Jul
30
2013
0

Alzheimer’s Is A Family Illness!

Our office represents many families who have a loved one who has been diagnosed with Alzheimer’s disease or another form of dementia. We typically will receive a call from the spouse or child of the person suffering from dementia. The person calling may tell us that their spouse or parent has become forgetful, is not paying the bills or that he is very depressed. On other occasions, we are told that their loved one is “acting out” and is doing unusual things, such as putting their socks on their hands instead of their feet, or are wandering off and getting lost.

Alzheimer’s disease and dementia definitely creates an extremely stressful time for the entire family. The fortunate victims of this disease have spouses and family members who can help them through their ordeal. Keep in mind also, that you do not have to handle this alone, and that help is available to you. The first thing that should be done is to have a physician give your loved one a complete physical examination. The examination should include neurological testing, medical history, lab tests, function tests and brain imaging. The examination results can determine whether the symptoms are temporary, and could show that the behavior of your loved one is caused by depression, poor nutrition, drug interaction or alcohol abuse. If the symptoms are permanent, they could be caused by dementia or Alzheimer’s disease. If the diagnosis is Alzheimer’s disease, you can also consult with a geriatric psychiatrist who can help with behavioral issues. If you need help finding a doctor, you can check with a physician’s referral service. Also, if you participate in caregiver support meetings, you can ask the other participants at the meetings.

Your elder law attorney can also be helpful to you to plan the elder care journey for the loved one who is suffering from dementia and their family. We meet with families, and help get the family’s “ducks in a row” from a legal and estate planning perspective. We can give advice on asset protection and qualification for Medi-Cal and the VA Aid & Attendance Pension Benefit. The families we meet with derive a great deal of peace of mind from these meetings.

This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney. At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help Baby Boomers and older clients and families through the Elder Care Journey. We help families with long-term care planning, asset-protection plans, comprehensive estate planning, wills, trusts and powers of attorney. We also help Baby Boomers, older clients and families get their “Ducks in a Row” in order to help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit.

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Jun
10
2013
0

2013 CA Medi-Cal Quick Reference Guide

The State of California has changed some of the Medi-Cal qualification figures and requirements for 2013. A brief listing of these changes and requirements is set forth below:

2013 CA Medi-Cal Quick Reference Guide

Community Spouse Resource Allowance

$115,920

This is the amount that the community, or (at home) well spouse can retain in liquid assets. This amount does not include exempt assets, such as the home and qualified accounts, such as IRA’s.

Minimum Monthly Maintenance Needs Allowance

$2,898

This is the minimum amount of income the well spouse can keep. 

Average Private Pay Rate (Divestment Penalty Divisor)

$7,549

This is the amount the State pays to nursing homes on the Medi-Cal program, minus a share of cost by the applicant. This figure is also used to calculate penalty periods of ineligibility for Medi-Cal.

Applicant Resource Allowance

$2,000

The applicant can keep this amount in cash, checking, etc.

Monthly Personal Needs Allowance

$35

The amount of income the ill person is allowed to keep.

At the Law Offices of Michael J. Young, at 1931 San Miguel Dr., Ste. 220, Walnut Creek, CA www.WalnutCreekElderLaw, 925-256-0298, lawyoung1@gmail.com we practice Elder Law and we help families through the Elder Care Journey. We help families with long-term care planning, asset-protection plans, comprehensive estate planning, wills, trusts and powers of attorney. We also help families get their “Ducks in a Row” in order help them qualify for Medi-Cal and the VA Aid & Attendance Improved Pension benefit. This information is not to be taken as legal advice, and you are encouraged to see your elder law attorney regarding any planning.

Mar
18
2013
0

Getting Your Ducks In A Row Before a Crisis Occurs

You should get your ducks in a row long before a crisis occurs, especially where your health and finances are concerned. Many of our clients come to see us when a crisis is occurring. For instance, their spouse or loved one is in the hospital or has just entered a skilled nursing facility. At this stage the planning is usually more difficult, and we may be facing memory issues of the ill person. It may also be more difficult to preserve the home as a legacy for the clients’ beneficiaries. The home is many times our clients’ largest asset.

As part of long term care planning, we plan how various stages of care will be paid for and determine what assets and resources are available. We proceed to get our ducks in a row to protect assets. We also line our ducks up for obtaining Medi-Cal to pay for the skilled nursing facility and the VA Aid & Attendance Pension Benefit to pay for in home care or an assisted living facility. Gifting and spending issues for Medi-Cal and VA are considered. The longer we have to do long term care planning, the easier it is for all concerned. In addition, your peace of mind can be assured earlier on. 

FAMILY DYNAMICS: When we are able to do pre-planning for our clients, we can better take into account issues concerning family dynamics. We need to know which family members are helping the ill person, and who can be relied upon when help is needed. We can offer suggestions for the well spouse for her care for the ill spouse when he comes home. We will be better able to find out if there is serious infighting and resentments among family members. When a crisis occurs, these dynamics become intensified.

LEGAL DOCUMENTS: Are the legal documents up to date? If they are, you are in a tiny minority. If you have not gone to an elder law attorney in the last several years, your documents are probably not up to date. There is specialized language that can be utilized for asset protection and for government benefits planning in the various documents. For instance, if we want to preserve the home and protect it from a Medi-Cal lien, and the ill person has severe memory issues, we may not be able to proceed to transfer the home to the well spouse or a child without going to court. Most revocable living trusts and financial durable powers of attorney do not contain this specialized asset protection language.

Pre-planning will also allow us to discuss any changes that may be needed in the trust, will, financial durable power of attorney and other estate planning documents. Family dynamics are always changing with the occurrence of deaths, divorces, children who are themselves in need of care, second marriages, etc.

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.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. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Mar
11
2013
0

Can Mom Go On Hospice at Home?

Most of our clients make it well known in their long term care plans, that if they become ill, they wish to be taken care of at home for as long as possible. My parents made a pact with each other that if either of them had to go to “rehab”  as my mother called it, which is a skilled nursing facility, that they wanted to return home and be taken care of at home. My mother died at home under hospice care. Your elder law attorney can make these desires known in your elder care estate planning documents. In fact, at the Law Offices of Michael J. Young in Walnut Creek CA, we have our clients sign a separate “Intent To Return Home Document,” which states that if they have to go to a nursing home, it is always their intent to return to their home.

Most of our clients also make it known in their long term care planning documents that if they have a terminal illness, and they would only survivie by being hooked up to machines, that they would rather instead, be allowed to die with dignity, and not be hooked up to machines.

Many people do not know that hospice care can take place at home, and that hospice care professionals can come to your home. Hospice is also often paid for by Medicare or private insurance. To qualify for hospice, a physician must confirm that in their opinion, their patient is likely to die within a six month period. This is generally all that is required. I remember how relieved my siblings and I were when my mother was on hospice at home, and various nurses, social workers, doctors, priests and other aides came into my parents home to attend to my mother. All of us benefitted from this process. 

The hospice process allowed my mother, my dad, myself and my siblings to  to appreciate our last days together with my mother, outside of the traditional, more hectic hospital atmosphere.  

For more information about hospice, long term care planning, asset protection, Medi-Cal qualification and the VA Aid & Attendance Pension Benefit, please feel free to contact Michael J. Young at The Law Offices of Michael J. Young in Walnut Creek, CA. www.youngelderlaw.com www.walnutcreekelderlaw.com

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. Mr. Young is a Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.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. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

Mar
04
2013
0

Protect Your Home From a Medi-Cal Lien With a Reserved Life Estate

Medi-Cal can pay for your stay in a skilled nursing facility if you qualify. Under the state’s regulations, your home can be confirmed as an exempt asset in the Medi-Cal application. This means that you can keep your home, if you are otherwise qualified, and still receive Medi-Cal. This is true whether you are single or married. The concept is that you should not have to lose your home in order to receive this public benefit.

 The problem is that the state will want to recoup the payments it has made to the nursing home for your benefit, when you die. If your home is in your estate when you die, the state will put a lien on your home for the amount it has paid to the nursing home on your behalf. If the state has paid out $150,000 for you, they will put a lien on your home for that amount. When you die and your estate is settled, the state will be satisfied first for their lien of $150,000, and your beneficiaries will receive what is left. The state will not pursue a lien against a surviving spouse who still owns the home, but when she dies, the state’s lien will attach to the home and the state will recoup their payments at that time. 

There is a legal technique which is permitted under the regulations, which will allow you to protect your home against a Medi-Cal lien. It is called a “reserved life estate,” and your elder law attorney or senior law attorney can advise you in this regard. If the Medi-Cal applicant owns a home, we can transfer her interest in the home to her spouse, or to her children, for instance. A life estate in the home is reserved on the deed in favor of the Medi-Cal applicant. This means that the applicant owns the home for the rest of her life, and that her spouse or children own the remainder interest. The applicant is entitled to rents, issues and profits derived from the real estate. These interests are confirmed on the county record. When the Medi-Cal applicant dies, the home is not in her estate because her life interest disappears at the time of her death by operation of law, and her spouse or her children then receive the full interest in the property. Elder law planning and asset protection planning can be further pursued for the surviving spouse with your elder law attorney, to likewise protect her interest in the home.

Although under real estate law the home is not in the Medi-Cal applicant’s estate when she dies, so that a Medi-Cal lien cannot attach to the home, another benefit in using this technique is that under the IRS regulations, the reserved life estate interest should be recognized as keeping enough interest in her home in her estate, so that there should be a “step-up in basis” for capital gains purposes at the time of her death.  

If you have lost mental capacity at the time we would like to make a transfer of your interest in your home and reserve a life estate in your favor, we will need to look at the language and powers in your revocable living trust and financial durable power of attorney. If the powers are not there, and they usually are not, you may have to pursue a court petition through an elder law attorney who is familiar with this area of the law, in order to reform your documents to allow for this transfer. Most revocable living trusts and financial durable powers of attorney do not contain this favorable language. As a result people who are “baby boomer” age or older should consider getting their “Ducks In A Row” and have their elder law attorney or senior law attorney create an elder care plan for them, which will include estate planning documents with this favorable, asset protection language. An elder law attorney who is familiar with Medi-Cal qualification can certainly help you in this regard. Michael J. Young is an elder law attorney who practices in Walnut Creek, CA.

Written Michael J. Young, elder law attorney, Medi-Cal attorney, senior law attorney and probate attorney in Walnut Creek, CA and former in-house counsel for title insurance companies. He is Medi-Cal attorney and is VA Certified.  www.WalnutCreekElderLaw.com LawYoung1@Gmail.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. Mr. Young advises clients regarding Probates, Probates with Real Estate, Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is an Elder Law Attorney and Probate Attorney with offices in Walnut Creek, CA. Walnut Creek Elder Law Attorney, Walnut Creek Probate Attorney. Senior Law Attorney

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Apr
19
2012
0

The Importance of an “Elder Law” Durable Power of Attorney

     Does your Financial Durable Power of Attorney (financial DPA) contain asset protection and government benefits qualification language? It probably does not, unless it was prepared by an elder law attorney. If you lose mental capacity, your spouse or children may be prevented from gifting your assets to themselves, in order to help you qualify for Medi-Cal or for the VA Aid & Attendance Pension benefit.

If your financial DPA contains any gifting language at all, it is probably limited to the annual gift tax exclusion amount, which is $13,000 per person this year. This language is usually of little help for Medi-Cal qualification. In addition, the language will probably not allow for gifting to the ”attorney in fact”, who is the person acting for you.  Specialized language is required under the law in order to allow for any gifting to the person acting as the “attorney in fact.” This specialized language usually does not appear in a “regular” financial durable power of attorney.

For instance, the home can easily be established as an exempt asset for Medi-Cal qualification. If the home is in the name of the Medi-Cal applicant who has lost mental capacity, and we want to transfer the home to a child and reserve a life estate to the applicant in order to avoid a Medi-Cal lien, most financial durable powers of attorney will not allow for this. Most financial durable powers of attorney will allow a transfer only upon receipt of consideration from a sale for fair market value of the real property.

To give another example, the Medi-Cal applicant, under the regulations, is allowed to own a life insurance policy, with a pay on death figure in any amount. However, in order to qualify for Medi-Cal, the applicant’s life insurance policy cannot have more than $1500 cash value. If there is a $5,000 cash value, for instance, the Medi-Cal applicant cannot qualify. The remedy is to liquidate the cash from the policy and then gift it out. What do you do however if the Medi-Cal applicant has lost capacity? We need to then look at the powers in the financial durable power of attorney. However, although most financial DPAs may allow for a liquidation of the cash value, they will not allow you to gift the cash out. The Medi-Cal applicant can only retain $2,000 in non qualified accounts, and if the cash from the policy cannot be gifted, it would have to be spent before qualification for Medi-Cal can be obtained.

The financial DPA in an elder law context, is also coordinated with the revocable living trust of the applicant. There should be specialized asset protection language in the trust, which refers to the financial DPA. This specialized language will allow the attorney in fact to “stand in the shoes” of the maker of the trust, for all purposes, including for Medi-Cal qualification. This technique is allowed by law, and provides the greatest amount of flexibility for the family who is helping the older person who has lost capacity, when we are applying for Medi-Cal.

Remember that if existing estate planning documents are not updated before the older person loses capacity, we may have to resort to a court proceeding to modify the language in the documents. This process is expensive and is not always guaranteed. The best approach is to pre-planning, and to have your estate planning documents updated as early as possible by a qualified elder law attorney, who practices full time in this area of the law. 

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. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is a Concord Elder Law Attorney with offices in Walnut Creek, CA.

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