Elder Law

U.S. Department of Justice Creates Several New Elder Justice Task Forces

Published on: May 27, 2016 | By McCulloch & Miller, PLLC

Nursing homes that give substandard care to residents are the target of new Elder Justice Task Forces intended to move faster in targeting and penalizing certain facilities.

The National Review reports in "DOJ Task Forces Target Elder Fraud in Health Care" that teams from several Elder Justice Task Forces deployed by the U.S. Department of Justice will go after heath care providers who commit crimes against residents and patients, most of whom are elderly and vulnerable.

The Elder Justice Task Forces have a goal of coordinated, joint investigations to allow for quicker enforcement actions and prosecutions. These Task Forces combine federal, state, and local resources from law enforcement, the U.S. Department of Health and Human Services, state adult protective services agencies, long-term care ombudsman programs, U.S. attorneys' offices, state Medicaid fraud control units, and state and local prosecutors' offices.

Don’t Dive into Texas Medicaid Without a Full Understanding

Published on: May 5, 2016 | By McCulloch & Miller, PLLC

People think that Medicaid will solve all financial problems if they or a spouse will need expensive medical care late in life. It's not that simple.

Concerns about outliving assets or having all their wealth spent on nursing home care has led many Houstonians in different economic brackets to take steps to qualify for Medicaid as part of their estate planning. But Medicaid was not designed to be the first source for health care costs.

Remember that your income and assets have to be at a very low level to qualify for Medicaid. This program isn't a right or an entitlement—even if your tax dollars paid for it. Medicaid provides assistance for ongoing living needs and services provided by home care or, in advanced cases, at a nursing facility.

Financial Tactic for Houston Alzheimer’s Patients: A Trusteed IRA

Published on: May 4, 2016 | By McCulloch & Miller, PLLC

Houston families with an Alzheimer's patient must address the issue of financial planning as well as care and treatment. A number of planning tools should be discussed once a diagnosis has been made.

Any family faced with helping a loved one who has been diagnosed with Alzheimer's disease has a number of challenges ahead. In The Wall Street Journal's "Voices: Consider Trusteed IRAs for Clients With Alzheimer's," the article suggests that frank discussions must begin to address a number of concerns for the present and the future. Issues include care and treatment, wishes for care when the person can no longer speak for themselves, determining who will manage finances, estate planning and how a spouse will be supported during the loved one's illness—however long it may last.

Many of those with an Alzheimer's diagnosis really are concerned with not becoming a financial or practical burden on their family. Loved ones can encourage them to see an elder law attorney to help them organize and designate their assets early, so that they will ensure appropriate distribution before they're not able to manage their money directly.

Nevada TV Investigation Leads to Clark Co. Guardianship Reform

Published on: December 14, 2015 | By McCulloch & Miller, PLLC

Much needed changes are underway at the Clark County Nevada Guardianship program, after a local television reporter uncovered major lack of oversight, including families torn apart and financial abuse by the individuals charged with protecting the elderly. According to a follow-up report by KTNV News, "More staff means more oversight in guardianship system," some of the changes are the establishment of a hotline and the examination of all guardianship processes.

Clark County District Court will add more staff to better supervise guardianship cases in response to what they have termed a clear need for compliance oversight after the KTNV investigation showed double billing and questionable charges. They found cases where the entire life savings of vulnerable "wards" went missing and their homes were sold without court approval.

The court has hired a new Guardianship Compliance Administrator who will oversee the adult guardianship program, create a citizen complaint process, and look into any claims of discrepancy or fraud. The court is also taking action on several other issues stemming from the news investigation, including greater transparency and scrutiny of how private professional guardians handle a person's money.

Hawaiian Advocates Focus on Dementia Task Force

Published on: December 8, 2015 | By McCulloch & Miller, PLLC

As with the rest of America, Hawaiians are coping with a growing population of citizens over age 65 diagnosed with Alzheimer's, approximately 25,000 in total. Advocates, including members of a dementia task force under the Executive Office on Aging and members of the local Alzheimer's Association, are focusing on preparing professionals and caregivers to address the often complex needs of individuals with dementia.

A recent article in KHON, titled "Task force aims to help seniors living with dementia" recently reported on this.

James Pietsch, the director of the University of Hawaii Elder Law Program, told KHON that there are multiple tasks under this task force, one of which is supportive research to determine whether professionals are qualified or capable of handling these type of cases. Professionals like doctors, social workers, nurses, and lawyers need to be better prepared to handle issues involving dementia.

Long-Term Care Insurance: Good Investment for Houston Families

Published on: December 1, 2015 | By McCulloch & Miller, PLLC

Nursing home and other long-term care expenses can be a financial burden for most families. And although long-term care insurance policies can help offset those expenses, LTC premiums are on the rise and can be quite costly. It can take careful planning to determine if LTC premiums can be paid for, without dipping into retirement funds.

When people purchased their policies 10 to 15 years ago, nursing home costs were about $150 or $200 a day. In some parts of the county, today’s costs can exceed $400 a day, or $12,000 per month for higher levels of care.

The expense incurred by the insured going on claim has caused the long-term care insurance industry to downsize. Those companies still offering policies are bumping up the premiums amid the rising cost of long-term care.

Medicare 2016 Premium Concerns Loom

Published on: October 23, 2015 | By McCulloch & Miller, PLLC

As a direct result of complex relationships between Social Security and Medicare and a number of other unforeseen issues, 2016 will be an expensive year for some seniors, according to Forbes' recent article, "Untangling the Medicare Premium Mess — And What It Means For You." Medicare laws require it to increase premiums annually to cover increases in per capita costs. This would typically be about $16, which most seniors can manage.

Except that 2016 will not be a normal year. Most retirees have their Medicare premiums deducted from their Social Security benefits, but because inflation was so low this year, there won't be a cost-of-living increase in 2016 for Social Security. And the law says that if Social Security benefits don't rise—you guessed it—neither can the Medicare premiums.

That means about 70% of Medicare beneficiaries won't see the premium hike. However, that leaves the entire burden of this year's Medicare cost increases on the remaining 30%. Those guys are going to be hit with 50% premium hikes.

What Is Your Houston Family’s Long-Term Care Plan?

Published on: October 8, 2015 | By McCulloch & Miller, PLLC

Do you have a plan for long term care? It can be costly and prohibitive for many families, especially for dementia care. Several key points about long term care are clarified in a recent article from The Arizona Daily Star, “Costs pile up fast for dementia care.”

Don’t count on Medicare. The median annual cost for a private room in a skilled nursing facility in Tucson last year was more than $90,896. Assisted living costs about $45,000. In a 2015 annual Cost of Care survey, results showed that Americans paid approximately $16,060 more per year in 2015 for a nursing home than they paid in 2010.

Remember that Medicare doesn’t pay for long-term care, including home care, aside from 100 days of skilled services or rehabilitative care. After that, it’s up to the family to figure out how to pay. The options include long-term care insurance, public assistance through Medicaid programs for people over 65, Veterans Aid, or private pay. On average, an American turning 65 today will incur $138,000 in future long-term services. This cost could be financed by setting aside $70,000 today.

Medicaid Planning: Estate Planning AND Elder Law Skills Required

Published on: October 7, 2015 | By McCulloch & Miller, PLLC

The Huffington Post published an interesting article on the ethical and legal issues posed by two related legal practice areas, “Some Legal Issues at the Intersection of Elder Law and Estate Planning.” There are legal and ethical issues that arise when determining courses of action in both areas.

One is whether to dispose of assets through pre-need planning to qualify for means-tested government programs such as Medicaid that might pay, for example, the cost of long term nursing home care. This is very complicated, and you should work with a qualified elder law attorney.

If you want to maximize eligibility for means-tested governmental benefits, a common income reduction technique is to create a Qualified Income Trust (QIT), also called a “Miller Trust.” There are also other types of "special needs trusts" that can be created without reducing government benefits. Again, this is a highly complex area that requires help from an elder law attorney.

More States Seeking New Legislation to Protect Elderly Investors

Published on: August 21, 2015 | By McCulloch & Miller, PLLC

After a long and high profile life of philanthropic endeavors, socialite Brook Astor died in 2007 with an estate worth $200 million. Two years later, her son Anthony Marshall was convicted of stealing millions from her. Astor suffered from dementia, and Marshall was paying himself from her assets. While not all families enjoy this level of wealth, the fact pattern is not all that unusual. A large and growing number of Americans suffer from dementia-type illnesses and a equally large number of them will be taken advantage of by family members.

States are now trying to provide greater protection for elderly investors, according to a recent Reuters article titled “Protecting dementia sufferers from scammers gains ground in U.S.” Retail brokers – in three states thus far, have been permitted to help deter scams against people with dementia.

The laws, which are being examined by other state legislatures, allow brokerages to halt an older client’s request to transfer money to others (at least temporarily) if a wealth manager suspects that his or her customer may have dementia and may be unknowingly be the victim of a scheme.