Long Term Care Planning
In the Long Term Care Section of the Center for Estate and Long Term Care Planning, long term care services are divided into two categories: planning for long term care and implementing long term care plans.
Planning for long term care involves creating various legal documents that can be used should you become incapacitated and in need of care services. A long term care plan is unique to each individual. There is no such thing as a “one size fits all” approach and, in fact, you should be leery of any such pitch. An improper long term care plan or a “do it yourself” approach may have irreversible effects costing you tens of thousands of dollars or more in the long run. In order to develop the most appropriate individualized long term care plan, our advanced planners do a comprehensive assessment of an individual’s potential care needs, his or her assets and income, any potential tax consequences, and determine which public benefits might be available to supplement the cost of care. Unlike estate planning, long term care plans are often designed to allow the transferring of your assets during your life rather than at death. With the exception of long term care insurance, most long term care planning involves utilizing Medi-Cal and Veteran Administration programs. Such programs often have asset and/or income limitations along with some form of transfer prohibition. Developing and executing long term care planning tools while competent ensures that your loved ones will be able to take advantage of then-current options should you become incapacitated. The tools stay dormant until needed.
Implementation of a long term care plan is the actual process of putting your long term care plan into action. In many cases, implementation is an immediate response to a crisis. In other instances, implementing a plan occurs at the time of an early diagnosis or the beginnings of a problem.
Elder Law is the only area of law defined by the clients we serve rather than the areas of law in which we practice. Elder Law is the name that has been given to the area of our profession that deals with providing different types of legal services to meet the legal and financial challenges of older persons and their families. This field of law includes, among other things, long term care planning, asset preservation, incapacity issues, public benefits such as Medi-Cal eligibility and appeals, Medi-Cal Recovery avoidance, Veteran’s Benefits, and Medicare.
At Harris & Plottel, LLP we take a holistic approach in serving the needs of our elderly clients and their families. We offer an integrated, elder-centered solution to maximize the elder’s quality of life and independence. In order to develop the most appropriate individualized plan for our clients, our advanced planners do a comprehensive assessment of one’s potential care needs, his or her assets and income, any potential tax consequences, and determine which public benefits might be available to supplement the cost of care. A well devised long term care plan preserves one’s assets, minimizes tax ramifications, maximizes benefits, and may include the use of specialized durable powers of attorney, special needs trusts, irrevocable defective trusts, Medi-Cal benefits, and/or Veteran’s benefits.
Asset preservation planning is legal planning used to protect your home, investments, and other hard earned assets from being taken or depleted during your lifetime. Historically, it has been used by wealthy people to protect their estates from risks such as business failures, lawsuits, and taxes. More recently, however, it has become of tremendous importance to typical middle-class older Americans needing to protect their property and life savings from the potentially devastating cost of long term care. As life expectancies increase, so does the potential need for long term care later in life. The cost of long term care continues to rise exponentially while strict laws make eligibility for government assistance much more difficult. Given this challenging dichotomy, now is the time to put an asset protection plan in place.
Although one of the greatest fears of aging Americans is the possibility of aging in a nursing home, an even greater fear is that it will cost them and their loved ones their life’s savings in the process. Careful planning, whether in advance or in response to an unanticipated need for care, can help protect your assets to provide for your care or to pass on to your loved ones. Although it’s always better to plan early, the team at Harris & Plottel, LLP can help devise and implement an asset preservation plan at any stage, even after a family member is in a nursing home.
Harris & Plottel, LLP helps clients to obtain and coordinate public benefits as a part of their individualized long term care plan. Public Benefits are funds provided by the government based on a person’s financial assets and income. These benefits may include Medi-Cal, County Medical Service Program (CMSP), Social Security Income (SSI), and certain Veteran’s Benefits, all of which are need-based programs. A well devised long term care plan preserves one’s assets, minimizes tax ramifications, and maximizes public benefits such as Medi-Cal and Veteran’s Benefits.
Family members often desire to provide for a loved one with special needs by leaving that person with an inheritance to cover care costs. When an inheritance is left directly to a disabled child or person with special needs, there can be tax complications, reduction or elimination of public benefits, and the recipient may not be able to manage the funds themselves. A properly designed and administered Special Needs Trust will serve to supplement that recipient’s public benefits such as SSI and Medi-Cal without jeopardizing eligibility. We will help you design a plan that not only protects such public benefits for your disabled child or loved one, but that addresses the personal care needs of that individual as well.
Planning for a disabled child or loved one with special needs may include the use of a Third Party Special Needs Trust (SNT). Not all Special Needs Trusts are created equal and careful consideration should be used when drafting a Special Needs Trust. Depending on your circumstances, we may establish the SNT as a sub-trust under your living trust or will, or as an irrevocable or revocable stand alone entity. The SNT will be managed by a trusted loved one or other fiduciary and can own various assets to be used for the benefit of the child. However, since the child is not considred an owner of the assets, his or her eligibility for government programs will not be affected. Additionally, unlike a Self Settled SNT (also known as D4A Trust, or Litigation SNT), the Trustee of the Third Party SNT has no obligation to notify the state or pay back Medi-Cal payments after the beneficiary’s death. If you would like to provide for a disabled child or loved one, the attorneys at Harris & Plottel, LLP can draft a Special Needs Trust to suit your unique goals.
Unlike the more traditional revocable living trust used in estate planning, the terms and conditions of an irrevocable trust cannot be easily changed, modified, altered, amended and/or revoked. A properly created and administered irrevocable trust can be used to hold the assets belonging to a person in need of long term care in such a manner as to be considered a completed transfer of assets for public benefits purposes, an incomplete transfer for estate and/or income tax purposes, and indirectly available to meet the uncovered long term care needs of the trust originator. These types of trusts are extremely complex and require exptert knowlege in many competing areas of the law such as tax laws, Medi-Cal law, and VA laws. Harris & Plottel, LLP pioneered the use of these types of trusts in long term care planning, which will become ever more prevalent as the waiting and/or “look back periods” for public benefits qualification are extended.
Made up of various programs, each with its own requirements and regulations as modified and/or clarified by periodic All County Welfare Director’s Letters, qualifying for most of California’s Medi-Cal services can be a daunting and overwhelming process. The attorneys and staff at Harris & Plottel, LLP have decades of experience representing clients in the Medi-Cal application and qualification process. In most cases, we will work on your behalf to prepare and submit the application, respond to the requests and demands of the eligibility worker and ensure that a proper eligibility determination is made in a timely manner. In those cases where an eligibility determination has been wrongfully decided, we are available to represent you throughout the administrative fair hearing process. Harris & Plottel, LLP can navigate the entire process for you so you can focus your time to care for your loved one. One mistake in eligibility can cost you months of nursing home care. Let the expertise of Harris & Plottel, LLP work for you.
At the death of a recipient of Medi-Cal benefits or his or her spouse, whichever last occurs, the State of California has the right to seek reimbursement or recovery for Medi-Cal benefits paid. Such recovery is governed by a complex maze of rules, regulations, and case law. While avoiding recovery through proper long term care planning is one of our primary objectives, we also represent the beneficiaries of a Medi-Cal recipient throughout the entire recovery process – from proper death notification to final settlement and release. If you have received a Medi-Cal claim, contact us immediately.
For those of you who are veterans or the spouse of a deceased veteran, Harris & Plottel, LLP can assist you in obtaining a monthly check from the Federal Veteran’s Administration known as Veterans Aid & Attendance. We can navigate the various eligibility requirements for Veteran’s and Medi-Cal Planning because quite often they don’t go hand-in-hand. Most people do not take into consideration the conflicting requirements between Veterans and Medi-Cal Planning, nor do they consider the adverse effects improper planning can have on one’s estate plan, financial plan, or tax plan. Do not fall victim to unaccredited insurance salesmen requiring the purchase of an annuity in order to qualifty. Each of the partners at Harris & Plottel, LLP are accredited attorneys by the Veteran’s Administration and can provide sound advice and strategies for you to qualify for these valuable benefits.