Can I Get Paid To Care For an Elderly Family Member?

As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many.

The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving.

Seeing a need to give support to family caregivers the federal government Administration on Aging created the National Family Caregiver Support Program.

State Area on Aging division manages this program on the state and community level to offer support services that include:

§  Information to caregivers about available services;

§  Assistance to caregivers in gaining access to supportive services;

§  Individual counseling, organization of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their roles;

§  Respite care to enable caregivers to be temporarily relieved from their care giving responsibilities; and

§  Supplemental services, on a limited basis, to complement the care provided by caregivers.

Medicaid Cash & Counseling Program:

A Medicaid approved assistance program called Cash & Counseling may be used to provide funds to hire personal care aides as well as purchase items or services, including home modifications that help them live independently.

The PayingForSeniorCare.com website gives the following information about the program:

"For Medicaid eligible seniors, the process begins with an assessment in the home to determine the senior's home care needs; this includes interviews with caregivers and possibly the senior's physicians. A determination of how many monthly care hours are required is made. The benefit amount is calculated using that determination and cost of care for that geographic area. This amount can be increased or decreased as the senior's needs change. A family care giver may need to qualify as a home health aid by the state to receive these funds."

This program is executed by each individual state Area on Aging Services division. It is a relatively new program and is not yet available in all States. Check with your state Area on Aging Services department for availability.

Using the Veterans Aid and Attendance Pension Benefit:

A totally overlooked source of money to pay family caregivers to provide care at home is the Aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,949 a month in additional income to pay family members to provide care at home.

Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place, a physician medical evaluation done, income and asset qualifications met and proof of medical expenses provided. Submitting the correct forms and documentation can easily be completed with the help of a VA Accredited Consultant who understands the process.

Long Term Care Insurance Benefit:

If the senior being cared for has a long term care insurance policy that covers home care, payment to the care giver from this source could be arranged. Some policies require the care provider to be through a licensed home car agency, but others will pay for individual aides certified as such. This would require some training by the family member to become certified. There are policies that pay a daily benefit amount to the insured to use as they want to pay for their care. Check with a long term care insurance professional about types of policies.

Caregiver Contract:

In some cases the senior parent has the funds to pay for care. If a family member is giving care it is very important that a caregiver contract be in place. A signed and dated agreement will outline the services provided as well as the amount of pay for these services. The contract will eliminate questions about what is expected from both parent and caregiver as well as providing a legitimate contract and payment record of services to qualify for Medicaid.

Attorney John L Roberts, in his article titled "Caregiver Contracts that Protect Elders and Their Family Members" states:

"A written Caregiver Contract is a good idea for every family that wants to protect family harmony, and make sure everyone in the family understands how care is being provided to an elder.

The family member who provides care can save an elder from needing nursing home services, and may also protect assets if nursing home care is needed in the future. Elders who want to cover all of these bases must have a written Caregiver Contract. Whenever adult children and other family members are providing valuable care, only a written agreement will protect assets from nursing home care costs and qualify the elder for Medicaid."

In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.

This can also be set up by an elder law attorney at the time the contract is done.

Final Note:

Taking the time to create the caregiver contract, research the government and state services that are available to caregivers and using community resources will make the family caregiving experience less stressful.

 To learn more about Medicaid and VA Benefits in Tampa or Brandon, Florida,  please contact the Law Offices of Laurie Ohall today.

A 'Do It Yourself Will' may be an inexpensive route, but...

A potential client called my office to discuss the probate of her mother’s home now that the mother has passed away.  She told me how she prepared a Will for her mother to sign (she’s not an attorney or paralegal – she just used a form she found on the Internet) and how the Will states that, at death, the homestead should be sold with the proceeds being distributed among all the children (there are 6 of them).  She also mentioned to me that her mother was receiving Medicaid benefits before she died.

...And, therein lays the problem.

In Florida, a person’s homestead is exempt from forced sale by creditors and this exemption passes to your heirs at law (i.e., your blood relatives) so that creditors of your estate cannot force the sale of the home to be paid what they are owed.  The home will pass free and clear (unless there is a mortgage) to the family, the family can sell the house if they choose to and then split the proceeds.  So, why is there a problem with this potential client’s situation?

The daughter prepared a “do it yourself” Will for her mother, and thought she was doing everyone a favor by drafting language into the Will requiring that the house be sold with the proceeds being split amongst the children.  If the mother would not have had a Will at all (i.e., died “intestate”), the house would have gone through probate, been transferred into the kids’ names, and they could have sold it and split the proceeds.  Or, mom’s Will could have just stated that “all the rest, remainder and residue” goes to the children and the house would have gone through probate and into the names of the children.  However, because the Will requires that the house first be sold, Florida case law is pretty clear that this subjects the proceeds from the sale to creditors’ claims, meaning that, before the money can be divided amongst the kids, the creditors can file claims against the estate and collect on their share.  And, that means that Medicaid’s lien must now also be paid back (which would not have happened if the Will had been drafted properly).

So, what have we learned?

There are reasons why you go to an elder law attorney to prepare your Will (and Durable Power of Attorney, and Living Will, and Health Care Surrogate) because they know what should and should not be in the document.  They can weigh the pros and cons of things you might want in your Will and can tell you the legal reasons for why you should or should not have a particular provision in your Will.  Please, don’t do it yourself.  

Laurie Ohall is a board certified elder law attorney practicing in Brandon, Florida.  Contact Ms. Ohall today if you are in need of estate planning, elder law, probate or guardianship assistance.

For over 20 years, Laurie Ohall has been serving the legal needs of Tampa Bay area families. Ms. Ohall is a Florida Board Certified Elder Law Attorney, and is also licensed in the state of Ohio.  It is her mission in the practice of law to protect, honor and educate her clients.  She advocates on behalf of her clients in the areas of Medicaid Reform and resident’s rights (in ALFs and nursing homes). She also provides clients with comprehensive estate planning including wills, trusts, and advanced healthcare directives, and gives Tampa area seniors and their children piece of mind as they navigate Florida Elder Laws. Her blog is updated regularly to educate Florida residents about the laws affecting seniors, estate planning and probate.

(813) 438-8503   1127 Nikki View Drive,  Brandon FL 33511

I recently read an article in Kiplinger’s Personal Finance entitled “The Money Talk You Must Have” (November, 2013) written by Jessica Anderson.  In this article, she discusses the fact that, as you age, and your children age, it is important to discuss the issues of inheritance, estate planning and long-term care.  I most definitely agree.  I am amazed by the number of clients who are very secretive with their children about what assets they have and what kind of planning they have done (or not done).  The number one reason parents do not want to discuss their estate planning with their adult children is because they do not want their children counting on a huge inheritance.

Why is this such a scary conversation to have?  I guess I could understand if you do not have someone you could trust to handle financial decisions, but most clients that come to see me DO trust their kids.  So what is stopping them from having the conversation?

Your Finances and Your Children

Ms. Anderson cites a 2012 Fidelity study that shows the number one reason parents do not want to discuss their estate planning with their adult children is because they do not want their children counting on a huge inheritance.  I always tell my clients they should spend it all and enjoy it while they can, and hopefully, they bounce the check to the funeral home on the way out (just kidding)!  Personally, I believe that people do not want to have these discussions with their children for the same reason they put off having their estate planning done in the first place – because they do not want to think about their mortality.  Who does?

The fact of the matter is that, the more informed your children are, the easier you will make it on them when you are no longer around.  While I can certainly understand the need for privacy, it is important for your adult children (or whomever you are appointing to make financial decisions for you) to know where the important documents are kept (even if you do not want them to know what is in those important documents).  They should know that you have actually taken the time to do a Last Will and Testament, a Durable Power of Attorney and a Living Will/Health Care surrogate designation (the Big 3 as I call it).  And hopefully, you think to do these while you are still young and healthy and there is no disputing that you have the ability to make these decisions.

And just think what a good example you will be setting for your kids!

For over 20 years, Laurie Ohall has been serving the legal needs of Tampa Bay area families. Ms. Ohall is a Florida Board Certified Elder Law Attorney, and is also licensed in the state of Ohio.  It is her mission in the practice of law to protect, honor and educate her clients.  She advocates on behalf of her clients in the areas of Medicaid Reform and resident’s rights (in ALFs and nursing homes). She also provides clients with comprehensive estate planning including wills, trusts, and advanced healthcare directives, and gives Tampa area seniors and their children piece of mind as they navigate Florida Elder Laws. Her blog is updated regularly to educate Florida residents about the laws affecting seniors, estate planning and probate.

(813) 438-8503   1127 Nikki View Drive,  Brandon FL 33511

Meet Laurie E. Ohall:

Link: The Law Offices of Laurie E. Ohall

Laurie Ohall is a Florida Board Certified Elder law attorney who has been practicing law since 1994. She concentrates her practice in the areas of estate planning and elder law which includes the related fields of asset protection planning, probate, guardianship and trust administration. Ms. Ohall is Of Counsel at the law firm of Browning, Meyer and Ball Co., LPA.

Ms. Ohall is a member of the Florida Bar (1994) and the Ohio Bar (2010) and is also admitted to practice in the United States District Court for the Northern, Middle, and Southern Districts of Florida. She is a member of the Brandon Bar Association (Past President, 2009 – 2010, Treasurer 2010-2011), the National Academy of Elder Law Attorneys (NAELA), and the Academy of Florida Elder Law attorneys (AFELA). She is also a section member of the Real Property, Probate, and Trust Law Division and the Elder Law division of the Florida Bar, and serves as co-chair of the Resident’s Rights Committee for the Elder law section. Ms. Ohall is also a Board member of the Momentum Festival, Inc., a not-for-profit committed to raising money for local charities.

Ms. Ohall graduated in 1991 from Stetson University with a Bachelor of Arts in Psychology and received her Juris Doctorate in 1994 from Stetson University College of Law. She served as a Teaching Fellow in Legal Research and Writing while in law school at Stetson University College of Law.

Ms. Ohall has published several articles related to estate planning and asset protection and she is a speaker in the elder law, estate planning and probate related fields for the National Business Institute. She is also a frequent lecturer at community events for topics related to estate planning basics, Medicaid and VA benefits.

Medicaid: Transitioning from Skilled Nursing to Assisted Living.

If you have a loved one who is being cared for in a skilled nursing facility and is receiving Medicaid benefits, and that person no longer needs to be in skilled nursing (but cannot live on their own or is unable to come home), they may be able to transfer to an assisted living facility and qualify for Medicaid without having to be on a waiting list.  Unfortunately, the Medicaid program that pays for care in assisted living  typically has a long waiting list and it is hard to get benefits under this program (while the program that pays for skilled nursing care does not have a waiting list).

There is a little known rule under the Medicaid rules known as the "60-day Transition Rule" which allows a nursing home resident to move from skilled nursing to the community (whether that be back home or into assisted living) and qualify for Medicaid without having to be on the waiting list.  Unfortunately, most nursing home and assisted living facility administrators do not know about this program or how it works because the Department of Elder Affairs and the Agency for Health Care Administration have done nothing to get the word out about this program.  And, if you do not follow the exact rules for this program (which is also not well-known), you could lose Medicaid services and be placed on the wait-list for the Medicaid Diversion programs.

It is important to note that, in order for this program to work, the applicant must have been in skilled nursing for 60 consecutive days.  Next, the applicant (or his/her representative) must contact the CARES unit (CARES stands for "Comprehensive Assessment and Review for Long-Term Care Services" and is Florida’s federally mandated pre-admission screening program for nursing home applicants) in their area to open a transition case.  It is up to the CARES caseworker to determine whether the person can be safely discharged into the community.  Once the application is approved, the applicant can transition into an ALF and does not have to go on a waiting list to receive Medicaid Diversion services.

Although this sounds complicated, with the help of a qualified Elder law attorney, your loved one may be able to make the transition from skilled nursing back into the community either to their home or assisted living and still be able to receive some Medicaid benefits.  Contact Laurie Ohall, Board Certified Elder law attorney, for further questions.

Meet Laurie E. Ohall:

Link: The Law Offices of Laurie E. Ohall

Laurie Ohall is a Florida Board Certified Elder law attorney who has been practicing law since 1994. She concentrates her practice in the areas of estate planning and elder law which includes the related fields of asset protection planning, probate, guardianship and trust administration. Ms. Ohall is Of Counsel at the law firm of Browning, Meyer and Ball Co., LPA.

Ms. Ohall is a member of the Florida Bar (1994) and the Ohio Bar (2010) and is also admitted to practice in the United States District Court for the Northern, Middle, and Southern Districts of Florida. She is a member of the Brandon Bar Association (Past President, 2009 – 2010, Treasurer 2010-2011), the National Academy of Elder Law Attorneys (NAELA), and the Academy of Florida Elder Law attorneys (AFELA). She is also a section member of the Real Property, Probate, and Trust Law Division and the Elder Law division of the Florida Bar, and serves as co-chair of the Resident’s Rights Committee for the Elder law section. Ms. Ohall is also a Board member of the Momentum Festival, Inc., a not-for-profit committed to raising money for local charities.

Ms. Ohall graduated in 1991 from Stetson University with a Bachelor of Arts in Psychology and received her Juris Doctorate in 1994 from Stetson University College of Law. She served as a Teaching Fellow in Legal Research and Writing while in law school at Stetson University College of Law.

Ms. Ohall has published several articles related to estate planning and asset protection and she is a speaker in the elder law, estate planning and probate related fields for the National Business Institute. She is also a frequent lecturer at community events for topics related to estate planning basics, Medicaid and VA benefits.

Top 10 Reasons People Procrastinate about Estate Planning

 Link:Top 10 Reasons People Procrastinate about Estate Planning

Are you guilty, as most American adults are, of putting off your estate planning? As an estate planning attorney, I've heard all of the excuses as to why --

1. They are intimidated by the process. Estate planning does not have to be intimidating – you just need to know what to expect. Most attorneys will have you fill out a questionnaire that lists your assets and liabilities and asks you questions like, “Who do you want to appoint as your personal representative of your estate” or “Who do you want to appoint as your agent under a Durable Power of Attorney?” You should come prepared to the initial consultation with any documentation you want the attorney to review, or any questions you have for the attorney. The attorney will review your goals and make suggestions or recommendations. The consultation generally takes one to two hours, and then there is a follow-up meeting to sign your planning documents which takes about an hour. It’s pretty simple.
2. They just don’t care. Some clients tell me that they intend on spending every dime before they die, to which I say, “Go for it!” However, what about the things that could happen to you before you die? What if you become incapacitated? Who will pay your bills? Make healthcare decisions on your behalf? Estate planning is not about planning for death, it’s also about planning for incapacity.
3. Not sure who they’d appoint as personal representative, agent under a power of attorney or health care surrogate. Certainly, these can be tough decisions, but that’s not a good reason to procrastinate. If you do not have family that you can trust, look to your friends, a pastor, a bank representative, a trust company, or even your own attorney.
4. Think they are too young. Remember Terri Schiavo? She was 26 years old when she suffered cardiac arrest which left her in a vegetative state. If she would have had a durable power of attorney, living will and health care surrogate designation, you may never have heard of her. Her situation is the perfect example of how you are never too young (if you are an adult) to do your estate planning.
5. Think it’s too expensive. The cost to do your estate planning really depends on what area of the country you live in, and whether you choose to have an attorney prepare the documents. You could “do it yourself” by purchasing software, or buying forms from your local office supply store. However, if you have a complicated situation, it might be smarter to utilize the services of an attorney.
6. They don’t have time. The process doesn’t really take that long (see #1 above), but you have to make the time to fill out some paperwork and meet with an attorney (or answer the questions on software if you are going to do it yourself).
7. They don’t think they have enough assets to worry about it. As I’ve already stated, the Last Will and Testament (which governs what happens at death) is not the only document an individual should have. You need to appoint someone who can deal with your finances and health care decisions should you be unable to do so, and that’s where a Durable Power of Attorney, Living Will and Health Care surrogate designation come in. These documents allow you to appoint someone that you trust to make financial decisions and health care decisions for you in the event that you become incapacitated and while you are still alive.
8. They think it will get done when they are gone. Notwithstanding what I’ve already covered regarding incapacity issues that could arise prior to death, yes, it very likely will get taken care of after you are gone. However, if you do a little planning, you could make it easier on your loved ones.
9. It’s too complicated (so they stick their head in the sand). It doesn’t have to be complicated, and if you think it is, see #1.

     10.They don’t want to think about their mortality. Ok, that I understand. Who wants to think about their mortality? No one that I know. However, once you’ve accomplished the process, you will have peace of mind knowing that your affairs are in order!