Archive for the ‘Long-term Care Planning’ Category

2012 Medicaid Income and Resource Allowances

Medicaid income and resource allowances for eligibility change every year. The  numbers effective January 1, 2012 are:

Nursing home resource allowances

Applicant: $14,250

Applicant’s spouse in the community: $74,820-$113,640

Nursing home income allowances

Resident: $50 (plus cost of health insurance, if any)

Spouse in the community: $2,841

Community Medicaid resource allowances

Single care recipient: $14,250

Married care recipient: $20,850 (this includes resources for both spouses)

Community Medicaid income allowances

Single care recipient: $792 (plus $20 if over age 65

Married care recipient: $1,159 (including spouse’s income)

Anyone considering a Medicaid application whose income and or resources exceed these figures should consult a knowledgeable attorney.  There are many opportunities to achieve Medicaid eligibility when these allowance are exceeded.

Alzheimer’s Assoc. LI Chapter to Honor Judy Raskin

I am pleased to write that I will be honored tonight at the Gala for the Alzheimer’s Association, Long Island Chapter.  I will be honored as a past chair and long time member of the Chapter’s Legal Advisory Committee along with the other members of the committee.

The chapter’s Executive Director, MaryAnn Ragona, continues to enhance the programs and services provided by the Chapter. You can get more information at the Chapter’s website: www.alzheimersli.org.

2011 SuperLawyers Both: Ellen G. Makofsky and Judith B. Raskin

I am honored to announce that I have been named one of the 2011 TOP 100 SuperLawyers and one of the 50 TOP WOMEN SuperLawyers in the New York Metropolitan area. This is the third consecutive year that I have received the SuperLawyers designation , second  time I have been named to the 50 Top Women Lawyers list but the first time I have been named to the Top 100 Lawyers.

Judy Raskin, my partner at Raskin & Makofsky, has also been named to the 2011 SuperLawyers list for the second consecutive year in the Elder Law category.  In fact, she is spotlighted in the SuperLawyers publication counseling other lawyers on how to create a client-friendly office.

The SuperLawyers list is created by peer nominations and recognition plus an analysis of the nominated lawyers background, credentials, experience, honors and awards. The final SuperLawyers selection represents the top 5 percent of lawyers in New York State.

We are very proud of the work we do at Raskin & Makofsky, and are honored to have both of our firm’s partners recognized in this way.

Budget includes expanded Medicaid Recovery

We now have the wording of the NYS Budget Bill in regard to the expanded recovery from estates of Medicaid recipients. The legislation states that in addition to assets passing under a valid will or by intestacy,

“..an individual’s estate also includes any other property in which the individual has any legal title or interest at the time of death, including jointly held property, retained life estates, and interests in trusts, to the extent of such interests;…”

The legislation takes effect April 1, 2011. There is no reference to grandfathering such  assets created prior to the effective date. There will be efforts made to modify the legislation to include grandfathering. Hopefully these efforts will be successful.

Medicaid planning will be significantly affected by this new legislation.

Just in: NYS Budget Affects Medicaid Recipients

The NYS Budget for 2011 has been passed.  According to the information we just received, there is one significant change that will affect many Medicaid recipients. The budget includes a provision for a regulation which will expand the assets from which Medicaid may recover its costs on the death of a Medicaid recipient. These newly recoverable assets may include  life estates, joint accounts and revocable and irrevocable trusts. More details will follow as we get more information.

The good news, if there is any, is that according to our current understanding, this provision is the only change in the new budget affecting Medicaid applicants and recipients.

Can an agent amend a trust?

A recent New York case held that an agent under a Power of Attorney cannot amend a trust on behalf of the principal unless the principal’s Power of Attorney specifically grants that power to the agent. The case is Perosi v. Ligreci, 2011 NY Slip Op 21048 (Supreme Court, Richmond County, February 14, 2011.) This decision confirms that you must think very carefully about what you want your agent to be able to accomplish on your behalf when signing a Power of Attorney and specifically provide for the needed authority in your document.

In our office we post an interesting saying every week. I will be adding our weekly saying to my blogs. This week’s saying is:

“Do not let what you cannot do interfere with what you can do.”  -John Wooden

New NAELA Leadership Position

My colleagues recently elected me to the Board of Directors of the National Academy of Elder Law Attorneys (NAELA) New York Chapter at the group’s January 2011  Annual Meeting.  One of the main functions of the Chapter is to advocate and lobby for legislation which will benefit older adults and the disabled and their families.

Now is an especially auspicious time to be in a leadership position within this organization because there is much work ahead for the NAELA New York Chapter.  New York State is in the midst of a budget crunch. Governor Cuomo recently created a Medicaid Redesign Team whose purpose is to find ways to save money within the Medicaid program.  In the Governor’s 2011 proposed New York State budget he slashed $2.8 billion in spending for Medicaid programs. The likely loss of Federal matching funds will roughly double these proposed cuts to the Medicaid program.  In searching for ways to implement these cuts it is possible that spousal refusal will come under attack and that penalty periods will be proposed for those applying for Medicaid at home.

 I look forward to assisting  NAELA in advocating for the protection of those individuals who rely on the Medicaid program.  I will keep you posted on what happens next.

Medicaid Ordered to Provide Temporary Home Care Services

A woman applied to the Human Resources Administration (HRA) in New York City for Medicaid home care services under the community Medicaid program. Her application was approved subject to determination of her personal care needs. The woman advised HRA that she was in immediate need of 24 hour home care in two shifts. Medicaid denied her request. The denial was upheld at a fair hearing. The applicant then appealed to the New York Supreme Court.

The Court ordered HRA and the New York Department of Health (DOH) to issue regulations setting out the step by step procedure for Medicaid applicants to follow in order to receive temporary personal care services. HRA and DOH were also ordered to implement plans to facilitate the procedures and to notify Medicaid applicants of the availability of temporary services.

Ninety Is Not The New Sixty

We all like to think that we will live a really long time. Although many of us harbor fantasies of being able to retain our youthful hearts and bodies, ninety is not the new sixty.  Young-old is different from old-old and we need to be sure that we are prepared for it. Susan Jacoby authored a thoughtful essay in the December 31, 2010  edition of the New York Times entitled Real Life Among the Old Old.   In her essay Ms. Jacoby reflects on her Mom who appeared active and ageless at 75 but who at ninety, has no more “adventures” in her future, because pain from age related illnesses made the smallest errand an “excruciating effort.”

Modern medicine has many living longer and longer.  According to Ms. Jacoby the over 85 set is the largest growing segment of the over 65 population and at least fifty percent of this population  will spend some time in a nursing home before they die because of a mental or physical disability. Ms. Jacoby’s musings point out  that we all need to have a plan for health care decision-making, surrogate financial decision-making and a plan for protecting assets in the event long term care is required at home or in in a nursing home.  Ninety is not the new sixty, do you have a plan?

Medicaid 5 Year Look Back in Full Effect February 2011

An applicant for institutional Medicaid benefits must submit financial documentation so that Medicaid can determine whether the applicant made non exempt transfers of assets prior to applying. Such transfers would result in a period of ineligibility for the applicant. For several years, an applicant needed to supply financial documentation for the prior 3 years. The Deficit Reduction Act of 2005 (DRA) changed the look back period to 5 years effective February, 2006.

This 5 year Medicaid look back period has been phased in slowly. For each month after the DRA was enacted, one month was added to the 3 year look back. Assets transferred before February, 2006 came under the 3 year rule.

Starting in February, 2011, the look back will be the full 5 years set out in the DRA.