When Maryann Pittas left the country without paying a $93,000 bill she racked up at an eastern Pennsylvania nursing home, the facility’s owner took her son to court and won, thanks to a little-known law that’s been on the books for almost 400 years.

“We do expect to receive payment for services provided,” a Health Care and Retirement Corp. of America spokesman wrote in a statement after the Pennsylvania Supreme Court rejected John Pittas’ final appeal in May 2012.

The nursing home’s owner won its case because Pennsylvania is one of 30 states and U.S. territories — including Oregon — that has a filial support statute holding adult children responsible for their parents’ debts.

And while lawsuits that use the laws to collect a debt are extremely rare for now, one legal expert said they may see a resurgence given the ever-increasing costs of long-term care services and the 77 million baby boomers who will start needing care over the next 20 to 30 years.

“(Filial support statutes) may make a comeback,” said Warren Deras, a retired attorney from Portland who sits on the Oregon State Bar’s estate planning and elder law sections.

The laws

In a January 2013 article in the Elder Law Journal, University of Pennsylvania law professor Katherine Pearson wrote that today’s filial support statues date back to a series of “English Poor Laws” the British Parliament adopted at the end of the 16th century to deal with that country’s growing poor population. Other legal scholars trace their history back even further, to the early Roman Empire or even to the Fifth Commandment — “Honor thy father and mother” — of the Old Testament.

The 13 original American colonies incorporated their own versions of the British filial support law into their legal systems at the end of the Revolutionary War and the notion of holding adult children legally responsible for their parent’s debts spread west as the country’s remaining states and territories sought ways to keep their poor and elderly residents from falling through the cracks.

“At one time, as many as 45 of the 50 U.S. states had filial support statutes,” wrote Pearson, who found 30 states and U.S. territories had a filial support statue in June 2012. She found seven cases where these laws had been used to collect a parent’s debt since the 1990s.

Deras said Oregon’s filial support statute — which was adopted by the Legislative Assembly of the Territory of Oregon in 1854 — can only be used when the indigent parent or a third party files a lawsuit seeking the payment of a parent’s debt from his or her adult child.

But while the law has been on the books for 160 years, Deras couldn’t think of a single recent case where it’s been used.

That’s because most adult children feel a moral duty to take care of their parents and will provide this care as long as they can afford it, he said. The state’s Medicaid system, the Oregon Health Plan, can catch those with no other resources.

Though given the recent political climate and the strains aging boomers may place on the country’s long-term care system, Deras said, the safety net provided by publicly funded health plans could buckle, which could cause filial support statues to make a comeback.

The future

According to an ABC News report, Maryann Pittas filed an application with the Pennsylvania Department of Public Welfare to have the state’s Medicaid program pay for her long-term care bills. She moved out of the state to stay with a child who lived in Greece before this application was processed, so it’s not certain whether she would have received these benefits and been able to pay her bill.

Deras said the existence of this safety net for the indigent elderly is one of the main reasons filial support laws are hardly used. Many states — including Iowa, which repealed its statute in July 2012 — have done away with them altogether.

That’s because the Medicaid system, which uses a combination of federal and state money to provide health care benefits to the country’s poor, elderly and disabled, bars private third parties such as doctors, hospitals and long-term care providers from finding anyone except for the patient and the Medicaid system liable for the cost of a covered expense.

But providing this safety net comes at a considerable cost, according to a report produced by the Deloitte Center for Health Solutions, which found Medicaid spent $106.4 billion on long-term care expenses alone during the 2008-2009 fiscal year. These expenses made up 32.1 percent of Medicaid’s total spending that year and represented a 3.8 percent increase in spending from the previous fiscal year, according to the report.

Based on this information, the report’s authors predicted the Medicaid expenses absorbed by each state will continue to grow until they make up more than 35 percent of each state’s overall budget in 2030 — when the youngest baby boomers will turn 66 — and more than half of this money will go toward long-term care expenses.

“Everything I keep reading about the federal and state budget situations is that something has got to change and that might be one change they make,” said Deras, who is confident government officials will try to pare back these long-term care expenditures by making it harder to quality for the benefits or by reducing payments to providers so they avoid the budget nightmare predicted by the Deloitte report.

Either one of these situations means private third parties will have to spend more money providing services to the country’s elderly, Deras said, and may turn to lawsuits like Health Care and Retirement Corp. of America vs. Pittas as a way to recoup their losses.

— Reporter: 541-617-7816, mmclean@bendbulletin.com