Walnut Creek Elder Law Blog

The VA Aid and Attendance Improved Pension Benefit can help pay for the costs of in home care, assistant living facilities and board and care homes for the older wartime veteran. A single veteran can receive up to $1,644 per month, or $19,736 per year. A widowed Spouse can receive up to $1,056 per month or $12,681 per year. This pension benefit is considered non service connected, meaning that you do not have to be suffering from a wartime injury to obtain the benefit.

This VA program is needs based, and your elder law attorney can help you qualify and apply for this VA benfit. When we plan for Aid & Attendance, we also plan for Medi-Cal qualification at the same time. The Medi-Cal qualification rules regarding gifting and transfer penalties must be taken into account when you plan for Aid & Attendance. If you do not do so, you may become qualified for Aid & Attendance, but disqualified for Medi-Cal. Medi-Cal pays for nursing home costs, which can run $7500 per month or more in Contra Costa County.

As part of the Aid & Attendance Improved Pension Benefit qualification, the VA now considers the veteran’s life expectancy in determining how much a claimant can retain in assets. If the veteran has over $50,000 in assets, not including the home, you may want to pursue transfers of assets and asset protection, and coordinate any such transfers with Medi-Cal transfer regulations. You should not transfer assets without the help of your elder law attorney, who is also certified by the VA.  

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for your particular situation. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

We do Alzheimer’s planning in our lawfirm. This type of long term care planning includes, in part, the preparation of estate planning documents. These specialized documents contain required, updated language for asset protection and government benefits planning regarding Medi-Cal and the VA Aid and Attendance Improved Pension Benefit. Part of the planning may also include asset protection of the home and monetary assets.  

However, a big part of Alzheimer’s planning involves working with the family of the loved one who is afflicted with this disease. Alzheimer’s disease can last many years, and our relationship with the families we represent can be very long. As an example, my mother in law, who has Alzheimer’s disease, and who turns 90 next month, has been in a board and care facility for the last 10 years. Other than the disease, she is fairly healthy for a 90 year old.  She does not recognize her three “girls”, but she is being well cared for.  

Currently, there is no cure for Alzheimer’s, but there are treatments and services that will make life more bearable for the Alzheimer’s patient, and his or her family.  We offer  support for our clients and their families, regarding resources for care as part of the  long term care planning. We also encourage our clients and their families to become knowledgeable about the disease. For additional information regarding Alzheimer’s planning, please feel free to contact our office.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for your particular situation. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

When finding a nursing home for your loved one is necessary, it is important to decide what is important for him or her. Things such as location, religious orientation and  access to hobbies should be considered. You should request brochures from several facilities you are interested in, and you should tour several of the the facilities. After you have narrowed your choices, plan on visiting the facilities during business hours, and during off hours. The atmosphere and staff may be quite different, and not what you expected during the off hours.

When you visit the facilities, pay attention to your instincts. Do you feel welcome? Did you have to wait to meet a representative? Did the representative seem genuinely interested in your particular situation? When visiting the facility, do not be afraid to ask as many questions as you can think of. If you are shy about asking questions, bring someone with you to encourage the questions, or they can ask the questions for you. Ask if the facility has survey results you can review, and ask if they have been prohibited from accepting new residents by the state at any time.

You will be under great stress at this time, so it is important that you take a deep breath and understand that there are positive things that you can do for your loved one. Also, do not neglect getting your ducks in a row through the help of an elder law attorney, regarding asset protection, estate planning, public benefits planning and long term care planning for your loved one. 

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for your particular situation. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

The VA Aid & Attendance Pension Benefit is available for wartime veterans or their surviving spouses. For 2011, a single veteran can receive up to $1,644 per month, and $1,949 if married. The widowed spouse can receive up to $1,056 per month. This benefit is most helpful for payment of in home care, assisted living facility and board and care costs.

For qualification, the VA takes into account, among other things, income and assets. If the applicant’s income and assets are too high, he may not qualify. That is where planning by your elder law attorney, who is certified by the VA, comes in. In addition, when we plan for the VA Aid & Attendance Pension Benefit, we also plan for Medi-Cal benefits at the same time. Medi-Cal pays for nursing home costs after your Medicare days are used up. Nursing homes in our area can cost upwards of $7,500 or more per month. If you plan for VA alone, without taking into account the more stringent Medi-Cal rules at the same time, you may become eligible for VA but ineligible for Medi-Cal.

Beware of being asked to purchase an annuity to qualify for VA. We have been informed by clients and others that there are annuity salesmen out there, who are also usually not certified by the VA, who will ask you to purchase an annuity for VA qualification. I understand that they usually do not tell you about the annuity at first. The purpose for the sale of an annuity, from a legal perspective, is at best unclear, and is generally viewed by the elder law legal community as unnecessary.  Your elder law attorney can best help you with asset protection and planning, within the Medi-Cal and VA regulations, without the sale of annuities. Medi-Cal also has stringent requirements about annuities, which could make the Medi-Cal applicant either ineligible for Medi-Cal, or require him to pay more than necessary in the share of cost, which money goes from the applicant to the nursing home.  We receive calls from individuals, and their families, who are quite angry that they have purchased an annuity for VA qualification, angry that they do not understand what the purpose of the annuity was, and would like to know how to reverse the process. Your elder law attorney, who is certified by the VA, can best help you with long term care planning, asset protection, VA and Medi-Cal qualification, and estate planning at the same time, legitimately and within the regulations.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney, who is certified by the VA, for professional advice.

When I was younger and people started to talk about their grandchildren, I would practically plug my ears. Now that we have two grandchildren, ages 4 and 2, I am the one who can’t stop talking about them.

So, since I can’t stop myself, I must tell you a story about my granddaughter, Edie. She will be 3 this coming September. Grandma and I were watching both grandchildren a few weekends ago, and Edie was on my lap. I was opening a package that came in the mail, and when I opened the package, bubble wrap came out. My granddaughter said to me, “BaPa, cut a small piece for me.” So I cut a small piece for her and said, “Like this?” She said, “Yes, not pop it! Pop it! Pop It!” I started to pop the little bubbles for her, and she couldn’t stop laughing. It made me laugh that she was laughting, and I was also laughing at how this little girl could give me orders which I would immediately comply with.

I felt like my life was made at that moment. My granddaughter and I were both happy and laughing. I was also astonished that this little girl at age 2  1/2 would know about these things and could tell me what to do like that! I just can’t imagine that other grandchildren are that smart. (ha ha)

I hope you didn’t plug your ears. Thank you, BaPa, Mike Young.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

This information is not to be taken as legal advice, and you are encouraged to see an elder law attorney for professional advice.

Most (perhaps 99%) of all revocable living trusts and financial durable powers of attorney are defective for asset protection and government benefits planning, when incapacity occurs.
 
For the older client, we become focused on how we will pay for in-home care,  board-and-care, assisted living facilities and skilled nursing home costs. We are concerned about how to make our assets last longer for our own care. We want to protect assets, and we would like to hopefully leave something to our loved ones.
 
We become concerned with how to qualify for and utilize Medi-Cal  and VA benefits for our care. 
 
The standard language in the revocable living trust and financial durable powers of attorney do not allow for asset protection, protection of the home from a Medi-Cal lien, transfers of assets between spouses (including the home), transfers to children or to other trusts for government benefits planning, if incapacity occurs.
 
Updating the revocable living trust and financial powers of attorney  before incapacity occurs is good planning. 

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

Most estate planning documents are prepared for what happens when we die. They are not prepared for what happens if we don’t die. With regard to the trust, if one spouse dies, for instance, everything goes to the other spouse. When the second spouse dies, everything goes to the children. During the lives of the spouses, all assets stay in the trust. If any gifting is allowed, it is not to exceed $13,000 per year per child. If there is no trust, the financial durable power of attorney will usually not provide for any gifting or asset protection.

But what if we want to do Medi-Cal or VA Aid & Attendance Benefit planning, and the makers of the trust or the makers of the financial durable powers of attorney have lost their mental capacities. For this planning, we at times will transfer assets, including the home,  from the ill spouse to the well spouse. We might also make transfers of various assets from parents to the children or to other loved ones.  The language to do this type of planning, 99% of the time, is not included in the typical estate planning documents. If the makers of the documents have lost their mental capacities, we cannot do this planning, and may have to go to court to reform the documents. As a result, long term care planning should include updating the estate planning documents to include government planning and asset protection language.

This blog is for informational purposes only and is not legal advice. You should consult an elder law attorney for your particular case, and before you proceed with any planning.

Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young serves Contra Costa and Alameda Counties, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

     Medicare is a Federal health insurance program. Social Security funds are used to pay the costs of the program. Individuals who are over the age of 65, and who have made Social Secuirty contributions during their working lives are entitled to benefits. Part A of Medicare pays for hospitalization, hospice and some health care. It also pays for rehabilitation in a nursing home for specific periods of time. Part B is designed to pay for outpatient hospital care and doctors’ visits. Co-payments, deductibles and monthly payments may be required for Part B.  

     If a person is hospitalized for three days under Medicare, and then goes into a skilled nursing facility (SNF), Medicare will pay pay 100% of the bill for up to 20 days in the SNF. After that, for days 21 to 100, Medicare will pay only for 80% of the cost. During this time, the Medicare recipient will be required to make a co-payment, through supplemental insurance or will pay privately.

    After 100 days, there is no Medicare coverage for a SNF. After that time, you must pay privately, pay through your long term insurance policy (if  you have one) , or qualify for Medi-Cal to pay for the SNF. The average stay in a SNF under Medicare is under 24 days. Medicare and Medi-Cal are two different programs, and are not related to each other.

     Planning for Medi-Cal qualification should be made early on, through your elder law attorney. There are qualification requirements with regard to assets, income,  spending down, gifting, and a share of cost which goes to the the nursing home. There are legitimate and legal methods through the Medi-Cal regulations to protect assets and create qualification for Medi-Cal. You may visit our web site at htt://WalnutCreekElderLaw.com, for information on how to plan for and how to qualify for Medi-Cal. The estate planning documents, including the financial durable powers of attorney and revocable living trust are usually updated to include government benefits and asset protection language. If a client loses mental capacity, and this language is not present in the estate planning documents, qualification for government benefits, including Medi-Cal, and asset protection is much more difficult.

 Written Michael J. Young, lawyoung1@gmail.com, elder law attorney in Walnut Creek, CA. www.WalnutCreekElderLaw.com mike@WalnutCreekElderLaw.com. 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. 925-256-0298. Mr. Young, who also advises on Medi-Cal qualification, asset protection, nursing homes and the VA Aid & Attendance qualification, serves Contra Costa and Alameda Counties in CA, including the cities of Walnut Creek, Alamo, Danville, Concord, Brentwood, Pleasant Hill, Antioch, Clayton, etc.

If you die after having been on Medi-Cal, the State can pursue a claim against your estate for recoupment of the money they paid to the nursing home. But, if there are no assets in your estate when you die, there will be nothing for the State to recover. The State will not pursue a claim however while the surviving spouse is alive. There are also exemptions if there is a minor, blind or disabled child of the recipient, living at the time of the recipient’s death.

 It is a common misconception that the revocable living trust of the recipient provides protection against a State lien. California will pursue claims against assets in living trusts. They will also pursue claims against joint tenancy interests and tenants in common, for instance. The amount of the potential recovery is limited to the amount of the benefits paid by Medi-Cal, or the value of the recipient’s estate, whichever is less. If your home is encumbered by a mortgage, this will reduce the available equity the State could pursue.

 An elder law attorney who is familiar with the Medi-Cal rules and regulations, can help you qualify for Medi-Cal, and can help you legally arrange your assets so that they will not be susceptible to a lien after you die. This process will also allow you to preserve your assets for a longer period of time while you are live. Remember, that if you run out of money, you run out of options.

 By Michael J. Young, Elder Law Attorney.

 Mr. Young practices elder law in Contra Costa County, and his office is located at 1931 San Miguel Dr., Ste., 220, Walnut Creek CA 94596. (925)-256-0298. He advises clients in cities such as Walnut Creek, Concord, Danville, Alamo, Antioch and Brentwood. You may visit his website at www.WalnutCreekElderLaw.com.  Mr. Young helps clients qualify for Medi-Cal benefits to pay for nursing home costs. He also helps clients qualify for the V.A. Aid & Attendance pension benefit for wartime veterans to help pay for in-home care. Many of Mr. Young’s clients are Alzheimer’s or Parkinsons’s disease patients.

Parkinson’s disease is a brain disorder, wherein certain nerve cells in the brain become impaired or die. These nerve cells, called “neurons” normally produce a chemical known as dopamine. This chemical allows for smooth, coordinated functions of the body’s muscles and movements.

When a high percentage of the brain cells which produce dopamine are impaired, symptoms of Parkinson’s disease may appear. Symptoms may include tremors, changes in facial expression, imbalance, small handwriting and slowness of movement. In time, the symptoms may become worse. Mild tremors can become more severe. Body movements may also become slower, and mobility problems may become worse. The use of eating utensils, dressing, and performing various activities of daily living may become more difficult.

Parkinson’s disease, which is difficult to diagnose officially, affects both sexes in equal numbers, and does not discriminate on the basis of ethnicity, social status or where you live. There are different rates of progression for the disease. We encourage our clients who have Parkinson’s disease and their familiy members to seek the help of support groups, to pursue ongoing medical care, and to learn adaptive techniques from medical professionals.

 Parkinson’s disease is the most common brain disorder, after Alzheimer’s disease, that we see with our clients. When symptoms of Parkinson’s disease appear, as with symptoms of Alzheimer’s disease, we receive inquiries from individuals who may have the disease, or from their loved ones. They want know what should be done now regarding the establishment of a long term care plan for the person with the disease.

We help clients review and update their existing estate planning documents, to be sure the documents contain the requisite asset protection language. We then help the family plan for long term in-home care, which is the preference of most of our clients. We help the family plan for the VA Aid and Attendance benefit, which can help pay for in home care, for veterans. We also help with planning for Medi-Cal benefits, which can pay for nursing home care.   

 If you or a loved one has symptoms of Parkinson’s disease, please feel free to call elder law attorney Michael J. Young, with offices in Walnut Creek, CA, at 925-256-0298. Mr. Young serves clients principally in Contra Costa and Alameda Counties. You can visit our web site at www.WalnutCreekElderLaw.com