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Advocacy Needed to Prevent Proposed Medicaid Changes in Illinois

The STAMP Act, HB 2840 just passed the executive committee  of the Illinois General Assembly and will go to the floor next.  If passed, the STAMP Act will dramatically cut the  Illinois Medicaid program. The Illinois Department of Healthcare and Family Services proposed many changes  incorporated into the Bill which will significantly restrict Medicaid eligibility of seniors for long term care coverage. 

 Please click here to read more and learn how you can help.

Medicaid, Spousal Impoverishment and Same-Sex Couples

SAGE, the country’s largest and oldest organization dedicated to improving the lives of lesbian, gay, bisexual and transgender (LGBT) older adults has published a booklet on  Medicaid, Spousal Impoverishment and Same-Sex Couples.

Click here to go to the SAGE website for the guide and other helpful information.

One of the Practice Areas of  the law firm of Dutton & Casey is Medicaid planning. For information on we can assist you, or someone who you love, please click here.

Medicare D

Just a reminder, Medicare beneficiaries have until December 7 to enroll in, or change, Medicare D coverage.

For Resources on Medicare D, please go to www.medicare.gov; www.medicareinteractive.org; www.insurance.illinois.gov/ship

How to Tell When Your Parents Need Help…

How Do I Know When My Parents Need Help?

As your parents age, you may begin to wonder or worry: “Are they safe at home? How can I tell if they need help?” Your parents are independent, private people who are not going to share with you incidents that make you think they are not okay. They do not want to go to a nursing home and lose their independence. They love their home and enjoy being in it. So they are not going to tell you the things that happen that may send them to a nursing home. As a matter of fact, they will hide these issues from you. They are afraid of going to a nursing home, and this is a rational fear. They have seen their friends and neighbors placed into facilities when their health begins to decline. All of their possession are sold or given away, the home they have spent years in is sold, they can no longer sleep in if they feel like it or eat whatever and whenever they want; their losses are great. You need to acknowledge that this is a rational fear, something that may happen to them that can be unpleasant.

The following is a list of indicators for change. Observing any of these things happening does not mean your parent cannot live at home. What it does mean is the situation needs to be assessed. Professional or informal and volunteer services can be put into place to allow your parent to stay in their home safely.

  • Unexplained weight loss
  • Falls, accidents or bruises
  • Forgetting food on stove (look for burned or scorched pans)
  • Unpaid bills or utilities being shut off
  • Housekeeping decline: dirty walls, floors, windows or bathtub
  • Unable to maintain home; broken items not being repaired over long time
  • Refrigerator and cabinets empty; not enough food
  • Unable to recognize or react to danger
  • Getting lost or locked out of the house
  • No longer able to transfer independently from bed to wheelchair
  • Incontinence
  • Lack of social support
  • Decreased interest in fun or social activities
  • Medication errors
  • Increased emergency room visits
  • Wearing dirty clothes
  • Needs to reminded to bathe; has dirty hair or personal odor

For more infomation, please click here

Medicaid Protection for Same-Sex Couples

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.

 Click here to read the entire article.

Increase in Prevention of Spousal Impovershment Standards for 2012

The amounts for 2012 of monthly income, and total assets, that a person can keep when their spouse enters a long-term care nursing hom, supportive living,e or needs the services of the Illinois Community Care Program (CCP) and federal financial assistance is used to help pay for these services have been released.

Click here to read more.

Resource: Chart of Benefits by Income Level – October 2011

New, updated Chart of Benefits. Here’s a breakdown of the updates:

  • Income levels for LIHEAP increased September 1, 2011. Clients have 2 options- Percentage of Income Payment Program (PIPP) or Direct Vendor Payment (DVP)
  • Income levels for the Weatherization program increased effective September 1, 2011
  • Income levels for SNAP will increase effective October 1, 2011
  • Income levels for Illinois Cares Rx decreased effective September 1, 2011
  • Illinois Cares Rx-Basic is for those who are under 65 and do not have Medicare or for those who are 65 years of age or older and are not a U.S. citizen or qualified non-citizen
  • Illinois Cares Rx- Plus is for those with Medicare or those without Medicare who are 65 years of age or older and  a U.S. citizen or qualified non-citizen
  • Seniors who want the Free Ride program must qualify by income effective September 1, 2011

 

To download the Chart of Benefits, please click on the path below to access the document on AgeOption’s website:

http://www.ageoptions.org/newsandviews/documents/ChartofBenefits-October2011.pdf

Update: Illinois Medicaid

On September 13, 2011, the Joint Commission on Administrative Rules (JCAR) again considered the comprehensive new Medicaid regulations proposed by the Department of Healthcare and Family Services (DHS) which in part implement the requirements of the federal Deficit Reduction Act provisions affecting Medicaid eligibility.  DHS released revisions of its proposed rules to the public on Friday, September 9, 2011, giving advocates little time to consider the revisions.  JCAR had the option of lifting its prohibition or continuing it.  Due to the remaining concerns of the elder law bar and others, JCAR announced that it was continuing the prohibition and directed DHS to sit down and negotiate with the interested parties.  On September 28, 2011 JCAR staff, Julie Hamos, Director of DHS and her staff members met with various members of the elder law bar to negotiate some of the controversial provisions.  As of now, it is not certain whether DHS will adopt all or some of the proposed revisions suggested by the elder law bar.  If JCAR does not lift its prohibition in its October meeting on October 11,   2011, the proposed regulations will expire and DHS will need to start over in the future.  Director Hamos has suggested that if this occurs, that she will take the matter (implementation of the Deficit Reduction Act) to the Illinois General Assembly for passage in the form of a statute.  Stayed tuned next month – Illinois may or may not have new Medicaid regulations in place.

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.

Event: Elder Law Update

In this session, Attorney Janna Dutton will update you on two important subjects…New Power of Attorney Act and DRA. Bring your questions!

Date: September 15, 2011 – 830-10am

Location: Terrace Gardens Assisted Living, 8415 North Waukegan Road, Morton Grove, Illinois   60053

Registration: There is no cost to attend this program. However, advanced registration is required. Call 847-470-4550 or email tbischoff@bethanymethodist.org by September 12, 2011. Seating is limited.

Continuing Education: 1.5 hours of credit will be awarded to LPC, LCPC, LSW, LCSW, and RN. Credits provided by Silver Connections.

Planning for a Hospital……Discharge

An admission to, and a discharge from,  the hospital can be scary for the patient, and the family. The National Family Caregiver Alliance published a guide on the hospital discharge process. It is vital to pay attention, and be involved, in the plans being for when your relative leaves the hospital.

read the entire article.

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The law firm of Dutton & Casey concentrates in assisting older adults, people with disabilities, and their families. Many times, plans following a hospital stay also include the need for legal planning.  With over 50 years in expertise and offices in Chicago, Skokie, Arlington Heights, and Vernon Hills, the advocates at Dutton & Casey are available to assist. Please click here to read more about how we can assist you or those you care about.

Family Caregiver Training in Arlington Heights Illinois

Training Tips for the Caregiving Marathon, Speaker: Daniel Kuhn, LCSW

May 18, 2011     7:00-8:30 p.m.

Arlington Heights Senior Center, 1801 Central Road, Arlington Heights, IL

 Please call Kathy Peck at (847) 253-5500 ext. 375 to reserve your seat

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For assistance with the legal planning that is involved with being a family caregiver, please contact the law office of Dutton & Casey. Kathryn Casey is an experienced elder law attorney who sees clients in our Arlington Heights office. For more information or to schedule an appointment, please go to www.duttonelderlaw.comor email us at contact@duttonelderlaw.com

 

YOUR Elder Law Connection… From Dutton & Casey

The April, 2011 issue of the newsletter from the Law Firm of Dutton & Casey was published today.

Please take a few minutes to read the newsletter… it contains many helpful articles and resources focusing on older adults, adults who have a disability, and the people who care about them, including family members and professionals.

Should there be any questions on the newsletter, to learn more about the many resources that the attorneys and staff can provide, or/and to schedule an appointment with a firm attorney, please go to https://www.duttonelderlaw.com/

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.