May 29, 2016

Veterans Choice Program falls short of the mark

Our veterans have not always gotten what they deserve from our nation. With Memorial Day here, it's time we recommit ourselves to doing a better job.

The Veterans Aid and Attendance program provides disabled and elderly veterans financial help to cover the cost of at-home care, assisted living or nursing home care. In our experience, too many veterans do not know that the program exists; and among those who do know, too many wrongfully believe they are not eligible because they do not have a service-connected disability. 

Aid and Attendance is but one of a myriad of Veterans Administration health-related programs. Unfortunately, applicants often experience so much stress and frustration getting access to benefits that the process becomes, well, almost like fighting a war. No doubt the V.A. has its heart in the right place But the vast lumbering bureaucracy falls short more often than it should.

Take, for example, the Veterans Choice Program I told you about in 2014. Veterans Choice was introduced to shorten the horrifyingly long wait times veterans experienced trying to get medical care from the V.A. Under the Choice program, a veteran could receive care from a private medical provider, at V.A. expense, if the veteran (1) faced a wait time of over 30 days, or (2) had a medical issue that required timely attention, or (3) lived more than 40 miles from a V.A. health facility. 

Simple idea, right? As it turns out, deceptively simple. The program has been plagued by numerous problems from its inception. A recent NPR article notes that wait times have actually increased. Veterans and medical providers alike are still struggling to understand the program. Providers have difficulty getting authorized to provide care, and the V.A. does not pay them on a timely basis. According to a February 2016 report in Military Times, many veterans using the Choice program have even seen their credit scores compromised when unpaid providers go after them for payment.  

Critics attribute the problems to the fact that the V.A., under enormous pressure to lessen wait times, put together the complex $10 billion dollar program too quickly. Many also find fault with TriWest and HealthNet, the two private contractors to which the V.A. outsourced the day-to-day responsibility of administering the program. 

In short, the program has fallen far short of the solution that veterans, Congress and the V.A. had hoped it would be. One of the program's original proponents, Senator John Tester of Montana, says this: "Bottom line is the Choice program is broken. We need to fix it and we need to fix it as soon as possible." On March 3 Senator Tester introduced his fix: Senate Bill 2633, the "Improving Veterans Access to Care in the Community Act" which would allow the the V.A.'s own community care programs to be consolidated into one program with streamlined and consistent rules. You can read the text of the bill here

By next Memorial Day - and far sooner, preferably - I hope to report that our veterans have a Choice program that really works for them. They deserve it!

May 18, 2016

How will you pay for long-term care?

Genworth just released its latest analysis of long-term care costs. Nationally, the current median cost for a semi-private room in a nursing home is $82,125 per year; for a private room, $92,378. That's an increase of 2.27% from last year. Florida costs are higher, of course: $89,060 for a semi-private room and $100,375 for a private room. (Oklahoma is the most affordable state for long-term care, but even there, the cost for a private room in a nursing home exceeds $60,000 annually!)

There is every reason to expect increases to continue, and every reason to expect more and more people will need them: Genworth reports that 70% of Americans reaching age 65 will at some point depend on long-term care services. And a recent article in US News & World Report notes that  while 12 million Americans need long-term care today, the number is expected to rise to 27 million by the year 2050.
  
As yet, we have no effective public policy to address this crisis, nor is there one on the immediate horizon. Families in Florida and across the country continue to struggle. A 3/26/16 article from NerdWallet reports that medical debt (including debt incurred in long-term care facilities) is the number one cause of personal bankruptcy in the U.S. 

Most Americans are unaware of this grim situtation unless they've been personally affected by it.  Polls of Americans over age 40, conducted by the Associated Press in cooperation with the University of Chicago, reveal the public's persistent the belief that Medicare pays for long-term care. It doesn't: Medicare provides limited benefits for skilled nursing care, but none for custodial care. Fifty-four percent of poll respondents also said they are doing little or nothing to plan to finance future long-term needs. Of course, there may not be much the the average person can do. Saving up to self-fund sounds logical, but is not financially feasible for many. Long-term care insurance is another possibility and is more affordable if purchased when you are younger. Once you are too old or too sick, you may not be able to get coverage or it may be prohibitively expensive.

The last possibility is Medicaid. While Florida Medicaid has look-back rules and penalties built into its regulations, our attorneys can often help a family preserve a significant amount of its assets and gain access to benefits before "spending down." Even at the last minute - when a loved one is about to enter a nursing home or is already residing in one -- the right legal guidance may allow you to preserve assets. Better yet, Medicaid planning can be done in advance. Contact The Karp Law Firm to schedule a consultation.

May 14, 2016

WASP veterans win another war

The Women Airforce Service Pilots helped the United States win World War II. More than half a century later, they have won another battle.
As I told you in February, the WASPs flew many non-combat missions, freeing up male pilots for combat.  WASPs flew every type of military plane, tested out newly overhauled aircraft, and transported personnel and equipment. Thirty-eight women perished in service to the country. Notwithstanding their contributions, these brave women were classified as civilians during the war. It was not until 1977 that they were officially recognized as veterans, a status which also gave them the right to have their ashes placed in Arlington National Cemetery. That is a final honor many WASP's and their families feel they deserve.

Unfortunately, in 2015, Army policy changed and deceased WASPs could no longer be inurned at Arlington. The policy change did not sit well with the WASPs, who began fighting for the policy to be reversed. An online petition got more than 178,000 signatures.
Now the WASPs can claim another victory: Congress just passed a bill that will restore the WASPs' right to have their ashes placed in the hallowed ground of Arlington National Cemetery. The bill is expected to be signed by President Obama. How fitting that we are honoring these women just as Memorial Day approaches, when we remember with reverence and gratitude all our deceased war veterans. 

Veterans are entitled to all kinds of benefits, which as it should be. Elderly and disabled veterans and their widows may be eligible for Aid and Attendance benefits to help cover the cost of nursing home care, assisted living or home care. Click here for more information.

May 11, 2016

Sumner Redstone's competency trial dismissed, but the saga continues

Who do your sympathies rest with in the legal brouhaha swirling around ailing media tycoon Sumner Redstone? Are you inclined to believe that the frail 92-year-old billionaire's ex-girlfriend, Manuela Herzer, is just a good soul looking out for her friend's welfare? Or are you the more cynical type  (that's probably most of us) who think she's just after his considerable fortune? This week's ruling by a Los Angeles court regarding Sumner's mental competence seems to support the latter view. 

Media mogul Redstone is the former chief executive of Viacom Inc. He met Herzer, then age 36, in 1999. Although she reportedly declined his marriage proposal, the two remained on-again, off-again lovers and companions over the years, during which time she received gifts and cash from him totaling in the millions. She was living in his Beverly Hills home last fall, and in September 2015, he named her his health care decision-maker. Redstone also provided generously for Herzer in his estate plan: She was to get $70 million, along with his Beverly Hills estate, when he passed away. 

Redstone's largesse came to an abrupt end the morning of October 12, 2015, when she was ejected from his home. On October 16 he replaced her as his health care proxy with his daughter, Shari. Herzer was also cut out of his estate plan. 

Herzer quickly filed a lawsuit requesting to be reinstated as his health care proxy. She alleged that while Redstone was competent to name her as his agent in September, his rapidly declining health left him without the capacity to know what he was doing when he removed her from the position just one month later. She accused his nurses and other employees of colluding with Shari, unduly influencing Redstone, and turning him against her. 

Redstone's lawyers counter-argued that their client is competent and has been financially exploited by Herzer. They point to $265,000 she charged on his credit card between August and October of 2015, as well as an additional $40,000 she requested to be delivered to her at his home, where she had him sign for it. 

Herzer's attorney, Pierce O'Donnell had predicted that the upcoming trial would "...expose the tragic inconvenient truth that Sumner Redstone needs the court's protection from those who have lied to and exploited him in his debilitated condition." But his predictions did not pan out: The trial that pundits thought would last several days came to an abrupt halt May 9, just a few days after Redstone, several nurses, a geriatric psychiatrist and others gave depositions in the case. Redstone's 18-minute deposition revealed significant speech difficulties. He also had trouble answering some basic questions - for example, he did not remember his birth name, Sumner Murray Rothstein. One geriatric psychiatrist reported that Redstone suffers from significant memory problems and delusions. One nurse reported that he had secretly provided Shari information about the relationship between Redstone and Herzer. Nonetheless, on the Herzer issue Redstone was very clear: "I want her out of my life," he said, indicating he wanted his daughter Shari to care for him.

Upon reviewing thje videotaped deposition, Los Angeles Judge David Cowan dismissed the suit, ruling that Herzer had failed to prove that Redstone was not competent to select his own health care decision-maker. Cowan stated: "The court was able to see the strong conviction he had about what he said. He seemed very alert. He was composed and did not appear angry... There are no legal grounds not to follow his stated wishes." You can read the transcript of Redstone's deposition here. (Warning: it contains abundant foul language.) 

Of course, the judge's ruling hasn't put an end to the saga. Herzer has already filed another lawsuit claiming that Shari Redstone and her father's nurses owe her more than $100 million, the expected inheritance she has lost as a result of their conspiring against her and unduly influencing Redstone. You can read the legal filing here. 

The uncertainty surrounding Redstone's status has also shaken things up at Viacom and depressed its stock value. The world's sixth-largest media company that includes Paramount Pictures and various television cable channels, Viacom is still largely controlled by Redstone and his family. According to Sharon Waxman of the LA Times, the succession plans for Viacom are "a mess," adding that Redstone "...could not see beyond his own tenure. Redstone was famous for declaring he intended never to die." 

Few of us are Sumner Redstones, but all of us will grow old, if we're lucky. Unfortunately, statistics show a significant number of the lucky ones will also become cognitively incapacitated with age. While no estate plan is absolutely bullet-proof, there is much you can do to protect yourself, your family, your finances and your business from financial predators.  A Durable Power of Attorney and a Health Care Power of Attorney are essential building blocks of such a plan. You could also set up a living trust, naming an adult child or other trusted individual as co-trustee - not successor trustee - so that if you become incapacitated, the co-trustee can take over right away, with the ability to act independently  if need be. Another possibility is naming a pre-need guardian. This allows you to name, in advance, someone in whom you have faith and trust to manage your affairs should it ever be necessary. The courts are not obliged to name that person your guardian, but ordinarily do so unless the person is unsuitable to serve.
 
Get in touch with your certified elder law/estate planning attorney for assistance in setting up these important plans.
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