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The New Illinois Power Of Attorney Act And How It May Affect You

On July 1, 2011, the new Illinois Power of Attorney Act will go into effect. Existing properly executed Illinois powers of attorney will remain valid; however, one may want to consider revising existing powers of attorney to make the most of the amendments to the Act. For any adult 18-years-of-age or older who does not have in place properly executed powers of attorney, this is a good time to obtain them.

Tools to Help Choose a Good Nursing Home

By Carolyn M. Clancy, M.D.

December 6, 2011

Finding a high-quality nursing home for a family member is a daunting task.

Many people have not had to make this decision before. And it’s often made under stress, when asking good questions and thinking carefully about your options are harder than usual.

Fortunately, more information is available that can help you learn about nursing home quality and prepare you to make a well-informed decision.

Start this process with an online tool from the Federal Government called Nursing Home Compare. This lets you look up nursing homes in your area by name, city, county, State, or ZIP Code. First unveiled in 2009, Nursing Home Compare has detailed information on every nursing home certified by Medicare or Medicaid.

Nursing homes are rated using a 1- to 5-star scale, with those earning 5 stars being rated the highest. Ratings are based on how many and what type of staff members they have, how well they perform on health inspections, and how they rank on quality measures. Ratings for each measure are given individually and are also combined into an overall rating.

Starting in 2012, Nursing Home Compare will include a new measure that includes input from the nursing home residents. This new information will take the place of the quality measures that currently appear on Nursing Home Compare. Findings will be part of the ratings starting in April 2012.

Staffing and health inspection data add important information and will continue to be a factor in each nursing home’s overall rating. The staffing measure tells you the average staffing levels—such as the number of registered nurses, licensed practical nurses, and certified nursing assistants—for each resident each day. This is a good benchmark, but it has limits. It does not show the number of nursing staff present at any given time or describe the amount of care give to any one resident. The health inspection measure looks at many major aspects of care in a nursing home. This includes how medicines are managed, whether food is prepared safely, and whether residents are protected from inadequate care. Inspections take place about once a year, but they may be done more often if the nursing home has several problems to correct.

Even with so much good information, the Nursing Home Compare tool and rating system won’t answer all of your questions. For example, the ratings won’t tell you if the nursing home has improved, or gotten worse, in certain areas since it was rated. That’s why it’s important to visit any facility you are considering. Be sure to ask questions of the staff, especially people who provide care to residents. It’s also a good idea to visit a nursing home a second time on a different day of the week and another time of day. You may get a better idea of changes in staff, activities, and other factors that could make a difference in your choice.

An excellent list of questions to ask during such visits is available from a nursing home checklist (PDF File; PDF Help) by the Centers for Medicare and Medicaid Services (CMS). And a new handbook (PDF File; PDF Help) from CMS explains how to pay for nursing home care, describes residents’ rights, and gives alternatives to nursing home care. Another good resource is your State ombudsman; select to find yours.

click here to read more.

Who Are We?

Dutton & Casey, PC (Elder and Disability Law)

Advocates for Elders, Persons with Disabilities, and their Loved Ones.

The law firm of Dutton & Casey, P.C., is committed to serving our clients with the comprehensive and personally tailored service they need and deserve. With 50 years of combined legal experience, we have acquired the depth and breadth of knowledge necessary to address the full scope of elder law and disability issues. 

Our Areas of Concentration:

  • Medicaid Eligibility
  • Elder Abuse, Neglect, and Financial Exploitation Litigation
  • Estate and Disability Planning
  • Guardianship
  • Litigation
  • Mental Health Law
  • Probate Administration
  • Public Benefits
  • Special Needs Planning
  • Trust Administration

* Full Time Social Worker/Certified Care Manager On Staff

Office Locations:

Arlington Heights, Chicago, Skokie, and Vernon Hills, Illinois.

Phone / Video Conferencing  Appointments are also Available.

Contact Information:

Telephone:      312-899-0950 or 847-261-3584

Website:          www.duttonelderlaw.com 

 

-please click here for a flyer on the law firm.

Medicaid Spousal Impoverishment Protections for Same – Sex Civil Union Partners

When one partner in a long-term relationship needs expensive long term care, often the only way for the couple to pay for it is to look to Medicaid. Historically, there have been no spousal impoverishment protections afforded to partners in same-sex relationships when one partner needs long term care and applies for Medicaid. However, the combination of the new Illinois Civil Union Act and a policy change recently announced by the U.S. Department of Health and Human Services ensure that Medicaid spousal impoverishment protections are afforded to Illinois same-sex civil union partners.
On April 1, 2011, U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced that, effective immediately “[t]he Centers for Medicare & Medicaid Services will notify states of their ability to provide same-sex domestic partners of long-term care Medicaid beneficiaries the same treatment as opposite-sex spouses in the contexts of estate recovery, imposition of liens, and transfer of assets. This includes not seizing or imposing a lien on the home of a deceased beneficiary if the same-sex domestic partner still resides in the home. It also includes allowing Medicaid beneficiaries needing long-term care to transfer the title of a home to a same-sex domestic partner, allowing the partner to remain in the home.” In additional to these protections, the partner in the community is allowed to receive assets, in addition to the home, from the nursing home partner in an amount sufficient to bring the community partner’s assets to the Community Spouse Asset Allowance standard – presently $109,560. The community partner may also be eligible to receive income from the nursing home partner when Medicaid is paying for that partner’s long term care.
The new Civil Union law which became effective on June 1, 2011 provides that a “party to a civil union” is to be included in any definition used in state law where the term “spouse,” “family,” “immediate family,” “dependent,” “next of kin” and other terms that denote “spousal relationship” are stated. The Civil Union Act stops short of granting same-sex couples the right to “marry”; however, it does guarantee “[a] party to a civil union … the same legal obligations, responsibilities, protections, and benefits as are afforded or recognized by the law of Illinois to spouses.
The Civil Union Act in Illinois mandates that the Illinois State Medicaid agency, the Department of Healthcare and Family Services, treat partners in civil unions the same as married partners. The federal Medicaid agency, the Department of Health and Human Services, is allowing states to treat same-sex partners as opposite sex spouses for purposes of Medicaid. Therefore, same-sex partners in Illinois Civil Unions should be afforded Medicaid spousal impoverishment protections if Medicaid coverage of long term care becomes necessary for one of the partners. Dutton & Casey, P.C. is available to represent civil union partners needing long term care in accessing Medicaid and Medicaid spousal impoverishment protections. Please note, federal Medicaid spousal impoverishment protections apply to the Medicaid programs covering nursing homes and assisted living (supportive living) facilities, as well as to the home based services program, the Community Care Program, administered by the Illinois Department on Aging.

Changes in Medicaid: Special Needs Pooled Trusts Still Available for Seniors

Since we published last month’s Proposed Chages in Medicaid article, outlining a few ways in which Illinois is attempting to change its rules on Medicaid eligibility, you may wonder what hasn’t changed about qualifying for Medicaid benefits in Illinois.  One method of Medicaid eligibility that Illinois has contemplated eliminating entirely, but still currently allows, is the special needs pooled trust for disabled people over the age of 65.

Ordinarily and generally speaking, to qualify for Medicaid, a person cannot own more than $2,000.00 in assets, a home, a car and a prepaid funeral.  Medicaid is intended to provide healthcare coverage for the indigent blind, disabled and aged.  However, one shortfall of this policy is that the indigent disabled usually have special needs and those needs are not met through Medicaid coverage.  To correct for this shortfall in policy, the federal government allows disabled people to qualify for Medicaid even though they have more than $2,000.00 in assets as long as they place those excess assets into a special needs trust.  That special needs trust can then be used to pay for the disabled person’s special needs which are not covered by Medicaid.  Special needs can include special medical and dental equipment, therapies, treatments, pharmaceuticals, custodial and companion care, clothing, personal products and transportation.  For a disabled person living in either the community or a long term care facility, a special needs pooled trust can increase quality of life enormously.  

While the federal government allows disabled people to hold their excess assets in a special needs trust and to use those assets to pay for their special needs, the government does impose some limitations.  For instance, the funds in the special needs trust can only be used for the benefit of the disabled person and any funds remaining in the trust at the end of the disabled person’s lifetime must be used to pay back the bill Medicaid has incurred providing benefits for the disabled person.  Those limitations are minor considering the benefit a disabled person receives from being able to preserve and use their own funds during their lifetime while still qualifying for Medicaid coverage.  The special needs trust is an exceptional tool to prevent the complete impoverishment of the disabled and it is very fortunate that Illinois has not yet attempted to eliminate this important option for disabled people over the age of 65.

For more information on how to prepare a special needs pooled trust, or for other questions you may have in the face of the proposed changes to Medicaid eligibility, contact the experienced elder law attorneys at Dutton & Casey, P.C. at www.duttonelderlaw.com or (312)899-0950.

HHS Launches New Consumer Focused Health Care Website

There are a lot of pieces to the health care puzzle, and you are not alone in wishing that information regarding affordable health care coverage was located in a centralized location.  In fact, enough people seemed to be interested in the same thing, because at the beginning of July, the U.S. Department of Health and Human Services unveilied an innovative new on-line tool that will help consumers take control of their health care by connecting them to new information and resources that will help them access quality, affordable health care coverage.  Called for by the Affordable Care Act, HealthCare.gov is the first website to provide consumers with both public and private health coverage options tailored specifically for their needs in a single, easy-to-use tool. 

HealthCare.gov  helps consumers take control of their health care and make the choices that are right for them, by putting the power of information at their fingertips,” said HHS Secretary Kathleen Sebelius.  “For too long, the insurance market has been confusing and hard to navigate.  HealthCare.gov makes it easy for consumers and small businesses to compare health insurance plans in both the public and the private sector and find other important health care information.”

HealthCare.gov is the first central database of health coverage options, combining information about public programs, from Medicare to the new Pre-Existing Conditions Insurance Plan, with information from more than 1,000 private insurance plans.  Consumers can receive information about options specific to their life situation and local community.

In addition, the website will be a one-stop-shop for information about the implementation of the Affordable Care Act as well as other health care resources.  The website will connect consumers to quality rankings for local health care providers as well as preventive services.

“This website is unlike any government website you have ever seen or used before,” said HHS Chief Technology Officer Todd Park.  “It was developed with significant consumer input and is remarkably easy to navigate.  This is despite the sheer volume of content it offers consumers: billions of health care choices through the insurance finder and more than 500 pages of new content, all of which is designed to grow with ongoing consumer feedback and as our health care system improves.”

As the health care market transforms, so will HealthCare.gov.  In October, 2010, price estimates for health insurance plans will be available online. In the weeks and months ahead, new information on preventing disease and illness and improving the quality of health care for all Americans will also be posted.  The website also includes a series of opportunities where users can indicate whether pages were helpful to them and we will continue to seek user feedback to grow and strengthen the site. 

“People need to see what choices are offered, what options cost, and how coverage works in practice,” said Karen Pollitz, Deputy Director for Consumer Support, Office of Consumer Information and Insurance Oversight. “Today HealthCare.gov takes an important first step in that direction.  In the coming months and years, we will add pricing and plan performance information so that consumers can see and understand and make meaningful choices about their health coverage.”

For information on how you can plan ahead to finance long-term care for yourself or your loved one, contact the experienced elder law attorneys at Dutton & Casey, P.C. at www.duttonelderlaw.com or (312)899-0950.

Haven’t Completed Your Census Form? It’s Not Too Late!

Have you been counted? Complete and return your census form… it seems like such a simple item, but as estimated 48 million households have not sent their’s back this year.  Why do it?  Well, the information the census collects helps to determine how more than $400 billion dollars of federal funding each year is spent on infrastructure and services like:

  • Hospitals
  • Job training centers
  • Schools
  • Senior centers
  • Bridges, tunnels and other-public works projects
  • Emergency services
  • and many other programs

If you haven’t recieved a census form, received one and can’t find it, or thought your information didn’t count and threw the form away, please call 1-866-872-6868 or go to 2010.census.gov to complete the census today.  It only takes about 5-10 minutes, but could help your community get the funding it needs.

The Patient Protection and Affordable Care Act

Late into the day on Wednesday, November 18th, Senate Majority Leader Harry Reid ( Dem.- NV) unveiled the proposed health care reform bill senate leaders plan to bring to a floor debate at the end of November. The bill, named the Patient Protection and Affordable Care Act, is a combination of the health bill approved by the HELP (Health, Education, Labor and Pensions) Committee and the Senate Finance Committee bill.

Key elder issues:

  • Nursing Home Transparency and Improvement
  • The Elder Justice Act
  • Criminal Background Checks on Long-Term Care Workers
  • The CLASS (Community Living Assistance Services and Supports) Act 

According to the NCCNHR, there’s no word yet on whether Senator Reid has enough votes to pass the bill, but he is expected to call for a procedural vote by this weekend.

Keeping up with all the recent health care reforms and bills can be quite a task. Luckily, Senate leaders prepared an overview and section-by-section analysis of the Patient Protection and Affordable Care Act.  Click here to view it.

For more information on how these proposals will affect-term care planning for yourself or a loved one, contact the attorneys at Janna Dutton & Associates.

11/23 UPDATE: On November 21st, the U.S. Senate Democrats got a “fililbuster proof 60 votes that will allow them to bring their version of health care reform to the Senate floor for debate.”  While the vote is considered historic, the passage of this bill is in no way a sure thing.  Read here for complete details from the Examiner.com.