions Day (NHDD) has put the spotlight on educating people about the importance of medical advance care planning, a subject that too many people choose to avoid. This may be understandable, since discussing what healthcare measures you wish to receive if you are incapacitated is not pleasant, but the consequences are serious.

Medical advance care planning gives people the information and the tools they need to have meaningful and appropriate conversations with loved ones, choose an agent to make decisions on their behalf, and complete documents in order to implement individualized plans. Taking these steps will allow for advocacy on their behalf in a medical setting and the implementation of end-of-life treatment according to their preferences. Without a plan, family members or friends can be forced to make difficult decisions without knowing what their loved ones would have wanted.


In the past NYLAG has marked NHDD by holding awareness and training programs for the low-income clients it supports, but this year the agency decided to look inward and devote not just a day, but the entire month of April to helping its staff get past the squeamishness associated with talking about the end of life, learn the basics of advance planning, and document their own healthcare preferences.

The idea for Healthcare Decisions Month came to Lia Minkoff, Staff Attorney with the LegalHealth Division, during a meeting when a colleague brought up a challenging case about a couple with young children. The husband had had an accident and was in a coma and the wife came to NYLAG because she was having trouble accessing his financial information. Her issues would have been avoided had they planned properly.

“As my colleague was speaking I noticed several of us around the table shift in our chairs because despite executing these documents regularly for our clients we didn’t have them for ourselves,” said Minkoff. “If we as attorneys are going to encourage our clients to make these decisions and plan ahead, shouldn’t we be doing the same thing for ourselves and our families? There is also no better way to feel comfortable counseling your clients than to go through the process yourself.”

Spearheaded by Tina Janssen-Spinosa, Senior Staff Attorney and Program Coordinator for Total Life Choices (the advance planning program at NYLAG), Minkoff, and Sara Meyers, Chief Operating Officer, Healthcare Decisions Month includes a Continuing Legal Education session on organ donation, various presentations and group trainings, and one-on-one meetings with members of the legal staff who have the expertise to execute advance planning documents, including Medical Advance Directives and Powers of Attorney.

“There are many attorneys at NYLAG who either directly advise and assist clients in executing medical and/or financial advance directives, or refer them to others within the organization who can do so,” said Janssen-Spinosa. “And yet, like the old proverb about the shoemaker who is so busy making shoes for his customers that his children go barefoot, they don’t pay the same attention to themselves and their families as to those they serve.”

A 2014 study showed that just 26.3 percent of those surveyed had a medical advance directive stating what care they would or would not want, and naming a proxy to speak on their behalf if they are unable to speak for themselves. Those who were older or suffering from chronic disease were more likely to have complete advance directives, while younger people either were unaware of advance planning options, or thought that it was something they didn’t need to think about yet.

The response to Healthcare Decisions Month has been strong, with legal and support staff members participating in various programs and 35 of them completing Medical Advance Directives and/or Powers of Attorney.

“Just as exciting for us has been the fact that 26 NYLAG attorneys have volunteered their time (offering to do two to three sessions each) to advise colleagues and help them execute their documents,” said Meyers. “Together we have all gotten a great education about the importance of advance planning in our personal lives, and benefitted very directly from the expertise of our colleagues and friends.”

Here are thoughts from a few NYLAG staff members about the program:


katieocampo2Katie Ocampo, Staff Attorney
LegalHealth Division

Age: 33

I celebrate my one-year anniversary with NYLAG on May 2. I do not have many living family members and the training made me realize that certain default laws would allow some members of my family I am not close with to make important decisions should something happen to me. I think it is important to have peace of mind that things are in order, instead of a delay due to chaos if something happened. Professionally, I think being able to tell clients that I have my advanced directives complete shows them that it is important for them to have these documents finalized.


Kathleen Krumpter2Kathleen Krumpter, Senior Financial Counselor
Financial Counseling Division

Age: 47

I just started at NYLAG a month ago. The health care proxy is something, as an unmarried person especially, I’ve thought about ever since the Terri Schiavo case. After that I had a long conversation with my parents about my wishes but never executed any documents. Both my parents are gone now though and I think it’s more important than ever that I have documents in place indicating who can make medical decisions on my behalf were anything to happen to me.


justin brown2Justin Brown, Staff Attorney
Storm Response Unit

Age: 30

I’ve been at NYLAG since January 2016. I want to feel confident that my wishes are known and advocated for should I become incapacitated. When my father was suffering through late-stage cancer, clearer, advanced communication about his desires could have made  the experience a lot easier for all involved, so I’m grateful to have the opportunity to work through this now while I’m young and healthy.


Nina Martinez2Nina Martinez, Skadden Fellow
Employment Law Project

Age: 28

I came to NYLAG a year and a half ago, right out of law school. When my grandfather died we were not prepared, and had not discussed his wishes with him. Now my grandmother is older, and as the person who went to law school, I want to be informed for my family. My interest in this subject got even more personal when my fiancé and I spent New Year’s Eve in the emergency room and found out he needed to have gall bladder surgery. He made me his healthcare proxy – my first exposure to the importance of having someone who can advocate on your behalf and make medical decisions if you are incapacitated.