David Cutner named as eCareDiary Expert

Add comment December 17th, 2014 10:55am Cynthia P. Kuster

We are pleased to announce that founding Partner David Cutner has been invited to serve as an expert for the “Expert Q&A” section of the eCareDiary website. eCareDiary describes itself as
“a web community created based on the founders’ experiences as caregivers for their parents … [it is] a centralized place to help families with care coordination, offering comprehensive online tools, expert content and resources.” Here is a link to the eCareDiary website: ecarediary.com.

“Expert Q&A” is an interactive online community within eCareDiary.com. It is intended to engage family caregivers to ask questions about any aspect of caregiving and eldercare, and to create a collaborative site for weighing options. The caregivers can respond to the experts’ answers with their own thoughts and insights. Numerous areas of expertise are included, such as Dementia, Care Providers, Cancer, Depression, Finances, Fall Prevention, Legal, Long Term Care, Successful Aging and End-of-Life issues.

Aging is a natural part of life, but it comes with complications. Having experts available to answer questions in a variety of fields can be extremely useful. Lamson & Cutner can answer your Elder Law questions on the eCareDiary web site, or by contacting us directly.


Add comment December 8th, 2014 12:29pm Kristina A. Slifkin

CaringBridge is an invaluable resource for families experiencing a major health challenge with a loved one (i.e. hospitalization, home with an illness). CaringBridge allows you to create a website (at no charge) to keep everyone in the loop with updates on health status, test results, visiting hours and other related news. You can gain access to relevant information regarding the loved one, share updates and offer words of encouragement. You can also use it as a vehicle to coordinate and schedule tasks such as meal delivery and arrangement of transportation. It’s a non-profit organization that serves more than 500,000 people each day. The organization is committed to using technology to amplify love, hope and compassion.

Please visit www.CaringBridge.org for more information.

Recalculating Your 2015 Pooled Income Trust Monthly Deposits

Add comment December 1st, 2014 11:10am Tracy Connors

Good news for approximately 64 million Americans who receive monthly Social Security and Supplemental Security Income (SSI) benefits: there will be an increase of 1.7% for 2015. For New York State Community Medicaid recipients, this also means they need to recalculate the monthly deposit to their pooled income trusts.

When New York State Community Medicaid recipients receive a Social Security Award letter, pension letter, or any other official information which indicates there has been an increase in their monthly benefits, they need to recalculate the monthly deposit to their pooled income trusts. The Medicaid system receives notification of the increases to Social Security benefits and applies them to each recipient’s budget.

To calculate the additional surplus that needs to be deposited to the pooled income trust, the Medicaid recipient should add the gross amounts of their monthly income such as Social Security, pensions and other forms of income, then deduct their monthly supplemental health insurance premium and Medicare Part B premium, and also subtract the 2015 Medicaid allowance. We suggest cushioning the net result with additional money in case there are any unexpected increases in income. The end result of these calculations will be the amount the recipient should deposit every month into the pooled income trust.

Social Security Increases for 2015

Add comment November 25th, 2014 10:26am Caitlyn McStay

The Social Security Administration has announced that Social Security benefits will increase by 1.7 percent in 2015, which translates to an average increase of $20.00 for the typical Social Security recipient. The 1.7 percent cost of living increase will become effective on January 1, 2015, but recipients should expect to receive a new Social Security award letter in the mail this December. For Medicaid recipients who are utilizing a pooled income trust, it is important to factor this adjustment into your income calculations for 2015. If you have questions about how this increase may affect you, contact an Elder Law attorney for more information.

Community Based Long Term Care: Home Care and Assisted Living Facilities

Add comment November 17th, 2014 03:26pm Julia M. Greenberg

A large percentage of senior citizens will reach a point where living alone is no longer safe and prudent. An elderly person who is living alone is exposed to many risks and dangers that could lead to injuries such as trips and falls. Living alone often compounds depression, anxiety and feelings of loneliness and social isolation. The senior may forget to take her medication, leave the stove on, or have difficulty bathing herself.

When such a change occurs, the senior and her loved ones must consider the best course of action.

The first option, for someone who is self-directed and wants to remain in her own home, is to hire a home care attendant. A home care attendant can provide assistance with activities of daily living, such as dressing, grooming, toileting, cooking and cleaning, in the comfort of the senior’s home. Seniors who feel isolated can attend adult day care centers and other senior programs in order to engage with others and remain socially active in their communities.

Another option is to move to an assisted living facility. Assisted living facilities are housing alternatives for seniors who choose to reside in a more supported environment. Assisted living facilities have amenities that provide for a broad range of senior’s needs in a holistic setting. The support of the staff and the companionship of fellow residents can greatly improve a senior’s quality of life and provide relief from loneliness and depression. If a senior requires additional assistance she can hire a private aide to care for her in the facility.

When paying privately, home care and assisted living facilities can be extremely expensive. Many people do not have long term care insurance to assist with the costs of care. If they have sources of income or financial assets, many mistakenly believe that they cannot access Medicaid benefits to help shoulder some of the costs. Because of these financial constraints and misunderstandings, people will not hire the help they need in fear that it will cost too much money, or alternatively, they will deplete their entire life’s savings paying privately for care.

It is crucial that seniors and their families know that Medicaid is available for those in need of long-term care who desire to remain in the community. Through New York State’s Managed Long Term Care program, Medicaid will pay for a home care attendant to provide care for those in need of assistance with activities of daily living.

Many assisted living facilities do not accept Medicaid payment for room and board. However, if the facility allows outside attendants, residents may be able to access Medicaid to pay for a home care attendant to provide additional care in the facility. There is also a Medicaid Assisted Living Program (“ALP”), which provides assistance, including room and board, to qualifying applicants at several assisted living facilities throughout the state.

Many individuals have been told erroneously that they cannot qualify for Medicaid because they have too many assets, too much income, or because they own their home, and that they must spend-down their assets before they can access Medicaid benefits.

After speaking to an Elder Law attorney you’ll realize that most people can qualify for Medicaid and preserve their life’s savings if they plan properly. They can also protect their income so that they may continue to pay their bills and support themselves in the community by using a pooled income trust. An Elder Law attorney can review alternative housing options, such as assisted living facilities, and analyze the potential costs, to help determine if such an arrangement is right for you. Do not make the mistake of assuming that you cannot qualify for benefits due to your current financial status before learning what options may be available to you.

2014 Alzheimer’s Association Report Shows Effect of Disease on Women

Add comment November 10th, 2014 10:00am Caitlyn McStay

The 2014 report from the Alzheimer’s Association showed that over 5 million Americans are affected by Alzheimer’s Disease. This number is expected to grow to 13 million over the next 35 years. According to the report, women are disproportionately affected by the disease. Three out of five Americans living with Alzheimer’s are women. Women over 65 have a one in six chance of developing the disease, compared to one out of eleven men. Women are also more likely to take on the primary responsibility of caring for loved ones with Alzheimer’s, with twice as many women as men acting as full-time care givers.

The cost of long-term care for individuals with Alzheimer’s is also on the rise, and according to the report, few individuals with Alzheimer’s Disease have sufficient long term care insurance or can afford to pay privately for long term care services. Fortunately, there are strategies available to assist with the care of those living with Alzheimer’s Disease. For information on these strategies, you can visit our website and download a free copy of our report, “The Top Ten Elder Law Strategies for Alzheimer’s Patients and their Families”, here.


Confusion in Medicaid Rulings

Add comment November 6th, 2014 01:23pm Cynthia P. Kuster

Last August, a ruling from the Department of Health (DOH) dramatically changed the way married couples were permitted to use their income, when one was receiving services from a Managed Long Term Care (“MLTC”) program and Medicaid was the payor. The ruling effectively discriminated against married couples, limiting the amount of monthly income they were permitted to keep in a way that is not the case for single individuals.

The Elder Law and Special Needs Section of the New York State Bar Association protested to the Department of Health, met with them, and now the DOH has rescinded the ruling, with retroactive effect.

This back-and-forth problem highlights the importance of consulting with competent Elder Law attorneys when you are trying to protect your assets and still gain access to health care. The landscape is constantly changing, and it will continue to change. At Lamson & Cutner, we make it our business to know any changes in the laws that may affect you, and to have the most effective, up-to-date strategies.

Conflict-Free Evaluation and Enrollment Center

Add comment November 3rd, 2014 01:47pm Traci D. Blake, JD, MSW

This Fall, the Medicaid program implemented a new rule, which requires a preliminary evaluation for individuals seeking home care services for the first time. The Conflict-Free Evaluation and Enrollment Center (CFEEC) is a screening program designed to ensure that persons enrolling in Managed Long-Term Care (MLTC) plans need home care services for at least 120 days. The evaluation process takes place prior to the time the individual joins a MLTC. The evaluation includes a home, hospital, or nursing home visit by a registered nurse, who will ask the patient a series of questions to understand his or her care needs. The CFEEC program results do not determine the number of home care hours the applicant will receive after joining a MLTC.

Accordingly, the MLTC will still conduct its own assessment with a registered nurse, but only after receiving confirmation from CFEEC that the patient is eligible to receive home care services. The CFEEC will not approve those patients needing only housekeeping services for home care services. If a patient needs housekeeping services, they will be directed to their local Medicaid office. The certification by the CFEEC is valid for 60 days.

The program began on October 1, 2014 for Manhattan and Bronx residents approved for Medicaid. This change will begin on November 1, 2014 for Kings, Queens, Nassau, and Richmond counties. On February 1, 2015, Westchester and Suffolk counties must adhere to this new program as well. For more information on this program, please visit www.nymedicaidchoice.com or call Lamson & Cutner, P.C. at (212) 447-8690.

Top 5 Strategies To Pay For Elder Care

Add comment October 27th, 2014 12:38pm Cynthia P. Kuster

On October 20, 2014, the popular personal finance website, Investopedia, published a very informative article on the “Top 5 Strategies To Pay For Elder Care.” The article is written by veteran reporter, Greg Daugherty.

The article points out that long-term custodial care “can quickly wipe out a person’s life savings,” and that Medicaid provides a possible solution for this problem.

The article goes on to discuss “legal strategies that can help older people qualify for Medicaid without impoverishing themselves or their spouse.”

Mr. Daugherty provides an excellent review of asset protection trusts, the use of private annuities or promissory notes to protect assets, pooled income trusts, personal care agreements, and spousal transfers and spousal refusal.

The article relies in part on information provided by Lamson & Cutner attorney, David Cutner, and it quotes him on several points. For example, Mr. Cutner notes that “If a person needs to apply for Medicaid before the five-year look-back period is up, it still may be possible to preserve a significant portion of his or her assets using a properly drafted private annuity or promissory note that complies with federal law.”

Those who are or will be concerned about the costs of their health care may benefit from reading this article.

To read the article click here.

When Heirs Collide

Add comment October 20th, 2014 01:38pm Julia M. Greenberg

In its weekend edition of September 27-28, 2014, as the lead story in its “Weekend Investor” section, The Wall Street Journal published an article by veteran reporter, Liz Moyer, entitled “When Heirs Collide.” The article is sub-titled “Fights over estates can tear families apart – and it’s not just about the money. Here are guidelines for keeping the peace.”

According to the article, “Roughly 70% of families lose a chunk of their inherited wealth, mostly due to estate battles . . . .”

The article relies in part on information provided by Lamson & Cutner attorney, David Cutner. It quotes Mr. Cutner as stating “It’s not about the money. It’s more about ‘Did Mom or Dad love me?’”

Those who are or will be involved in estate proceedings will benefit from reading this article.

Here is a link to the article:  http://online.wsj.com/articles/when-heirs-collide-1411749577

Inside the Minds

Add comment October 10th, 2014 04:51pm Julia M. Greenberg

Aspatore Books, an imprint of Thomson Reuters, has just published a new book in their “Inside the Minds” series. The book is entitled: Elder Law Client Strategies in New York. The book is sub-titled: Leading Lawyers on Understanding the Changing Landscape of Elder Law and Its Affect on Client Needs.

According to Aspatore, “The different niches represented and the breadth of perspectives presented enable readers to get inside some of the great legal minds of today, as these experienced lawyers offer up their thoughts on the keys to success within this rapidly expanding area of law. . . Each chapter offers thought leadership and expert analysis. . . .”

Chapter One on “Planning and Paying for Long-Term Care” was written by David Cutner of Lamson & Cutner, P.C.

The book is currently available through the Thomson Reuters website (www.thomsonreuters.com) or on Amazon.

Observation Status and the “Pumpkin Rule” under Medicare Coverage

Add comment January 29th, 2014 12:09pm Traci D. Blake, JD, MSW

As the cost of decent Nursing Home care in New York City steadily increases towards $20,000 per month, families must remain vigilant and proactive in the medical treatment of their loved ones who are on Medicare during a hospital stay. Medicare will pay for (more…)

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