Articles Posted in Caregiving

Medicare helps seniors pay for a whole host of mental health treatment services, including both inpatient and outpatient treatment services to help diagnose and treat mental health conditions. Depending on the type of care needed, beneficiaries may incur some out of pocket costs, including deductibles, and are subject to some limitations on the length of treatment you can receive at in patient centers.

Medicare Part A will cover inpatient mental health services at either a psychiatric hospital or a general hospital, depending on the type of care determined by the primary care doctor. Medicare will cover up to 190-days of treatment at a psychiatric hospital during a person’s lifetime and may cover additional inpatient care at a general hospital if necessary.

When receiving inpatient care with Medicare Part A, beneficiaries will need to pay an out of pocket deductible before they enter the facility. As of 2018, that cost is estimated to be $1,340. After paying the deductible, Medicare Part A will pay the first 60-days of inpatient treatment in full. The next 30-days require the patient pay a daily co-insurance of $355 and the remaining 90-days require a daily co-insurance of $670.

If you have a beloved elder who currently needs or will eventually need long term, in-home health care, you need to know about new changes to federal labor laws that may not only raise the cost of these services but potentially alter quality aspects. In addition to federal labor and wage laws, state and even local laws may impact what you pay for in home health care and who provides it.

When a person suffers from dementia, alzheimer’s, or or another cognitive health condition, he or she will likely need the aid of a home health care aide to provide even the most basic of care needs. For many years, home health care providers who also lived in the patient’s home were subject to different portions of the federal Fair Labor Standards Act (FLSA) which made them exempt from overtime and would essentially earn less than minimum wage because the individual was expected to be on call even during the evening.

However, a recent legal decision determined these in-home health care workers were not overtime exempt and must be paid one and a half times their average hourly wage when working more than 40-hours per week. This meant that it became economically feasible for many families to maintain constant care to their loved one from a familiar person that could be counted on to provide attentive, individualized service to the patient.

The Trump administration recently issued a directive to revoke the Temporary Protected Status (TPS) for tens of thousands of immigrants from poverty stricken countries living in the country, many of whom who have found roles in the home healthcare market. With the cost of in-home and assisted living facility growing every year, the change could potentially add to those costs and put seniors and the disabled in a more difficult financial situation.

Approximately 59,000 Haitians came to live in the United States after the 2010 earthquake which devastated the country. Nursing homes and in-home care providers are already reporting staffing shortfalls as immigrants who found employment in their sectors have returned home for fear of forced deportation after losing their legal status. Even despite the threat of deportation, many immigrants working in nursing homes and as in-home health aides do not stay long in these jobs as they find professions in much higher paying sectors of the economy.

In Boston, Massachusetts for example, some elder care providers are speaking out about the selfless, hard work that their immigrant employees living on TPS status perform for long hours and modest pay. With many coming from nations where the witnessed humanitarian crises and seek to give back as part of the aid they themselves received in their times of need.

The dream of Americans is to age with dignity and independence while enjoying their golden years with family and friends and avoiding the need for any type of long term institutionalized care. However, trends in aging show that more and more Americans these days are relying on some type of intermediate institutionalized care before eventually moving into a nursing home to receive the attentive services they need.

However, despite receiving an estimated $10 billion in federal funding from the Centers for Medicare and Medicaid Studies (CMS), states encounter little oversight from regulators over the quality of care residents receive. Furthermore, over half the states do not report “critical incidents” to the federal government that include unexplained deaths, abuse, neglect or financial exploitation. All of that is according to a recent report from the Government Accountability Office (GAO).

Advocacy group Justice for Aging issued its own response to the GAO report to highlight the lack of accountability from many states and facilities receiving CMS funding. The directing attorney for Justice in Aging went as far as to point out that even among the 22 states that do provide the federal government with data on critical incidents the information is hard for the public to obtain and may not even illuminating enough.

The U.S. Department of Justice recently announced hundreds of indictments against individuals engaged in often elaborate schemes to defraud hundreds of thousands of elders across the country. The Justice Department said in a statement that it levied charges against over 250 defendants for their roles that contributed to an estimated $500 million in total financial damages against victims.

“Today’s actions send a clear message: We will hold perpetrators of elder fraud schemes accountable wherever they are,” Attorney General Jeff Sessions said in announcing the charges at a press conference. The Department of Justice coordinated with dozens of federal and local agencies to make the arrests, including working with Federal Bureau of Investigations, the Federal Trade Commission and state attorneys generals.

The perpetrators of the scheme allegedly used everything from mass mailing system and telemarketing schemes to identity theft to commit financial crimes against some of the most vulnerable portions of the population. In the past several years, the Senate Aging Committee received thousands of calls from individuals complaining they were either victims or an attempted target of some type of elder fraud.

Retirement is a time to relax and enjoy the things you have worked hard for all of your life. For many people, that means spending more time at the golf course or spoiling grandchildren. For others, it means adventure and traveling to places they have always wanted to go. In many cases, a person or couple’s objectives in retirement can best be met by retiring abroad. Whether you are doing so for the cost of living, to be closer to family, or just because you want to there are important considerations to keep in mind when it comes to your comprehensive estate plan.

Taxes

No matter what country they live in, citizens of the United States are still required to pay taxes to Uncle Sam. If you maintain residence in a state, that state may also continue to impose taxes on you. While you would likely be paying those taxes if you remained in the United States, living abroad could also subject you to taxes in the host country. That means you may face issues of double taxation, and that can have a significant impact on the assets you retain within your estate.

The co-founder of Americans Against Abusive Probate Guardianship recently organized a town hall meeting about guardianship.  The topic of the meeting is the increasing number of guardianship cases occur in which guardians take money from a loved one’s estate. This concern comes at a time when other states like Nevada have made multiple arrests of guardians who were accused of abusing their relationship with an incapacitated individual.  In addition to a lack of enforcement by the law of elder abuse, the meeting discussed the other inequalities that are occurring in the system.

The Types of Elder Abuse

Financial abuse is just one type of elder abuse. The Center for Disease Control and Prevention consider elder abuse to include any intentional act that has the potential to harm a person who is 60 years of age or older. 1 in 10 senior citizens are reported by the Center for Disease Control to be subject to elder abuse. Some of the common types of elder abuse are:

While none of us expect to become so ill we cannot manage our own affairs, we should nonetheless prepare contingencies in case these types of situations arise out of an injury, old age, or another unexpected event. One of the most important types of planning we can do is to create a financial power of attorney to allow a trusted person to manage money for health care and and lifestyle to ensure we continue to live comfortably with dignity.

 
With a financial power of attorney, an individual can perform many duties on your behalf such as making bank deposits and withdrawals, paying bills, manage government benefits, and watch over any financial investments. Income and finances are an incredibly important part of our lives and need continuous oversight to ensure there are no interruptions that could negatively impact our ability to provide for ourselves.

 
In New York, any competent person may serve as your agent to manage your finances. While legal and financial management experience are always a plus, the individual creating the financial power of attorney need only choose a capable and trusted person, depending on the situation he or she may find themselves in. When and for how long the financial power of attorney lasts depends entirely on the wording of the document.

New York’s Surrogate’s Courts handle a wide variety of civil issues, mostly related to trusts and estates, guardianship, and adoption. The Surrogate’s Court is established in every county in New York, helping to provide residents with timely and effective due process for legal issues under the court’s jurisdiction. The following is a brief overview of the types of cases the Surrogate’s Court handle and what individuals can expect from the proceedings.

Probate – Probate proceedings deal with the process validating the last will and testament of a deceased person, if the individual created such a document. A last will and testament are the final directions given by the deceased to allocate his or her to estate to heirs and other beneficiaries.

It will be the responsibility of the person named as the executor of the estate to file the will with the probate office of the Surrogate’s Court, collect all the necessary documents, pay off creditors, and finally divide assets of the estate among beneficiaries per the wishes of the deceased.

In New York state, individuals can place their estate into a trust to distribute to beneficiaries and thereby avoid lengthy and costly probate proceedings in a Surrogate’s Court. While a traditional last will and testament may be better for some individuals, for many it may be best to create some form of a trust, particularly a living trust, to ensure loved ones receive their portions as quickly as possible and with as little tax liability.

It is also worth noting that even after creating living or inter vivos trusts, you will still need a last will and testament to ensure any of your final wishes are carried out and assets left out of the trust are dealt with as you see fit. Without a will to cover newly acquired assets or those not named in the trust, the remainder of your estate could considered in intestacy and pass on to your heirs in succession under New York law.

While creating a trust is a fairly straightforward affair, it may still be necessary to consult with financial advisors or an estate planning attorney to ensure proper transfer of your assets. The first step will be to create the trust and there are many resources from the New York State Bar and Surrogate’s Court system online you can go to for forms and information how to file.

Contact Information