Bob Michaels is extremely passionate about providing the best possible legal experience for his clients, and focuses his practice on elder law, estate planning, business, and real estate matters. Bob has been able to provide piece of mind and a solid foundation to many folks in the Puget Sound area over the years and wants to provide resources and relevant information whenever he can. For more information on how Bob can help your loved ones through these troubling times, contact Bob to schedule a FREE consultation.
Since the Covid-19 crisis began, nursing home residents have been separated from their families. Some families have gotten creative – visiting through windows, via Zoom, Facetime, and from parking lots. Although many have had no way to reach their loved one, and must rely on staff to give them updates.
Unfortunately, this isolation has increased depression and confusion in many residents, leading to heartbreaking scenes of seniors dying alone and families not finding out until after the fact, or families unable to enter their loved ones’ room during their final days.
Nursing Home Recommendations
(According to article in Kaiser Health News, posted February 21, 2020, by By Phil Galewitz)
The Trump administration’s top Medicaid official, Seema Verma, has been increasingly critical of the entitlement program she has overseen for three years.
Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS), has warned that the federal government and states need to better control spending and improve care to the 70 million people on Medicaid, the state-federal health insurance program for the low-income population. She supports changes to Medicaid that would give states the option to receive capped annual federal funding for some enrollees instead of open-ended payouts based on enrollment and health costs. This would be a departure from how the program has operated since it began in 1965.
In an early February speech to the American Medical Association, Verma noted how changes are needed because Medicaid is one of the top two biggest expenses for states, and its costs are expected to increase 500% by 2050.
“Yet, for all that spending, health outcomes today on Medicaid are mediocre and many patients have difficulty accessing care,” she said.
Approximately 50 million—or 20 percent—of American adults reported donating to a crowdfunding campaign to help raise money for a medical bill or treatment.
(CHICAGO, Feb. 19, 2020)
One in five Americans reported that they or someone in their household have contributed to a crowdfunding campaign to pay for medical bills or treatments, according to a new AmeriSpeak® Spotlight on Health survey from NORC at the University of Chicago. Crowdfunding is the process by which individuals may raise funds from a large amount of people, often through sites such as GoFundMe.
Seniors have unique legal needs that are best served by an attorney with extensive knowledge and experience in the field of elder law. Elder law encompasses a range of issues of importance to seniors, including estate planning, Medicaid planning, guardianship, and estate administration and litigation.
Let’s say your father owns two homes and now must go into a nursing care facility, where it’s anticipated he will have to stay. Let’s say the one home was his primary residence, but the second home he built for his disabled daughter. Unfortunately, the financial burden of his care has now fallen to you and you’re trying to apply for Medicaid, but based on this second home, he’s been denied. What can you do?
There are some ways you can protect the homes and receive the Medicaid he needs, but chances are you will need an elder law attorney.
For example, let’s assume the daughter is under the age of 65 and meets the Social Security definition of disability, meaning she is either receiving SSI or SSD or is eligible for such benefits. With the aid of an attorney, your father can transfer the second home to her without incurring a Medicaid penalty for the transfer.
The transfer of the house should not adversely affect any means-tested benefits such as SSI or Medicaid that the disabled daughter might receive if that house is used as her principal place of residence. The primary home could also be transferred to the disabled daughter in a trust or it could be sold, and the proceeds would be transferred to the trust, without incurring a Medicaid penalty.
The primary home could also be sold to pay the nursing home privately, with a portion of the proceeds transferred into a trust for the benefit of the disabled daughter.
However, to get these transfers done properly, your dad needs the help of an elder care attorney. Bob Michaels of Tacoma Elder Care can help. Contact Bob today by calling his office at 253-627-1091 to set up a free consultation. Or attend one of his FREE Workshops.
Caring for an ailing family member is difficult, but it doesn’t have to be unpaid work. There are programs available that allow Medicaid recipients to hire family members as caregivers.
All 50 states have programs that provide pay to family caregivers. The programs vary by state, but are generally available to Medicaid recipients, there are even some non-Medicaid-related programs.
Medicaid's program began as "cash and counseling," but is now often called "self-directed," "consumer-directed," or "participant-directed" care. The first step is to apply for Medicaid through a home-based Medicaid program. Medicaid is available only to low-income seniors, and each state has different eligibility requirements. The Medicaid application approval can take months, and there may be a waiting list to receive benefits under the program.
The state Medicaid agency usually conducts an assessment to determine the recipient's care needs—to determine how much help the Medicaid recipient will need with daily activities such as bathing, dressing, eating, and moving. Once the assessment is complete, the state draws up a budget, and the recipient can use the allotted funds to pay for goods or services related to care, including paying a caregiver.
Recipients can choose to pay a family member as a caregiver, but there may be some restrictions on which family members are allowed. Most programs allow ex-spouses, in-laws, children, and grandchildren to serve as paid caregivers, but typically family caregivers are paid less than the market rate in order to prevent fraud.
In addition to Medicaid programs, some states have non-Medicaid programs that also allow for self-directed care. These programs may have different eligibility requirements than Medicaid and are different in each state. Family caregivers can also be paid using a "caregiver contract," increasingly used as part of Medicaid planning.
In some states, veterans who need long-term care also have the option to pay family caregivers. In 37 states, veterans who receive the standard medical benefits package from the Veterans Administration and require nursing home-level care may apply for Veteran-Directed Care. The program provides veterans with a flexible budget for at-home services that can be managed by the veteran or the family caregiver. In addition, if a veteran or surviving spouse of a veteran qualifies for Aid & Attendance benefits, they can receive a supplement to their pension to help pay for a caregiver, who can be a family member.
To find out more about these programs, and to see if you qualify, contact Tacoma Elder Care for a consultation. Or attend one of our FREE workshops.