Walnut Creek Elder Law Blog

When choosing an assisted living facility for a loved one who suffers from dementia, certain things should be taken into account regarding the facility. More and more assisted living facilities can now accommodate residents with various levels of dementia. Some facilities have separate wings or dementia units. I have visited many assisted living facilities, and have many clients with loved ones in assisted living facilities. In addition, I have made personal observations about the quality of care for persons with dementia in these facilities.

Music: My wife’s mother, who is 89, has advanced Alzheimers disease, and has been in an assisted living facility for a number of years. Although she does not seem to recognize her children, she does respond very positively to music. When music is played for her, or if someone performs or sings for her, her face lights up. She smiles, and tries to sing. I have noticed this for many residents with dementia, when I have played jazz piano for them in various facilities. Also, on researching the subject, it seems that music is processed and understood through a different part of the brain, usually with positive results.   As a result, find out if the facility you are interested in arranges for music to be played or performed for the residents on a regular basis.

Religious Services: Another item to take into account, is whether the facility is consistent with your religious beliefs. If the resident and family are religious, it will be important for them to have the facility provide religious services for their loved one during all phases of dementia. When my father, who was Catholic, was in an assisted living facility,  I know that he cherished receiving communion every week.  

Behavior: Find out whether the facility will be able to accommodate your loved one during all stages of the disease process. Plan for the future, as the disease may progress and become worse. Ask the facility what behaviors would trigger them to say that they can no longer accommodate your loved one. Also, ask how they would handle the behavior of your loved one if he or she becomes aggressive, loud, or acts out. You will find out more if you are very specific.  

 Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

The surviving spouse of a wartime Veteran may be eligible for the VA Aid and Attendance Pension Benefit. This benefit can help pay the costs of in home care, board and care and assisted living facilities for the surviving spouse. We must be able to show that the surviving spouse had been married to the Veteran for at least one year, or had children by the Veteran if married less than one year.

The surviving spouse is not eligible if he/she has remarried. Also, the surviving spouse must have been living with the Veteran at the time of the Veteran’s death, unless they were separated because of  medical or military reasons. The Veteran must have a discharge from the military that is other than dishonorable.  The pension rate for the surviving spouse may be as much as $1,056 per month, or $12,681 per year. 

Each VA claim is different and unique, and there are never any guarantees that any claim will be granted by the VA. When we plan for the VA Aid and Attendance Pension benefit, we also plan for Medi-Cal at the same time. Both benefits have different qualification rules, which must be coordinated.

This blog is general in nature, is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

When we plan for the VA Aid and Attendance Pension benefit, we plan for Medi-Cal at the same time. Medi-Cal and the VA benefit are both asset and income based programs. Medi-Cal pays for the costs of skilled nursing facilities, minus the share of cost paid by the recipient. The VA benefit can help pay for the costs of assisted living facilities, board and care facilities, and in home care costs. Under both programs, if the applicant is “over assets”, they can spend down, gift some of their assets away, or use other legitimate asset protection techniques to obtain qualification. 

The VA Aid and Attendance Pension Benefit program does not have a “look back” penalty period. The applicant could give away $50,000 for instance, today, and theoretically be eligible for the VA benefit tomorrow. If the same applicant then went to apply for Medi-Cal, after having gifted the $50,000, there would be an eight month penalty period. Divide $50,000 by $5,698 (penalty divisor) and you have 8.775 or, rounded down, eight months of ineligibility. As a result, the applicant would not be eligible for Medi-Cal for eight months.

There are legitimate gifting and planning techniques which your elder law attorney can show you to  create fewer months of ineligibiity for Medi-Cal. Remember that Medi-Cal pays for skilled nursing, which is much more expensive than assisted living facilities. Planning for Medi-Cal and the VA Aid and Attendance Pension benefit at the same time, is good planning. Your Medi-Cal, elder law attorney can help you with this.

 Written Michael J. Young, elder law and asset protection attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa County and Alameda County, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. Medi-Cal Attorney Contra Costa.

The California Welfare and Institutions Code Section 15610.07 defines elder abuse as follows:

“Abuse of an elder or a dependent adult” means either of the following:

(a) Physical abuse, neglect, financial abuse, abandonment, isolation, abduction, or other treatment with resulting physical harm or pain or mental suffering.

(b) The deprivation by a care custodian of goods or services that are necessary to avoid physical harm or mental suffering.

In addition, the California Penal Code, Section 368 provides for criminal penalties for elder abuse, against someone who willfully causes or permits an elder to suffer, or inflicts unjustifiable physical pain or mental suffering on the older person.

Examples of elder abuse could include physical injury, broken bones, unusual bruises and, bedsores. In addition, social isolation, abandonment and financial abuse can be forms of elder abuse.

Persons who provide care for elders, whether licensed or not, are mandated to report elder abuse.  In addition, any private citizen can report elder abuse.  You can report abuse by calling (APS) Adult Protective Services or by calling 911.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law and asset protection attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc. His practice includes Medi-Cal qualification for nursing homes, elder law, asset protection and estate planning for seniors.

http://lawyoung.byoaudio.com/files/media/7452d421-cf4f-8f57-c8f8-e1ee605d10e0.mp3

 Parkinson’s Disease has affected all kinds of people. Pope John Paul II. Michael J. Fox. Even Hitler. But you don’t need to be advanced in age or even genetically predisposed to suffer from Parkinson’s Disease. It’s not inher­ited. And it’s not just confined to seniors. But most people tend to suffer in isolation due to the embarrassment it causes.

 You may have a loved one in your family, who you suspect of having Parkinsons disease. This disease can have many devastating consequences, which go beyond the obvious physical and psychological strains. Many of these consequences can include financial and legal grief.

People with Parkinsons disease and their families are concerned about future medical costs and the possible loss of assets, including the home and savings, etc. We are always encouraging families and their loved ones to address their legal issues that NEED TO be addressed as soon as possible, even when the disease is merely suspected, and not necessarily diagnosed. In my workshops, I talk about the long term planning that is needed for this disease.  I remind people at the workshops that when you are out of  money, you are out of options. As an elder law attorney, I see this all too many times in my practice, particularly the desire to do something very late in the game, which can make planning much more difficult. 

To help you in this regard, I have prepared a white paper entitled:

“9 Steps to Peace of Mind for the Parkinson’s Family”.

If you would lilke to obtain a copy of this pamphlet, please contact our office at 925-256-0298, or send an e-mail to mike@walnutcreekelderlaw.com, requesting a copy.

            By, Michael J. Young elder law attorney in Walnut Creek, CA.

            Mr. Young is an elder law attorney who practices in the east bay. His office is in Contra Costa County, located at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA. Mr. Young has East Bay elder law clients who live in such towns as Brentwood, Antioch, Concord, Alamo, Walnut Creek, etc.  Many of his clients are concerned about how they will pay for their nursing home costs. Mr. Young prepares long term care plans for his clients, which may include utilizing Medi-Cal and the Veterans Administration Aid and Attendance Benefit for wartime veterans. www.WalnutCreekElderLaw.com  Mike@WalnutCreekElderLaw.com 925-256-0298

In the seminars presented by Walnut Creek elder law attorney Michael J. Young, www.WalnutCreekElderLaw.com, he talks about the Veterans Affairs Aid & Attendance Improved Pension Benefit, which is paid to wartime veterans or to their surviving spouses. The program is asset and income based, as is Medi-Cal. However, the two programs have different qualification rules. The VA program is often utilized to pay for in-home care, assisted living facilities and board and care facilities. Medi-Cal is most often used to pay for skilled nursing facilities.

The VA program is “non-service connected,” which means that the disability does not necessarily result from being in the service. If you are over age 65, you are deemed to be “disabled” by the VA, and you could be eligible for the lowest amount of the benefit. If you are also housebound, you could be eligible for the next higher amount. And, if you are also in need of help with various activities of daily living, you could be eligible for the highest amount of the benefit.

 The veteran must have been discharged from the U.S. armed forces, with anything but a dishonorable discharge. Also, the veteran must have served 90 days continuously in the military, one day of which had to be during a war time. The periods of war are as follows:

•  WWI: April 6, 1917 through November 11, 1918
• WWII: December 7, 1941 through December 31, 1946
• Korean War: June 27, 1950 through January 31, 1955
• Vietnam War: August 5, 1964 through May 7, 1975
• Persian Gulf War: August 2, 1990 and continuing

The VA application, if prepared by someone other than the veteran, must be prepared “pro bono,” that is, without charge, and by someone who is accredited by the VA. An elder law attorney who is accredited by the VA is best equipped to help you with the planning and application for the VA benefit. He would also prepare an integrated long term elder care plan for you, that would take into account all of your assets, plus the VA and Medi-Cal benefits.

 Caveat: Beware of non-attorney individuals and organizations who offer to help with the VA applications. First check to see if they are accredited by the VA, which is required by federal law.  Also know that VA applications are prepared pro bono, that is, without charge. You may be advised by an organization to gift all of your assets away in a large gift, which can create immediate eligibility for the VA program, but ineligibility for Medi-Cal for a long period of time. Medi-Cal and VA have different rules. Finally, if the person or organization who wants to help with the VA application wants to sell an annuity to you as part of the process, you most certainly should get a second opinion.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

We receive calls from people asking us if they need to sell their home in order to qualify for Medi-Cal. They also ask us if the State will take their home after they die, if they have been on Medi-Cal.

Your home is generally an exempt asset for qualification for Medi-Cal. You confirm to Medi-Cal that you have an intent to return home, even if you have to go to a nursing facility for an extended period of time. At the present time, a home of any value is exempt for Medi-Cal qualification. Under the Deficit Reduction Act (DRA), which is not effective yet in California, there may be a qualification that a home cannot have more than $750,000 equitable value. But the DRA is not law yet, and to date, we do not have final language in this regard.

However, if the home is in your estate at the time of your death, it is subject to an estate lien for recoupment by the State. The State can claim against your estate, the amount of Medi-Cal benefits paid to the Medi-Cal recipient, but only up to the value of the estate. There are legitimate ways to protect the home from a State lien however, such as removing it from your estate before you die. The planning techniques in this regard this should be accomplished through an elder law attorney, in that there are potential tax issues to be dealt with.

If the deceased Medi-Cal recipient has a surviving spouse, minor, blind or disabled child, the State cannot pursue a lien. A home in joint tenancy between the surviving spouse and her children, does not provide protection against a State lien. As an aside, the State cannot recover against qualified accounts, such as IRAs, or term life insurance policies.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

When we interview clients at the Law Offices of Michael J. Young, www.WalnutCreekElderLaw.com, regarding Medi-Cal qualification, we always ask if the Medi-Cal applicant owns any life insurance policies. For Medi-Cal qualification, the applicant can own any amount of term life insurance. As a result, term life insurance is an excluded asset for qualification. However, if the applicant owns whole life insurance, the face value cannot exceed $1500. The face value is also sometimes called “combined death benefit.” At times, it is difficult to ascertain the type of policy the applicant owns, and what the face value or “cash in value” is. VA policies, for instance, can present problems because the veteran, who is also a Medi-Cal applicant, may have forgotten that he even owns a VA life insurance policy. When it is discovered, and if the cash in value is over $1500, the applicant will be disqualified from receiving Medi-Cal benefits.

There are remedies to fix the problem, such as cashing in the policy, borrowing against it, and gifting or transferring ownership. If the applicant has lost mental capacity to do these things, we will need to rely on the powers in his financial durable power of attorney. Gifting or transferring ownership of the policy may not be an option for the applicant who has lost mental capacity, if the durable power of attorney does not contain the appropriate “elder law” asset protection and gifting language.  Most financial durable powers of attorney do not have this special language. You should see your elder law attorney to pre-plan for these issues.

It is also a good idea to discover whether the Medi-Cal applicant is the beneficiary of any life insurance policies, such as from a spouse. If the well spouse dies first and the Medi-Cal applicant receives the proceeds from the policy, the applicant could immediately lose eligibility.  

This blog is for informational purposes only and is not legal advice. Please see an elder law attorney for your particular case.

Written Michael J. Young, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Alamo, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

For Medi-Cal qualification, one car is generally deemed exempt. We receive calls in our office, The Law Offices of Michael J. Young, 925-256-0298, www.WalnutCreekElderLaw.com,  from people telling us that they are going to immediately sell the second car.  They think they need to do this in order to create Medi-Cal eligibility for their loved one. We tell them that this may not be necessary, in that Medi-Cal allows you to have more than one car. The first car is exempt if it is used for the benefit of the applicant/beneficiary, or if it is needed for medical reasons. You can declare the most expensive car as the exempt car. The value of the second car, which is not exempt, will be added to the total value of the assets of the applicant. Remember that an individual applicant can only have $2,000 in non-exempt assets. A couple can have $2,000 in non-exempt assets for the “ill spouse” and $109,560 in non-exempt assets for the “well spouse.” The second car is not an exempt asset, and may have to be sold or transferred to create eligibility. 

If the applicant does not have a car, they can purchase a car to “spend down” assets in order to create Medi-Cal eligibility. There is no “look back period” for this purchase. When I mentioned this at one of my recent seminars,  one of the attendees jokingly asked if his parents could purchase a $1.5 million dollar Bugati automobile in order to create eligibility.  I suggested that if they could afford such a car, they probably wouldn’t be calling me, and also that the eligibility worker may view this as an abuse of the system.

This blog is for informational purposes only and is not legal advice. Please see an elder law attorney for your particular case.

By Elder Law Attorney Michael J. Young. The Law Offices of Michael J. Young is located at 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. www.WalnutCreekElderLaw.com, LawYoung1@Gmail.com. Serving Contra Costa and Alameda Counties, including Walnut Creek, Concord, Brentwood, Pleasant Hill, Alamo, Antioch.