Florida Elder Law Blog - ElderLawAssociates.com

“There are only four kinds of people in this world. Those who have been caregivers, those who are caregivers, those who will be caregivers, and those who will need caregivers.” Rosalynn Carter, Former First Lady

The U.S. Department of Labor estimates that in the year 2010, 54% of workforce employees will provide eldercare for a parent or parents and that nearly two-thirds of caregivers will experience conflict between demands at home and demands from employers.

Today’s employed Baby Boomers are the caregiver generation for their parents. They are finding themselves juggling care responsibilities around their employment obligations. Sometimes employees find they have no option but to take leave from work or use sick time to meet their caregiving demands.

Employers also feel the toll it is taking on their employees. A report by the AARP describes the cost to employers:

“Companies are also seeing the emotional and physical toll that caregiving takes on their workers. In one study, 75% of employees caring for adults reported negative health consequences, including depression, stress, panic attacks, headaches, loss of energy and sleep, weight loss, and physical pain. Businesses suffer, too, by having to pay high health insurance costs and in lost productivity. That doesn’t count the promotions or assignments workers turn down that require travel or relocation away from aging relatives."

Businesses that don’t offer benefits or address eldercare wind up paying for them. A recent study by the MetLife Market Mature Institute and the National Alliance for Caregiving states that U.S. companies pay between $17.1 billion and $33.6 billion annually, depending on the level of caregiving involved, on lost productivity. That equals $2,110 for every full-time worker who cares for an adult.

Eldercare cost businesses:

* $6.6 billion to replace employees (9% left work either to take early retirement or quit)
* Nearly $7 billion in workday interruptions (coming in late, leaving early, taking time off during the day, or spending work time on eldercare matters)
* $4.3 billion in absenteeism" AARP

Typically, human resource departments work with employees on many issues that may affect their work productivity. There are programs for drug and alcohol abuse, domestic violence, illness, absenteeism and child care; but, help with eldercare issues is not normally provided.

The AARP report follows several companies who are providing help with eldercare issues and what they are doing for their employees.

* “Freddie Mac has a free eldercare consultant and access to subsidized aides for a relative up to 20 days.
* Verizon Wireless offers seminars on eldercare issues and allows full-time workers 80 hours a year in back-up care, 40 hours for part-time, and $4/hour for in-home help.
* At the Atlanta law firm Alston & Bird LLP, workers can donate vacation time to colleagues who have used up theirs to care for family members. “ AARP

A growing number of companies nationwide are directing their HR departments to provide resources, education and group help for caregiving issues by:

* Providing materials from community resources such as phone numbers to their local Senior Centers or Area Agencies on Aging.
* Making available brochures and booklets on specific programs and services by eldercare experts
* Providing speakers to educate employees on caregiving options
* Allowing options to use paid sick leave, employee job sharingand flexible hours
* Allowing employee caregivers to use business computers for caregiving research
* Contracting with companies who provide eldercare services to help employees

Eldercare service providers are also reaching out to help employee caregivers by providing informational presentations at the work place during lunch time or other times set up by employers. One such presentation provided information on reverse mortgages. Jason, who had been trying to help his parents pay for home care, learned at a work site presentation that a reverse mortgage was one way to cover caregiver expenses.

The HR Department of a local business in Utah, invited the Salt Lake Eldercare Planning Council to present a “Brown bag, Lunch and Learn” during their employees' lunch hour. In 30 minutes time, those who attended learned how the services of a Care Manger, Home Care Provider, Elder Attorney, Medicaid Planner and Financial Consultant can help with caregiving decisions. Problems were discussed, questions answered and employees left armed with information and the names of professional people they knew could help them.

“This was the most productive lunch I have ever attended”, related Mary, one of the attendees.

“I had been very hesitant to contact an attorney to discuss my parents' estate, because of the cost involved. The attorney at our 'lunch and learn' answered my few basic questions which will allow me to prepare what I need before I meet with him to finalize my parents' estate planning.”

Besides workplace help for employers and employees dealing with caregiving, the internet is also a great research tool. The National Care Planning Council website at www.longtermcarelink.net is a comprehensive resource for eldercare, senior care and long term care planning. It contains hundreds of articles on all aspects of eldercare. Professional providers list their services on the NCPC website. Each of their listings provides unique information on specific eldercare services and how to obtain help.

Employers, employees and eldercare service providers working together can make parent or senior caregiving a workable solution for all.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

The Department of Health and Human Services Agency for Healthcare Research and Quality has provided a top notch WEB page to guide us all in improving the healthcare we receive by being involved, interactive and asking questions.

They list the ten primary questions as:

1. What is the test for?
2. How many times have you done this?
3. When will I get the results?
4. Why do I need this surgery?
5. Are there any alternatives to surgery?
6. What are the possible complications?
7. Which hospital is best for my needs? (and why)
8. How do you spell the name of that drug? (or medical term)
9. Are there any side effects?
10. Will this medicine interact with medicines that I'm already taking?

They continue why nine more lists of questions pertinent to specific situations such as when considering surgery, picking a hospital, etc. To learn more about these excellent tools you can go to their site by clicking on the link below.

HRQ.gov/QuestionsAretheAnswer

Of course, when doing Elder Care Planning, please make sure you consult a Florida Elder Law Attorney to get the best advice possible.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

In the month of February we celebrate Presidents Day in honor of two great United States Presidents; George Washington and Abraham Lincoln. Both were heroes of wars fought on U.S soil for freedom and unity of our great country.

The United States has fought many wars throughout the world since that time to keep freedom here at home and continues to do so. From the beginning our country has established a program to care for the men and women of our military who fought in those wars.

The veterans assistance program goes back to 1636 when Pilgrims of Plymouth Colony fought with the Pequot Indians. The Pilgrims enacted a law from English law that reads, “If any man shall be sent forth as a soldier and shall return maimed, he shall be maintained competently by the colony during his life.” In 1789 U. S. congress passed as law that pensions were to be provided to disabled veterans and their dependents and in 1811 the first domiciliary and medical facility for veterans was completed.

Since that time the Department of Veterans Affairs has opened a multitude of care facilities nationwide. An article from the US Department of Veterans Affairs website states:

“VA's health care system has grown from 54 hospitals in 1930 to 157 medical centers in 2005, with at least one in each state, Puerto Rico and the District of Columbia . More than 5.3 million people received care in VA health care facilities in 2005, a 29 percent increase over the 4.1 million treated just four years earlier.

VA operates more than 1,300 sites of care including nearly 900 ambulatory care and community-based outpatient clinics, 136 nursing homes, 43 residential rehabilitation treatment programs, nearly 90 comprehensive home-care programs, and more than 200 Veterans Centers.”

State veterans homes have been built or are approved for future construction in many states.

Here are some of the benefits provided for Veterans by the Department of Veterans Affairs:

* Health Care Clinics
* Mental Health
* Counseling
* Job training
* Burial and Memorial benefits
* Education
* VA Home Loan
* DIC
* Compensation
* Pension
* Care Management
* Home Renovation for Disability
* Assisted Living
* Prosthetics
* Rehabilitation
* Weight management
* Nursing Homes
* Prescriptions
* Hospitals
and much more

Thomas Day, founder and Director of the National Care Planning Council, has a deep gratitude for the services provided by the VA. He served as an Air Force pilot during Vietnam. Later he developed a crippling auto-immune disease. It was the doctors at the George A Wahlen VA Regional Medical Center who prescribed a new treatment that saved his life. Many of the VA programs continue to improve his life.

Tom is passionate about the Aid & Attendance Pension Benefit and the relief it brings to veterans and their families who need care services and ways to pay for it in their elder years.

“Aid and attendance" is a commonly used term for a little-known veterans’ disability income. The official title of this benefit is "Pension." The reason for using "aid and attendance" to refer to Pension is that many veterans or their single surviving spouses can become eligible if they have a regular need for the aid and attendance of a caregiver or if they are housebound. Evidence of this need for care must be certified by VA as a "rating." With a rating, certain veterans or their surviving spouses can now qualify for Pension. Pension is also available to low income veteran households without a rating, but it is a lesser dollar amount.

Pension is an underused benefit.

There are different income categories for Pension, but the highest could pay as much as $1,949 a month in disability income to a qualifying veteran household. A study commissioned by VA in 2001 estimated, over the next 14 years, only about 30% of eligible veterans would apply for Pension. This is likely due to the fact that most veterans simply don't know about it. In fact, about a third of all seniors in this country, age 65 and older, could become eligible for pension under the right circumstances. That's how many elderly war veterans or their surviving spouses there are.

To receive Pension, a veteran must have served on active duty, at least 90 days, with at least one of those days during a period of war. There must be a discharge under conditions other than dishonorable. Single surviving spouses of such veterans are also eligible. If younger than 65, the veteran must be totally disabled. If age 65 and older, there is no requirement for disability. There is no age or disability requirement for a single surviving spouse.

There are income requirements, but a special provision does allow household income to be reduced by 12 months worth of future, recurring medical expenses. Normally, income is only reduced by medical expenses incurred in the month of application. These allowable, annualized medical expenses are such things as insurance premiums, ongoing prescription drug costs, out-of-pocket cost of monthly medical equipment rental, the cost of home care, the cost of paying adult children to provide care, the cost of adult day services, the cost of assisted living and the cost of a nursing home facility. These are all considered medical costs and they can be deducted from income to receive this benefit.

According to Mr. Day,

"I talk to a number of people every day who are inquiring about this benefit. In many cases they don't know that the benefit can pay members of the family to take care of the veteran, the veteran couple or the surviving spouse at home. I have literally had people who are sacrificing dearly to take care of their loved ones at home, break down and cry when they find they can receive some money from the government for that sacrifice."

Thomas Day has written two books for the National Care Planning Council to educate and help veterans obtain this long term care benefit. The first, “How to apply for the Aid & Attendance Pension Benefit” is to educate the public what the benefit is and how to get it. The claims process for pension is described and information is provided to help understand what documentation is necessary to provide evidence of recurring medical expenses. All forms necessary for filing a claim are included in the form support section of the book. Here is a link to the book. http://www.longtermcarelink.net/a16Veterans_standard_book.htm

Although this is a do-it-yourself book, Tom recommends if you have excessive assets and income or are not sure how to apply medical deductions, use the services of a qualified consultant.

The second book, “Aid & Attendance Handbook for Professionals & Consultants,” is for the professional consultant. It is 782 pages of rules, forms, instruction on the submission process and Medicaid planning strategies as well as software for calculating income, benefit and medical expenses. Here is a link to that book. http://www.veteranbook.com

The secret for receiving a successful award for aid and attendance or housebound ratings is not in filling out the form but in knowing what documents and evidence must be submitted with the application. Knowing the secrets for a successful award -- with the special case of long term care recipients -- is 95% of the battle. Even though the form is challenging, filling out and filing a claim is a formality.

A knowledgeable consultant can provide information to shorten VA’s decision window of 6 to 12 months to possibly 3 or 4 months. The consultant also understands how to maximize the benefit or avoid a denial. The consultant can also provide guidance for meeting the asset test. Finally, the consultant can provide the actual strategies for reallocating assets and he or she can arrange for trusts or income conversions to allow for the best possible accommodation of assets for beneficiaries thus avoiding or reducing taxes, family disputes and Medicaid penalties.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

For those people who are caring for an elder parent or relative (and that's most of our clients) healthcare-associated infections are not a new issue. But what you need to know is that this is a largely preventable problem.

Recognizing the rapid growth in cases of hospital-related infections like MRSA and ventilator-associated pneumonia (VAP), a new Web site has been created. Called "Not on My Watch" at http://www.haiwatch.com, it's purpose is to educate patients and healthcare professionals. Their goal is to eliminate these preventable illnesses and their often tragic consequences.

Reaching more people with this important information means fewer people having to endure avoidable infection and suffering. There's even a micro-site that covers just the latest news on the subject: http://haiwatchnews.com

If you have any questions about the legalities of caring for an elderly parent or relative, please contact the qualified Florida elder law attorneys at Elder Law Associates at info@elderlawassociates.com. Your inquiry will be handled quickly and privately.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

Many elderly persons rely entirely on their children, family members or other trusted individuals to help them. This dependence upon caregivers or family members makes an older person more vulnerable to abuse and financial exploitation. Legal arrangements and protective actions by family may be necessary to shield loved ones from making bad decisions or from being taken advantage of. It is very important to find a qualified Florida Elder Law Attorney to help you make any legal decisions.

Though you wouldn’t think a child could take advantage of his or her mother or father, there is no way to know what someone will do who is desperate for money or who feels entitled to an inheritance. For example:

David’s parents' health was failing and living alone in their home was becoming a concern. His sister Jill wanted to look into assisted living for them. David immediately became upset at Jill for wanting to spend their money. He packed up his parents and brought them to his home. Being single and working, he was not available to them during the day, but left food and water on the table to sustain them until he returned home in the evening. Jill lived over 300 miles from David and when she could get to his house to visit; she found her parents' care was not acceptable. They could not remember if they took their medications or if they had even eaten a meal that day. David was also draining their savings account and when confronted about it, became angry and complained that he needed their money to pay expenses for their care. Clearly Jill felt her brother's care of their parents was abusive, but David’s defense was he provided a home for his parents in which he could care for them. This family needs a professional advisor to help them understand and clarify the issues concerning their parents' care.

Making legal decisions about property, finances, power of attorney, and final wishes are important tasks to complete for the final years of life. Having legal documentation for a will, for medical treatment and for the person designated to be responsible for parents' welfare can avoid family disputes and financial abuse, and help to conserve assets that are needed for care.

Elder law attorneys specialize in legal issues affecting the elderly. They are knowledgeable about Medicare and Medicaid programs. They work with the elderly in assisting them and their families with all aspects of estate planning and implementing necessary legal documents for the final years of life. In addition, they help individuals to apply for and possibly accelerate coverage from Medicaid. An elder law attorney can also help with disputes with Medicaid. Below is a partial list of what an elder law attorney might do:

• Preservation or transfer of assets seeking to avoid spousal impoverishment when a spouse enters a nursing home
• Medicaid qualification and application and Medicaid planning strategies
• Medicare claims and appeals
• Veterans Benefits claims
• Social security and disability claims and appeals
• Disability planning, including use of durable powers of attorney, living trusts and living wills
• Help with financial management and health care decisions; and other means of delegating management and decision-making to another in case of incompetence or incapacity
  Probate
• Administration and management of trusts and estates
• Long term care placements in nursing homes and assisted living
• Nursing home issues with patients’ rights and nursing home quality
• Elder abuse and fraud recovery cases

A Certified Elder Law Attorney (CELA) is an elder law attorney who is highly proficient in meeting the legal needs of elders and in understanding and applying the rules of Medicaid. A CELA has successfully handled a requisite number of pertinent cases in order to receive that designation. This experience will make an attorney with this designation more competent with elder planning issues than other attorneys lacking this designation.

Most elder law attorneys do not specialize in all of the areas iterated above. When considering an attorney you will want to find one who has experience in the area you need help.

According to The National Academy of Elder Law Attorneys -- http://www.naela.org/:

“Ask lots of questions before selecting an elder law attorney. You don't want to end up in the office of an attorney who can't help you. Start with the initial phone call. It is not unusual to speak only to a secretary, receptionist or office manager during an initial call or before actually meeting with the attorney. If so, ask this person your questions.

• How long has the attorney been in practice?
• Does his/her practice emphasize a particular area of law?
• How long has he/she been in this field?
• What percentage of his/her practice is devoted to elder law?
• Is there a fee for the first consultation and if so, how much is it?
• Given the nature of your problem, what information should you bring with you to the initial consultation?"

A good way to choose an attorney is by referral from friends, family, clergy or other associations. Before you meet for your initial consultation, prepare the items you want discussed and taken care of. Bring pertinent documents and questions. Be sure you get clear answers and that you understand what your attorney is proposing.

Two-way communication is the best way your attorney can understand your needs and concerns. Does the attorney listen to what you say, appear to really care about your concerns or return your phone calls? If not find another attorney. Most Elder law Attorneys sincerely want to help make you or your parent's elder years a well planned for, peaceful experience for all involved.

There are a number of ways attorneys charge for their services. They may charge a flat hourly rate. Or they may charge hourly for some services and add on additional expense for out-of-pocket costs such as paperwork, stamps, phone calls, etc. Or they may charge a single fee for a mutually agreed-upon course of action or plan. Some attorneys who specialize in appeals for veterans benefits or Social Security may work on a contingency basis. It is important to understand how you will be billed so there will be no surprises in the end.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

In a recent Florida case, Bank of America rebuffed the request of an agent under a durable power of attorney (POA) to withdraw funds from a jointly held account. The agent fought back in court and just won a $64,000 judgment against the bank. (It's always important to find a qualified Florida Elder Law Attorney who can litigate the cases.)

Clarence Smith, Sr., named his son, Clarence Smith, Jr., as his agent under a POA. When his father no longer wanted to manage his own finances, he asked Clarence Jr. to step in as his agent. Clarence Jr. reviewed his father's account activity and became suspicious about some withdrawals from a bank account that Clarence Sr. owned jointly with a friend from his retirement community.

Acting as his father's agent under the POA, Clarence Jr., asked Bank of America to transfer $65,000 from the account into a new account that listed only his father as the owner. Before doing so, Bank of America contacted the other person named on the account. When she told the bank that she did not want the funds withdrawn and also accused Clarence Jr. of stealing his father's money, Bank of America refused to honor Clarence Jr.'s request. The other account owner then withdrew all of the funds from the account and placed them into her own account. Clarence Sr. died several weeks later.

Clarence Jr. sued Bank of America under a Florida law that imposes penalties on financial institutions that refuse to honor reasonable requests from agents named in properly executed POAs. In November 2009, after a week-long trial, a Florida jury returned a verdict against the bank and awarded $64,142 to Clarence Sr.'s estate. The jury found that Bank of America had not acted reasonably when it rejected Clarence Jr.'s request, even though the joint owner of the bank account had not agreed to the release of the funds.

Bank of America plans to appeal. "We believe that neither the facts nor the law support the verdict," said spokeswoman Shirley Norton.

Labels: florida elder law, Florida Elder Law Attorney, Florida Litigation

There is a popular tune played this time of year called “Grandma Got Run Over by A Reindeer” which relates that Grandma -- after drinking too much eggnog -- went out into the winter cold to get her medication and was run over by a reindeer. The question is, “Who was supposed to be watching Grandma?”

Though this little tune is just for fun, it may very well raise alarms to many caregivers of the elderly. Caregivers know that even at a holiday party they cannot let down their diligent watch over their elderly loved one. As far-fetched as it may sound, with all the people and noise, an elderly family member with dementia or Alzheimer’s may be enjoying the family gathering and then suddenly become confused and walk to the door and leave. (One should alway make plans well before-hand with the wise counsel of a qualified Florida Elder Law Attorney.)

For family caregivers the added stress of the holidays with decorating, shopping, parties and keeping up with all the family traditions is an overwhelming quest. Feelings of isolation, depression and sadness come with this added stress. There are millions of Americans who are caring for elderly frail loved ones and most of these caregivers will go through some of these emotions, especially this time of year.

There are some things you can do as a caregiver to help you and those you care for enjoy the holiday season.

First take care of yourself. Try to eat right, get plenty of sleep and exercise. This will help reduce stress and strengthen your ability to cope with caregiving responsibilities.

Prioritize your holiday traditions. Perhaps instead of cooking a large family dinner, have everyone bring his or her favorite dish. Use paper plates. Forfeit the traditional outside light decorating for a lighted wreath on the front door. Choose one or two parties or concerts to attend instead of trying to do it all.

Arrange for help. Call on other family members to help with the caregiving while you do your shopping or go out for the evening. If family is not available, ask your church group or a neighbor if they would donate a few hours.

Use community services. Many senior centers provide meals for the elderly and supervised activities, onsite, at no charge or a minimal charge. For locating senior services in your state, call your state Area Agency on Aging or check the national locator website at http://www.n4a.org/

Use adult day care services. Some assisted living facilities provide day activities and meals for seniors on a day by day basis. Other organizations called "adult day service providers" specialize exclusively in this sort of care support at a reasonable cost. These support services provide respite for caregivers from their caregiving responsibilities as well as social interaction for their elderly family members. There is a cost for adult day services, but the benefit for all is worth it.

For example:

Jean had brought her mother into her home to care for her when mom's Alzheimer’s made it impossible for her to be alone. When the Christmas season approached, Jean realized she had to make some choices. She did not want to give up the traditions she had set with her daughters in shopping and lunches, but it wouldn’t be possible with her caregiving responsibilities. In searching for a solution, Jean visited an adult day services facility near her home. She found she could schedule the days she needed off for her mother to come in. The adult day services company also provided transportation and would pick up mom and bring her home in the evening.

Although Jean's mother was not sure she would like to go at first, she found she enjoyed the programs, meals and conversation with new friends and the activities provided.

The time it gave Jean to have for herself was worth the extra cost for the day care.

Technology to the rescue. Here is a solution that would have kept “Grandma” from going out in the winter cold and getting run over by a reindeer. Companies that have created monitoring systems, security alarms and other safety equipment are “tweaking” them to adapt to the needs of seniors and their care givers.

Here are a few examples:

• Ankle or wrist bands that monitor location and alert the provider when a person has gone beyond the designated perimeter, such as out the front door of the house.
• Motion detectors. Set throughout the home, motion detectors allow someone outside the home to follow a senior as he or she moves through the house.
• Smart medication dispensers. Live monitoring and dispensing of pills.
• Emergency response alert. At a touch of a button on a desktop monitor, bracelet or necklace, emergency help is summoned.

Whether providing care in your home or helping senior family members in their own homes, your use of monitoring and “tech” help aids can provide extra safety for your loved ones, and peace of mind for you.

You are not alone. Join a caregiving help group. Your local senior center may have one or go on the internet to find one. Hearing about other caregivers' problems and solutions and being able to share your own and ask questions is a great way to relieve stress and gain a new perspective. Check out websites like the National Family Caregivers Association at http://www.nfcacares.org/

Work with a Senior Care Professional. Recognize that you are doing the very best you know how. You are not a geriatric health care practitioner, geriatric care manager, home care nurse or aide, hospice provider or family mediation counselor, nor do you have the years of training and experience these professionals have, but you can definitely use their experience. In fact, using a senior care specialist will make caregiving easier for you and more beneficial for your elderly family member.

As an example:

Mark stopped by his father Dan’s home every night after work to help with any errands or things he needed around the house. He began to notice that Dan was not showering, dressing or even fixing meals some days. Another concern was his father's growing confusion and disorientation. A trip to the family doctor only brought more concern to Mark, since the doctor claimed it was just the aging process that caused the confusion.

Wanting a second professional opinion on what was best for his father, Mark hired Shelly -- a Professional Geriatric Care Manger -- to do an assessment. Shelly arranged for Mark and Dan to see a geriatrician, who advised that proper meals and an increase in some vitamins, would help clear up the confusion and disorientation. Shelly arranged for a home care company to come in daily to help with personal needs and prepare meals.

Soon Dan was back to his old self and able to function on his own.

One more thing to remember. As a family caregiver, the greatest gift you are giving this holiday season is “Love.”

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

In the year 1919 President Woodrow Wilson proclaimed November 11 as Armistice Day to honor those Veterans who served during World War I. On November 11, 1954, Armistice Day was proclaimed a legal national holiday and the name was changed to "Veterans Day" to honor all veterans of all wars.

Every November 11, ceremonies are held throughout the United States honoring Veterans of wars. A National Ceremony is held at Arlington Cemetery at the Tomb of the Unknown Soldier, where the laying of the presidential wreath and military playing of “Taps” is presented.

Since its establishment in 1930, the Department of Veterans Affairs has evolved to supporting and aiding the nation’s veterans in numerous ways. One of these services for example, the Veterans Health Administration, is the largest single provider of medical care in the United States. Its 22 regions with 154 hospitals and their associated 875 outpatient clinics offer the following services.

* Hospital, outpatient medical, dental, pharmacy and prosthetic services
* Domiciliary, nursing home, and community-based residential care
* Sexual trauma counseling
* Specialized health care for women veterans
* Health and rehabilitation programs for homeless veterans
* Readjustment counseling
* Alcohol and drug dependency treatment
* Medical evaluation for disorders associated with military service in the Gulf War, or Treatment for exposure to Agent Orange, radiation, and other environmental hazards
* HISA grants
* Other special benefits

The Department of Veterans Affairs provides three types of long term care services for veterans.

The first are health care benefits provided to veterans who have service-connected disabilities, who are receiving VA Pension or who are considered low income. These services include free medical care, possible free prescription drugs, orthotics and prosthetics, home renovation grants for disabilities, home care, assisted living, domiciliary care, nursing home care, and a possible host of other services or benefits.

The second benefit is state veterans homes. The majority of these homes offer nursing care but some may offer assisted living or domiciliary care. The Department of Veterans Affairs in conjunction with the states helps build and support state veterans homes. Money is provided to help with construction and a federal subsidy of $72.71 a day is provided for each veteran using state veterans nursing home services. These homes are generally available for most veterans and sometimes their spouses and in some cases for so-called "Goldstar parents." Veterans homes are run by the states, sometimes with the help of contract management. There may be waiting lists in some states.

The third benefit for veterans is disability income programs. The most familiar of these benefits is an income for service-connected disabled veterans called "Compensation." The least known of these is a program officially called "Pension" but popularly known as the "aid and attendance benefit."

All active-duty veterans who served at least 90 days during a period of war are eligible for Pension and the additional income from aid and attendance or housebound allowances. A single surviving spouse of such a veteran is also eligible.
All qualifying veteran applicants over the age of 65 are eligible for pension but must meet income and asset tests. Applicants under the age of 65 must in addition be totally disabled to qualify. Disability does not have to be service-connected.
A surviving spouse can be any age and there is no need for disability.
The aid and attendance benefit can pay additional income to provide for the costs associated with home care, assisted living, nursing homes, adult day care and other unreimbursed medical expenses. It can also pay for a family member other than a spouse to be the care giver. The amount of payment varies with the type of care, recipient income and the marital status of the recipient. Here are some examples of how this benefit can help veterans.

Example #1
The National Care Planning Council receives many calls from family members of veterans, asking if there is any help available to them. One such call came from a woman who had been juggling her job and caring for her father in her home for over five years. She had just lost her job and with no income, did not know how she would keep her home or give her father the care he needed. She read an article that had been written by the National Care Planning Council and published in her local newspaper and called their phone number. The article mentioned that a member of the family -- not including a spouse -- can be paid through VA to provide care for a loved one at home who is either a war veteran or the surviving spouse of a war veteran. Her father is a war veteran. When told that she could get an additional $1,644 a month through her father by providing her father's care she was shocked. She was also extremely grateful and ended up sobbing into tears over the phone when she found out about the benefit and realized it would help her keep her home and her father may probably get a check for her retroactive previous care from VA worth tens of thousands of dollars.

Example #2
Another recent caller’s mother is 89 years old and has been in assisted living for four years. As a widow of a veteran she did not qualify for the Aid & Attendance Pension 4 years ago because her assets were too high. In the meantime she has been using up her assets along with her income to pay for the assisted living. The local veterans service office has not been helpful in getting this claim approved even though she had reached the allowable asset limit over two years ago. The family was considering putting her in a less desirable facility under Medicaid. The family knew this would be devastating for their mother. Her health was still good and she had many friends and comforts at the assisted living.

The National Care Planning Council directed the caller and his family to a more cooperative veterans service office that will submit the claim and likely get it approved retroactively so that this woman can get a check for roughly $40,000 worth of previous care costs for which she was not reimbursed. In addition, she will likely get the full benefit of $1,056 a month to help pay the cost of the assisted living where she is happy.

These types of claims require medical evidence in order to receive a rating for aid and attendance or housebound allowances. These ratings must be received or certain non-medical expenses associated with long term care are not deductible from income. Special rules also allow for deducting the annual anticipated cost of month-to-month long term care from household income in order to meet the income test. This special treatment requires special documentation and evidence. In addition, those households with substantial assets will be denied for a Pension income unless those assets are below a certain level determined for each case by VA. The personal residence, personal vehicles and personal property are exempted from this asset test. Finally, evidence must be supplied every year in January that the anticipated costs for the previous year were actually incurred or VA will likely demand for its money back.
The National Care Planning Council has compiled the necessary forms, rules and information about claims together in one book titled “How to Apply for the Veterans Aid & Attendance Pension Benefit.”

This book contains information about how a typical applicant receives a successful pension award. VA often tells callers to go ahead and fill out the application but generally provides no information on the special treatment of annualization of anticipated recurring medical costs. The claims form also contains no information on this important issue. One simply has to know how to do it. This crucial information can make the difference between a successful award and being declined. All necessary forms for filing a claim are in the book.

Veterans who have substantial assets may need to do some estate planning and realigning of assets to qualify. An expert in this area should be sought to help with the application in order to avoid lengthy delays in awarding a benefit or a possible denial of benefits.

To learn more about this benefit go to http://www.veteransaidbenefit.org/

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

Financial exploitation is the illegal or improper use of another individual’s resources for personal profit or gain. This type of exploitation encompasses a broad range of conduct, from deception to intimidation. If you think you've been exploited, please contact a qualified Florida Elder Law Attorney.

Ways to Prevent Exploitation: Stay Socially Active

Social isolation increases your risk of becoming a victim of abuse. Become familiar with the many programs in your community designed to bring people together and to help elderly people and their families.

Get to Know Your Banker, Attorney, and Financial Consultant

Establish relationships with the professionals who handle your money. They can help detect changes in your financial activity that may signal a problem.

Don’t Give Away Property

Before you enter into an agreement for lifelong care, discuss the arrangement with a trusted friend or advisor. Document the agreement and specify the compensation, if there is any, paid to the caregiver. If there is someone helping you with your personal finances, get a trusted third party to review your bank statement.

Understand What You Are Signing

Before you assign a power of attorney, be sure you understand the scope of the agreement and the authority you are giving to your agent. Know the person to whom you are giving this authority. Also, specify the compensation, if any, to be paid to your agent.

Be Cautious of Joint Accounts

Both parties are equal owners of the account and both have equal access to the funds in the account.

Document Financial Arrangements

By putting financial arrangements in writing, you not only protect yourself but you also reduce the likelihood of legal proceedings. Put all financial instructions in writing and be specific. Keep complete financial records of all transactions. Put all financial documents in a safe place.

Ask For Help

Financial matters can be confusing. If you have questions or need assistance, ask for help from your bank, a trusted family member, clergy member, social worker or other professional.

Other helpful tips include:

· Use Direct Deposit for your checks.

· Don’t sign blank checks allowing another person to fill in the amount.

· Don’t leave money or valuables in plain view.

· Don’t sign anything you don’t understand.

· Protect your money. The bank may be able to protect your money by arranging your accounts to control access to your funds.

· Be aware of scams. If it sounds too good to be true, it probably is.

· Don’t give anyone your ATM PIN number, and cancel your ATM card immediately if it is stolen.

· Check your bank statements carefully for unauthorized withdrawals.

· Be cautious of joint accounts.

· Build good relationships with your professionals who handle your money.

To report Elder Financial Abuse, Neglect, or Exploitation, please call the Adult Protective Services Abuse Hotline at (800) 962-2873.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

If we were to ask an older person what his or her most important concerns for aging are, we would probably get a variety of different answers. According to surveys frequently conducted among the elderly, the most likely answers we would receive would include the following three principal concerns or life wishes:

1. Remaining independent in the home without intervention
from others

2. Maintaining good health and receiving adequate health care

3. Having enough money for everyday needs and not outliving
assets and income

To address these concerns or wishes and maintain the quality of life wanted in the elder years, it simply takes a little preplanning.

Few people do this kind of planning.

It is human nature not to worry about an event until it happens. We may prepare financially for unexpected financial disasters by covering our homes, automobiles and health with insurance policies.

However, no other life event can be as devastating to an elderly person’s lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal lifestyle wishes listed above.

The majority of the American public does not plan for this crisis of needing eldercare. The lack of planning also has an adverse effect on the older person's family, with sacrifices made in time, money, and family lifestyles.

Because of changing demographics and potential changes in government funding, the current generation needs to plan for long term care before the elder years are upon them.

Let us look at some facts.

• The population of the "very old,"--older than age 85--is the
  fastest growing group in America. This population is at
  highest risk for needing care. (Statistical abstract of the United States,
  2008, population)
• Medical science is preventing early sudden deaths, which
  means living longer with impaired health and greater risk of
  needing long term care.
• The Alzheimer's Association estimates the risk of
  Alzheimer's or dementia beyond age 85 to be about 46% of
  that population.
• It is estimated that 6 out of 10 people will need long term
  care sometime during their lifetime.
• Children are moving far away from parents or parents move
  away during retirement making long distance care giving
  difficult or impossible.
• Government programs--already stretched thin for long term
  care services--will experience even greater stress on
  available funds in the future.

One of the important things for planning is how to maintain your lifestyle as you age. You may be healthy enough to stay in your own home with help provided for the following activities of daily living:

maintaining a home,
providing meals,
supervision,
companionship,
transportation and
shopping services.

This type of care at home is non-medical and must be provided free of charge by family, friends, or volunteers or the care must be paid for out-of-pocket by the family.

Government programs, in most cases, will not pay for this kind of care. It is estimated that 80% of all long term care is non-medical, with 90% of that care provided in the home. It is most likely that your long term care will begin with home care.

It is wise to plan now how you will pay for care when it is needed. In evaluating your future income you may find it necessary to add some resources such as long term care Insurance to pay for assisted living or nursing home costs. Long term care insurance must be purchased while you are younger and healthy. Failing health, stroke or other aging issues will not allow you to qualify for this insurance.

A reverse mortgage will also help pay for home care if staying in your home is an option.

Consider where you may want to live in your elder years. Many assisted living facilities offer complete care alternatives with a nursing home wing if needed. Senior retirement communities also offer many amenities with some including home care options.

Now is the time to do estate planning. A professional estate planner will give you direction on how best to protect your assets for future needs and for Medicaid planning.

Do your paper work. Now is the time to create your trusts, will, medical directives in a living will and any other documents you want noted for future use. Gather Insurance policies and bank records where they can be found by family members in case you are not able to get them yourself.

We don’t like to think of our elder years in terms of health problems, but a sudden stroke, heart failure or onset of dementia could make it impossible to carry out our own wishes if preparation was not made ahead of time.

The process of long term care planning involves the following four
principles:

1. Knowledge and preparation are the keys to success.
2. Having funds to pay for care expands the choices for care settings and providers.
3. Using professional help relieves stress, reduces conflict, and saves time and money.
4. Success is assured through a written plan accepted by all parties involved.

As always, before making any plans, please consult a qualified Florida Elder Law Attorney.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

Community Aging Services and Long Term Care
There are many private, religious and government organizations across the country that provide supportive services for older people. Many of these services center around helping people stay in their homes and avoid having to go to live in an institution or perhaps move in with family. Because of the emphasis on helping people remain independent, many community aging programs could be viewed as long-term care programs. In fact it's probably just a matter of semantics; long-term care and community aging services are just two sides of the same coin. Other community services may provide socialization or training opportunities. Community aging programs might include:

• Meals served in community centers or delivered to the home
• Community Senior Center activities and training
• Transportation and shopping services for people who can't drive or leave their homes
• Home repairs, snow shoveling, telephone support, caregiver support, care management, legal services, energy and weatherization services, housing subsidies, home health care, counseling and much more
• Adult day care
• Protection from abuse
• Help with health insurance and government entitlement programs

Private support groups might be the Red Cross, women's auxiliaries or foundations. Many religious communities support activities for their elderly members as well as nonmembers. Both private and religious groups often provide services for free to people with little income and few assets. They may, however, charge people for services who have adequate income or assets. Many of these groups may also operate nursing homes and assisted-living facilities.

Senior centers are often the focal point for all aging services in a community. Experts or contact people are housed in senior centers and can provide many services in the center itself or refer out to other organizations that can help. The community served meals or congregate meals in senior centers are a means for attracting older people into the centers. Seniors can then be exposed to the many services that are available.

Government support for aging services comes from the Older Americans Act, passed in 1965. This act, over the years, has produced a large network of care providers and local government managers called Area Agencies on Aging. This network also includes federal agencies, state agencies as well as local area agencies and is called the "national aging network".

The National Aging Network
The Older Americans Act establishes an effective interrelationship between the federal government, State aging units and local service coordinators called Area Agencies on Aging. All three centers of service, the Federal, the state and the local engage in detailed future planning in order to accomplish their jobs. Input at the local level is received from diversified advisory boards representing stakeholders in the elder community. Community meetings and feedback from patrons of senior centers are also used in the planning process. Over the past 44 years, a great deal of thought and energy and research has gone into devising a delivery system that is both efficient and cost effective. In fact, the 29,000 service providers nationwide providing care under the act are the largest single network of long-term care providers in the country.

Local agencies on aging represent geographic areas in a state that can be serviced effectively by that local unit. Area agencies on aging normally contract with local for profit or nonprofit or public providers to deliver benefits. An agency may be allowed to provide directly, supportive services, nutrition services, or in-home services if it can prove a case for providing these services more effectively. An agency may also provide directly, case management services and information and assistance services depending on the methods used for such services in that state. Agencies may also use employees from cooperating or sponsoring counties or cities to staff and administer programs such as senior centers. Much of the work performed comes from dedicated volunteers who are both individuals and employer sponsored teams. This entire aging network system seems to work very well in accomplishing the goals of the Older Americans Act.

Why Is the Older Americans Act Important?
The decade from 1960 to 1970 was a period of social unrest and change. We lived through an unpopular war which resulted in student protests and mass demonstrations. Hippies, it seems, were everywhere and we were experiencing the so-called sexual revolution. It was a exciting time when civil rights were being extended to all Americans.

During this same period a number of organizations were lobbying Congress for the rights of older Americans. An outcome of this effort was not only the 1965 creation of Medicare and Medicaid but also the passage of the Older Americans Act. The act was designed to protect elderly Americans, including Indians, from unfair discrimination in the workforce as well as providing protection and services to help older people stay independent and remain in their homes.

Although the initial emphasis was directed more towards civil rights and recognition of the dignity of the elderly, over the years, new provisions of the Older Americans Act have become more focused on providing long-term care services for older Americans. These benefits are designed to help frail, memory-impaired, disabled, poor and socially needy elderly remain in their homes and avoid the cost of elder care institutions. And more recently, funds were provided under the act to support caregivers of the elderly and elderly grandparents babysitting or raising minor children at home.

The OAA provides benefits to all Americans over the age of 60. And employment benefits are available for all Americans over the age of 55. The act itself stipulates reauthorization or amendment on an ongoing basis and since 1965 the OAA has been changed and updated 14 times. The year 2005 is designated as a reauthorization year and Congress is busily working on additions to the act. Because of the constant additions, the Older Americans Act has become a giant mishmash of thousands of words, redundant sentences and hundreds of rules and procedures. It's our guess that the complexity of the act probably requires states to hire attorneys to run their aging departments. Notwithstanding, members of the care community who provide administration and services with the Older Americans Act work around the complexity of its rules in serving the aging community.

Funding for the services required under the OAA is provided by Congress yearly. These funds are then distributed to states, territories, the District of Columbia , Indian tribes and native Hawaiians on a formula basis which provides minimum funding levels to small population groups and sparsely populated states and proportional funding levels based on state elderly populations of the majority of the other states. Because of its large elderly population, as an example, California receives almost 10% of the money. And because of its high proportion of older people, Florida is next. Ten states receive 52% of the money.

Funds are provided in the form of grants for various programs authorized under the act and states have some limited latitude in administering these monies in local areas. Certain of the mandated programs require matching funds from state and local governments. Other program funds do not require matching dollars. Many states chip in additional funds to maintain their programs and these funds often exceed matching requirements. States, counties and cities recognize the value of these services and are often generous in providing additional funds, buildings, office space and other in-kind economic benefits. For every dollar provided by Congress local governments provide about two dollars in direct money, in-kind services from volunteers, community voluntary contributions and cost sharing funds.

The federal appropriation for 2005 was $1,369,028,000 and the breakdown for specific spending categories is listed below. Notice that over half of the dollars goes towards nutrition services which are typically weekday meals provided in community settings or delivered at home as well as incentive programs to help the elderly maintain proper nutrition.

• Congregate Nutrition Services, Home-Delivered Nutrition Services, and Nutrition Services Incentive Program (money from the Department of Agriculture), 52.1%
• Home & Community-Based Services, 25.9%
• National Family Caregiver Support Program, 11.7%
• Grants for Native Americans, 1.9%
• Program Innovations Grants, 1.7%
• Preventive Health Services, 1.6%
• Protection of Vulnerable Older Americans, 1.3%
• Program Administration, 1.3%
• iAging Network Support Activities Grants, 1%
• Alzheimer's Disease Demonstration Grants, 0.8%
• White House Conference on Aging, 0.3%
• Senior Medicare Patrols (HCFAC), 0.2%

Find your state Area Agencies on Aging or State Aging Services

Senior Citizen Centers
The first Senior Center in the country opened in 1943 in the Bronx, New York and was called the William Hodson Community Center . By 1961 about 218 senior centers had opened all across the country. The first Senior centers were operated by cities or nonprofit or religious organizations. Funding came from government, community donations and fees from people using the facilities. In the early days some federal funding came from Title XX of the Social Security act but funding for Title XX has been decreasing and much of that money today is being used for other programs. In 1972, the Older Americans Act was amended to provide funding for senior centers as this was considered to be an important piece of the aging network. Today, there are estimated to be about 15,000 senior centers across the country serving about 10 million older Americans annually. About 6,000 of these centers receive part or all of their funding through the Older Americans Act.

Senior centers act as a focal point for older Americans to receive many aging services. They are a vital part of the aging network. For Area Agencies on Aging, the senior center has become a place where many AAA services can be provided, where outreach and targeting can occur and where feedback can be received from the elderly. The most common services offered at a senior center are:

• Health and wellness programs
• Arts and humanities activities
• Intergenerational programs
• Employment assistance
• Community action opportunities and social networking opportunities
• Transportation services
• Volunteer opportunities
• Educational opportunities Information and referral
• Financial assistance
• Senior rights counseling and legal services
• Meal and nutrition programs
• Leisure travel programs

Larger senior centers in major cities may offer additional specific services because they serve a large and diverse group of patrons. Here are some examples:

• Education classes, perhaps through a local college
• Foot care
• Health clinics
• Haircuts
• Daily exercise
• Telephone friends
• Support groups for Alzheimer's caregivers
• Support for Parkinson's disease
• Low vision and diabetes services
• Weekly health speakers
• Grocery shopping
• Many and varied classes for personal growth and learning
• Special events and fundraisers such as auctions, raffles, sales, bazaars, rummage sales, bingo, special meals and parties, fashion shows and facility rentals

Most elderly people are aware of senior centers in their neighborhoods but for those who are not familiar with the program, senior centers are listed under that title in the Yellow Pages.

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

We heard this story on NPR and thought it was interesting and thought provoking, especially to our Florida Elder Care clientele. It's about delirium, a sudden and frightening onset of confusion. A common but often unrecognized problem in hospitalized elderly people, delirium is estimated to affect more than 2 million seniors a year.

Click here to read or listen to the story from NPR's Web site: Treating Delirium: An Often Missed Diagnosis

Ellen Morris & Howard Krooks
Florida Elder Law Attorneys

Labels: Florida Elder Care, florida elder law, Florida Elder Law Attorney

We are proud to announce that Howard S. Krooks, JD, CELA was appointed to a one-year term as Secretary for the National Academy of Elder Law Attorneys (NAELA) Board of Directors. Mr. Krooks was also recently honored at the NAELA Annual Conference, which took place April 1-5, 2009, in Washington D.C. Mr. Krooks was one of four attorneys bestowed the organization’s highest honor of becoming a NAELA Fellow.

Howard S. Krooks is a partner of Elder Law Associates PA with main offices in Boca Raton, Florida and Of Counsel to Amoruso & Amoruso, LLP in Westchester County, New York. He is admitted to practice law in Florida and New York. Mr. Krooks’ professional practice is devoted to elder law and trusts and estates matters, including representing seniors and persons with special needs and their families in connection with asset preservation planning, supplemental needs trusts, Medicaid, planning for disability, guardianship, wills, trusts and advance directives.

As a member of the Joint Public Policy Task Force of the Florida Bar Association Elder Law Section and the Academy of Florida Elder Law Attorneys, Mr. Krooks works to protect the rights of the state’s most vulnerable citizens. Mr. Krooks is certified as an Elder Law Attorney by the National Elder Law Foundation. He was honored with the designation of NAELA Fellow in 2009. He serves on the Executive Council of the Elder Law Section of The Florida Bar as the NAELA Liaison. He is a Past Chair of the Elder Law Section of the New York State Bar Association (NYSBA), where he continues to serve on the Executive Committee.

Labels: florida elder law, Florida Elder Law Attorney

As our population continues to age, more and more individuals are concerned about how they will pay for care as they get older. Often individuals and families find that they are unable to take care of themselves and need assistance.

As medical costs have continued to rise, so have the costs of home health care. As a result we are seeing more individuals need the assistance of Medicaid. Too often we find individuals who have received advise from family members, friends, and professionals who do not understand Medicaid and only deal with elder law or estate planning issues. While it may be great to avoid the costs and fees associated with probate, what if you end up being disqualified from nursing home coverage. This could cost far more than the savings on probate.

Florida is a great state to live at the time you need Medicaid coverage because of the large exemption allowed on one's home. Generally you can protect up to $500,000 of equity in a Florida homestead. Unfortunately in an effort to save a few thousand dollars many individuals transfer a partial ownership in the property to their children with rights of survivorship. Often this is done with a life estate deed.

This can cause many problems for the owner in the event they ever need nursing home coverage. There is way to accomplish similar results without risking the tax detriments, gifting issues, loss of control, and Medicaid eligibility - use a Florida Enhanced Life Estate Deed.

If you would like a review of your estate planning that takes into account Florida Elder Law, Medicaid planning, and probate and tax issues Contact a Florida Elder Law Attorney who is familiar with estate planning and medicaid planning.

-- Ellen Morris, JD

Labels: florida elder law, Florida Elder Law Attorney, medicaid

If you work with individuals over the age of 65 (as all Florida elder law attorneys do), you may be getting phone calls requesting help with Medicare questions. It’s that time, once again, to make changes to Medicare options. According to CMS, which is the government entity that oversees Medicare, the six weeks from November 15, 2008 through December 31, 2008 is a hectic time of the year otherwise known as the Annual Election Period (AEP.) Once a year, Medicare allows enrollees to opt in or out of Medicare Part D and Medicare Part C -- otherwise know as Medicare Advantage Plans. Before we get into what that means, some background is in order.

Medicare consists of four parts -- Part A, Part B, Part C and part D. The majority of Medicare enrollees have Part A and Part B. In addition they may have an employer-sponsored supplement or a Medigap policy to go along with Part A and Part B. The fourth part of Medicare is Part D or prescription drug coverage. Most people think that the "D" in Part D is because of the word "drugs." Actually it’s because there is a Part C. Part C is the Medicare Advantage program. It was started in 2003 as part of the Medicare Modernization Act -- the same Act that created the Medicare Part D prescription drug coverage. Medicare Advantage Plans have been around for some time. Before 2003 they were known as Medicare + Choice Plans. With Medicare Advantage, Medicare pays a private insurance company to take over and administer someone’s Medicare benefits. That person is still a part of the Medicare system. He or she doesn't leave the system. A person is simply now receiving his or her benefits from a Private company not the Government.

Back to the massive stack of mail from Medicare that is coming and will be coming over the next few months. Hopefully your people are sitting down. This gets confusing. From November 15, 2008 through December 31, 2008, those eligible for Medicare have the option to change existing Medicare Advantage Plans and/or Medicare Part D. This period is called the Annual Election Period or AEP.

There is also another period of time from January 1, 2009 through March 31, 2009 that is called the Open Enrollment Period or OEP. During OEP, a person can enroll in Advantage but cannot change Part D status, meaning if there is just a Part D, a change or cancellation to the drug Plan cannot occur at this time. If there is a Medicare Advantage Plan which includes Prescription Drug Coverage (MAPD), a change can be made by purchasing another MAPD. Or, if there is just prescription coverage, an MAPD can be purchased. Going the other direction from an MAPD to prescription coverage only, is not allowed.

On April 1, 2009 and thereafter, Medicare institutes a lock-in period. During this time, no changes to drug coverage or an MAPD are allowed. As with most government programs there are a few exceptions to the rule. If a person has moved out of the area the plan operates in, or if a person becomes a resident in any long term care facility, or if a person involuntarily loses coverage, that person can enroll for new coverage under a Special Election Period or SEP. Finally, most people who are eligible for or who are on Medicaid can change coverage whenever they choose.

So why the big deal? Why does someone need to be aware each year of what is going on? The reason is the insurance companies that sponsor the Medicare Advantage and the Part D Plans have the option to change what they offer each year. Changes may come as a result of directives from Medicare, from previous years' claims experience, or from a multitude of other issues. Asking 10 people if there are pending changes to the plans they are in will result in 9 of them replying they have received notice of adjustments or premium changes. However, not all changes are for the worse. There are some instances where the plans have gotten better. Nevertheless, from year to year most plans will have changes. Sometimes a plan may pull out of an area thus forcing an individual to make an unwanted change.

Medicare allows the Advantage companies to start marketing their plans to the public on October 1 and the companies can release information on intended changes to existing plans. For any pending changes, a beneficiary should receive an Annual Notice of Change (ANOC.) Most people will receive this document in November. People need to take the time to review changes. They need to be aware of the plan they are in and the benefits it provides when they might need to use the coverage.

Medicare Advantage Plans can be a great fit for many Medicare enrollees. As with anything, one size does not fit all. During the six-week period when changes can be made, people owe it to themselves to evaluate their options. In the past, many Advantage Plan companies made a big push during this change period to move people out of existing plans and into new ones. Medicare has changed the rules on how companies can induce people to change. In the past, seniors were invited to attend presentations where they received free meals as an inducement to attend. Starting in 2009, only snacks can be provided. Preliminary indications are that pie and coffee are on the menu. Personally we like Pecan pie and free pie is good pie.

On the National Care Planning Council website, at www.longtermcarelink.net, is a link to all medicare approved advantage plans in every state. All the plans listed in an area can be found there. Finally, those people who need help or who are facing changes should contact a trusted insurance agent. Medicare Advantage plans are only available from someone who is licensed to sell health insurance.

Labels: florida elder law, Medicare

We've all known for a long time that the State of Florida has failed its obligations to provide seniors and people with disabilities access to long term care in the least restrictive setting and, if possible, in the community rather than in a nursing home. We're pleased to see that there are some who are doing something about it.

Take a look at this Associated Press article from September 20, 2008, Florida Medicaid Recipients Want Out of Nursing Homes by Matt Sedensky for details.

Labels: florida elder law, medicaid

Eldercare providers and advisers who deal with the public know from experience that the need for long term care can often arise without warning. In many cases, desperate caregivers are frantically trying to find services, advice or care funding sources to help their loved ones with unexpected long term care needs. This sudden need for help often occurs when the loved one needing care has recently demonstrated unsafe behavior, or there has been an injury or sudden illness or there is a pending release from nursing home rehab or the current caregiver can no longer cope. Help must be found right now.

Unfortunately, many of these caregivers -- who are typically operating in crisis mode -- don't know where to turn for help. It's not that there aren't advisory services out there to help them, it's just that the caregivers often don't know where to find these services.

Government caregiver resource services such as area agencies on aging and related ADRC pilot programs typically reach out to caregivers through referrals from hospitals, discharge workers, doctors, home health agencies and nursing homes. Caregivers seeking help outside of this referral network generally aren't aware of government advisory services. In the private sector, help with caregiving issues is generally provided when a caregiver calls a specific agency, nonprofit organization or an advisor. There is no nationwide, private sector one-stop shopping source of help for all the types of care provider services that are available in the community.

The national care planning Council has discovered an answer to help desperate caregivers find the one-stop shop support they need. A 2004 study by the National Alliance for Caregiving and AARP estimates nearly six in ten (59%) caregivers are currently employed. Many of these working caregivers will use their Internet access at work to find the caregiving support they need.

The National Care Planning Council is in the process of developing websites in every state that contain the Internet resources employed caregivers are looking for. Currently, results from websites operating in 10 states indicate that harried caregivers will indeed search out these state care planning council websites for help. For example, one state website sponsored by the National Care Planning Council -- the Utah Eldercare Planning Council website, www.careUtah.com-- last year produced over 1,000 inquiries for help primarily from younger family caregivers. Additional requests for help were also received by Utah Eldercare Planning Council members through traditional outreach networking channels such as eldercare advisers, eldercare service providers, government agency referrals, associations, brochures and community presentations.

The National Care Planning Council is currently seeking qualified individuals to be Directors and oversee geographic service areas of state care planning councils. The Director's job is to coordinate local requests for help from the community and provide needed eldercare services. If you are a professional care provider or eldercare advisor please contact us about this opportunity to help the community and at the same time expand your services by becoming a Director of a Service Area. Or you may simply want to become a member of your local state care planning council.

-- Ellen S. Morris, JD

Labels: elder care, florida elder law

We are proud to announce our panel of speakers for our 1st Annual Elder Law Forum "A Forum for Diverse Professionals with a Common Interest: Facing the Challenges of Home, Hospital and Facility-Based Care":

• Darrick D. McGhee, Director of Legislative Affairs for the Department of Elder Affairs
  
• Jaclynn I. Faffer, PhD, Executive Director of Ruth Rales Jewish Family Service (RRJFS) of South Palm Beach County
  
• Elayne Forgie, PhD, CMC, president and founder of the ElderCare Resource Center, ElderCare at Home, and The ElderCare Foundation, a not-for-profit corporation that provides 24 hours of emergency respite care in the patient’s home.
  Veronica Logan, Administrator of Springtree Rehabilitation and Health Care Center in Sunrise, Florida
  
• Marc Dubin, Esq., Director of Advocacy for the Center for Independent Living of South Florida (Miami-Dade) and consultant on the federal civil rights of people with disabilities
  
• Laura Goodhue, Executive Director of Florida CHAIN, a statewide health care advocacy organization that leads the state in championing for access to affordable and quality health care for all Floridians
  
• Yolanda Rodriguez, Project Director of the Northwest Focal Point Senior Center and Adult Day Care in Margate, Florida
  
• Julie Gelbwaks Gewirtz, VP of Marketing for Gelbwaks Insurance Services, Inc.

We hope to see professionals of all kinds on November 12, 2008 from 1:00 pm to 4:30 pm at the Classic Residence by Hyatt in Boca Raton.

Labels: florida elder law

I came across a great article in the New York Times Wealth and Personal Finance section recently entitled, "Learning to Share - Surprises in the will can leave your heirs squabbling over inheritance. The solution is to be open about who is getting what."

While its advice may be hard to follow, the article's message is both poignant and important. I invite you to read the article below and share your thoughts.

Howard Krooks, JD, CELA

Labels: florida elder law, Inheritance

It never gets old, having your company mentioned in the news. Elder Law Associates is featured in a recent article by Elder Law Answers on satellite offices in the Elder Law field. With Florida Elder Attorneys in such high demand (especially quality ones), a satellite office is a natural extension for a qualified Florida elder law attorney.

Click here to read the entire article.

-- Howard Krooks, JD, CELA

Labels: florida elder law, Florida Elder Law Attorney

Elder Law Associates is very excited about how our first ever Florida Elder Law Forum is shaping up. "A Forum for Diverse Professionals with a Common Interest: Facing the Challenges of Home, Hospital and Facility-Based Care" will be held Wednesday, November 12, 2008 from 1:00 pm to 4:30 pm at the Classic Residence by Hyatt in Boca Raton.



The Forum will feature a unique array of presenters from health care, insurance, government, law and consumer advocates, who will address critical questions facing seniors and people with disabilities living in Florida. We will focus on home and community-based care initiatives to provide a vision of the future that includes rapid changes in health care and responses to budget cuts. Stay tuned for details.



For more information, please call me, Leslie Lautin Davis, at 561.750.3850.

Labels: florida elder law

I recently published an article on the latest goings on in the area of elder law in the Florida legislature for The Elder Law Advocate, entitled "What happened in the Florida Legislature of interest to us?"

It specifically provides you with a summary of bills of interest to elder law attorneys that are expected to be or have been signed by the governor, including:

• SB 366/HB 233 - Elderly Persons & Disabled Adults/Abuse & Neglect
  
• SM 2662/HM 1045 – Alzheimer’s Disease Research/Federal Funding
  
• SB 1092/HB 7047 – Alzheimer’s Disease/Medicaid Waiver Program
  
• CS/HB 739/SB 688 – Guardian Advocates for Persons With Developmental Disabilities
  
• CS/CS/SB 2012/HB 1431 – Insurance Policies
  

Click here to read "What happened in the Florida Legislature of interest to us?"

-- Ellen S. Morris, JD

Labels: florida elder law

Wealth Counsel, a quarterly magazine for the estate planning community, recently published an article I wrote on the Deficit Reduction Act, entitled "How the DRA Has Affected the Use of Personal Care Contracts."

It specifically details how Medicaid agencies have responded to the upswing in the use of personal care contracts, and what you need to know when preparing a personal care contract for a loved one.

Click here to read "How the DRA Has Affected the Use of Personal Care Contracts."

-- Howard S. Krooks, JD, CELA

Labels: florida elder law, medicaid, personal care contracts

On June 13, I spoke twice at the 10th Anniversary Family Cafe Conference in Orlando, FL. This was the first time I attended this amazing statewide conference designed to meet the informational and networking needs of individuals with disabilities or special health care needs and their families. I can attest that this event provides a truly unique environment, where Floridians can attend educational breakout sessions relevant to their specific needs, interact with government policy makers, network with other families and learn about the wide range of services available to them. Information on the widest range of topics was at the attendees’ fingertips, from financial planning to outfitting a van with wheelchair accessible equipment, from legal advice to care giving. The speakers were top-notch as was the quality of the information and products.

Two things in particular made lasting impressions. First, the conference was able to address the needs of so many different populations including adults with disabilities, parents of children with disabilities, children with parents with disabilities and so on. It is very difficult to maneuver through daily life and the challenges faced by these groups. By bringing everyone together, under one roof, this event made things a little bit easier.

The second thing that impressed me was that the conference is extremely kid-friendly, reducing parents’ stress and maximizing the quality of time they spend at the conference. The Disney setting is intrinsically exciting for children and allows parents to take turns attending sessions and enjoying time with the children.

Some of the topics I addressed included Special Needs Trusts, Supplemental Income Trusts and Longevity Planning, or ways to address the complex legal and financial issues faced by individuals with disabilities or special health care needs and their families. I was very glad to be a part of this event. It truly makes the road easier for those who travel it every day. I look forward to attending next year.

– Ellen Morris, Esq.

Labels: florida elder law, special needs trusts