Archive for the ‘Caregivers’ Category

Advocates Say Proposed Cuts to Medicaid Will Harm Seniors and People with Disabilities

Tuesday, July 11th, 2017

Health care legislation currently being considered by Congress includes steep cuts to the Medicaid program, which advocates for seniors and people with disabilities say will cause tremendous harm.

The U.S. House of Representatives passed its version of the legislation, the American Health Care Act, on May 4, 2017. The U.S. Senate is now considering its amended version, which is called the Better Care Reconciliation Act (BCRA). The bill is a move by Republican lawmakers to repeal major parts of the Affordable Care Act, passed under President Obama.

The nonpartisan Congressional Budget Office said that under the BCRA, the number of uninsured people would increase by 15 million next year, and by 22 million by 2026.

Critics have numerous objections to the bill, but advocates for seniors and people with disabilities have focused on the harm they say will be caused by cuts to Medicaid, the joint federal and state program that insures nearly one in five Americans.

The Affordable Care Act expanded eligibility for Medicaid, though states could opt out. The BCRA would phase out that expansion by 2024, and would make further cuts as well, by permanently restructuring the program. Medicaid is a partnership between the federal government and the states, and the new legislation would cap the amount contributed by the federal budget, leaving states to make up the difference or cut benefits.

Medicaid is the nation’s largest government health care program, covering more people than Medicare. Medicaid covers 64 percent of all nursing home residents, 60 percent of all children with disabilities, 30 percent of all adults with disabilities, 76 percent of poor children and 49 percent of all births.

Some nursing home residents could be forced out by the cuts. Under federal law, state Medicaid programs must cover nursing home care, but the Center for Medicare Advocacy predicted that under the budgetary pressures that would be imposed under the BCRA, states would have to limit how much they pay, or restrict eligibility. The AARP said that under the new legislation, older adults could also be charged up to five times more for health insurance than younger people. Under the Affordable Care Act, rates are capped at three times more.

People with disabilities say that cuts to Medicaid would be devastating, likely resulting in reduced access to home and community-based services that allow many to live independently rather than in institutions.

The BCRA is opposed by the Arc, the AARP, the American Hospital Association, the American Medical Association and the American Cancer Society’s action network.

Concerned citizens can contact their representatives in Congress by calling the U.S. Capitol switchboard at 202-224-3121.

 

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NYC Program Helps Seniors with Home Repairs

Friday, May 5th, 2017

Seniors who own their own home in New York City and need help paying for repairs may qualify for the Senior Citizen Home Assistance Program (SCHAP).

The SCHAP program is administered by the city’s Department of Housing Preservation and Development (HPD), in partnership with the Parodneck Foundation. Qualifying low- and moderate-income seniors can receive low-interest repayment loans or deferred no-interest loans to prevent physical deterioration of their home or to improve living conditions. The maximum loan amount is $40,000 for single-family homes or $30,000 per dwelling unit for two- to four-family homes.

Seniors may qualify if they have owned their home within the five boroughs of New York City for at least two years, and are 60 years old or older. Income guidelines apply, and the home must have liability and property insurance.

In the case of deferred, interest-free loans, there are no monthly payments, and fees plus ten percent of the loan are forgiven after the first year. The loan is payable in full if the house is sold, but if the borrower still resides in the home after 30 years, the balance of the loan is forgiven. In the case of low-interest repayment loans, the borrower is charged with 0-3 percent interest and repays the loan over 30 years.

The SCHAP program has been in operation since 1986, and has assisted more than 1,000 senior homeowners. In addition to affordable loans, the program also offers extensive technical assistance to qualifying seniors.

To learn more about the SCHAP program, including application requirements and the loan process, contact the Parodneck Foundation at 212-431-9700, extension 313, or visit: parodneckfoundation.org/schap.

 

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Nursing Home Residents Will Soon Have Greater Rights

Tuesday, November 22nd, 2016

Update (12/1/2016): “The rule was supposed to take effect Nov. 28, but the American Health Care Association, an industry group that represents most nursing homes in the U.S., filed a lawsuit in October to block the rule, which it called “arbitrary and capricious.” To read more, click here.

 

A rule change by a federal agency will provide nursing home residents with major new legal protections by preventing facilities from forcing disputes into arbitration.

littman krooks long-term-careThe Centers for Medicare and Medicaid Services (CMS), part of the Health and Human Services Department, issued a rule preventing nursing homes from requiring that residents resolve disputes in arbitration rather than through a lawsuit. The rule applies to all facilities that receive federal funding, protecting the rights of 1.5 million residents. The arbitration ban is one of several new nursing home regulations promulgated by CMS, including new standards for nutrition and infection control.

Many families must make the decision about a nursing home under time pressure and in emotional turmoil, and they often are not able to consider the implications of all the contract terms. Nursing home contracts often contain fine print requiring that disputes be resolved through arbitration, taking away the right to sue for elder abuse, neglect and even wrongful death.

The nursing home industry said that the rule change, “clearly exceeds the agency’s authority.” Arbitration has reduced legal costs for nursing homes, but advocates for seniors say that it has prevented residents and their families from getting justice. Officials in 16 states and the District of Columbia had urged government action, arguing that private arbitration kept patterns of abuse hidden.

The new rule goes into effect on Nov. 28. It does not apply to contracts signed prior to that date, but current nursing home residents or their families can review their contracts and attempt to renegotiate or choose to move to another facility. After Nov. 28, nursing homes may still ask for a dispute to be settled through arbitration, but residents and their families have the right to file a lawsuit instead.

 

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Westchester to Receive $3.3 Million Grant for In-Home Senior Services

Tuesday, September 27th, 2016

Governor Andrew M. Cuomo recently announced that the Westchester County Department of Senior Programs and Services will receive a $3.3 million grant for in-home services for seniors.

Gov. Cuomo said that the funding would help older New Yorkers continue to live in their homes with dignity and would improve their quality of life.

New York State’s county-based Area Agencies on Aging will receive a total of $50 million through the Expanded In-Home Services for the Elderly Program to help seniors remain in their homes and communities. The program is intended to maximize independence, providing the assistance that seniors need in order maintain a high quality of life in their communities. This may prevent the need for more expensive care, the cost of which is often borne by Medicaid.

The services are designed to help lower income seniors who may have functional impairments and need help with activities of daily living. The in-home services program provides non-medical supports such as assistance with cooking, shopping and getting bills paid.Littman Krooks Elder Law

State Senator Sue Serino, chain of the Senate Standing Committee on Aging, said that both seniors and the community at large benefit when people are able to age in place. When seniors maintain their independence costly nursing home placement is prevented. The program is expected to benefit nearly 70,000 New York seniors.

To be eligible, seniors must not be eligible for similar services such as Medicaid, must be 60 years of age or older and must be able to reside safely in the community. It is not necessary to show that there is a medical need for the services.

 

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Settlement Reached for Seniors Who Must Leave Assisted Living Home

Tuesday, July 5th, 2016

An assisted living home for seniors in New York City is closing and five residents who had refused to move will accept a $3.35 million settlement.

In March 2014, the management of a home for seniors in Brooklyn announced that the facility was closing and the residents would have to move within 90 days. Many of those affected were angry, alleging that the building owners wanted to sell to a developer. Most moved out as requested, but one group filed a lawsuit to halt the closing.

Littman Krooks Elder LawThe New York State attorney general, investigated the matter, saying that giving seniors 90 days to leave their homes was unreasonable. Some had Alzheimer’s disease or other dementia; family members worried that they would not be able to find the same level of care at another facility and that moving would be traumatic.

By November 2014, there were eight holdouts in the building, faced with empty halls and dwindling services. Now there are five, ranging in age from 91 to 101. Each of them will receive more than $500,000 in the settlement, but they must leave their apartments by the end of the summer.

Attorneys for the residents said the settlement was a victory, giving the seniors the time and money they need to find other accommodations. An attorney for the building’s owner said he was satisfied.

The lawsuit also named the New York State Health Department as a defendant, claiming that the agency did not follow federal and state rules regarding the closing of the home. A resolution to that part of the lawsuit has not been reached at the time of this writing.

 

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Medicaid Asset Transfers: What Are The Rules?

Tuesday, June 21st, 2016

For many families, paying for a loved one’s extended stay in a nursing home would be difficult without the help of Medicaid. However, in order to qualify for the program, a person’s income and assets must fall within certain limits.

Federal rules state that to qualify for Medicaid nursing home coverage, a person must have no more than $2,000 in “countable” assets. However, New York State has more generous rules, so for New York residents in 2016 the limit is $14,850 for a single person. If a married person needs nursing home care, there are protections for a spouse who remains outside. In this situation, the community spouse has a maximum threshold of &74,820 to $119,220 ($14,850 for the institutionalized person and $119,220 for that person’s spouse). Certain types of resources are exempt, such as up to $828,000 of equity in a home and one motor vehicle.

Littman Krooks Elder LawIf you have countable resources above the limits, you may be told that you need to “spend down” your assets, paying for nursing home care yourself, until you reach the resource limits, at which point Medicaid begins covering the cost. This is what happens in many cases. In other cases, a family may anticipate the need for long-term care and wish to transfer assets to the next generation ahead of time, in order to preserve the family’s resources while still qualifying for Medicaid. This is an excellent strategy, as long as the Medicaid rules are followed.

Medicaid has a five-year “look-back” period for transfers of assets. A person applying for Medicaid must disclose all financial transactions for the previous five years. During this time, any transfers of assets for less than fair market value may prevent the person from being eligible for Medicaid. (However, in New York State, the asset transfer rules do not apply for recipients of Medicaid for home care services.) In addition, invalid transfers may result in a costly penalty period during which ineligibility may continue even after assets are spent down.

To avoid ineligibility and penalties, it is important to plan ahead. Transfers made more than five years in advance are not affected by the rules. There are also important exceptions to the asset transfer rules as well as legal strategies including certain trusts that can help preserve assets while ensuring eligibility. As you can see, Medicaid planning is very complex and it is essential to have help from a qualified elder law attorney.

 

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Cold Weather Safety for Seniors

Wednesday, January 13th, 2016

Our guest blogger this week is Louis Giampa, President, Right At Home In House Care & Assistance (Westchester)

When winter’s beauty turns more beast with arctic winds, mounds of snow and bone-chilling temperatures, the season’s harsh side can prove especially dangerous for senior adults. Even older snowbirds escaping to warmer climates still can encounter dips in the thermometer, dampening rains and icy navigation.

“Colder weather is not particularly kind to seniors,” said Lou Giampa, President of Right at Home Westchester. “Slick sidewalks lead to falls; colds and the flu escalate; and depression looms because of indoor confinement and less social interaction. To counter the wintertime risks for older adults, basic planning and prevention can make the cold weather manageable and actually enjoyable.”

Littman Krooks Elder LawTo help families ensure their seniors stay warm and safe during winter months, Giampa recommends the following precautions:

  • Stay warm indoors. A comfortable thermostat setting in winter is 68° to 70° F. Many elders push their thermostats to higher temperatures, but this promotes over-dry skin and nasal passages, and raises the heating bill. Instead, seniors who feel chilled might consider wearing thicker socks, fleece slippers and a thin, thermal undershirt and leggings. Today’s lightweight “long johns” trap body heat, wick away moisture and layer well beneath outer clothes. Wearing a scarf around the neck and a knit hat also can increase one’s warmth around the house.
  • Beware of slick outdoor conditions. Inclement weather can create a buildup of snow, ice and mud on walkways and driveways. Outdoor fall prevention includes these tips: wear nonskid boots, get help with snow shoveling, use ice melt or sand for traction, and watch diligently for black ice.
  • Wear appropriate clothing outdoors. To prevent heat loss or hypothermia when body temperature drops too low, the elderly who venture into the cold should wear light, layered, loose-fitting clothing under an insulated, waterproof winter coat. Outerwear with a fleece lining and windproof shell is a plus. A hat is a must since as much as 50 percent of body heat is lost through the head. Weatherproof, lined gloves or mittens that still allow for flexibility are also a smart answer to the cold.
  • Stay current on immunizations. Seniors with a weakened immune system are more vulnerable to catching colds and the flu or more severe illnesses including pneumonia. Older adults should consult with their doctor about seasonal and year-round immunizations that are best for their individual overall health.
  • Consume a balanced diet. Individuals who remain indoors more during winter find it tempting to eat starchy convenience foods and skip fresh fruits and vegetables. Adding vegetables to soups and fruits to smoothies is an easy way to add vitamin-enriched foods to a senior’s diet. With less natural sunlight during winter to boost a body’s vitamin D level, eating vitamin-D fortified foods including grains, milk and seafood can help.
  • Keep well-hydrated. Although the elderly may not feel as thirsty in cooler weather, drinking six to eight glasses of liquid a day is still advised. Hot tea, apple cider and cocoa are fun additions to a wintertime beverage list, but stay mindful of the extra sugar and calories.
  • Ward off isolation and depression. Harsh weather invites less social interaction, and for many seniors, can put a damper on mental health. To prevent loneliness and the winter blues in the elderly, schedule regular outings, personal visits, phone calls and social networking. Staying connected with others helps trigger the body’s natural mood lifters including dopamine, serotonin and endorphins.
  • Be prepared for power outages and other emergencies. Every home needs a year-round emergency preparedness kit that includes a flashlight, batteries and first aid supplies. For a comprehensive list of what to do and not do during a power outage, visit the Department of Homeland Security’s website at http://www.ready.gov/power-outage.
  • Don’t forget the car. For safe wintertime driving, good wipers and tires with plenty of snow-gripping tread are essential. Always keep the gas tank near full and carry an ice scraper, windshield washer fluid and a safety kit. Before getting on the road, it is smart for seniors to share their travel routes and expected arrival times with family or friends. Traveling with a charged cellphone and a car charger is another safety tip for any season of the year.

Giampa also advises that throughout winter, families check in daily with their elder loved ones who are living alone. Home healthcare companies like Right at Home provide senior care services including regular home visits for everything from companion care to driving the elderly to appointments, errands and wintertime activities.

With safety steps in place, aging adults can enjoy more beauty in winter than beast.

About Right at Home

Founded in 1995, Right at Home of provides in-home care and assistance to seniors and the disabled.  They help care for seniors who require some assistance in order to maintain their independence, improving their quality of life, and enabling them to remain in their homes.  Their caregivers help with all the activities of daily living, as well as cooking, light housekeeping, safety supervision, medication reminders, and transportation to medical appointments, grocery shopping, social activities, etc. Our caregivers are thoroughly screened, trained, and bonded/insured prior to entering a client’s home.

About the Owner

Lou Giampa is the President of Right at Home Westchester. Lou is a New York State Certified Nurse Aide (CNA) who volunteers in hospitals and nursing homes throughout Westchester County.  He also volunteers with the Alzheimer’s Association, Meals on Wheels, and the Aging in Place community. For more information, visit www.westchesterseniorcare.com.

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Proposed FINRA Rules Will Help Prevent Financial Elder Abuse

Monday, November 16th, 2015

Under new rule proposals soon to be released by the Financial Industry Regulatory Authority (FINRA), financial advisers would be able to delay disbursing funds from the accounts of senior investors if they believe financial elder abuse may be taking place.

Littman Krooks Elder LawOne of the proposed rules would allow financial advisers to wait up to 15 days to disburse funds from senior investors’ accounts if they reasonably believe that financial exploitation is occurring. The proposed rule defines a senior investor as a person who is age 65 or older, or an investor who may be vulnerable for other reasons. The rule would allow advisers to reach out to a person designated as a trusted contact.

A related proposal would require financial advisers to make a reasonable attempt to get contact information for a trusted person on senior investors’ accounts. Under the current proposal, if a senior investor declines to provide such information, the adviser is still permitted to open the account.

The proposed rules would require that if an adviser paused disbursements on a senior investor’s account because of suspected financial elder abuse, the adviser would be required to notify the trusted contact. However, if the trusted contact is the person suspected of committing the exploitation, then the adviser could notify another family member or other responsible party.

The proposed FINRA rules are similar to rules proposed by the North American Securities Administrators Association (NASAA) recently. The NASAA rules allow for a 10-day hold on disbursements when abuse is suspected, and provides for qualified immunity from civil or administrative liability for firms that report suspected financial exploitation of seniors.

 

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The Medicare “Donut Hole” Explained

Monday, September 21st, 2015

Seniors and others with Medicare prescription drug coverage (Part D) should be aware of the coverage gap known as the “donut hole,” so that they can plan properly for the cost of their medication.

Most Medicare prescription drug plans have a “donut hole” coverage gap, which means that when you have spent a certain amount on medication, your coverage will be reduced until your costs reach a higher amount where coverage picks up again. The Affordable Care Act reduced the effects of the donut hole, but it can still result in a significant cost for seniors. Here is exactly how the donut hole comes into play with Medicare prescription drug coverage: Littman Krooks Elder Law

First, you are responsible for 100 percent of your deductible (not more than $320 in 2015 and not more than $360 in 2016). After you have paid the deductible, you are covered (meaning you are only responsible for your co-payments or coinsurance), until you and your plan have spent a combined total on covered drugs that reaches a certain limit ($2,960 in 2015; $3,310 in 2016). Above that limit, you have entered the “donut hole” coverage gap.

Previously, Medicare Part D beneficiaries were responsible for paying 100 percent of drug costs in the donut hole. Now, under the Affordable Care Act, you pay 45 percent of the price for brand-name drugs; however, 95 percent of the price counts toward getting out of the donut hole. For generic drugs, you pay 65 percent of the price in 2015; that percentage will drop each year until it reaches 25 percent in 2020. However, for generic drugs, only the price you pay counts toward getting out of the donut hole.

You exit the donut hole when you’ve spent above a certain limit ($4,700 in 2015; $4,850 in 2016). At that point, catastrophic coverage begins, and you will pay a small copayment or coinsurance for covered drugs for the rest of the year.

Expenses that do not count toward the coverage gap include your monthly premium, pharmacy dispensing fees, and any amount you pay for drugs that are not covered.

Stay Socially Engaged As You Age

Tuesday, July 21st, 2015

Staying socially active as you age not only makes life more fun, it can be good for your health. Researchers with the Rush Alzheimer’s Disease Center conducted a study that found that seniors who were highly social had a rate of cognitive decline 70 percent lower than less-social seniors. Interacting with others and keeping your mind stimulated can help ward off depression and dementia in some cases. Perhaps surprisingly, such mental stimulation and social interaction seem to have positive effects even when they take place on the Internet. Researchers from the University of Alabama at Birmingham found a 30 percent drop in symptoms of depression among Internet users.

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There are lots of easy ways for seniors to stay socially engaged and intellectually stimulated. Seniors should, according to their ability, make an effort to attend social events, visit friends and neighbors, and keep in touch with family members, if not in person then by phone, email or social media. Seniors can also play games, such as crossword puzzles, or chess to keep their minds active.

Older individuals may also want to do volunteer work or even work a part-time job for the social benefits. Non-profit organizations like At Home on the Sound are run by volunteers and assist their members with a range of services that are designed and coordinated to empower senior citizens and support their wellness, independence and vitality while aging in place, in their own homes within the community they love.

People often become socially withdrawn as they age, but that is something that should be resisted as much as possible. It is important for seniors to take advantage of opportunities for social interaction, to get more satisfaction out of life, and to stay healthy.

 

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