What is The New Medicaid Lookback period?

What is the appropriate Medicaid Look-Back period under the DRA?

This is an important question for anyone making a Medicaid application in that the local office will request financial records for the time period of the Look-Back. I find it can be very difficult to gather 3 years of records for a senior who now requires Medicaid to pay for his or her long term care, and 5 years is an even greater burden.

So what is the Look-Back Period? I had been going with 60 months, as until recently all the States that had created the DRA enacting legislation had used that timeframe.

However, in Most States Fudging DRA Look-Back Change from Elderlawanswers.com, there is an excellent analysis that the states may have the changes to the Look-Back Period wrong.

In New York's enacting legislation, they have taken note of the fact that that DRA did NOT in fact changes the Look-Back Period from 36 months to 60 months. Instead, it said that IF there had been a transfer in the 60 months after enactment, THEN there was a 60 month Look-Back for the transfers.

New York then has taken a staggered approach to the Look-Back Period, since 60 months obviously have not expired since the DRA was enacted. For the first 36 months, the Look-Back Period remains 36 months (since any transfers would be before the DRA was enacted). The Look-Back Period then extends to 37 months in the 37th month after the DRA to capture any transfer in that month, until it finally reaches 60 months.

This approach appears to resolve the issue of the 60 month Look-Back for transfers after 2.8.06 with the 36 month Look-Back period in the Code not being changed by the DRA.

One would hope that in creating its enacting legislation to the DRA that New Jersey would take such a measured approach as well.

Most States Fudging DRA Look-Back Change - Elder Law Answers Articles:

"Since 1993, the look-back date on a Medicaid application for long-term care coverage has been 36 months, 42 U.S.C. S. 1396p(c)(1)(B), and this figure was not erased by Congress in the amendments to the statute it made through the DRA. Instead, the 36-month figure was preserved and a 60-month look-back date was added to the statute but made applicable only to transfers that occurred after the DRA effective date.

The last time Congress made any modification to the look-back date was in the Omnibus Budget Reconciliation Act of 1993, P.L 103-66 (OBRA-93), when it simply deleted '30' from the statute and replaced it with '36,' and thereby left little doubt that it intended to increase the look-back period on all prospective applications to 36 months. But Congress chose not to make the change in the same manner in its DRA amendments. In keeping the 36-month figure in the statute, Congress was clearly indicating that a 36-month look-back date is still applicable in some fashion. By attaching the 60-month look-back date to transfers made after the DRA enactment date, as opposed to applications filed after that date (a la OBRA-93), the design was obviously to at least phase in the extended look-back date over time. Based on the language Congress used in the DRA, the look-back period cannot be greater than 36 months until at least February 2009, because that will be the first point at which an
individual will have possibly made a transfer that occurred more than 36 months after the DRA enactment.

Agreeing with this reading of the DRA statute, New York keeps the look-back period at 36 months (60 months for trusts) until February 1, 2009. Beginning on that date, Medicaid offices will require resource documentation for the past 37 months (60 months for trusts). "

This is a confusing issue. Before you rely on "the grapevine", consult an elder law attorney who can help you sort through the convoluted laws of Medcaid.

Social Security E-mail Scam

Beware e-mails that look to be sent from the government regarding Social Security, as they are a scam to obtain your personal information.

These messages have a subject line of "Cost-of-Living for 2007 update" and have a bit of information about a benefit increase for 2007. The email states:

NOTE: We now need you to update your personal information. If this is not completed by November 11, 2006, we will be forced to suspend your account indefinitely.

The reader is linked to a fraudulent website where the user is asked to enter their personal information to avoid losing the Social Security benefits.

Remember: The Social Security Administration (SSA) will not request your personal information online. In fact, SSA Inspector General O’Carroll recommends people always take precautions when giving out personal information. She says:

You should never provide your Social Security number or other personal information over the Internet or by telephone unless you are extremely confident of the source to whom you are providing the information.

If you have received this scam email, call 1-800-269-0271 (TTY: 1-866-501-2101) to report it.

Advancing Excellence in America's Nursing Homes

On September 29, 2006 the National Nursing Home Quality Summit was held in Washington, D.C.

The Advancing Excellence in America's Nursing Homes website describes their work as follows:

Advancing Excellence in America's Nursing Homes is a new coalition based, two-year campaign that launched in September 2006. The campaign is reinvigorating efforts to improve the quality of care and quality of life for those living or recuperating in America's nursing homes.

The campaign's unprecedented coalition includes long-term care providers, caregivers, medical and quality improvement experts, government agencies, consumers and others. Together, we are building on the success of other quality initiatives, including Quality First, the Nursing Home Quality Initiative (NHQI), the culture change movement, and other quality initiatives.

Learn more about the campaign and its goals.

To learn about how you can help by registering as a Nursing Home consumer, visit this link.

Web Link - Ohio Association of Senior Centers

The Ohio Association of Senior Centers exists to support and enhance the ability of Ohio's senior center network to effectively serve older adults by providing 1) education, mentoring, and training to senior center and aging network staff; 2) professional senior center staff certification; 3) development of new funding resources; and 4) information on legislative issues and organized advocacy efforts on behalf of older Ohioans.

Click here for OASC Member Senior Centers.

Coping With The Sudden Death of an Elderly Parent

Lucy Whelchel works with businesses, professionals, and agencies to prepare for the demographic shift to an aging America. In her article "Coping With the Sudden Death of an Elderly Parent", she reminds us that even when we don't plan ahead, there are resources for spouses or family members in crisis.

Ms. Whelchel reccomends calling or visiting the website of the National Association of Professional Geriatric Care Managers. Members of this organization ore knowlegeable about aging, as well as the services and programs available to families. Care managers often create plans of action aimed at meeting the specific needs of that person, and may help on a daily basis to help with daily activities or to find appropriate housing.

Second, the Area Agency on Aging is a reccomended resource. The Agency for your community can be found by visiting the Eldercare Locator Website. This can link to services such as "Meals on Wheels, senior centers, home nursing and personal care, respite care for caregivers, homemmaking and chore services, adult day care, senior victims advocate programs, injury prevention and protection programs, information on Medicare, Medicaid, Medigap and Long Term Care Insurances, Alzheimer's Disease and other dementias servicses, transportation, senior employment services, long term care ombudsman programs, and health promotion and disease prevention."

Finally, Ms. Whelchel points out that those that are 85 and older will increase by 56% from 2010 to 2030, and the number of persons from 65 to 84 will increase by 81% from 1010 to 2030. The important piece to take out of this article is to realize that planning for these changes and the aging of your family and loved ones can ensure that all live a full, healthy life.

Squidoo Lens - Elder Law

Check out my Squidoo Lens on Elder Law. It has many links and is generally a portal I've created for you to access information related to issues you may be facing. Please sign the guestbook and leave a suggestion so that I may make it better!

Thank you!

Where Can I Check Out My Financial Adviser?

Visit the Securities and Exchange Commission website to make sure that your financial adviser (or a potential advisor that you're interviewing) is on the "straight and narrow".

You can download the adviser's "form ADV" to find out if he or she has ever been disciplined by the SEC or another ageny, what type of misconduct was found, and the resolution. There is also information on the adviser's education and business. For Ohio-specific information, visit the Ohio Department of Commerce - Securities Division.

Be aware, however, that I am told only advisers that manage more than $25 million in assets must register with the S.E.C. This means that many advisers may not show up on this webpage, which does not necessarily mean that adviser is "good" or "bad".

I've had the good fortune of creating some good working relationships with advisers with many varied backgrounds. I find that they are often a valuable, even indispensable, part of creating the best plans for my clients. For more information about retirement planning with your IRA or 401(k), feel free to contact me today.

The "Senior Sandwich"

The "Senior Sandwich" generation refers to persons over 60 years old and who face costs related to 1) college tuition for thier kids, 2) retirement for themselves, and 3) at-home or nursing home care for thier parents, all at once.

The fact that nearly 50% of people in thier 60's today have at least one parent still living is a far cry from the near 10% at the beginning of last century. This means that these families are facing concerns and problems that no generation before them have had to face. The bottom line can be a crushing financial burden.

Jean Chatzky of Money Magazine suggests in "Just When You Thought It Was Safe to Retire" that if you're already in your 60's you might plan to work a little longer, live a little leaner, and encourage your kids to study hard and qualify for merit aid. She goes on to sugges that if you are planning ahead in your 40's or 50's you're in a better spot, especially if you focus on the following:

1) Fit kids into your budget. When you make projections about your annual spending in your retirement years, be sure to plan for the possibility that one of your kids moves back home! This can increase food, utilities, and other costs.

2) Ask your parents hard questions. Understanding what sort of assets your parents have, and what type of lifestyle they wish to live is important. Ask them the following: How expensive a lifestyle do they want to live for the rest of thier life? Where do they want to live, and in what kind of home? What sort of health-care and lifesaving measures do they want to have taken, if needed? Who do they want to put legally in charge of carrying out all of these wishes?

3) Consider insurance. Long term care is very expensive. Buying long term care insurance may bring a great deal of financial secuirty, and personal comfort.

4) Look out for No.1. Too often those in the "sandwich generation" put thier own needs last. If you ruin yourself financially (by neglecting your own needs) at this point to take care of those around you, you'll only be setting up your children to face these difficulties later.

If you are a card-carrying member of the "sandwich generation" and you'd like to learn more about how to help implement a plan to make sure you and your family members are taken care of personally, legally, and financially, feel free to contact an elder law lawyer for assistance.

Look Closer, See Me

I am told that this poem was found with the belongings of an elderly woman who died in the geriatric ward of a hospital near Dundee, Scotland. It is a powerful piece that should remind us all that a failing mind or body does not change who we are. I hope it helps you in some way.

If you can share a story, or any way that this poem affects your life, please leave a comment or contact Golowin Legal.

Look Closer, See Me

What do you see nurses, what do you see?
Are you thinking when you are looking at me— A crabby old woman, not very wise,
Uncertain of habit, with far-away eyes.
Who dribbles her food and makes no reply,
When you say in a loud voice—"I do wish you'd try."
Who unresisting or not, lets you do as you will,
With bathing and feeding the long day to fill.
Is that what you are thinking—is that what you see?
Then open your eyes, nurse, you're not looking at me.
I'll tell you who I am as I sit here so still;
As I do at your bidding, as I eat at your will,
I'm a small child of ten with a father and mother,
Brothers and sister, who love one another.
A young girl of sixteen with wings on her feet,
Dreaming that soon now a lover she'll meet;
A bride soon at twenty—my heart gives a leap,
Remembering the vows that I promised to keep;
At twenty-five now I have young of my own,
Who need me to build a secure, happy home;
A woman of thirty, my young now grow fast,
Bound to each other with ties that should last;
At forty, my young sons have grown and are gone,
But my man's beside me to see I don't mourn.
At fifty, once more babies play round my knee.
Again we know children, my loved one and me.
Dark days are upon me, my husband is dead.
I look at the future, I shutter with dread,
For my young are all rearing young of their own,
And I think of the years and the love that I've known.
I'm an old woman now and nature is cruel—
'Tis’ her jest to make old age look like a fool.
The body it crumbles, grace and vigor depart,
There is now a stone where I once had a heart;
But inside this old carcass a young girl still dwells,
And now and again my battered heart swells.
I remember the joys, I remember the pain,
And I'm loving and living life over again.
I think of the years all too few—gone too fast,
And accept the stark fact that nothing can last.
So open your eyes, nurses, open and see
Not a crabby old woman, look closer see me!

Courtesy of the Peninsula Hospital Center, Far Rockaway,
New York, and Greater New Hospital Association.

Golowin Legal is your source for elder law, estate planning, probate and asset protection.

How Can I Save On My Energy Bill?

Visit the Department of Energy for money saving tips to learn how to keep dollar bills from slipping away (under the door, through the windows, and down the drain).

This site features an "energy audit" and other tools which show you how to do things such as check insulation, plumbing, or even to compare gas mileage in different models of cars.

Another section of this site educates on which tax credits are available for energy-conscious consumers. For example, installing a central air conditioning system can give you a $300 tax credit!