Bill
Puts Seniors at Risk
Written
By: Attorney
Jeffrey A. Marshall
, CELA*
Congress
is about to pass a new law that will make it harder for frail seniors to
pay for long term care. Senate Bill 1932 includes changes to the Medicaid
program that will make seniors ineligible for government financial
assistance if they have given anything away over the past five years.
Since few individuals have insurance that covers
nursing home care, most people in nursing homes are on Medicaid.
Medicaid pays for needed care for people who have limited financial
resources. The proposed
law attempts to save the Government money by shifting more of the cost of
long-term care to families and nursing homes.
Most harmful is a provision in the legislation that
will change the way gifts are treated. Giving assets away makes the donor
ineligible for Medicaid help for a period of time.
Under current law, the penalty period starts to run when the gift
is made. Under SB 1932, the
penalty period will not begin to run until the donor needs nursing home
care and has run out of money to pay for it.
This means that our nursing homes will soon be filled with
residents who need care but have no way to pay for it.
Regrettably this is not a joke.
Congress is about to pass this law.
The grandparent who helped pay for a grandchild’s education, the
church supporter who contributed to the church building fund, the parent
who helps a child with medical bills, the family farmer who passes on the
farm, will all be caught by this law if they get sick within 5 years of
making the gift.
AARP, the Alzheimer’s Association, the Catholic
Health Association and over 40 aging advocacy organizations oppose these
changes. They believe the new
law will put the health of many older Americans at risk.
The nursing home industry also strongly opposes the change in the
calculation of the penalty period, since nursing homes will have to
provide care to residents who have no source of payment.
The penalty start date change is particularly
significant in
Pennsylvania
since the Pennsylvania Legislature recently re-enacted a law that makes
children liable for the financial support of their indigent parents.
Nursing homes, stuck with residents who have no means to pay for
care, may seek reimbursement from the residents’ children. Litigation
between nursing homes and children is likely to flourish. Nursing
homes will sue children who will counter-sue for sub-standard care.
The change in the transfer penalty is not the only
provision of the legislation that will harm seniors.
Spouses of nursing home residents will also be hard-hit. States,
like
Pennsylvania
, will no longer be allowed to let low-income community spouses keep
additional financial resources to avoid later spousal impoverishment. Farmers may be required
to sell their farms to pay for their long term care costs.
Individuals owning annuities may be required to name the state as a
beneficiary.
Unfortunately, the legislation does nothing to
address our country’s growing long-term care crisis. Its provisions
don’t even cut much government spending. It
certainly doesn’t address our desperate need to find ways to provide
older Americans with affordable means to pay for long-term care. SB 1932
is yet another example of Congress passing laws that diminish the ability
of seniors to live a modest and safe life.
Attorney Marshall can be contacted
at webmail@paelderlaw.com or
at 1-800-401-4552
The
Philanthropist Next Door
Written By:
William “Bill” Fox, Vice President for Philanthropic Services
First Community Foundation of
Pennsylvania
You
may associate the concept of philanthropy with names like Carnegie, Mellon
and Heinz, but did you know that you could be the
philanthropist next door?
You can make an impact in your own community, while
maximizing tax and estate planning benefits, and you do not need to be a
wealthy industrialist or a billionaire to do it.
You can establish your own community legacy simply by using your
community foundation for your charitable giving.
One of the fastest growing sectors of philanthropy,
community foundations use gifts of all sizes for the betterment of
residents of a specific geographic area.
Community foundations share common traits:
they use donated assets to create permanent, endowed funds that
generate grants to qualified charitable organizations and scholarships to
promising young people.
Establishing a fund at a community foundation differs
from making a gift to a nonprofit organization for a specific program.
Instead of spending donors’ dollars immediately, the foundation
creates endowed funds with the money.
Income from the funds is used for grants and scholarships, and the
principal continues to grow. Over
time, the donation will provide many times over the amount of the original
gift to the community.
Because community foundations are nonprofit
charitable organizations, gifts made to them are tax-deductible to the
fullest extent allowed by the IRS. The
foundations can accept many different types of gifts, making them a
flexible giving option for donors. Community
foundations may also offer professional gift planning expertise for
individuals and can work closely with their professional advisors as they
structure their gifts.
Gifts that
may be accepted by community foundations include:
·
Cash Gifts and
Memorials
·
Gifts of Appreciated
Assets
·
Bequests Via Wills
or Living Trusts
·
Gifts of Homes,
Farms and Vacation
Property
·
Gifts of IRA’s and
Retirement Accounts
·
Gifts of Life
Insurance
·
Charitable Gift
Annuities
·
Charitable Remainder
Trusts
·
Charitable Lead
Trusts
Donors also have many options to decide how the
community will benefit from their donation.
Funds that may be established at a community foundation include:
Unrestricted Funds
For donors who prefer to use the community
foundation’s knowledge of community needs, unrestricted funds award
grants to charitable organizations through the foundation’s competitive
grant process. Unrestricted
funds benefit a variety of causes, based on community needs.
Field of Interest Funds
Grants are made to benefit causes within a broad
field of interest (i.e. the arts, youth, animals, or the environment).
Designated Funds
Grants are made to a charitable agency, or agencies,
designated by the donor at the time of the donation.
Designated funds allow donors to provide perpetual income for their
favorite charities.
Donor Advised Funds
The donor or the donor’s fund representative(s)
make recommendations on grants. Donor
advised funds are ideal for individuals who want to stay connected with
their gift, or who want to involve their family in making recommendations
on grants.
Scholarship Funds
Income from these funds provides scholarships.
The donor may specify criteria for the scholarship at the time of
the gift.
So how can
a community foundation help you become the philanthropist next door?
By offering many options to donors, community foundations make
giving to your favorite causes easy and highly personalized.
The
First Community Foundation of
Pennsylvania
serves donors in Central and Northcentral
Pennsylvania
.
Bill Fox can be reached at the First Community Foundation of
Pennsylvania
at (570) 321-1500 or toll free (866) 901-2372.
For more information on the Foundation, visit its website at www.fcfpa.org.
End of Life Care for
Veterans
Written By:
Don Cohick,
Lycoming
County
VA
Coordinator
Do
you know how many veterans die each day? More than 1800 - about a quarter
of all deaths in
America
. About 85% of veterans do not
receive care through the VA health system: and most die in the community,
with only about 4% of them dying in VA facilities. Many of these veterans
could benefit from hospice or palliative care.
Can veterans access hospice
and/or palliative care?
Hospice care is part of the basic eligibility package for veterans enrolled
in the Veterans Health
Administration (VHA). (See Title 38 Code of Federal Regulations (CFR)
17.38(a) (1) (xi) (A). If
hospice care is appropriate for enrolled veterans, VA Medical Centers
either provide hospice care directly or purchase it from community
hospices.
All Medicare-eligible veterans, whether or not they
are enrolled in VHA, have access to hospice through Medicare.
Veterans not eligible for Medicare may have hospice benefits
through Medicaid or other private insurance.
However, like 90% of all Americans, most veterans
simply do not know that these options for hospice care exist.
Sometimes even VA and hospice providers do not know about all the
options: community hospices may know of the hospice units in VA
facilities, and VA facilities may not know about the service community
hospices can offer. Sometimes
there is some confusion about payment and how to work with each other.
Many VA Medical Centers have Pallative Care Consultation Teams.
Where can
veterans find hospice and/or palliative
care? Go to the
National Hospice and Palliative Organization’s website: www.nhpco.org.
Click on “Find a Provider” which is towards the right hand side
of the page. From there, you
can be guided to hospice(s) in a specific state or zip code, or by its
name.
What is a
Hospice-Veteran Partnership (HVP)?
In November 2001, to improve end-of-life care for veterans, the
Department of Veterans Affairs established the VA Hospice and Palliative
Care Initiative (VAHPC). One
of the programs launched by the VAHPC is the National Hospice Veteran
Partnership (HVP) Program, which is working with the National Hospice and
Palliative Care Organization, and other end-of-life care advocates to
develop a national network of HVPs.
HVPs are coalitions of community hospices, VA
providers, and organizations such as end-of-life care community
coalitions, and others working together to ensure that excellent care at
the end of life is available for our nation’s veterans and support is
available for their families. These
partnerships can be community-based or statewide and may function
independently or within existing structure.
Some HVPs are hosted by state hospice organizations or VA Medical
Centers, while others are coordinated by community end-of-life care
coalitions.
For further information and assistance, please contact Don Cohick,
Lycoming
County
VA
Coordinator at dcohick@lyco.org
or 570-327-2365.
Pennsylvania
to
Collect Premiums from Some Parents of Special Needs Children
Written
By: Attorney
Jeffrey
A. Marshall
,
CELA*
Under
Federal law, states have the option to provide Medicaid coverage to
children with physical and mental disabilities if the child needs an
institutional level of care but can receive that care at home.
Pennsylvania
is one of twenty states that have chosen to provide this benefit.
To receive benefits in this category, a child must
meet the level of disability established by the Social Security
Administration. This year
Pennsylvania
will spend almost $400 million to serve over 38,000 children with special
needs.
In the past,
Pennsylvania
generously allowed these special needs children to become eligible for
Medicaid benefits without consideration of their parents’ incomes.
However, Act 42 of 2005 directed the Department of Public Welfare
to begin to collect a premium from families if the custodial parent's
income is above 200% of Federal Poverty Income Guidelines.
Act 42 requires the Department to verify income of
the custodial parent of the child with a disability who is applying for or
receiving Medicaid. If the
custodial parent's total gross adjusted earned and unearned income is
greater than 200% of the Federal Poverty Income Guidelines, the Department
will collect a premium.
The Department has issued rules implementing these
provisions of Act 42. The rulemaking is available online at http://www.pabulletin.com/secure/data/vol35/35-53/2401.html.
The Department estimates Fiscal Year 2005-2006
savings to the Government will be $13.015 million ($5.813 million in State
funds) with annualized savings of $26.764 million ($12.130 million in
State funds) estimated in Fiscal Year 2006-2007.
The new premium requirements will not be immediately
effective because a waiver must be received from the Federal Government.
The waiver is required because Federal law does not otherwise allow
states to collect premiums for children who are determined Medicaid
eligible. It is anticipated
that the waiver will be received.
A copy of the Medicaid
for Children with Special
N
eeds
Monthly Premium Chart is
available on our website at http://www.paelderlaw.com/pdf/special_needs.pdf
Attorney Marshall can be contacted at webmail@paelderlaw.com
or at 1-800-401-4552
He Wrote the Book on
Elder
Law
:
Williamsport
Sun-Gazette
features article on Attorney Marshall’s new book
Attorney
Jeff Marshall has always had an affinity for older people – he loves to
hear their histories and the stories of their lives.
It wasn’t a surprise that when he moved his law practice “back
home” in 1980, that he decided to focus on planning for seniors. Back
then, the term “
Elder Law
” didn’t exist, but as Attorney Marshall began to counsel more and
more families about legal, financial and nursing home planning, word
slowly spread that there was a lawyer who understood the rules and could
help families struggling with nursing home costs protect their financial
security.
N
ow, after more than twenty-five years in practice and blazing the trail
for so many other elder law attorneys, Attorney Marshall has written the
book
Elder
Law
in
Pennsylvania
.
The
January 8th, 2006
edition of The Williamsport
Sun-Gazette
’s Business Section featured
an interview with Attorney Marshall about the book.
The entire article is available online at http://www.sungazette.com/articles.asp?articleID=1628.
More information about
Elder
Law
in Pennsylvania is also available at www.paelderlaw.com/book.html,
and from the publisher at www.pbi.org.
Back
issues of The
Elder Care Law Alerts
are available on our website.
You
can even search our site by a keyword
or phrase!
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colleague who would enjoy reading the
Elder Care Law Alert? If
so, please feel free to forward it to them. Simply use the “Forward” button on
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To subscribe or unsubscribe to the Elder Care
Law Alert,
simply send your request to:
webmail@paelderlaw.com
*Attorneys
Marshall and Parker are certified
as Elder Law Attorneys by the National Elder Law Foundation under
authorization from the Pennsylvania Supreme Court.
© 2000-2005
Marshall & Associates www.paelderlaw.com
