May 23, 2015

Documents your 18-year-old needs

Has your child turned 18? Then he's an adult, says the law - even if he's still on your insurance plan, even if you're paying his tuition, even if he's living in your house and you're doing his laundry. From a legal perspective, your parental rights have terminated. That means that if he experiences a medical emergency, you may not be able to help or even get information about his condition - unless he has given you the authority to do so.

Why? Privacy laws. Two come into play here: The first is HIPAA, the Health Insurance Portability and Accountability Act, which limits those to whom health care providers can release data. The second is FERPA, the Family Educational Rights and Privacy Act, which restricts the information a school can release about an adult student.

Adults are entitled to their privacy, of course. And nobody wants to discourage an 18-year old to avoid seeing a doctor or visiting the college infirmary because he's afraid mom and dad will find out about his personal life. On the other hand, most parents want to be there in the event of a child's health emergency, without having to go to court to get a guardianship over their child. And in my experience, once a young adult understands how the law works and its ramifications, he/she generally wants the parent to be able to assist in the event of emergency.

There are numerous examples of well-intentioned privacy rules gone awry. Consider one incident reported by Consumer Reports in its 8/26/14 article, "Will You Be Able to Help Your Child in A Medical Emergency? Sheri Warsh, an Illinois resident and mother of a University of Michigan student, learned that her son had been rushed to the hospital. The hospital did not phone her; her son's roommate did. In a panic, she phoned the hospital to find out what was going on, but she was rebuffed by the person who answered the phone. "She told me I had no right to talk to the doctor," Warsh says. Can you imagine how you would feel if this was your child? Fortunately, her son recovered.
 
Another instance is reported by Deborah Jacobs in a Wall Street Journal article of 8/15/14. Alex Franc, a Penn State sophomore, had been vacationing in Mexico during a school break. After returning to the U.S. he fell ill and was admitted to the school infirmary. His father rushed to the school to see him, but the doctors refused to talk with him, citing privacy concerns. Alex was "out of it" at that point and unable to give consent even if he wanted to.

With regard to mental health issues, the risks inherent in our privacy laws have come under intense scrutiny in the wake of recent violent incidents, from Sandy Hook to Virginia Tech to Aurora. In an attempt to recalibrate the balance between protecting privacy and protecting the public, U.S. Representative Tim Murphy (R-Pennsylvania), a clinical psychologist and co-chair of the Congressional Mental Health Caucus, has introduced the Helping Families in Mental Health Crisis Act. One section of the bill would give mental health professionals more leeway to release information about severely mentally ill adults under certain circumstances.  

So what to do when your child turns 18? First, he/she should sign a health care power of attorney that gives you the authority to get information and make medical decisions for him if he cannot do so. As a father myself, I realize not every 18-year old will take kindly to this idea; some may see it as an intrusion on their adulthood. If your child falls into the latter category, he may be more receptive to making someone other than you his agent. It could be a sibling, or perhaps an aunt or uncle. Or he might consider meeting, independently, with a good estate planning attorney who can explain the legal facts of life to him. Lastly, there's always the old-fashioned carrot-and-stick approach. No health care power of attorney? Fine - then no car.

Age 18 is also a good time for a child to create a property power of attorney, so that someone else - probably mom or dad - can manage his financial life if he is unable to do so. Most young adults have little in the way of assets to manage, but there are still occasions when he may need someone to act on his behalf. For example, if your child is out of the country and needs money wired to him out of his account, or wants you to handle an insurance claim arising from an accident he had.

Many young adults feel that they are immortal and untouchable. We know better. Even newly minted adults need someone watching their backs in the event of a medical emergency. If your child has the proper estate planning documents, you can be there for him.

May 19, 2015

"Still Alice" brings Alzheimer's Disease into the spotlight

I am a little late with this blog post, because there have been so many changes in the law over the past weeks that I had to tell you about first. 

I offer a belated congratulations to Julianne Moore, who in late February nabbed this year's Best Actress Oscar for her role as a woman diagnosed with early-onset Alzheimer's Disease in the film, Still Alice.  Moore portrays Alice Howland, a neurolinguistics professor who is diagnosed with the disease at 50. Based on a true story, the film shows Alice and her family struggling to cope with their new reality. 

Moore's research for the role involved speaking first-hand with early-onset Alzheimer's patients, including the Alzheimer's Association's Early-Stage Advisor, Sandy Oltz. Executive producer of the film was Maria Shriver, journalist, former California First Lady, and advocate for families struggling with the disease. Shriver's own father passed away in 2011 from Alzheimer's Disease. 

In her acceptance speech, Moore expressed happiness "that we were able to hopefully shine a light on Alzheimer's Disease....One of the wonderful things about movies is it makes us feel seen and not alone. And people with Alzheimer’s deserve to be seen, so we can find a cure.”

People with Alzheimer's Disease are not alone, and the public is seeing more of them in the popular culture. According to the Alzheimer's Association, 16 million Americans will be affected by 2016. It is currently the sixth leading cause of death in the country. In 2001 Judi Dench portrayed a novelist with Alzheimer's Disease in the film Iris. in 2006 Julie Christie was the patient in the film Away From Her. Literature abounds with stories about families coping with the disease, too, such as such as last year's bestselling novel by Matthew Thomas, We Are Not Ourselves.

Despite the spotlight on the problem and increased funding for research, there is still no cure and no prevention. I always encourage clients who have received a diagnosis to begin making financial and legal plans without delay, because there is simply no way to tell how long any one individual's capacity to understand and sign documents will last. It could be years, or months. When it comes to Alzheimer's Disease, time is not a friend. Putting the appropriate plans in place as soon as possible can prevent a future crisis and ensure a less stressful transition when the patient loses competence. Knowing plans are in place can give you a better quality of life right now. Steps to take include:
  • The spouse should also revisit his/her own plans.
  • Start thinking about how you will pay for long-term care should it become necessary. Do you have long-term care insurance? If paying out of pocket will financially devastate you, discuss asset preservation strategies with your Certified Elder Law Attorney, including exploring Florida Medicaid benefits and/or Veterans benefits.

Let's all keep hoping that a cure is on its way.

May 15, 2015

Veterans Adminstration to roll out new, improved website

Fueled by last year's horrifying wait-list scandal, the V.A. and government representatives have been promising to better serve our veterans. 

 

Ask any veteran and you'll learn that one area badly in need of improvement is customer service. Right now, there are over 1,000 veterans-related "hotlines" that often require those calling for information to make multiple calls and endure multiple wait times. Processing of applications is slow, and the application itself can be maddeningly complex. Veterans Services Officers are helpful but may not be available with regularity. Even the V.A. website requires users to go through contortions to provide or ferret out information. The V.A. is not succeeding at letting veterans know about their programs, either: Nearly half of all veterans are unaware that they are eligible for certain benefits or that those benefits even exist (see my prior post on Aid and Attendance benefits). 

 

One tool the V.A. is implementing to address these issues is a new website, which theoretically - hopefully in practice, too - will  provide veterans with a smoother experience. The new site will integrate nearly 200 separate veterans-related databases into one portal. Once registered, a veteran should have access to information about any and all benefits to which he is entitled. 

 

Don't get too excited just yet, though: The site is going to be in its beta phase for some time. The test period begins May 20. Hopefully the bugs will be worked out by the end of the year, when it will go live. The phone system is supposedly being overhauled, too. We'll see how that goes. I am cautiously optimistic!

May 13, 2015

Latest scam: Seniors hounded to pay for medical alert systems they don't want, never ordered

Seniors and families, be on the lookout: US Today (May 2, 2015) reports that scammers are suckering growing numbers of seniors into buying medical alert systems they never ordered or never wanted. Unsolicited callers tell the victim that the device has already been ordered by a relative and must be paid for. In other instances the victim is told the device is free, but is subsequently billed. Or the caller may say the cost is small -  $20, say - but the caller never tells the victim that that is the monthly charge.

Older people living at home are obviously the most vulnerable. Even when they discover they've been defrauded, victims may not tell anyone about it because they don't want their loved ones to think they are "losing it."

The Federal Trade Commission has caught one particularly egregious scam operating out of Brooklyn. Instant Response Systems, Inc. shipped medical alert devices to consumers without their consent. Then a letter came requesting payment. If the consumer did not pay, he/she was harassed. The company also placed calls to telephone numbers on the National Do Not Call Registry. The company is now required to pay back $3.4 million it garnered in "unjust gains."



Be very careful about who you talk with on the phone and skeptical about anything you receive in the mail! Better safe than sorry. You can also report suspected scams and fraud to the Federal Trade Commission by clicking here or calling 877-382-4357.

May 7, 2015

"Caring for Mom and Dad" debuts Friday May 8

Caring for Mom and Dad debuts tomorrow, May 8 on public television. The multi-part series focuses on how adult children are adjusting to their lives as caregivers for their aging parents, and is narrated by Meryl Streep. The website provides this description of the program:

Americans are living longer than ever before, and soon older adults will outnumber the young. Today, family caregivers are providing 90 percent of parent care, in addition to balancing work and family, a job most cannot afford to do.
Who will take care of those who can no longer care for themselves? How will the nation adapt to ensure that adequate care can be provided for both the caregivers and for those being cared for?
CARING FOR MOM & DAD (premiering May 2015 on PBS, check local listings), seeks to answer these questions as it explores the emotional, health and financial challenges that many caregivers face every day, and offers solutions and tips to help others embarking on this new future.

Learn more about the program and check the schedule in your area here.

May 3, 2015

Guardianship abuse and how to avoid it


As I advise clients, estate planning is not only about planning for death. It's also about making plans for whatever life can throw at you. Planning for disability is a key element of a good estate plan, allowing you to avoid becoming the subject of a guardianship, with all the accompanying trauma and expense.


Most of us would do well to avoid guardianship. Also known as "living probate," guardianship is intended to be a last resort if an individual is endangering himself or others. But recent media reports paint a grim picture of an elder guardianship system that is not always used as a last resort, and sometimes does more to benefit the guardian than to protect the frail and elderly. Instances have occurred in which someone who is not incapacitated has been declared incapacitated, had a guardian appointed, and lost the right to make his/her decisions regarding where to live, who to socialize with, how to spend money. Perversely, the ward's own assets have been used to feather the nests of for-profit guardians, providing a gravy train for the guardian, attorneys, and a small army of others who are supposed to be looking out for the best interests of the disabled person.

Any competent adult may petition the court to have a guardian appointed for an allegedly incapacitated person. Because petitions are frequently filed on an emergency basis, certain basic safeguards, including a thorough and timely examination of the alleged incapacitated person, may not take place. In a matter of days, an older person may be stripped of the right to control his/her own destiny. Sadly, often it is a family member with questionable intentions who initiates the guardianship proceeding. Or a well-meaning, concerned loved one may contact authorities, inadvertently setting the process in motion. Once an allegedly incapacitated person's rights have been removed, it can be extraordinarily difficult to restore them. 



If you have already selected someone to handle your affairs using a durable power of attorney for property and a power of attorney for health care, and you were competent when you executed those documents, the authority you gave your agent should prevail if you can no longer make your own decisions. However, those documents do not give your agent the right to supercede your own decisions. Thus, if you are making dangerous and harmful decisions, a guardianship may become necessary. However, if that occurs and you have also designated a pre-need guardian in your estate plan, the courts should give preference to the individual you have chosen to act as your guardian.


However guardianship comes about, it should result in the court protecting an incapacitated individual from his/her own bad judgment, and appointing and monitoring someone to ensure the person's safety and economic well-being. Unfortunately, abusive guardianship is a growing problem. The Americans Against Abusive Probate Guardianship, a national non-profit organization founded by retired Aventura physician Sam Sugar, summarizes the problem on its website:  


Anyone at any age can be deemed “incapacitated” –even seemingly healthy independent adults–and become  ” A Ward of the State.” A powerful, unrestrained, well connected and monied group of For Profit  Guardians and the  lawyers that protect them has ignored and subverted the laws designed to protect us all and taken advantage of a non-existent Court monitoring system to wreak terrible harm on Wards and their Families while they enrich themselves with exorbitant fees and abusive tactics. Archaic guardianship laws give these predators total power– including owning another person — over  innocent vulnerable citizens in our society. Instead of helping the frail among us,  they use the power of the law to strip away precious Civil Rights and plunder estates, isolate families who get in the way, and in  the process destroy lives. They use the very laws intended to help people to destroy innocent people and their families. 


Fortunately, just as a strong dam can fend off a flood, a robust legal plan can help protect you from being swept into the guardianship system... or at least ensure that if you ever become incapacitated and are truly in need of a guardian, the person the court appoints will be someone who you have named. Avoiding court-appointed guardianship should be a key element in everyone's estate plan.

Before discussing specific steps you may take to protect yourself from guardianship, let's look briefly at some of the nightmarish cases the media has reported in recent months.


A sampling of horror stories


The Palm Beach Post recently reported on the case of 88-year-old Gwendolyn Batson, a widow who in 2011 named a longtime family friend as her agent under her durable power of attorney. Shortly thereafter, Batson's brother, Kenneth Davis, petitioned the court to have a guardian appointed for Batson. He alleged his sister was suffering from Alzheimer's Disease and was being taken advantage of by her agent/friend. 

Under Florida law, the prospective ward of the state is required to have an attorney appointed for him/her, and to be examined within 5 days by a three-person panel, one of whom must be a physician or a psychiatrist. But this petition was done on an emergency basis, and Batson's examination did not take place. Batson's brother and his wife were appointed her temporary guardians. They then began to liquidate some of her belongings, and moved Batson to Alabama against her will. There were frequent clashes between Davis and Batson's friend/agent. 

Batson's agent fought back. The agent went to court and this time, Batson was examined and found to be of sound mind. In fact, the judge who spoke with her referred to her as "delightful." The guardianship was revoked. Batson returned to Florida and died in 2013.

The Palm Beach Post also reported the case of retired teacher Glenda Martinez-Smith. Shortly after her marriage to Alan Smith, he was in an auto accident and suffered traumatic brain injury. Smith's son then successfully petitioned the court to appoint a guardian for his father. The court appointed a professional guardian who had the marriage annulled, and placed Smith in a nursing home. There, despite Martinez-Smith's pleas, Smith was not provided with the appropriate physical therapy. Meanwhile, the professional guardian was being paid for his services from Smith's assets. At one point the guardian cashed in two of Smith's life insurance policies for a total of $145,000. 

The Post reports that Martinez-Smith spent nearly her entire life savings fighting to reverse the annulment and revoke the guardianship. She has now  been only partially successful. She has been reinstated as Smith's health care surrogate, and has moved Smith, unable to speak and in a dehydrated, partially paralyzed condition, to a different facility in Ft. Lauderdale.  

The Sarasota Herald Tribune devoted an entire series, "The Kindness of Strangers: Inside Elder Guardianship in Florida" to investigating Florida's professional guardianship system. It reports that "Monitoring elders and tapping their assets is a growth business: In 2003, there were 23 registered professional guardians in Florida, according to the (Department of Elder Affairs). Today there are more than 440 - an increase greater than 1,800 percent in 11 years." The paper unearthed several cases of elder guardianship abuse. Here's one:

Florida resident Marie Winkelman was approached in 2009 by her late husband's son-in-law, Robert Szychowski. At his request, she made him her power of attorney, an action she would come to regret. Szychowski lived in New Jersey and Winkelman did not know him well, but trusted him because "This was my husband's family... and anybody who was close to him, I respect them." A longtime friend of Winkelman's claimed she had been hospitalized just before signing the papers. That longtime friend believes he is the "boyfriend" Szychowski alleged was advising Winkelman to avoid taking necessary medications when Szychowski petitioned the court to declare Winkelman a ward of the state.

The petition was granted in 2013 and Winkelman became a ward of the state. Now, the report continues, "Strangers control her life savings, her worldly possessions and her medical care. The court has ordered a trust company to cut checks from her account for some $635,000 to pay attorneys, guardians and others involved in her case, with many more expenses pending....A professional guardian receives more than $1,000 a month, at $85 an hour, to coordinate Winkelman’s doctors’ appointments, help with financial transactions and communicate with her cousin and a family friend — who both sought unsuccessfully to free her from a legal status she finds expensive and intrusive."

Winkelman is sometimes forgetful, but far from incapacitated. "They know that I don’t need any of their help," she says. "Not that I am so smart — but I can handle certain things.”
 
The system does work, but there are too many bad apples


These reports reveal that the adult guardianship system in Florida can be manipulated by bad actors. That said, is also obvious that not all court-appointed for-profit guardians are the "cockroaches" Florida Senator Nancy Detert famously termed them. Even the founder of Americans Against Abusive Probate Guardianship concedes that “...there are some wonderful guardians; there really are. God bless them. But there are a significant number of predatory guardians who work with predatory attorneys.” Attorney Gerald Hemness, author of a manual for guardians, agrees that the vast majority of professional guardians do the right thing. “They work selflessly, and they don’t get paid on a massive number of cases,” he contends. “But that does not suggest there aren’t inexperienced, poorly trained, incompetent guardians out there. Unfortunately, the ones that are better prepared and have more training struggle on an every-case basis to be paid for the work they do." But, he adds, "The vast majority of the people under guardianship need to be there.”


Reforms needed: One bill now headed to the governor's desk, another just died in the Florida House


In response to the growing incidence of elder guardianship abuse, the Florida legislature this year considered several reforms to the system. Florida House Bill 5 cleared the legislature on April 28 and is now on Governor Scott's desk. It allows for mediation when there is a dispute over guardianship, which will save on attorney's fees that would otherwise drain the ward's assets; makes it easier for the ward's rights to be restored and guardianship removed; and clarifies who may serve as a guardian and how guardians may be paid.  Unfortunately, because the House session ended early, Senate Bill 1226 never made it out of the legislature. That bill would have established even greater oversight of guardianship procedures, creating an Office of Public and Professional Guardians to investigate and take disciplinary action in cases of abuse, and establishing a registry of professional guardians in each judicial circuit. That bill will likely be re-introduced in the next legislative session.

Steps you can take to prevent yourself from becoming the subject of a court-ordered guardianship

Now that you fully understand the potential perils court-ordered guardianship presents to you and your family, let's discuss how to prevent this from happening to you. As I noted above, incapacity planning is a critical element of good planning. 

Contrary to common belief, having a will provides absolutely no protection from guardianship. A will merely directs the disposition of your assets after you pass away. It affects nothing while you are alive.

The attorneys of The Karp Law Firm recommend the following steps to protect yourself:
  • Consider establishing a revocable trust. It must be properly drafted and funded, of course. A trust is useful because guardians cannot get access to your non-trust assets; those are beyond the jurisdiction of the court, thus providing you protection from a potentially greedy guardian. 
  • Establish a durable power of attorney for property. If you become incapacitated, this document allows your designated agent(s) to seamlessly step into your shoes and manage your financial affairs. Be sure to name back-up agents in case your first choice cannot serve. Review your durable power of attorney every so often since laws can change. Also, be sure those you have named as agents and still ready and willing to serve. As I have mentioned before in this blog, it's also wise to provide your financial institutions with a copy of your durable power of attorney after you execute it, and before any emergency arises. Ask the financial institutions to either sign off on it so you know it will be honored, or to tell you what modifications are required. Banks and other financial institutions are notoriously picky about honoring these instruments, even when the document conforms to all state requirements. So you want to be sure you have all your ducks in a row in advance, rather than have your agent find out in the future that the document won't be accepted.
  • Establish a power of attorney for health care. Make sure the person you are considering naming as your decision-maker wishes to serve. Appoint back-up agents. Provide your health care providers with copies of the document and check from time to time to ensure that your designated agents are still willing and able to serve. (I have had people consult with me whose health care power of attorney is decades old and name agents who are either deceased or too debilitated to serve!) An outdated document is a worthless document, and does nothing to protect you from guardianship.
  • Name a pre-need guardian.  You may incorporate this into your durable power of attorney and power of attorney for health care, or it may be a separate document. It allows you to tell the court who you wish to serve as your guardian if circumstances ever arise that you need one. A pre-need guardianship designation gives you some measure of control if you do end up in a guardianship, allowing someone you know and trust to serve as your guardian, instead of a stranger appointed by the court.
  • Use a Florida Bar Certified Elder Law Attorney to help you with your planning. This ensures that your documents are properly drafted, and should hold up if there is ever a legal challenge. Your attorney can be your most effective witness if someone alleges that you lacked capacity or were under undue influence when you executed your documents. All our firm's attorneys are very particular about how we handle our interviews with clients, and who we will allow in the room during our discussions. We do this to protect our client against allegations of undue influence. Rather than being retained as the lawyers to fight against a guardianship, or to fight against the appointment of a guardian not of your choosing, we can be material witnesses on your behalf who, with our years of experience, can support the claim that you were competent to select and designate a pre-need guardian, power of attorney for health care, and power of attorney for property. We can also testify that we met with you alone and were able to determine that you were not under the influence of any individual at the time you made your choices. 

If you wish to sign a petition urging a federal investigation into abusive elder guardianship, click here.

Apr 23, 2015

Meeting many wonderful caregivers today at the Fearless Caregiver Conference


Today I had the privilege of serving as a guest panelist at the Fearless Caregiver Conference in West Palm Beach. The conference was attended by hundreds of people who are caring for loved ones and are seeking advice, support and practical information. I met many wonderful people, all of whom are facing challenges as caregivers. I was able to answer questions not only about legal matters, but also other family issues my clients encounter, such as how to sensitively deal with a parent who should no longer be driving; facilitating a family intervention when a parent who needs more at-home help is refusing it; soliciting cooperation from difficult siblings, etc. Today's Caregiver magazine sponsored the annual event and publisher Gary Barg moderated the panel.


Here I am answering a question along with my co-panelists.


Apr 20, 2015

Part B Deductible Coverage to end as part of new "doc fix" legislation

The so-called Medicare "doc fix" (officially the Medicare Access and CHIP Reauthorization Act of 2015) was signed into law by President Obama on April 16. A rare instance of congressional bipartisanship, it replaces the 1997 law that caps Medicare payments to physicians. Each year since 1997, that law sent Congress scrambling to prevent doctors' reimbursements from being slashed. Under the new law, payments to participating doctors will increase by .5% each year, through 2019. The projected cost over the next 10 years is $200 billion. 

Not surprisingly, some of that cost - about $70 billion - will come from seniors' pockets. Here's what you can expect: 

If you sign up for Medicare starting in 2020, you will no longer be able to get a Medigap policy offering coverage of the Medicare Part B deductible (the current deductible is $147). Those who are currently covered by Medigap policies, and new enrollees up to 2020, will not be affected. Proponents of the legislation argue that this provision will save the government money by providing seniors with a financial incentive to seek outpatient care only when it is truly medically necessary. Critics claim that seniors will put off getting needed care, costing Medicare more money in the long run.

If your adjusted gross income exceeds certain limits, you will also have to pay higher Part B premiums.  Starting in 2018, if you have a modified adjusted gross income between  $133,000 and $160,000 you will be required to pay 65% of Part B premiums (current payment is 50%). If your income is between $160,000 and $214,000, you will pay 80% of the Part B premium (current payment is 65%).

Read more about the law and how it will affect Medicare beneficiaries here and here. 

By the way, the doc fix law also fixes something else, and it's good news for everyone concerned about identity theft: Social Security numbers will no longer be displayed on Medicare cards. We do not know the exact date new cards will be issued, but the date must be within four years of the passage of the law (in other words, by April 16, 2019). New Medicare beneficiaries will receive cards that don't display the number and current beneficiaries will be issued updated cards.

Apr 16, 2015

Urgent Update: Florida Supreme Court final opinion criminalizes Medicaid planning by non-lawyers


Thinking about getting Medicaid planning advice from someone other than an attorney? Thinking of referring someone to a non-attorney? 

Better think again. Besides getting bad advice, you also may be aiding and abetting a crime.

As I reported several weeks ago, the Florida Supreme Court on January 15 issued an advisory opinion aimed at protecting the public from non-lawyers who represent that they can do Florida Medicaid planning. The court's opinion is a response to Florida cases in which non-lawyers (1) failed to help clients achieve eligibility; (2) exposed clients to charges of fraud; and/or (3) failed to inform clients of the negative tax consequences that would result from such plans. You can read the court's opinion here.

The advisory opinion became final on April 10. "The opinion has full force and effect of an order of the court" and deems any of the following actions by a non-lawyer to constitute the unlicensed practice of law: 

  • Giving legal advice regarding the implementation of Florida law to obtain Medicaid benefits.
  • Drafting personal services contracts.
  • Preparing and executing qualified income trusts.
The unlicensed practice of law is a felony punishable by five years in prison. It follows that anyone who retains, or refers to, a non-lawyer for these activities may be considered to be aiding and abetting a crime, and therefore subject to criminal penalties himself/herself. 

Merely assisting someone with the Medicaid application is not a criminal act. The crime is defined as a non-lawyer giving planning advice leading up to the actual application.

What if a non-lawyer offering Medicaid planning services claims to have a working relationship with a licensed attorney who will handle the clients' legal issues and paperwork? It doesn't matter, the Florida Supreme Court concludes. Unless the client himself/herself hires and retains the attorney, that arrangement is still the unlicensed practice of law. 

Hiring a non-lawyer to handle Medicaid planning, while perhaps less expensive at the front end, can be a costly mistake. Now, it may also be considered a criminal activity.  It is always prudent to seek advice from a Florida Bar Certified Elder Law Specialist. Contact our office for assistance.

Apr 13, 2015

Medicaid could be the answer for your family as median nursing home bill rises to $91,250 (and even higher in South Florida)


One year in a long-term nursing facility now costs as much as three years of private college tuition. Frightening equation, isn't it? This is the staggering statistic revealed in Genworth Financial's  just-released 2015 survey of long-term care costs.

According to the survey, the median annual cost for a private room in a long-term care facility is now $91,250. But wait - that's the national median. In our area of Florida, the price tag is higher still: $106,580 in the West Palm Beach/Ft. Lauderdale/Miami area, and $99,463 in St. Lucie. The price has risen 4% annually for the last five years and there is every reason to expect the cost to continue to go up.

Obviously, this situation is jeopardizing the hard-earned savings of millions of middle class families. If an incapacitated person is married, the spouse naturally will worry about what he/she is going to be left to live on.

Most Americans who have not faced this situation are oblivious to the unimaginably high cost. They also believe, incorrectly, that Medicare will pick up the tab. That is not so: Medicare pays only for limited skilled nursing care, if it follows a hospital stay. It's only when a family member needs long-term care and a family finds itself facing financial ruin that the family discovers the bleak realities.

If you are a typical middle class person and do not have long-term care insurance, there may be another option, though: Medicaid (not Medicare). A combination federal-state program, Medicaid will pick up the cost of custodial nursing care once an otherwise qualified applicant has spent down his/her assets to $2,000. However, there are perfectly legal methods, done with full disclosure, that may hasten a person's Medicaid eligibility and may allow a family to retain a significant portion of assets. It is essential to consult with a certified elder law attorney for guidance, however. After all, the Medicaid office is not going to tell you about these methods any more than the I.R.S. is going to tell you about tax-reducing strategies. You need an expert!

Many people plan in advance so that they are Medicaid-eligible in the future, should they ever wish to apply for benefits. But even if your loved one is already in a nursing home or on the verge of entering one, it's not too late to take steps. Consult with The Karp Law Firm's Certified Elder Law Attorneys for expert guidance. Here are some helpful links:


Read about planning in advance for Medicaid benefits with a Medicaid Asset Protection Trust.



Read the Genworth Florida survey here. 

Read the Genworth report (inluding other state statistics) here.
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