Walnut Creek Elder Law Blog

This is a brief list of exempt assets for Medi-Cal qualification. Your home is generally exempt, and you can take steps to protect your home from a Medi-Cal lien after your death. Your household goods and personal belongs are exempt. You can have an exemption for one car. Term life insurance policies are excluded, but you cannot have more than a total of $1500 cash value in the policies.  You can keep your IRAs and other “qualified accounts.” You can only have $2,000 of non qualified assets. 

This is a brief synopsis of exempt assets, and of course planning and applying for  Medi-Cal is much more complicated than is presented here. In addition, if you are a wartime veteran or the surviving spouse of a wartime veteran, you should consider planning and possibly applying for the VA Aid & Attendance Pension Benefit. Planning for the VA Aid & Attendance Pension Benefit should be coordinated with your planning for Medi-Cal benefits. Your elder law attorney, who is also certified by the VA, can help you with planning for both benefits. 

This blog is written by Michael J. Young, Elder Law Attorney, for informational purposes only and is not legal advice. You should consult an elder law, government benefits and asset protection attorney for your particular case, and before you proceed with any planning.

For additional information you can go to Mr. Young’s website at  www.WalnutCreekElderLaw.com . You can send an e-mail to Mr. Young at mike@WalnutCreekElderLaw.com. His address is 1931 San Miguel Dr., Suite 220, Walnut Creek, CA 94596. Phone: (925) 256-0298. Mr. Young has clients in Contra Costa and Alameda Counties, including the cities of Walnut Creek, Pleasant Hill, Concord, Antioch, Bay Point, Alamo, Danville, Clayton, etc. Mr. Young advises clients regarding Medi-Cal, nursing homes, asset protection, the VA Aid and attendance pension benefit, and long term care planning. Mr. Young is a member of NAELA.

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.

In California, civil and criminal Elder Abuse Laws pertain to persons 65 years of age or older. Under the criminal statutes, elder abuse can occur when someone causes the elder to suffer mentally or physically. Under the civil statutes, abuse can mean neglect, causing financial abuse, abandonment, and physical harm or mental suffering. In addition, under the civil statutes, elder abuse can mean deprivation of care by the custodian of goods or services that the elder needs to avoid mental suffering or pain.

There are red flags to be on the outlook for regarding possible elder abuse, which many of us have seen. One red flag could be that the older person is not given the opportunity to speak for herself. Another red flag could be that the care giver or family member expresses anger toward the elder. A painful red flag is the isolation socially, of the older person. If you see signs of elder abuse, you should report it.

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 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.

It is highly recommended for the older person, that their estate planning documents be put in place as early as possible, in order to help guard against elder financial abuse. It is when the older person begins to show signs of a loss of mental capacity, that financial predators step in to take advantage of the older person. We have been seeing more and more of this lately, possibly because of a downturn in the economy.  

Older persons should consider preparing their estate plans right away, especially for instance, if there are beginning signs of dementia, a diagnosis of Parkinson’s disease or cancer, or if the older person has fallen. You will be able to pick who you know and trust as your health care agent and agent under your financial durable power of attorney while you still have good mental capacity.

If you are uncomfortable with appointing family members for these rolls, consider appointing a professional fiduciary. California has a rigid licensing program for professional fiduciaries, and they can be used in these positions in order to avoid financial abuse. Professionial fiduciaries are able to assist early on with bill paying and money management.

Unfortunately, the highest percentage of financial abuse and exploitation of the older person, involves the elder’s family members. Many times it is a child who has been dependent for support on the older parent. This child is usually unemployable, in financial straights, won’t work and many times has substance abuse problems. Many times they will badger their parent into giving them money. The parent gives in, just to get them off of his or her back. I have seen children who are completely exasperated that their parents are living so long! The children want their inheritance now, and don’t see why they should have to wait!

Other signs of elder financial abuse can include large bank withdrawals that the older person cannot explain, or a new friend or housekeeper gaining access to bank accounts. Another sign of problems is that bills are not being paid.

When the estate planning documents are being prepared, also consider asset protection and government benefits planning language to be included in the various documents. If the older person loses capacity, the asset protection plan can still be implemented.

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.

     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.

When choosing an assisted living facility for a loved one who suffers from dementia, certain things should be taken into account regarding the facility. More and more assisted living facilities can now accommodate residents with various levels of dementia. Some facilities have separate wings or dementia units. I have visited many assisted living facilities, and have many clients with loved ones in assisted living facilities. In addition, I have made personal observations about the quality of care for persons with dementia in these facilities.

Music: My wife’s mother, who is 89, has advanced Alzheimers disease, and has been in an assisted living facility for a number of years. Although she does not seem to recognize her children, she does respond very positively to music. When music is played for her, or if someone performs or sings for her, her face lights up. She smiles, and tries to sing. I have noticed this for many residents with dementia, when I have played jazz piano for them in various facilities. Also, on researching the subject, it seems that music is processed and understood through a different part of the brain, usually with positive results.   As a result, find out if the facility you are interested in arranges for music to be played or performed for the residents on a regular basis.

Religious Services: Another item to take into account, is whether the facility is consistent with your religious beliefs. If the resident and family are religious, it will be important for them to have the facility provide religious services for their loved one during all phases of dementia. When my father, who was Catholic, was in an assisted living facility,  I know that he cherished receiving communion every week.  

Behavior: Find out whether the facility will be able to accommodate your loved one during all stages of the disease process. Plan for the future, as the disease may progress and become worse. Ask the facility what behaviors would trigger them to say that they can no longer accommodate your loved one. Also, ask how they would handle the behavior of your loved one if he or she becomes aggressive, loud, or acts out. You will find out more if you are very specific.  

 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.

The surviving spouse of a wartime Veteran may be eligible for the VA Aid and Attendance Pension Benefit. This benefit can help pay the costs of in home care, board and care and assisted living facilities for the surviving spouse. We must be able to show that the surviving spouse had been married to the Veteran for at least one year, or had children by the Veteran if married less than one year.

The surviving spouse is not eligible if he/she has remarried. Also, the surviving spouse must have been living with the Veteran at the time of the Veteran’s death, unless they were separated because of  medical or military reasons. The Veteran must have a discharge from the military that is other than dishonorable.  The pension rate for the surviving spouse may be as much as $1,056 per month, or $12,681 per year. 

Each VA claim is different and unique, and there are never any guarantees that any claim will be granted by the VA. When we plan for the VA Aid and Attendance Pension benefit, we also plan for Medi-Cal at the same time. Both benefits have different qualification rules, which must be coordinated.

This blog is general in nature, 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, 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.