TIME IS RUNNING OUT!
The one FREE seminar you CAN’ WAIT to attend.
Presented by Davidow, Davidow, Davidow, Siegel and Stern, Long Island’s Elder Law, Special Needs and Estate Planning Firm.
Medicaid has long served as a safety net for middle class seniors faced with the catastrophic cost of a nursing home. This program is currently under attack and likely to change. Learn how to PLAN NOW before the window closes forever. Don’t limit your options and jeopardize everything you’ve worked a lifetime to acquire.
NOW, more than ever, it’s important to learn the answers to these crucial and timely questions:
• If I put together a plan right now to protect my assets from a nursing home, will I be grandfathered in?
• What will Medicare cover?
• If I can’t rely on Medicaid in the future to pay for long term care costs, what exactly should I be doing now?
• I want to learn from the Terri Schiavo case…do I need a Health Care Proxy or a Living Will or both?
• What exactly is a Living Trust?
• If I become incapacitated, how will my finances and medical decisions be handled?
• Do I really need a will?
• I have a disabled child. How can I protect and provide for that child when I can no longer do it myself?
• What is the difference between Revocable and Irrevocable Trusts?
Choose from these two seminars:
Wednesday, June 22nd at 10:00am
Breakfast Buffet and Presentation
Riverhead Polish Hall
214 Marcy Avenue, Riverhead
Or
Tuesday, June 28th at 6:00pm
Dinner Buffet and Presentation
The Milleridge Inn
585 North Broadway, Jericho
Reservations are required. Call 631-234-3030 or email JGrisolia@Davidowlaw.com to reserve your seats. Discover why planning NOW is more important than ever!
Wednesday, June 1, 2005
Thursday, May 26, 2005
Democrats to Boycott Medicaid Commission
Congressional Democrats have found the details of the Medicaid Commission to be established by the U.S. Department of Health and Human Services (HHS) so objectionable that they have already announced that they will not fill the four seats reserved to them on the 38-member panel.
A Federal Register notice published this week, reveals that the commission will comprise three separate "member groups." The first group, fifteen "voting members," will be the only commission members who can vote on recommendations. This group will be made up of former or current governors, three representatives of public policy organizations "involved in major health care policy issues"; former or current state Medicaid directors; individuals with "expertise in health, finance, or administration"; federal officials who administer programs that serve the Medicaid population; the HHS Secretary or his designee; and ex official members. All fifteen of these voting members will be appointed by HHS Secretary Michael Leavitt.
Leavitt also will have the exclusive authority to appoint the second member group, fifteen "nonvoting" members. These individuals "will include State and local government officials" and "consumer and provider representatives." The third member group, also without voting rights, was to consist of eight individuals currently serving in-an appointed by-Congress. In the Senate, the majority leader, minority leader, and chairman and ranking member of the Senate Finance Committee would appoint one person each. In the House, the speaker, minority leader, and chairman and ranking member of the House Committee on Energy and Commerce would each make an appointment.
However, at least half of the seats designated for congressional representatives will not be filled due to the Democrats' objection over the monopoly Leavitt will have on the commission's voting membership. The Democrat minority leaders in the Senate and House and ranking members of the Senate and House Committees announced that they will not exercise their authority to appoint members to the commission. Senate Minority Leader Harry Reid (D-NV) and House Minority Leader Nancy Pelosi (D-CA) claimed in their statements that "an invitation to Democrats to select four Members of the Senate and House to advisory roles without a vote is wholly inadequate to lend any Commission even the air of bipartisanship."
Democratic criticism of the commission is not limited to its membership but extends to its mission as well. The commission's first order of business will be to recommend to Leavitt by September 1, 2005, where $10 billion should be cut from Medicaid. Reid and Pelosi object to that assignment:
We fundamentally disagree with the premise that this Commission should make recommendations on how to cut Medicaid outlays by $10 billion by September 1...If Congress can decide how much to cut, it does not need a Commission to figure out how to cut the program. To the contrary, it is the responsibility of the elected Congress to make such cuts, and members who support those cuts should be held accountable for those decisions.
After submitting its initial recommendations, the commission will be charged with "making longer-term recommendations on the future of the Medicaid program that ensures the long-term sustainability of the program." The latter recommendations will be due by December 31, 2006.
Source: National Senior Citizens Law Center, Washington Weekly, Vol. XXXI, Issue No. 21.
A Federal Register notice published this week, reveals that the commission will comprise three separate "member groups." The first group, fifteen "voting members," will be the only commission members who can vote on recommendations. This group will be made up of former or current governors, three representatives of public policy organizations "involved in major health care policy issues"; former or current state Medicaid directors; individuals with "expertise in health, finance, or administration"; federal officials who administer programs that serve the Medicaid population; the HHS Secretary or his designee; and ex official members. All fifteen of these voting members will be appointed by HHS Secretary Michael Leavitt.
Leavitt also will have the exclusive authority to appoint the second member group, fifteen "nonvoting" members. These individuals "will include State and local government officials" and "consumer and provider representatives." The third member group, also without voting rights, was to consist of eight individuals currently serving in-an appointed by-Congress. In the Senate, the majority leader, minority leader, and chairman and ranking member of the Senate Finance Committee would appoint one person each. In the House, the speaker, minority leader, and chairman and ranking member of the House Committee on Energy and Commerce would each make an appointment.
However, at least half of the seats designated for congressional representatives will not be filled due to the Democrats' objection over the monopoly Leavitt will have on the commission's voting membership. The Democrat minority leaders in the Senate and House and ranking members of the Senate and House Committees announced that they will not exercise their authority to appoint members to the commission. Senate Minority Leader Harry Reid (D-NV) and House Minority Leader Nancy Pelosi (D-CA) claimed in their statements that "an invitation to Democrats to select four Members of the Senate and House to advisory roles without a vote is wholly inadequate to lend any Commission even the air of bipartisanship."
Democratic criticism of the commission is not limited to its membership but extends to its mission as well. The commission's first order of business will be to recommend to Leavitt by September 1, 2005, where $10 billion should be cut from Medicaid. Reid and Pelosi object to that assignment:
We fundamentally disagree with the premise that this Commission should make recommendations on how to cut Medicaid outlays by $10 billion by September 1...If Congress can decide how much to cut, it does not need a Commission to figure out how to cut the program. To the contrary, it is the responsibility of the elected Congress to make such cuts, and members who support those cuts should be held accountable for those decisions.
After submitting its initial recommendations, the commission will be charged with "making longer-term recommendations on the future of the Medicaid program that ensures the long-term sustainability of the program." The latter recommendations will be due by December 31, 2006.
Source: National Senior Citizens Law Center, Washington Weekly, Vol. XXXI, Issue No. 21.
Wednesday, May 18, 2005
Congress Cuts $10 Billion from Medicaid
The U. S. Congress agreed this week on a $2.56 trillion fiscal year (FY) 2006 budget resolution that includes a $10 billion cut in Medicaid expenditures over the next five years and $106 billion in tax cuts over the same time period. Because the budget resolution only sets the parameters on Congress' spending for the coming fiscal year, no details on the method by which Congress will achieve the Medicaid cuts are included. However, the sheer size of the cuts agreed to for the Medicaid program, which serves more than 50 million U.S. citizens, will undoubtedly translate into substantial reductions in either enrollment or services.
Earlier this month, the Senate and House passed budgets that contained radically competing proposals on Medicaid. While the House decided to cut Medicaid by $14 billion over five years, the Senate's budget omitted any cuts and instead set aside funds for the creation of a Medicaid Commission to consider possible changes to the program. Because of the importance that President Bush and various members of Congress have placed on reducing entitlement spending in order to cut the federal deficit in half by 2010 (a deficit which will exceed $400 billion in FY 2006), the competing Medicaid proposals stood to derail the budget conference at which the respective bodies were to harmonize their differing budget proposals.
The potential for derailment appeared to heighten recently when the 44 House Republicans delivered a letter to House Budget Committee Chairman Jim Nussle (R-La.) requesting that the Medicaid cuts in the House's budget resolution be erased. Then came a Democratic motion at the beginning of this week to instruct the House-Senate budget conferees to eliminate the Medicaid cuts from the FY 2006 budget. This motion, nonbinding and somewhat weak in form, passed the House by a vote of 348-72, and appeared to set the stage for a dramatic conference fight over Medicaid.
However, the budget conferees only needed a day to neotiate the budget and agreed to the $10 billion over-five-years Medicaid cut. The Senate and House immediately thereafter voted in favor of the conference's agreement. News reports indicate that the agreement was reached after Senator Gordon Smith (R-Or.), considered the leader of moderate Republican opposition to Medicaid cuts, was promised that the Medicaid commission he has called for would be created. Details relating to the committee are still being worked out, but initial reports indicate that the committee will be charged with providing recommendations on changes to the program no later than September 1, and that all commission members will be appointed by President Bush. The legislation Senator Smith sponsored earlier this year called for a bipartisan commission that would be allowed an entire year to consider program changes.
Specifics of the cuts will now be left to the Senate Finance Committee and House Energy and Commerce committee to decide on, and their proposals will only require a bare majority of each chamber before being submitted to President Bush. Because the fundamental elements of the president's own FY 2006 budget proposal - large reductions in entitlement spending more than matched with larger tax cuts-have essentially been adopted by Congress, it is likely that the president will sign what Congress presents.
Source: National Senior Citizens Law Center, Washington Weekly, Vol. XXXI, Issue No. 17.
Earlier this month, the Senate and House passed budgets that contained radically competing proposals on Medicaid. While the House decided to cut Medicaid by $14 billion over five years, the Senate's budget omitted any cuts and instead set aside funds for the creation of a Medicaid Commission to consider possible changes to the program. Because of the importance that President Bush and various members of Congress have placed on reducing entitlement spending in order to cut the federal deficit in half by 2010 (a deficit which will exceed $400 billion in FY 2006), the competing Medicaid proposals stood to derail the budget conference at which the respective bodies were to harmonize their differing budget proposals.
The potential for derailment appeared to heighten recently when the 44 House Republicans delivered a letter to House Budget Committee Chairman Jim Nussle (R-La.) requesting that the Medicaid cuts in the House's budget resolution be erased. Then came a Democratic motion at the beginning of this week to instruct the House-Senate budget conferees to eliminate the Medicaid cuts from the FY 2006 budget. This motion, nonbinding and somewhat weak in form, passed the House by a vote of 348-72, and appeared to set the stage for a dramatic conference fight over Medicaid.
However, the budget conferees only needed a day to neotiate the budget and agreed to the $10 billion over-five-years Medicaid cut. The Senate and House immediately thereafter voted in favor of the conference's agreement. News reports indicate that the agreement was reached after Senator Gordon Smith (R-Or.), considered the leader of moderate Republican opposition to Medicaid cuts, was promised that the Medicaid commission he has called for would be created. Details relating to the committee are still being worked out, but initial reports indicate that the committee will be charged with providing recommendations on changes to the program no later than September 1, and that all commission members will be appointed by President Bush. The legislation Senator Smith sponsored earlier this year called for a bipartisan commission that would be allowed an entire year to consider program changes.
Specifics of the cuts will now be left to the Senate Finance Committee and House Energy and Commerce committee to decide on, and their proposals will only require a bare majority of each chamber before being submitted to President Bush. Because the fundamental elements of the president's own FY 2006 budget proposal - large reductions in entitlement spending more than matched with larger tax cuts-have essentially been adopted by Congress, it is likely that the president will sign what Congress presents.
Source: National Senior Citizens Law Center, Washington Weekly, Vol. XXXI, Issue No. 17.
Thursday, May 5, 2005
Capital Gains Laws Changing Soon
A life estate is created when you transfer ownership of your house to someone else (usually your children) but reserve the right to exclusive use and occupancy for the rest of your life. After Medicaid "look-backs" and penalties have run their course, the house is deemed protected from Medicaid, should you need it. After your death, the life estate is extinguished and your children own the house.
How it works: Under current law, when your children sell the house, capital gains tax is assessed only on the increase in the property's value from the date of your death until the sales date, often a relatively short period of time. However, new rules are scheduled to come into effect in 2010 (or sooner) that measure the gain in the property's value from the purchase price, plus capital improvements, to the sales price. So, if you paid $10,000 for the house 40 years ago and added $40,000 in improvements over the years, your "tax basis" would be $50,000. If your heirs sold the property for $300,000, they'd have a $250,000 captial gain on which they would owe taxes.
The Strategy: There are two major Medicaid planning techniques that can be used to save your house: life estates and irrevocable trusts. Each technique carries certain tax consequences, which change often (even the 2010 law might be repealed in 2011). Life estates are common, but limit your ability to sell your home without causing other Medicaid and tax problems. And, if the capital gains tax rules change as anticipated, another benefit of life estates may no longer be available.
Consult with a certified elder law attorney about long-term care financing strategies, including the possibility of an irrevocable trust, which will no limit you from selling the house during your lifetime.
How it works: Under current law, when your children sell the house, capital gains tax is assessed only on the increase in the property's value from the date of your death until the sales date, often a relatively short period of time. However, new rules are scheduled to come into effect in 2010 (or sooner) that measure the gain in the property's value from the purchase price, plus capital improvements, to the sales price. So, if you paid $10,000 for the house 40 years ago and added $40,000 in improvements over the years, your "tax basis" would be $50,000. If your heirs sold the property for $300,000, they'd have a $250,000 captial gain on which they would owe taxes.
The Strategy: There are two major Medicaid planning techniques that can be used to save your house: life estates and irrevocable trusts. Each technique carries certain tax consequences, which change often (even the 2010 law might be repealed in 2011). Life estates are common, but limit your ability to sell your home without causing other Medicaid and tax problems. And, if the capital gains tax rules change as anticipated, another benefit of life estates may no longer be available.
Consult with a certified elder law attorney about long-term care financing strategies, including the possibility of an irrevocable trust, which will no limit you from selling the house during your lifetime.
Monday, April 25, 2005
Social Security: Not Just for Retirees
The rate of return debate diverts attention from the fact that Social Security is much more than just a successful retirement program. Retired workers account for only 29,953,000, 62.8 percent of Social Security's 47,688,000 beneficiaries. More than 3 million beneficiaries are spouses and minor or disabled children of retired workers, while almost 7 million are survivors of deceased workers. Close to 8 million are disabled workers and their spouses and children. To put a human face on this, several members of the House of Representatives have disclosed that they lost their parents early in life and were brought up with the assistance of Social Security survivor's benefits. These include two of the five Democrats on the Social Security Subcommittee, Rep. Earl Pomeroy (ND) and REp. Richard Neal (MA). Rep. Barney Frank (D-MA) and Rep. Rush Hold (D-NJ) also received survivors' benefits.
Since retirees account for only 62.8 percent of Social Security beneficiaries, if one were to accept the notion of comparing rates of return between Social Security Retirement and private accounts, the proper comparison would be with a reduced percentage of net earnings on private accounts in order to allow for the Social Security money used to fund non-retirement benefits.
Source: Washington Weekly, Vol. XXXI, Issue 6, February 2005.
Alzheimer's Aid
According to Boston University researchers, brightly colored plates might help Alzheimer's patients finish meals. Patients often have trouble distinguishing objects from backgrounds.
Since retirees account for only 62.8 percent of Social Security beneficiaries, if one were to accept the notion of comparing rates of return between Social Security Retirement and private accounts, the proper comparison would be with a reduced percentage of net earnings on private accounts in order to allow for the Social Security money used to fund non-retirement benefits.
Source: Washington Weekly, Vol. XXXI, Issue 6, February 2005.
Alzheimer's Aid
According to Boston University researchers, brightly colored plates might help Alzheimer's patients finish meals. Patients often have trouble distinguishing objects from backgrounds.
Monday, April 18, 2005
Clothing Gifts No Longer Count as Income Under New SSI Rules
The Social Security Administration (SSA) will no longer count gifts of clothing as part of income or household goods as resouces in deciding whether a person can quality for Supplemental Security Income (SSI) benefits under final rules just issued.
First, the agency is eliminating clothing gifts from the definition of income and from the definition of in-kind support and maintenance. As a result, it says it generally will not count gifts of clothing as income when deciding whether a person can receive SSI benefits or when it computes the amount of the benefits.
Second, SSA is eliminating the dollar value limit (previously $2,000) for the exclusion of household goods and personal effects. As a result, the agency will not count household goods and personal effects as resources in deciding whether a person can receive SSI benefits.
Third, the SSA is changing its rules for excluding an automobile in determining the resouces of an SSI applicant or recipient. It will exclude one automobile (the "first" automobile) from resources if the vehicle is used for transportation for the individual or a member of the individual's household, withouth consideration of its value.
The regulations took effect March 9, 2005.
Source: The ElderLaw Report, Vol. XVI, No. 9, April 2005.
First, the agency is eliminating clothing gifts from the definition of income and from the definition of in-kind support and maintenance. As a result, it says it generally will not count gifts of clothing as income when deciding whether a person can receive SSI benefits or when it computes the amount of the benefits.
Second, SSA is eliminating the dollar value limit (previously $2,000) for the exclusion of household goods and personal effects. As a result, the agency will not count household goods and personal effects as resources in deciding whether a person can receive SSI benefits.
Third, the SSA is changing its rules for excluding an automobile in determining the resouces of an SSI applicant or recipient. It will exclude one automobile (the "first" automobile) from resources if the vehicle is used for transportation for the individual or a member of the individual's household, withouth consideration of its value.
The regulations took effect March 9, 2005.
Source: The ElderLaw Report, Vol. XVI, No. 9, April 2005.
Monday, April 11, 2005
Terri Schiavo: The lesson from the loss
If we can all agree upon one thing, it is that similar situations can be avoided with advance planning and discussion with family members. Elder Law attorneys are uniquely qualified to assist individuals and their families when confronted with difficult decisions regarding medical treatment, or the withholding of medical treatment. Although court-appointed guardians can usually make healthcare decisions, including end-of-life decisions, an individual is far better served by executing an advance directive which can be in the form of a living will, health care proxy or a combination of these documents. A living will is an expression of how the individual wants to be treated during end-of-life care. The health care proxy is a delegation of authority to a third party to make healthcare decisions for the individual when the individual is unable to do so. All 50 states and the District of Columbia impose statutory requirements on the content and execution of health care proxies for them to be valid. However, New York does not have statutory law regarding the creation of a living will.
Should an individual use a Health Care Proxy and/or a living will? Some claim that the use of a living will is a failure because individuals lack the knowledge to make intelligent decisions in advance, and so their preferences are not adequately articulated in the living will. Others note that too often living wills are not accepted by third parties. Since New York does not recognize living wills, they are instead treated as a statement of the individual's values. Davidow, Davidow, Siegel & Stern recommend a combination of a living will and a health care proxy; we call this an advance directive. The living will is needed to state the individual's preferences and the health care proxy is needed to appoint an agent as well as a successor agent, and authorize the agent to implement the individual's preferences.
Davidow, Davidow, Siegel & Stern discuss with all their clients, how to make the existence of the client's advance directive known to the client's family and physicians. At a minimum, the client should have a candid and frank discussion of the advance directive and the client's healthcare preferences with the client's immediate family, healthcare agents and primary care physician, and provide each of them with copies of their advance directives.
Should an individual use a Health Care Proxy and/or a living will? Some claim that the use of a living will is a failure because individuals lack the knowledge to make intelligent decisions in advance, and so their preferences are not adequately articulated in the living will. Others note that too often living wills are not accepted by third parties. Since New York does not recognize living wills, they are instead treated as a statement of the individual's values. Davidow, Davidow, Siegel & Stern recommend a combination of a living will and a health care proxy; we call this an advance directive. The living will is needed to state the individual's preferences and the health care proxy is needed to appoint an agent as well as a successor agent, and authorize the agent to implement the individual's preferences.
Davidow, Davidow, Siegel & Stern discuss with all their clients, how to make the existence of the client's advance directive known to the client's family and physicians. At a minimum, the client should have a candid and frank discussion of the advance directive and the client's healthcare preferences with the client's immediate family, healthcare agents and primary care physician, and provide each of them with copies of their advance directives.
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