Geriatric Care Management
In addition to planning for the possibility of long-term illness, we advise clients and their families after such illness occurs. At such times, it is important to plan for present and future care needs as well as for preservation and distribution of assets. Our professional geriatric care managers work in concert with our elder law attorneys and staff to provide comprehensive guidance and support while our clients and their families make plans to live with changed circumstances and needs.
Long–Term Care and Asset Preservation
The costs of long-term care (in-home or in a facility) may reach as high as $8,000.00 per month. For most individuals and couples these costs would deplete assets in a short period of time. Therefore, preservation of one’s assets is of great financial and emotional importance especially when a healthy spouse is still at home. We assist clients in their consideration of all available options to finance long-term care. These options could include tapping into the equity of a person’s home, maximizing return on investments, long-term care insurance benefits and the availability of government assistance, especially the Medicaid program.
Medicaid Applications, Appeals and Recovery Actions
The rules of Medicaid eligibility change almost daily; as they become increasingly complex there are pitfalls for the unwary, but there are also opportunities for the astute planner. We assist clients in planning and positioning themselves to become eligible for Medicaid assistance. Once eligible, we prepare the Medicaid application itself and see it through the often lengthy approval process. At the state level in the Medicaid program, government workers often deny benefits to which applicants are entitled. We represent clients in the confusing administrative process to secure the benefits the system is supposed to provide. The state also has an aggressive program to recover from the estate of a Medicaid recipient all or part of all funds spent on his or her behalf. Our firm represents clients and their families assessing the legality of these state actions and challenging any recovery which is illegal or unfair.
Estate Planning for All Generations (Wills and Trusts)
Estate Planning encompasses a broad range of legal planning issues, including the use of a will versus a living trust; community and separate property interests; the use of community property and/or prenuptial property agreements; and the preparation of Medicaid Qualifying Trusts and Special Needs Trusts. Asset preservation and long–term care planning are often of major concern to our clients. Management of assets and health care decision–making are also important. We also advise heirs and fiduciaries on the process of probating estates and managing trusts. Estate planning does not end with our elder clients; it is multi-generational. It is equally important that the children of our clients follow in the footsteps of their parents and consider these same planning issues.
Incapacity and Disability Planning (Powers of Attorney)
Washington law permits a wide range of advance planning to designate persons who may act for you in financial and health care decision-making when you are not competent or physically able to handle such matters. We prepare durable general powers of attorney for financial affairs and durable powers of attorney for health care to suit our clients’ individual needs. Planning for incapacity or disability is not just for elders. Accidents and the sudden onset of disease or illness is not confined to any specific age group. We assist the children of our clients in a similar planning process taking into consideration needs that may differ from their parents.
End of Life Planning (Living Wills, POLST)
Special Needs Trusts for Elders and Disabled IndividualsIn 2005, the tragic Florida case of Terri Schiavo illustrated the importance of decision making for end of life treatment. Unfortunately Ms. Schiavo had not expressed her wishes in a written document, known as a Living Will. The battle over her wishes resulted in the involvement of the federal and state government not to mention the acrimony among family members. End of life planning requires a person to consider numerous issues such as the use of cardio-pulmonary resuscitation, hydration, nutrition, use of antibiotics and pain management to name a few. As part of our comprehensive planning, the Living Will is an essential document.
The medical community recently adopted the use of a document known as the Physician’s Order on Life Sustaining Treatment (POLST). Physicians often recommend that their patients complete and sign a POLST document oftentimes without adequate explanation as to their use. We counsel our clients on the appropriateness of this document and how it fits into a comprehensive plan.
Special Needs Trusts for Elders and Disabled Individuals
A Special Needs Trust, if correctly worded, allows elders facing long-term care and disabled individuals to enhance their quality of life through trust assets while retaining government benefits. There are several different Special Needs Trusts which can be created depending on the origin of the assets that may be used to fund the trust. These trusts are appropriate in situations such as: parents wishing to leave assets to their disabled children while the parents are alive or through their estates on their death; when disabled individuals directly receive monetary gifts through an inheritance or as the result of a settlement in a personal injury case; or, when an elder is disabled and receiving long–term care assistance from the government and a spouse or other family member wishes to provide funds to enhance the elder’s quality of life. We assist clients in all aspects of creating and administering Special Needs Trusts.
Probate and Trust Estate Administration
Probate is a court procedure for settling the financial affairs of a person who has died. The probate procedure is used to validate a will or administer an estate where there is no will, appoint a person to manage the process, and to determine the proper heirs of the estate. We help determine if the probate procedure is necessary and if so, we represent clients who will be responsible for administering the estate. We also represent heirs or others with interests in the estate if issues arise concerning the probate process. In some cases, a person may have created a trust which designates the disposition of the trust estate at that person’s death. The steps involved in wrapping up the affairs of the trust may require legal assistance to ensure that all the required formalities have been satisfied.
Guardianships are court proceedings where the court is requested to determine if a person is unable to manage their financial or health care affairs. If the court makes such a finding, a guardian will be appointed to manage these areas. We represent people seeking guardianships of minors or persons who are unable to manage their own affairs. We represent guardians after appointment by the court and assist them with fulfilling their legal obligations. We also represent the alleged incapacitated person when they object to the choice of guardian or to the appointment of one at all.
What would happen to your animal companions if you are no longer able to care for them? The answer is to create a pet trust. A pet trust is a contract that can provide for life-long continuing-care and well being of your animals in the event you die or become incapacitated. A pet trust becomes part of your comprehensive estate plan and provides you with the peace of mind that you have included instructions and funds to care for your pet. Washington is one of several states which legally recognizes and enforces pet trusts.
Medicare and Health Insurance
Persons 65 years of age and older and persons who have a disability are entitled to Medicare benefits through the Social Security Administration. These benefits cover hospitalization, visits to the doctor, rehabilitation and therapy, and hospice services to name a few. It is also necessary for the insured to have a supplemental Medicare or medigap policy to cover the 20% Medicare co-pay. In 2006, Medicare began offering an additional benefit to cover prescription drugs (Part D). We assist clients when disputes arise between the Medicare insured and the Medicare administrator regarding the availability and eligibility of benefits.
Protecting Vulnerable Adults From Exploitation and Abuse
Elders and the disabled are often the victims of financial, mental or physical abuse, exploitation and abandonment. The perpetrators of this abuse can be family members, relatives, acquaintances and even businesses and professionals. There are civil remedies available to immediately halt the abuse, restrain perpetrators from committing further abuse and to recover damages.
In April, 2007, the Washington Legislature passed a domestic partnership law, aimed at providing eligible unmarried couples (including elders) with basic legal protections. In the future, it is likely that the Legislature will expand the law to add more legal protections and that the courts will provide opinions and interpretations on these protections. In some cases, unmarried couples may decide it is not in their best interest to register as domestic partners. Even if couples register, they still may need additional protections provided by wills, powers of attorney and other legal documents. We assist unmarried couples in deciding if a domestic partnership is in their best interest.
Long–Term Care Insurance Review
Many financial planners and investment counselors recommend the purchase of long-term care insurance. There are many policies and options to choose from. We review these policies and provide a second opinion as to the choices available. We don’t sell these policies so we are able to be objective.
Reverse mortgages have grown into a $20 billion a year industry with elder homeowners taking out more than 132,000 loans in 2007, an increase of more than 270% from two years earlier. Many borrowers say such mortgages have improved their lives and provided money for retirement and long-term care expenses. Making the decision to take out a reverse mortgage is complicated. Some elders have complained about high–pressure or unethical sales tactics. There are substantial initial fees associated with these loans that many borrowers are not made aware. Some sellers of reverse mortgages have urged buyers to use loan funds to purchase other financial products, like annuities. If you are considering a reverse mortgage or have questions or concerns about the loan you currently have, we are available to counsel you on your options.