Archive for the ‘Elder Law’ Category

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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Seniors & Mental Health: Is it Mental Illness or Aging?

Sunday, May 22nd, 2016

Seniors are more at risk for mental illness than the general population. According to the Centers for Disease Control and Prevention (CDC), about 20 percent of people age 55 and older experience some kind of mental health concern. Not only are more seniors affected by mental illness, nearly one in three affected older adults does not receive treatment. By learning more about this often-misunderstood problem and watching for warning signs, we may be able to help elders in need get treatment.

Littman Krooks Elder LawMost people are aware that seniors are more at risk for Alzheimer’s disease and other cognitive impairment. About 11 percent of seniors have Alzheimer’s disease, but it is crucial to understand that cognitive decline is not a normal part of aging. Therefore, changes such as increased forgetfulness, confusion or disorientation should be taken seriously. With a prompt diagnosis, seniors can benefit from treatment earlier, and any necessary changes to their living environment can be made in order to keep them safe.

Seniors are also at risk for depression and mood disorders. According to the CDC, in a 2006 survey, 10.5 percent of people age 65 and older said they had received a diagnosis of depression at some time in their lives, and 5 percent had current depression. Another 7.6 percent received a diagnosis of an anxiety disorder at some time in their lives. Anxiety disorders can include a variety of problems, such as phobias, post-traumatic stress disorder and obsessive-compulsive disorder, including hoarding syndrome. Many seniors fail to seek treatment, in part because some people mistakenly believe that depression is a condition natural to aging.

Mental health concerns can have consequences beyond the symptoms of the condition itself. Untreated mental illness can lead to social isolation, take away from seniors’ independence, and cause physical problems and additional medical concerns. That is why it is important for seniors to take preventive measures, and for their loved ones to be aware of warning signs.

Studies have shown that preventive measures can alleviate mental health problems. The risk of depression and anxiety can be lowered as a result of better physical health. Simple exercise three times a week can be even more effective than prescription medication. Research also indicates that keeping the mind active, through social activities, games and puzzles, and communication with friends and family, can decrease the risk of mental health disorders.

Loved ones and caregivers should watch for changes that may indicate mental health concerns for seniors.

Warning signs include:

  • social withdrawal,
  • a depressed mood that lasts longer than two weeks,
  • memory loss,
  • confusion,
  • feelings of worthlessness or guilt,
  • unexplained physical changes, such as in dress, weight or hygiene.

If any of these symptoms appear, discuss them with the family doctor. Treatment such as counseling or psychiatric care can help seniors get on the right track to healthy aging.

 

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NYC Restores Assistance For Seniors and People with Disabilities

Thursday, April 21st, 2016

The New York City Department of Finance has agreed to a settlement that will reinstate or recalculate the previously frozen rent rates of widowed seniors who had been surprised by steep rent increases after the death of their spouses.

senior couple planningA 2014 rule change by the New York City Department of Finance instituted a new requirement that a spouse or disabled adult wishing to take over a Disability Rent Increase Exemption (DRIE) or Senior Citizen Rent Increase Exemption (SCRIE) from a deceased head of household file an application within 60 days of the death. According to the lawsuit, households receiving the benefits were not given notice of the new rule. As a result, many recently widowed seniors were hit with alarming rent increases.

In March, a settlement was reached awarding damages and legal fees to the plaintiffs and putting an end to the 60-day deadline. The deadline for benefits takeovers is now six months after the death of the head of household or 90 days after receiving notice, whichever is later. The Finance Department also agreed to send information to tenants in seven languages. Read about SCRIE or DRIE.

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Family History May Help Seniors

Thursday, March 3rd, 2016

Seniors and their loved ones can benefit from knowing the family’s health history.

Genetics plays a role in a wide range of diseases, and being aware of the ailments that previous generations suffered from can help inform the preventative steps that should be taken to safeguard seniors’ health, as well as the care they may need as they age. Family medical history should be provided to doctors, and adult children caring for elders will want to inform themselves as well, for the saLittman Krooks Elder Lawke of their loved ones and themselves.

Family medical history can give doctors guidance in determining the causes of symptoms a patient is experiencing, and warn them when certain treatments may have an increased risk of side effects. Family history also helps in a reverse way, by assisting doctors in ruling out possible reasons for a patient’s condition.

A family history of heart problems or problems with alcohol may prompt family members to eat better or restrict their drinking. Certain types of cancer in the family may mean that family members should get more than the usual checkups. Knowing about a family history of Alzheimer’s or other dementia can help families plan for the care that seniors may need.

Delving into your family’s medical history can sometimes be troubling, but doctors say that if there is a risk factor present, it is much better to be aware of it, so that preventative measures can be taken.

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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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Changes To Medicare Part D: What To Look For

Tuesday, December 1st, 2015

During Medicare Open Enrollment, which lasts from October 15 until December 7, beneficiaries can join or switch Medicare Part D prescription drug plans. It is a good idea to review your plan during this time, because Part D plans can change how much you have to pay and whatLittman Krooks Retirement Planning is covered, and you may want to look for a better deal. Here are some things to look for:

  • Which drugs are covered. Make sure the prescription drugs you take are covered by your plan, and review the covered drug list for any plan you consider. Most plans have a formulary, or list of covered drugs, which may include different cost tiers. Drugs may move from one tier to another.
  • Premium amount. Check to see what your premium will be for 2016 under your current plan, and make sure it is acceptable considering your out-of-pocket costs.
  • Copays and deductibles. The tradeoff for a low premium may be high deductibles and copays, so you may want to shop around and compare. Keep in mind that plans may not charge a deductible higher than $320 in 2015 or $360 in 2016.
  • Donut hole coverage. If you and your plan spend $3,310 on covered drugs, you enter the coverage gap. Use the Medicare Plan Finder to estimate drug costs to see when or if you will enter the coverage gap. If you need additional coverage in the coverage gap, look for plans that offer it.
  • Mail-order or preferred pharmacy benefit. Consider which pharmacies you prefer and which you might be willing to use. You may be able to save money with a mail-order pharmacy or with 90-day prescriptions. Different plans may have mail-order pharmacies, preferred pharmacies or network pharmacies.

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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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How a Succession Plan for a Family Business Fits Into Your Estate Plan

Wednesday, October 21st, 2015

When a family business is transferred to the next generation, careful planning and proper timing are essential. The succession plan should take into account interest rates, taxes and the effect that the transfer may have on one’s estate plan.

One factor that family business owners should take into consideration is interest rates. The importance of this factor depends on individual economic circumstances, but generally speaking it is beneficial for the transfer of a family business to take place when interest rates are low. The seller may wish to finance the sale of equity or make a distribution that is financed through borrowing, or the buyer may wish to borrow funds so that the seller can be paid in full. In any of these scenarios, lower interest rates will benefit both parties, so the owners of a family business may want to have a succession plan in place but wait to implement it until the interest rate environment is most beneficial.

A succession plan for a family business also needs to take income tax issues into account. The 3.8 percent net investment income tax (NIIT) will apply to many business sales. In addition, many transfers of a family business involve an installment sale. If the older generation’s estate plan calls for that debt to be forgiven, then there will be debt cancellation income to the estate, which can create an income tax burden for the estate. Starting the transfer of the business sooner reduces this risk.

A family business succession plan involves many individual factors, including the crucial matter of when the next generation is ready to lead. It is important to take a long view and have a plan in place that can be implemented at the right time, but business owners should also stay abreast of fluctuation in interest rates and any changes in tax laws that may be on the horizon.

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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.

Making Decisions on Senior Housing

Tuesday, September 15th, 2015

When an older person needs care and can no longer live with full independence, the senior and his or her family are faced with a number of decisions to make. There is often a range of choices available such as assisted living, in-home care, or a skilled nursing facility, and the task of deciding what is right for the individual senior can seem overwhelming.Littman Krooks Elder Law

The decision may be difficult, but families do not have to face it alone. With Americans age 85 and older the fastest growing age group, millions of Americans are now struggling with this very issue, and there are a number of specialists that are available to assist them.

The exact type of assistance that is required depends on the needs of the individual senior and the family’s situation. Families may need to seek guidance from their family doctor, a financial planner, or an elder care specialist. Crucial assistance can be provided by an elder law attorney, who can provide services such as drafting documents that give power of attorney to a trusted family member so that medical and financial decisions can be made if the senior loses the capacity to make them.

A key factor in making a good decision on senior housing is advance planning. Too often families end up making a decision because of a crisis such as a health issue that has taken a turn for the worse. However, in many cases, the need for care can be predicted and planned for. If the family waits for a crisis to develop, they may not have time to consider all the options.

Ideally, the choice of a housing situation for a senior will come out of a series of family discussions that incorporate the senior’s needs and desires, the available options, and the family’s financial situation. Taking the time to consider the options, and seek expert counsel, can allow a family to craft a unique solution for the individual’s unique needs.

 

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