Sep 1, 2014

Joan Rivers: Life turns on a dime sometimes

I saw Joan Rivers perform at Florida Atlantic University about 30 years ago. Whether you love or loathe the comedienne, it's undeniable she exuded incredible energy. She maintained a full schedule right up until her cardiac arrest a few days ago, turning in a Broadway performance the night before her throat surgery. The operation was an out-patient procedure - nothing to be concerned about for the otherwise  healthy 81-year-old.

These kinds of events remind us that sometimes, life turns on a dime. We can't dwell on them; we would drive ourselves crazy if we do. Better to live our lives with confidence, anticipating the best. And the best way to do that: prepare ourselves and our families for that turn-on-a-dime event. If you want to be truly free from unnecessary worry, you have to know you're prepared for whatever life throws your way.

My own family faced a similar, unexpected health crisis one year ago Sept. 5. My 76-year-old brother-in-law fell and hit his head on the sidewalk after exiting a restaurant, apparently because of aortic stenosis. While awaiting cardiac surgery to repair the valve, he sustained a brain aneurysm, had a stroke, and remained on life support for days, until we consented to disconnect life support. He was a gifted classical pianist who on the day of his fall, was practicing for a particularly challenging performance. The unveiling of his gravestone will be at a cemetery in New York State at the end of this month. 
Back to Rivers: The press releases say that her family will soon consider removing her from the breathing apparatus. I do not know for sure, but I suspect her daughter Melissa, who has become something of a Dean Martin to Rivers' Jerry Lewis in recent years, may be the decision-maker. I hope for her sake that her mother had a living will and other health care documents in place to guide her daughter's decision and spare her any more agony than she is already experiencing.  My brother-in-law's written wishes were certainly a help to my family.

Wishing peace to Rivers' family, and to the thousands of families each day who find that their lives have turned on a dime.

Aug 24, 2014

Florida Medicaid managed care workshops hosted by Karp Law Firm for local professionals

The Karp Law Firm presented three breakfast workshops in August for social work and health care professionals. Over 150 attended the events in Jupiter, Boynton Beach and Port St. Lucie to learn about the statewide Florida Medicaid managed care program. We want to thank the beautiful facilities that opened their doors to our group: Allegro Senior Living in Jupiter (thanks to Regina Natoli-Sanchez and her staff); and The Brennity at Tradition, Port St. Lucie (thanks to Cary Friedlander and his staff). 

Our terrific special guest speakers were:
  • William Albury, Manager, and Ivy Newton and Andrea Ferguson, District 9 of the Florida Agency for Health Care Administration
  • Kim Clawson, Helpline Director, Your Aging and Disability Resource Center
  • Paola Wierzbicki, Director and Rebecca Love-Wilson, Case Manager, PACE program  (Program for All-Inclusive Care for the Elderly)
  • Marianne Hall and Kim Nelson, Provider Relations Specialists, American Eldercare
  • Hylan Bryan, Regional Supervisor and Dejuana Johnson, Outreach Coordinator, Coventry 
  • Kathy Rupp, Provider Relations Manager, Sunshine State

    L-R: Attorney Karp; Andrea Ferguson, Florida Agency for Health Care Administration; Dejuana Johnson, Coventry; Kathy Rupp, Sunshine State; Nancy Partin, Department of Elder Affairs CARES unit; Marianne Hall, American Eldercare

    Kathy Rupp, Sunshine State

    Paola Wierzbicki, PACE Program

    Karp Law Firm Attorney Gina Grandinette
    L-R: Karp Law Firm Executive Assistant Julie McKeon; Case Manager Assistant Zamara Rosete

    Marianne Hall, American Eldercare

    L-R: Attorney Karp; Kim Clawson, Your Aging and Disability Resource Center; Ivy Newton, Florida Agency for Health Care Administration; Marianne Hall, American Eldercare

Aug 21, 2014

No peace for Casey Kasem or his family

Where is the body of Casey Kasem? It was in Washington State. Apparently, it's now in Montreal. But Norway might be next.  This is like asking Where's Waldo? Only this is no game. 

In a prior post, I discussed the battle between Kasem's wife Jean and his children from his first marriage regarding the late radio icon's end-of-life care. Yet even after his passing, neither he nor the family battle is at rest.

His children claim their father wanted to be buried in Los Angeles, his home for over half a century. His wife however, who moved Kasem's body from a Washington state funeral home to Montreal without notifying the children, is now asking Norway for permission to bury Kasem in that country. The children contend that Jean's request is a ruse, designed to prevent California medical examiners from examining their father's body for signs of abuse. They also say Jean's claim that she has Norwegian ancestry is a fabrication. In fact, her nephew has stated that as far as he knows, the family doesn't have "an ounce of Norwegian blood." Along with several family friends, including a former California lieutenant governor, the children are are now petitioning Norwegian authorities to deny Jean's request. Their decision is pending as I write this.

Surely all of Kasem's loved ones deserve peace at this sad time, not an ugly public circus. I suspect, though, that this episode is a forerunner to a protracted conflict over Kasem's multimillion dollar estate.

The sickness or death of a family member sometimes brings families closer together. In other cases, it creates or deepens the animosity, as we see here. The Kasem saga is an excellent if gruesome demonstration of why people should plan for the possibility of disability, and the certainty of death. A smart estate plan can ensure that your wishes are carried out, and help keep peace in your family. 

Aug 16, 2014

New legislation would help families of children with autism, other disabilities

Over the years, growing numbers of parents and grandparents have requested our help to create estate plans that provide for an autistic child. The statistics bear out what we see in our practice: According to the CDC, in 2010 one in 68 American children fell on the autism spectrum, up from 1 in 150 a decade earlier. The dramatic increase over the last decades is only partially explained by better screening and diagnosis.

Fortunately, many on the autism spectrum go on to lead fully functional lives. But for others, it is a severe and chronic disability that requires loved ones to make thoughtful legal and financial plans. One of the strategies we recommend to parents in these circumstances is the creation of a special needs trust to benefit the child.  You can read more about special needs trusts here.

We caution our clients against using a UGMA (United Gift to Minors Act) account as a vehicle to set aside money for a disabled grandchild - in fact, for any grandchild. A UGMA account is easy to set up, but beyond that, this type of account has little to commend it. Read more about UGMA accounts.

A recent and hopeful development in the fight against autism is the ABLE (Achieving a Better Life Experience) Act, currently under consideration in Congress. The bill would allow the creation of non-taxable 529 savings accounts that may be used to cover medical and other expenses of disabled children, while preserving the individual's access to key government benefits and services like Medicaid. Read more about the ABLE Act here. To contact your congressperson in support of the legislation, click here. To contact your senator, click here. 

Also this past week, funding was renewed for the Autism Collaboration, Accountability, Research, Education and Support Act (Autism CARES, for short) that had been set to expire in September. The Act provides funds for education and research, and for the first time, calls for the appointment of someone at the Department of Health and Human Services to oversee all autism-related initiatives. 

Aug 10, 2014

New Veterans Bill to begin system overhaul

The Veterans' Access to Care Through Choice, Accountability and Transparency Act of 2014 was signed into law by President Obama on August 7.  A too-rare example of bipartisan cooperation, the law provides $16 billion to address the urgent and chronic problems that have come to light at the troubled Veterans Affairs Department. "This will not and cannot be the end of our effort. Implementing this law will take time,” the President said. “Even as we focus on the urgent reforms we need at the VA right now, particularly around wait lists and the health care system, we can’t lose sight of our long-term goals for our service members and our veterans.”

Of the $16 billion allocated in the bill, $10 billion will be used to allow veterans to see private doctors, at government expense, over the next three years. The private option is open only to those veterans who (1) face a waiting period in excess of one month to see a doctor at a V.A. clinic or hospital; or (2) live more than 40 miles from a facility. Eligible veterans will be receiving a "choice card" that will allow them to receive services outside the V.A. system.

The law also allots $1.3 billion to open 27 new clinics nationwide, and $5 billion to hire additional doctors, nurses and other medical staff. The V.A. is tasked with fleshing out the details of the law within three months.

For an abstract of the new law, click here. To read about V.A. Aid and Attendance Benefits for elderly and disabled veterans, click here.

Jul 20, 2014

Casey Kasem: America's Top 40 host's final countdown

Over his long career, radio personality Casey Kasem helped Americans count down the the solid gold hits. Unfortunately, Kasem's latter years were anything but golden. His end-of-life story offers a high profile, sad illustration of why your estate planning should focus on the twists and turns that may occur during your lifetime - not just on what happens after you're gone. Planning for life is of particular importance if you are in a second marriage and have children from a first marriage; that situation is often a fertile breeding ground for family disagreements over how to care for a disabled loved one.

When Kasem died on June 15 at age 82, he was married to his second wife, Jean, 60. Kasem also had three children from his first marriage. After being diagnosed in 2007 with Lewy body dementia, Kasem signed a health care power of attorney that gave his children from his first marriage, not his wife, the authority to make his health care decisions. He stated that he did “not desire any form of life-sustaining procedures, including nutrition and hydration,” if all it accomplished was “mere biological existence, devoid of cognitive function." 

Kasem quickly declined and lost the ability to communicate. Family turmoil ensued. His wife, and his children from his first marriage, became embroiled in a series of court battles regarding caregiving arrangements and who had the authority to make Kasem's decisions. At one point the children even alleged that Jean was preventing them from visiting their father.

As the end drew near, the children wanted Kasem to live out his final days peacefully at home, as his instructions stated. Jean objected, saying, "My husband's a fighter! He's an American treasure. He would have never, ever wanted this." In June, without notifying the children, Jean removed Kasem from his Santa Monica home and drove him to Washington State. When they discovered their father was missing, they took their search to the airwaves.

Kasem died in Washington on June 15. His body was taken to a Tacoma funeral home. That's not where the story ends, though. Apparently Jean and the children also disagreed on what to do with the body. Jean said she wanted Kasem cremated; the children want their father buried in Los Angeles, and now, also want an autopsy conducted to determine whether he was physically abused. On June 16 Kasem's daughter Kerri obtained a restraining order from a Washington court preventing Jean from cremating the body or removing it from the funeral home. But when Kerri called the funeral home, she was told the body had already been taken from the premises.

Where is Kasem right now? The children believe that Jean took his body to Montreal, where they suspect she has a boyfriend. The Santa Monica police department is investigating.

If and when Kasem's body is found, don't think for a minute that is the end of the saga. Kasem's estate is estimated to be worth about $80 million. That's eighty million more reasons for the family to fight on. Daughter Kerri Kasem says she will not contest the estate -- unless Kasem signed a will or other document when incapacitated, or Jean somehow manipulated his will.

Bizarre situations like this happen in non-famous families, too; the stories just don't make it into the press. I encourage everyone to establish a well-crafted, crystal-clear estate plan that covers both death and life. A health care power of attorney is essential. While Kasem is to be commended for executing one, he might have spared his family grief with an additional step: A conversation with his family to fully explain his values and wishes, and answer their questions. It's a conversation no one really wants to have, but it can be a real gift to your family, especially when future friction seems likely. Most people know that it's important to talk about these sensitive issues before incapacity strikes. But most put it off until it's too late. For hints on how to approach the subject with your family, check out the Conversation Project.

Jul 15, 2014

Alzheimer's: A poignant interview

Public radio recently broadcast a touching story about a family coping with Alzheimer's Disease. Kimberly Williams-Paisley, actress and wife of country singer Brad Paisley, discusses her family's journey after her mother was diagnosed with Alzheimer's at age 61. Williams-Paisley's father discusses how he learned to let go and acknowledge that his beloved wife was, in a sense, no longer the person he married. This interview will be helpful for any spouse, child or other family member working through these challenges. Listen here:

Jul 13, 2014

Qualified plan longevity annuity hedges risk of outliving retirement savings

Are you are concerned about running out of money before you run out of years? With longer lifespans, skyrocketing health costs, the demise of fixed pensions and the looming Social Security crisis, everyone except the wealthiest are feeling skittish these days.

A new kind of deferred income annuity, commonly called "longevity insurance," may provide an answer. In the past, these annuities were unusable in IRAs and other qualified plans because the required minimum distributions (RMD's) from a qualified plan had to take into consideration the value of the longevity insurance annuity. Now, the RMD issue has been resolved as a result of new IRS regulations. The new regulations apply to these annuities if purchased after July 1, 2014.

You may now put a portion of your 401K or IRA into a deferred income annuity. The income stream kicks in when you attain a certain age and continues until you pass away. Effectively, you are buying protection against the possibility that you will outlive your money. Briefly, here are the new rules and features of the longevity annuity as it applies to qualified plans:
  • Up to 25% of the balance in your qualified plan, or a maximum of $125,000, may be put into the deferred income annuity. The dollar limit is indexed to inflation and will increase in the future in $10,000 increments.
  • You must begin receiving the income no later than age 85.
  • You are still required to take Required Minimum Distributions from your qualified plan at age 70 1/2, but the amount of the annuity is excluded when calculating RMD's.
  • Benefits to heirs: There is a return of premium feature. If the purchaser dies before or after the annuity begins, premiums paid but not yet received may be returned to the account, which means the initial investment can be passed to heirs. If the contract includes a life annuity to the surviving spouse, the premiums may be returned after the second death.

As with all annuities, the qualified plan deferred annuity is not right for everyone. If you and your spouse have ample savings and/or other sources of retirement income, you probably don't need one. But keep in mind that when one spouse dies, the survivor often has significantly less retirement income because of the loss of one Social Security check, and possibly the loss of some or all of the decedent's pension. A longevity insurance annuity may provide a safety net to replace that lost income. 

Contact Steve Levine, president of Karp Financial Services, for additional information, at 561-626-1130.  Also keep in mind that a deferred income annuity must be evaluated within the broader context of your estate plan, so be sure to consult with your estate planning attorney.

Jul 8, 2014

Florida Medicaid rules for long-term care benefits change - again

Florida's eligibility rules for long-term care Medicaid benefits are extraordinarily complicated. The rules change frequently, adding more confusion to the legal labyrinth. Florida has just issued its latest set of changes, effective July 1, 2014. Here is a brief explanation of the new guidelines:

Spouse's Minimum Monthly Maintenance Needs Allowance:
Florida permits a portion of the Medicaid applicant's income to be diverted to the community (i.e., well) spouse if the community spouse's income falls below the Minimum Monthly Maintenance Needs Allowance. Effective July 1, 2014, the Minimum Monthly Maintenance Needs Allowance is $1,966.00 (it was $1,938.75). There are certain circumstances when the diversion may bring the spouse's income even higher. 

Income the applicant may retain:
An applicant who does not qualify for Medicaid because his/her income exceeds $2,163.00 (the current lawful maximum) may establish a Qualified Income Trust, also known as a Miller Trust. The applicant's excess income is placed in the trust. Effective July 1, 2014, an applicant may retain $105 of the income from the trust, up from $35.

For a comprehensive explanation of Medicaid eligibility requirements, see the Medicaid eligibility guidelines at my website.

If you wish to preserve your family's assets and obtain long-term care Medicaid benefits, talk to our Florida Bar Certified Elder Law Attorneys. Do not go it alone. We have in-depth knowledge of the maze of Medicaid rules, and years of experience. We can help you and your family avoid costly missteps.

Jul 6, 2014

Veterans and active duty service members may qualify for special Florida property tax exemptions

Florida offers certain property tax exemptions to veterans and active service members. Are you taking advantage of them? From the Florida Department of Revenue, here are the different types of exemptions that may be available to you:

Disabled Ex-Service member: An ex-service member disabled at least 10% in war or by service-connected events may be entitled to a $5,000 exemption on any property he or she owns.

Service-Connected, Total and Permanent Disability or Confined to a Wheelchair: An honorably discharged veteran who is totally and permanently disabled or requires a wheelchair for mobility resulting from their military service may qualify for total exemption of their homestead. Under some circumstances, the benefit of this exemption can carry over to the surviving spouse.

Discount for Veterans 65 and Older with a Combat-Related Disability: A veteran who is disabled, 65 or older, and owns homestead property may qualify for a property tax discount based on their percentage of disability. To be eligible, you must have been honorably discharged from military service and be partially disabled with a permanent service-connected disability, at least part of which is combat-related.  

Deployed Military Exemption: A member or former member of any branch of the United States military or military reserves, the United States Coast Guard or its reserves, or the Florida National Guard may receive an exemption on this year’s tax bill if he or she: 
  • receives a homestead exemption
  • was deployed during the last calendar year outside the continental United States, Alaska, and Hawaii in support of a designated operation (each year the Florida legislature designates operations for this exemption), and
  • submits an application, Form DR-501M, to the property appraiser.
The percent of the taxable value that is exempt for the current year is determined by the percent of time during the last year when the service member was deployed on a designated operation.

Surviving Spouse of Military Veteran Who Died in the Line of Duty: A surviving spouse of a veteran who died from service-connected causes while on active duty may be granted a total exemption on their home. 
Filing and Keeping Your Homestead Exemption: When a person serving in the Armed Forces owns a property and uses it as a homestead, the service member may rent the homestead without abandoning the claim to the homestead exemption. Service members who can't file a homestead exemption claim in person because of a service obligation may file the claim through next of kin or through any other person who has been authorized in writing to file on behalf of the service member. 

For additional information on property exemptions, contact your county Property Appraiseror click here. 

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