Planning Needed to Safeguard Assets as Medicare Changes Loom in the Debt Talks

August 30th, 2011

The future of Medicare, Medicaid, and Social Security will become a heated topic again this fall as the 12-member Congressional super committee decides how to cut $2.4 trillion in spending by Thanksgiving. Medicare will most likely take the deepest cuts in the second stage of spending negotiations. This is of special concern to baby boomers who continue to retire and seek these government benefits. Questions regarding how long the Medicare trust fund will last, access to doctors, and the Medicare Part D coverage gap are increasing.

People are concerned that as the cuts get passed, Medicare costs for beneficiaries will rise. The Medicare Rights Center advocates that the bipartisan committee should look to raise revenues by doing away with tax cuts and increasing taxes on the wealthiest individuals and companies. “Only by promoting shared sacrifice can we avoid balancing the budget on the backs of older Americans, people with disabilities and their families,” said Joe Baker, the Medicare Rights Center president.

The second stage of spending negotiations will look at changes to Medicare including:

–       raising the age of eligibility, premiums, deductibles, and co-pays

–       changing the means test for income-related premiums

–       decreasing payments to health care professionals and pharmaceutical companies

–       shifting coverage for individuals who can receive both Medicaid and Medicare

–       allowing states to reduce benefits and eligibility

Littman Krooks Elder Law Attorneys and Medicaid Planning Attorneys are at the forefront of helping seniors stay abreast of the changes and how this can affect their health care and financial decisions. Their New York City, White Plains and Fishkill Elder Law attorneys are skilled in tailoring a plan to protect an individual’s assets and estate plan, deal with insurance and government benefit concerns, and properly plan for the future.

To learn more about New York elder law and New York estate planning, visit http://www.littmankrooks.com or http://www.elderlawnewyork.com.

Estate Plans Should Include Provisions for Pets

August 23rd, 2011

Many seniors fail to consider their pets when building an estate plan, an oversight that often finds them homeless or in animal shelters, according to the Humane Society of the United States.

People often incorrectly assume they will outlive their pet, or that a friend or family will take care of their pet when they are gone, according to Anne Culver, director of Disaster Services for the Humane Society. Formal provisions can ensure a pet will receive proper care in a loving home after its owner has passed away.

It is important to outline a temporary plan for a pet before even drafting a long-term plan. Estate plans can take time to carry out, especially if they are contested, but pets need daily care and immediate attention. A designated friend, family member or neighbor can ensure a pet’s needs are met while an estate plan is being carried out.

Formal, long-term arrangements for a pet can be created with the help of a lawyer in the form of a special will, trust, or other document. When selecting a caregiver, seniors should consider close family or friends who have met the pet and who have successfully cared for a pet of their own. If an estate plan includes more than one pet, they should be kept together, especially if they have bonded. Seniors should keep in contact with potential caregivers over time to ensure that their circumstances have not changed, and they are still willing to care for the pet.

In the event that a caregiver cannot be found, the executor of a will can be authorized to find a satisfactory new home for a pet. This may take time, so careful instructions and proper funding are paramount. An estate plan can include funding for a pet’s temporary and permanent expenses.

A trust for a pet may also be set up as an alternative to a will. Unlike a will, which only takes effect upon death, a trust goes into effect as soon as a senior becomes incapacitated. This means that a pet can be cared for immediately.

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To learn more about New York elder law, New York estate planning, visit http://www.elderlawnewyork.com or http://www.littmankrooks.com

VA Begins Massive Outreach Program for Female Veterans

August 16th, 2011

The U.S. Department of Veterans Affairs has announced that it will implement a comprehensive plan to improve care for female veterans.

Secretary of Veterans Affairs Eric K. Shinseki announced that the VA has first begun a massive outreach effort to contact female veterans and ask them to share their experiences with the system. Callers trained to be “friendly” and “conversational” to encourage candidness ask female veterans why they are not using VA benefits, whether they are aware of VA gender-specific services, and what additional services they would like the VA to offer. Callers also offer to connect women to the appropriate departments if they are interesting in receiving VA benefits.

Shinseki said the department would use the information obtained from the calls to draft its comprehensive plan. He said the initial draft would be released in January 2012.

The Women Veterans Health Care program has made significant changes in the past few years – including providing specialized and improved service for female veterans, comprehensive primary care for female veterans, and using cutting-edge research to study the effect of military service on women’s lives – but Shinseki said that even this “has not been enough.”

The new plan will likely include a renewed focus on military sexual trauma, childcare, homelessness, OB/GYN care, and aging issues.

Female veterans currently comprise 8 percent of the total veteran population in the U.S., and account for 6 percent of all veterans who use the VA system. The VA estimates that these numbers will rise to 10 percent and 9.5 percent, respectively, by 2020.

For more information on Veterans’ Benefits, visit www.elderlawnewyork.com or www.littmankrooks.com.

Social Security Benefits To Be Paid On Time

August 10th, 2011

Social Security payments for August 3, 10, 17 and 24th will be made on time and as scheduled. People that receive paper checks can sign up for Direct Deposit.All current beneficiaries must switch to electronic payments by March 1, 2013.

For more information, visit the officuial Social Security website by clicking here.

New Stipend Program for Caregivers of Veterans Disperses First Payments

August 1st, 2011

Family members caring for veterans received their first payments from the U.S. Department of Veterans Affairs’ new Family Caregiver Program in July.

The new program, officially titled the Family Caregiver Program of the Caregivers and Veterans Omnibus Health Services Act 2010, provides a monthly stipend to family members who care for veterans that were seriously injured in the line of duty after Sept. 11, 2001.

Nearly 200 Family Caregivers of Veterans completed the program’s required caregiver training program in time to receive a stipend in July. The VA is dispersing more than $430,000 this month, with each caregiver receiving an average of $2,500. This figure will lower to around $1,600 in following months, as the first payments are retroactive to the date of the application.

Since the program’s launch on May 9, approximately 1,250 Family Caregivers of Veterans applied for the program. The program requires applicants to complete a caregiver comprehensive core training program – developed by VA clinical experts and the nonprofit community-based health agency Easter Seals – before they can begin receiving payments. Eligible Family Caregivers of Veterans are also given access to mental health services and health care insurance if they do not already have it.

Caregivers who qualify for the program can also utilize in-home and community based care for when a veteran needs additional help, respite care that can help care for the veteran for a short time while the caregiver needs relief, additional education programs covering severe traumas like Traumatic Brain Injury, and caregiver support groups

Caregivers who wish to apply may download the application at www.caregiver.va.gov.

For more information about Littman Krooks LLP, visit www.littmankrooks.com or call (914)684-2100.

PACE Helps Seniors Remain at Home

July 25th, 2011

Most seniors prefer the warmth and familiarity of their own homes to nursing homes. The Program of All-Inclusive Car for the Elderly, or PACE, assists seniors who wish to remain in their homes by providing care and services similar to those provided by nursing homes.

Seniors who use PACE are assessed by a team consisting of professional and paraprofessional staff. The team creates a care plan tailored to an individual senior’s needs and delivers many services to the senior’s home, including acute care services and nursing facility services. Other social and medical services are completed in an adult day health center. These include adult day care, dentistry and prescription drugs.

To qualify for PACE, seniors must be at least 55 years old, qualify for Medicare or Medicaid, live in an area serviced by PACE, and be eligible to receive nursing home care from an appropriate state agency.

Seniors who use PACE pay a monthly premium, but all Medicare services are covered if the senior is eligible. The premium amount is dependent on the senior’s financial situation. Medicare also covers a small portion of the monthly premium.

The Balanced Budget Act of 1997 founded PACE as a national service and established it as a permanent part of the Medicare program. A similar program operated in California as early as the 1970s. The program is currently available to all eligible seniors near one of its 75 centers in 29 states.

In New York, the law firm of Littman Krooks LLP features Certified Elder Law Attorneys nationally recognized by the National Elder Law Foundation who can help seniors plan for their futures. To learn more, visit http://www.elderlawnewyork.com/blog/ or call 914-684-2100.

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National Resource Center on LGBT Aging Website Launches Legal Support Resources

July 5th, 2011


This week’s guest blogger, Hilary Meyer, is the Director at the National Resource Center on LGBT Aging

In February 2010, the U.S. Department of Health and Human Services awarded a landmark grant to establish the National Resource Center on LGBT Aging — the country’s first and only technical assistance resource center aimed at improving the quality of services and supports offered to lesbian, gay, bisexual and transgender (LGBT) older adults. Last week, the National Resource Center on LGBT Aging released a variety of new legal and financial resources on the website, providing critical legal information and tips to older LGBT adults, and seeks to inform aging services providers and LGBT organizations of LGBT elders’ legal needs. New resources include:

  • An interactive state-by-state map designed to direct LGBT older adults to legal resources specific to the state they live in
  • Informative articles on the legal documents every LGBT older adult should have, such as wills, advance directives, financial power of attorney, and more
  • Videos that clearly illustrate the legal and financial issues unique to LGBT older adults
  • Publications to help LGBT elders get a jumpstart on legal and financial planning  and
  • Various multimedia resources explaining Social Security and its importance to LGBT older people.

The website materials are designed to encourage older adults to draft the legal documents needed, especially because end-of-life issues can be of special concern for the LGBT population. Namely, if someone becomes incapacitated without the proper legal documents in place, or if the person dies intestate, the majority of states give decision-making authority and inheritance to the next-of-kin— either a legally recognized spouse or blood relative. Because so few states legally recognize same-sex relationships, this could result in surviving LGBT partners or other loved ones being unable to carry out end-of-life decisions, funeral and burial wishes, being shut out of an inheritance, forfeiture of a family home, and other unintended consequences.

The legal support section is one in a series of interactive, multimedia resources that the National Resource Center on LGBT Aging will unveil over the next year. These online resources will span the many issues affecting LGBT older adults —from housing and HIV/AIDS, to retirement and healthcare access and more.

The National Resource Center on LGBT Aging is a project of Services and Advocacy for GLBT Elders (SAGE) in partnership with 10 LGBT and aging organizations nationwide, including the American Society on Aging; CenterLink (the national association of LGBT community centers); FORGE Transgender Aging Network; GRIOT Circle; Hunter College; The LGBT Aging Project; the National Association of Area Agencies on Aging (n4a); the National Institute of Senior Centers (National Council on Aging); Openhouse and PHI (a national training expert).

HAVE YOU HEARD ABOUT… RideConnect?

June 7th, 2011

By Amy C. O’Hara, Esq.

RideConnect is an information and referral service that provides transportation options for older adults, individuals with disabilities and home health care workers in Northern Westchester. There are no membership fees to use RideConnect and riders will only pay the fare charged by the transportation provider. Currently, transportation providers are based primarily in Bedford, Lewisboro, Mount Kisco, Pound Ridge, North Salem, North Castle and Somers, but transportation can be arranged to destinations outside of the towns served. You can contact RideConnect at (914) 242-7433.

For more information, visit www.elderlawnewyork.com or www.littmankrooks.com

Chronic Illness and the Estate Plan

May 16th, 2011


Martin M. Shenkman, Esq., (www.shenkmanlaw.com) focuses on the estate and business planning needs of high-net-worth individuals, closely held business  owners, and real estate owners/developers. We recently spoke to him about estate planning when a loved one has a chronic disease.

Q: What’s different about estate planning for someone with a chronic illness?

A: You need to focus on the specific disease, the individual’s experience with it, and its likely future course. There’s lots of variability.  Generic approaches don’t work; I can’t think of a worse candidate for online estate planning. The standard disability clauses that appear in most legal documents, even lawyer-prepared documents such as a shareholder’s agreement, should be examined. People make lots of dangerous assumptions—even professionals.

Q: Can you give me an example?

A: For instance, they may automatically structure an estate as if the person will be or has been unable to work.  Take MS–you can be diagnosed with it as a child but the average age is in the thirties. Someone with MS may be able to work for 10-20 years, some until retirement. Or look at Parkinson’s.  Most people experience its onset in their mid-sixties or later, but some begin to have symptoms in their thirties.  The older individual diagnosed with chronic illness may have had a full career during which to acquire assets. Planning is not only for the elderly and not only about special needs issues. Each situation requires a different approach.

Q:  What about advance directives?

A:  That’s another area that requires careful consideration.  Consider diseases such as MS and Crohn’s that involve uncontrolled attacks. A good way to approach power of attorney (POA)  in such cases might be to structure an immediate limited POA that would authorize someone to handle routine matters—bill paying—for a couple weeks.  But they wouldn’t be able to handle anything major, such as selling someone’s home.  The comprehensive POA would “spring” when the illness became incapacitating.

Q: You’ve said that estate planning tools should empower, not disempower.  What do you mean?

A: Disease disempowers. If you are living with a chronic illness or disability it limits what you can do. It disempowers you on some level or in some manner. There’s a big emotional component to planning for a loved one with a chronic illness, and there are creative means of preserving someone’s independence as much as possible. Take a situation in which an individual has bipolar disorder.  The person may be exceptionally bright and capable, but a manic episode could pose serious problems. The bulk of this person’s estate could be protected by establishing a fully funded living trust having family and institutional trustees.  But the trustees could be directed to establish a small account –say, $5,000–outside the trust that’s accessible to the individual by checkbook, credit and debit card. This would empower the person to do anything anyone else can do.  It could be replenished, as necessary, while the bulk of the estate would remain protected.

Estate planning tools should be used to ensure quality of life.  They shouldn’t be used as blunt instruments.

Thanks, Marty, these are thoughtful approaches to complex situations.  I hope they prompt readers whose loved ones have chronic illnesses to think creatively about their own estate planning.

Aging Outside the Nuclear Family

April 26th, 2011

The demographics of aging are shifting, and the number of single, childless seniors is growing.  Baby boomers, now entering retirement, are much more likely to be childless than previous generations. Some estimates run higher than 25 percent. In addition, more couples have opted to live together outside marriage.  Add to that the fact that women tend to outlive men, and it’s obvious that an increasing number of seniors will be on their own.

Most of them, at some point, will develop a chronic disease or disability. So who will call the  insurance company or ensure that they’re taking their medication?  Most in-home care for the elderly is performed by family members. Hospital stays are getting shorter, driven by cost-saving initiatives, making it even more likely that these seniors will need outside help at some point in their lives.

Their options include friends, paid caregivers and government-sponsored social services. There may be an increased need for long-term care insurance to cover in-home, as well as nursing home, services. And more advance directives are likely to designate friends as health and financial decisionmakers.

Stories are beginning to appear about women building networks of close friends to share household and home care costs, to advocate for one another, and to provide the emotional support that might otherwise come from a spouse or child.  So far, it appears, men have  been less likely to test such situations.

One problem is that such measures are largely unprotected by law.  The Family Medical Leave Act, for instance, provides no benefits to individuals who may wish to care for a grievously ill friend.

There is also little guidance on how to financially structure such mutually supportive arrangements. There’s an emerging movement, though, that seeks to change that.  Some legal scholars are  espousing the establishment of “friendship law,” which would confer certain rights upon “designated friends”  who play a significant caregiver role—including hospital visitation,  tax breaks and claims to an estate if no will has been established. This is, to say the least, controversial.

On the other hand, when the nuclear family can’t provide an answer, what sort of “caretaking community” can step in? There’s  research to support the important role that friends play in the aging process.  Studies indicate that, especially for seniors, having friends can improve both physical and mental health.  It reduces stress, correlates with better immunity and may even be a factor in women’s longevity, given their .greater likelihood of having strong social networks. Ethan Leib, who teaches law at the University of California at Hastings, points to public savings that accrue when friends step in during illness and other emergencies.

Boomers have repeatedly changed our culture. Although childless seniors would seemingly be at greater risk than others, research indicates that –so far—they do not receive less care or enjoy life less than their counterparts.

Do you know someone in this situation? How is that individual planning for the likelihood that, at some point, outside help will be needed?

For more information, visit www.elderlawnewyork.com or www.littmankrooks.com.