Top 10 Most Important Cuts to MassHealth for Seniors, the Disabled, and their Families

Continued from March 7th 2011

Here are the major cuts that impact our clients. The following is a link that has a more inclusive list of budget cuts..

http://www.massbudget.org/documentsearch/findDocument?doc_id=614&dse_id=1293

1. Restorative Dental Care

700,000 adults relied on MassHealth for restorative dental care in 2010. Just over 18% were seniors.

2. Reduction in Hours for Day Services to Disabled Adults

Coverage for day services has been cut from six to five hours a day.

3. Personal Care Attendant Services Limited

Many disabled adults require only limited assistance. For instance they might need help getting in and out of bed, dressing and bathing, but are otherwise self sufficient. The 2011 plan establishes a floor. If your need is less than 14 hours a week, you will no longer be eligible.

4. Prescription Advantage Cuts

$26 Million has been cur tom the Prescription Advantage program, Some low income elderly will no longer have subsidies for the portion of their prescription drug costs not covered by Medicare Part D.

5. Respite Services Cut

$12.7 Million in funding will be cut for respite and intensive family support services. These services support the family care givers. Giving parents of disabled children, or children of parents with disabilities support and a safety net.

Stay tuned for the last 5 next week…

Alternatives to Nursing Homes as Nursing Home Populations Swell With Younger Patients - Part 2

 

One of the main reasons cited for this movement of younger people into nursing homes are the budget cuts most states face in Medicare and Medicaid.  In the long term, it is more cost efficient to care for a younger person in their home with part time caretakers.  However, in the short term, this is a more expensive way of treating patients, as the caregivers need to be hired and trained.  In the budget crunch most states are experiencing, short term funding takes priority over long term spending.   Younger people are being moved into nursing homes earlier, as in the short term, this is a more economically viable way of treating them.

According to a study by the AARP Public Policy Institute, the cost of at home care is about a third the cost of providing care in a nursing home or institution.  Many states, however, simply do not have the funding for at home care in their Medicaid programs.

One of the most telling quotes about the movement of younger people to nursing homes is:

“Over the past 20 years, federal laws and policies have established a civil right to get long-term care at home. But NPR's investigation found that is only sporadically enforced.

More than 60 percent of what states spend on long-term care for the elderly and disabled goes to pay for people — like Michelle Fridley — to live in a nursing home. The amount spent on home-based care has grown steadily, but not nearly enough to meet the need. Nationwide, there are some 400,000 people on state waiting lists for home-based care, double the number 10 years ago.”

Frequently attorney’s like our firm, that specialize in caring for the elderly, and those that have long term care needs, must be engaged to support a patient’s right to at home care.  In 1999, the right to at home care was clearly established in the Supreme Court, in the “Olmstead Case”.   In that decision, the Supreme Court stated that the unnecessary institutionalization of people with disabilities is  a form of discrimination.

 

To be continued…

MEDCottage or Granny Pod–Part 1

 

MEDCottage

One of the things that the elderly hate the most and find really upsetting is to be moved from their familiar surroundings to a hospital or nursing home. The clinical, coldblooded ambience of a medical treatment center possibly makes the older lot a bit nervous and also tentative about their future.

Priests attending to older people have commented on this feeling and also opined that it appears that closeness to family members and access to their loved ones are most important issues. There was one lady in particular about whom Rev. Kenneth Dupin had talked about when discussing this aspect of caring for senior citizens. Katie was a happy old lady living in her own home, filled with mementos and artifacts from her past and she loved to talk of the days gone by. Rev. Dupin enjoyed listening to her anecdotes when he visited her, but the entire scenario changed when Katie was shifted to a nursing home some time afterwards.

Katie’s entire demeanor and happy attitude had just disappeared, which was noticed by Rev. Dupin when he went to see her at the nursing home. She begged and pleaded to be taken back home with tears running down her cheeks. She did not get the chance to go back to her beloved home, as she passed away in the nursing home, but the entire episode had a profound effect on Rev. Dupin. He was extremely moved by Katie’s attachment to her home and her deep melancholy at being moved to a nursing home, away from her loved ones.

In a talk with Audie Cornish of the National Public Radio (NPR) he said that Katie and her emotional outpourings had left him thinking about the entire subject of elderly people and their happiness in their last days. He was seriously wondering whether there was some way whereby older people could be kept closer to their families and out of places like hospitals and nursing homes. His concern is now being addressed as a new concept called “granny pods” that is gradually becoming an alternative for the housing of the elderly.

 

In Part 2 Cohen & Oalican, LLP talk more about the concept of “granny pods” or MEDCottages. Call our attorneys to see if this is an option for you and if  Medicaid covers it.

Cohen & Oalican discuss The UPC and guardians

Cohen & Oalican, LLP; Medicaid, MassHealth and Elderlaw Attorneys in Boston, Andover, Raynham.

Welcome to the Uniform Probate Code cont'd...

Reports

In the past, courts have only been involved in keeping track of the incapacitated person’s finances. Specifically, guardians and conservators were required to file annual accountings to show how they were managing the funds. The UPC directs the probate courts to create a new system to monitor guardians. Guardians are now required to file a report within sixty days of their appointment describing the person’s condition, living arrangements, what the guardian has done on behalf of the person, plans for future care and whether the guardianship should continue. The guardian is required to then file these reports on an annual basis. It remains to be seen how the courts will monitor whether these reports are being filed.

Special Guardians

If a guardian is not meeting his or her obligations and the incapacitated person is at risk, the court has the authority to appoint a “special guardian” to take over as the patient’s guardian for up to ninety days or longer if necessary.

This series, brought to you by Boston Attorneys Cohen & Oalican, LLP, specializing in Guardianship and Conservatorship Attorneys in Boston. Posted by Elder Law Boston Lawyer

Boston Elderlaw Attorneys, Cohen & Oalican, discuss the Deficit Reduction act

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Changes to MassHealth (Medicaid) laws...

Elder law attorneys Cohen & Oalican of Boston, Andover and Raynham want to alert you that on February 8, 2006, President Bush signed the Deficit Reduction Act of 2005, which significantly changes the federal Medicaid laws. The three most important changes concern: 1) the transfer of assets to qualify for Medicaid; 2) Medicaid annuities; and 3) Medicaid’s treatment of the primary residence. This article covers the changes in Medicaid annuities.

Annuities

Congress has also changed the annuity regulations. Medicaid allows a spouse whose assets exceed the Medicaid limit to protect those “excess assets” by purchasing an irrevocable, immediate annuity. The old Medicaid rules allowed the spouse to name anyone he or she wanted to receive the remaining annuity payments if the spouse died during the annuity term. Under the new rules, Medicaid requires that annuities name the Commonwealth of Massachusetts as the beneficiary. Although the revised statute is somewhat ambiguous, it appears that the Commonwealth can only seek reimbursement from the annuity for benefits provided to the community spouse. The new rule does not apply to annuities purchased prior to February 1, 2006. Buying annuities remains an effective strategy to protect assets for the spouse of a nursing home resident; however, the new rules have added a risk to this strategy.

This is third in a series regarding changes the Deficit Reduction Act of 2005 has made in dealing with Medicaid (MassHealth). Thank you for putting your trust in our Elder Law legal practice, Cohen & Oalican, LLP

Boston Medicaid Attorney "Answers Can I give away my assets?"

Many people want to know if they can give away their assets to protect them from Medicaid. The answer of course is it depends. The bottom line is that most gifts (even those under the IRS permitted $13,000 limit) will disqualify an applicant and their spouse for MassHealth benefits. However, there are many exceptions where MassHealth allows you to make gifts. For example you can transfer assets to a disabled child without any penalty. In addition, you can give your house to a so called caretaker child who lives with you and helps take care of you.
If you are thinking of making gifts, its best to first consult with an attorney at Cohen & Oalican.

This is fifth in a series of questions and answers regarding your legal rights dealing with Medicaid (MassHealth). Thank you for putting your trust in our Elder Law legal practice, Cohen & Oalican, LLP

Medicaid (MassHealth) Boston Attorney answers "If I apply for Medicaid is my house vulnerable?"

MassHealth regulations describe a home as a “non-countable” asset. This is a confusing label. Although MassHealth does not count your home in determining eligibility, this does not mean that the house is protected: far from it. MassHealth will not force you to sell your house to obtain eligibility. However, if the house is in your sole name (part of your so called “probate estate) at your death, the State will have a claim against the house and will either use a Medicaid lien or its powers of estate recovery to seek reimbursement against the house. For this reason, its important to meet with a Cohen & Oalican asset protection attorney to protect your home before you apply.

This is fourth in a series of questions and answers regarding your legal rights dealing with MassHealth, Medicaid. Thank you for putting your trust in our Elder Law legal practice, Cohen & Oalican, LLP

Boston Elderlaw Attorneys answer: What happens if my MassHealth (Medicaid) application is denied?

MassHealth looks for any reason they can to deny an application. Typical reasons for denials include: missing bank statement, missed deadlines, unexplained deposits or withdrawals or excess assets. At Cohen & Oalican we help clients with every step of the application process. We walk you through the process so that there are no surprises. We anticipate Medicaid’s questions and give them the information they need to accept the application as quickly as possible. Cohen & Oalican attorneys can know how to best describe your family’s assets to offer the maximum protection. If your application is denied we can quickly file an appeal to determine what your legal rights are and how best to move forward and get your application approved.

This is third in a series of questions and answers regarding your legal rights dealing with MassHealth, Medicaid. Thank you for your trust in our Elder Law legal practice, Cohen & Oalican, LLP