Articles Tagged with NYC elder law

A recent report by Fidelity Investments indicates that couple’s may need to put away even more in their retirement over the coming years to cover the cost of their health care. According to the report, a married couple retiring this year at the ages of 65-years old would need a staggering $280,000 saved away to pay for the cost of their health care over the remainder of their lives, a 2 percent increase over the previous year and a 75 percent increase from Fidelity’s first estimate of retirement health care costs in 2002.

Fidelity estimates that on average, men will need a total of $133,000 for healthcare expenses in retirement, while a woman would need about $147,000 because of their longer life expectancies on average. The company’s estimates are based on calculations that may shift due to fluctuations in the economy as well as changes in how the federal and state governments regulate the healthcare market.

“Despite this year’s estimate remaining relatively flat, covering health care costs remains one of the most significant, yet unpredictable, aspects of retirement planning,” said Shams Talib, executive vice president and head of Fidelity Benefits Consulting. “It’s important for individuals to educate themselves and take steps while working to ensure they are prepared to address these costs. Otherwise, people risk having to dip into more of their savings than originally anticipated, potentially impacting their overall retirement lifestyle.”

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.

Your last will and testament is an incredibly important legal document needed to ensure New York probate courts carry out your final wishes and ensure your heirs receive the portion of your estate so delegated. After going through all of the careful considerations of consulting with family, speaking to an estate attorney, and drafting a will, testators need to take care in storing the original copy of the document to ensure the estate passes as swiftly as possible through probate courts and make the process easy on the executor.

Testators have numerous options to keep the original executed copy of their will safe. Often times, the last will and testament remains in the office of the probate attorney who helped craft the document. Other times, testators may choose to keep the document in a safety deposit box at a bank or another custodian of records. In any case, the executor of the estate needs to know the will’s location to pass the estate through probate.

Under New York probate laws, if the original copy of the last will and testament cannot be found, the court presumes the testator intended to destroy and revoke the document. Proving anything to the contrary can be extremely difficult and time consuming and the court may order an executor take custody of the will in keeping the chain of succession in New York state law. Furthermore, the Surrogate Court hearing the case will most likely not enter a copy of the will.

When planning for our later years, forward thinking individuals often wonder what is the best way to spend down their assets to qualify for Medicaid but still live a comfortable and dignified life until services like nursing care are absolutely needed. With the value of real estate skyrocketing over recent decades, homes that were just a few thousands dollars may put homeowners in a financially difficult spot now that the property is worth many times the initial investment.

Under federal Medicaid laws, individuals may only have a net worth below a certain level, including things like homes and automobiles in some cases. Often times, seniors need to “spend down” their assets to qualify for the invaluable services Medicaid provides and many individuals may attempt to give away homes or spend down savings accounts to qualify. However, Medicaid has a “look back” period that can last a few months, meaning seniors may be penalized for recently giving away assets or spending bank accounts before applying for coverage.

One solution which may be effective for some is to create a “life estate” with their home. By doing so, seniors can own, live in, and exercise full control over their home and simply pass it on to a beneficiary like a child once they pass. With the help of an estate planning attorney, individuals can create the life estate with the deed to their property and create a “remainder interest” for the person who will receive the property, known as the remainderman, upon the deceased’s passing.

Most folks never believe they or their elders could be the victim of financial exploitation by a family member or a caretaker but the truth is that every year, millions of well meaning or vulnerable individuals find themselves taken advantage of. Even independent and acute elders can find themselves fleeced by scammers over the phone or a seemingly trusted individual charged with ensuring their wellbeing.

However, with some careful planning and vigilance we can help safeguard ourselves and our loved ones from the malicious intentions of someone pretending to be someone they are not. Often times, warning signs pop up that can alert us to foul play and give us the opportunity to intervene before unscrupulous individuals unjustly enrich themselves.

Many situations of financial exploitation against elders involve family members such as adult children or another close person engaged in life care. Sometimes, these caretakers feel entitled to large portions of an individual’s wealth for rendering the care and attention needed for the elder to live a comfortable and dignified life. While there is nothing wrong with someone rewarding a child or a close individual for watching over them when needed most, some individuals may take matters into their own hands to see their inclinations through.

Individuals with disabled family members understand the many obstacles life can put in front of them and their family, especially when it comes to finances. For many, having a permanent disability can mean being unable to provide for oneself and that can mean relying on benefits from social welfare programs to get by. However, many of these programs have strict income thresholds that can exclude potential beneficiaries if they earn too much money or have too much capital.

Fortunately, New York is one of several states that allow disabled persons and their families to create special savings accounts to help maintain the person’s health, independence, and quality of life. The New York Achieving a Better Life Experience (NY ABLE) helps supplement but not supplant benefits provided through Medicaid, SSI, SSDI, private insurance and other sources and is exempt from om tax on its earnings and distributions, provided the funds are used to pay for qualified disability expenses.

The laws creating the ABLE statute was signed into law by Gov. Andrew Cuomo in December 2015 and is federally authorized by the federal Stephen Beck, Jr. Achieving a Better Life Experience (ABLE) Act enacted on December 19, 2014, as Section 529A of the Internal Revenue Code. The NY ABLE program is administered by Office of the State Comptroller in consultation with specific State agencies and individuals appointed by legislative leaders, as specified in the NY ABLE statute.

In New York, patients have the right to make many decisions about their end of life care and even appoint a representative to do so in their interests if circumstances leave them unable to make such decisions for themselves. Using what is known as a Medical Orders for Life-Sustaining Treatment (MOLST) form, patients can create a doctor’s order that informs physicians and emergency care givers whether to administer treatment like CPR or place the individual on ventilator or other life-saving equipments.

MOLST forms can be used in combination with a do not resuscitate (DNR) order to help give patients the most control over how their health care is delivered in an emergency situation or at the end of life where tough decisions must be made. In order for the MOLST form to be valid, the document must be signed by your physician and yourself, otherwise doctors may continue to deliver treatment during and emergency. The form will become a part of your medical file and will transfer over to whatever facility you may be treated at.

The main difference between a MOLST and DNR order is the former covers a broader range of care doctors may deliver, including intubation, administering antibiotics, and interesting feeding tubes, with DNR orders only cover administering CPR. Often times, patients using a MOLST face a life-threatening medical condition or lives in a long term care facility like a nursing home or hospice.

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