Safe Driving Bill Approved by Massachusetts House of Representatives

On February 4, 2010, the House of Representatives in Massachusetts amended and approved a bill dealing with safe driving in the Commonwealth. If passed by the Massachusetts Senate, this bill will have a direct impact on the senior citizens of Massachusetts because it will require drivers over the age of 75 to renew their licenses every 5 years instead of every 10 years.

Issues concerning elderly driving have been in the news on and off for many years now, but after a series of accidents involving elder drivers last year, the state legislature is looking to make some changes. The current bill does not just involve seniors though. It also seeks to completely ban text messaging by all drivers, and it provides for higher penalties for drivers under the age of 18 who are caught using cell phones while driving.

For seniors, the requisite 5-year renewal will include passing a vision test that will be administered at the local branch of the registry of motor vehicles. However, the bill would permit the registrar to create regulations allowing seniors to submit a vision screening certificate, signed by an optometrist or ophthalmologist that asserts they meet the minimum vision requirements to hold a driver’s license.

This bill further seeks to allow health care providers to notify the registry of anyone over the age of 16 whose cognitive or functional impairments make it unsafe for them to drive. Decisions regarding whether to revoke a license will depend more on the effects of the cognitive or functional impairment, rather than simply on the diagnosis of such impairment. More detailed regulations will be drafted by the registry with the assistance of various health care professionals, and any reports filed under this section of the proposed law would remain confidential.

Finally, this bill seeks to codify a rule that drivers of any passenger vehicle shall not use mobile telephones, hands-free mobile telephones, or any other mobile electronic devices while driving on duty.This section was drafted in response to the rising number of accidents involving the T in recent years where drivers were text messaging, or using mobile electronic devices in other ways.

Now that the House has published and amended the safe driving bill, it moves on to the Senate Committee on Ways and Means. State Senator Stephen M. Brewer, is one member of the Ways and Means Committee, and he represents parts of Worcester, Hampden, Hampshire, and Franklin. If you are interested in voicing your opinion on this bill, call Mr. Brewer at (617) 722-1540, or email him at Stephen.Brewer@state.ma.us.Click here for the full text of the current bill.

No, You Can’t Just Give It Away! The Dangers of “Gifting” when Considering Long Term Care

Hardly a day goes by when I don’t have a client who tells me that they can give away a certain amount of money free and clear, avoiding look-back periods for long-term care planning. They inform me that their neighbor, friend, or cousin told them that this is allowable. I then have the unfortunate task of telling them that they are wrong and that most states that have enacted the Deficit Reduction Act. After February 8, 2006, the rules relative to gifts changed. National Academy of Elder Law Attorneys

Regardless of the amount, any gift that is made is a transfer and is subject to a look-back period of five-years for MassHealth (Medicaid) purposes. This doesn’t mean that the State will take that money, but rather, that the State will not pay for the donor’s long-term care costs until the five-year look-back is exhausted, or in the alternative, until all the gifts that have been transferred are used to pay for the institutionalized person’s care.

The sum that most clients feel that can be gifted (erroneously) without a look-back is $10,000. This amount actually relates to a past year’s annual amount that could have been gifted on an annual basis to as many individuals as the donor wishes without the need to file a GIFT TAX return. This has NOTHING to do with the look-back period when applying for MassHealth (Medicaid) coverage of a nursing home. However, the exemption in 2010 for gift giving on an annual basis is $13,000 per donee per year. Again, this is only a tax amount gift, and is not a Medicaid or asset protection plan exempt amount. A gift of $13,000 from a parent to a child will constitute a non-taxable gift, but this gift will carry with it a waiting period of five-years relative to MassHealth (Medicaid) qualification.

Far too often, family, friends, and other non-professional advisors provide well-intended but erroneous advice that can lead to significant adverse consequences if relied upon. If in doubt, it is always appropriate to contact a professional accountant, geriatric care manager, attorney, or other financial advisor for the appropriate and up to date laws relative to gifts, Medicaid planning, taxes, etc.

If you don’t know how to find a qualified lawyer, you may contact your local bar association or the
This blog was modified from one originally posted by Attorney Hy Darling from Bacon Wilson, Attorneys at Law in Springfield, MA. Its original version can be found here.

Proposed Massachusetts Legislation Could Change the Way Assets are Counted for MassHealth

How often do you feel like you know what your state legislators are doing? The whole process can be mysterious and confusing. This week I would like to shed some light on the subject and tell you about a potentially helpful piece of legislation currently pending in the Massachusetts state legislature.

The proposed law would change the way assets are counted when determining whether a spouse in a nursing home, or certain other institutions and community based programs, is eligible for medical assistance through MassHealth (Medicaid). For MassHealth purposes, the spouse in the nursing home is called the “institutionalized spouse” and the spouse still living at home is referred to as the “community spouse.” Currently, under Massachusetts General Laws, chapter 118E, subsection 21A, many different types of income and asset types of both spouses are considered countable for purposes of determining eligibility. The total amount of countable income and assets are major factors the Division of Medical Assistance takes into account when determining if the institutionalized spouse is eligible for medical assistance from the Commonwealth (MassHealth/Medicaid).

The proposed legislation, sponsored in the State House by Representative Alice Peisch, and sponsored in the State Senate by Senator James Eldridge, would alter the language in the statute to make some assets that are currently countable, no longer countable. The proposals in both houses are identical. The proposed legislation would make any money held by the community spouse in an IRA, Keogh plan, or other pension fund non-countable assets as long as regular income distributions are made from the fund OR the community spouse is employed. This means that those assets would not affect the institutionalized spouse’s eligibility for medical assistance. This would come in handy in lots of potential situations, but especially in situations like a spouse in their 50’s suffering from early onset dementia, where the community spouse is still working. Many spouses in their 50’s, 60’s, and even early 70’s still work and more importantly have to work to make ends meet.

This change in the law would also be hugely beneficial to aging couples who have worked hard and diligently saved their money. If one spouse is institutionalized, the community spouse still needs to have the means for adequate support. No one should be penalized for following their financial planner’s advice and putting money away for retirement. In this system, frivolity and impoverishment would no longer be the only path to assistance from MassHealth.

The proposed legislation has been referred to the Joint Committee on Health Care Financing, and a public hearing is scheduled for June 3, 2010, at 1:00, in Hearing Room B1. If you are interested in learning more, contact State Senator James Eldridge. He represents parts of Middlesex and Worcester county. Most importantly, if you would like to see this legislation passed, contact your own local representative and express your support.

What about Fluffy? Pet Trusts: Another Important Estate Planning Tool

It’s estimated that two-thirds of American households currently have at least one pet, a number that has steadily increased in the last 60 years. With more pets comes a growing industry devoted to helping Americans better care for, and even indulge, their pets, has developed. Businesses that provide pet day care, pet sitters, grooming, spa services, and even pet cemeteries have become common.

Many even consider pets part of their family, a sort of child, brother, sister, or at the very least, friend. Since so much love and attention is given to these fury and feathery companions, many wish to provide for their animals in the event that they become incapacitated or die before their pet. With family greed, skepticism, and fraud on the rise, many seek a better solution than hoping Junior will “do the right thing.” As a matter of fact, owner death and/or disability is one of the top reasons that animals end up in Shelters across the country.

Several states have made changes to their laws to help people provide for the care of their pets after the owner’s death, thereby statutorily allowing for “Pet Trusts.” Pet trusts can be useful in a number of situations. Should the owner of a pet die, a pet trust can ensure that the pet continues to be taken care of, provided a home, food, and veterinary care. A properly-funded pet trust can give an owner peace of mind that should something happen to them, their pet will continue to be cared for, and not end up in an animal shelter or otherwise abandoned.

Forty states currently have pet trust laws on the books. Sadly though, Massachusetts is not one of them (Start writing those letters to your Representative). However, that doesn’t mean that you can’t provide for “Mr. Droolsalot” and “Fluffy Von Furball” when you pass in Massachusetts.

Should you choose an intervivos trust, one that exists outside of your Will, you’ll need to be very specific as to what your money can and can’t be spent on for your pet’s care. In states with pet trust legislation, you are able to leave many of the details to the statute. Depending on how you fund your trust, it can be effective on your disability, incapacity, or death.

You also have the option of choosing a testamentary trust, one that exists within your Will itself. This option is often less expensive than an intervivos trust, however the trust is not in existence until after your passing and therefore does not protect the pet if you were to enter a nursing home or were otherwise incapacitated. Both of these options can be accomplished by adding an extra clause or two to your existing documents.

It is important to remember to have an attorney experienced in estate planning for pets prepare or update your documents. If your current attorney doesn’t take you seriously when you indicate your desire to care for you animals, they may not have YOUR best interests in mind. Estate planning is intimately personal and cookie-cutter plans should not be accepted.

Top photo courtesty of Maggie Smith. Bottom photo courtesy of my cat, Mr. Griffin.

Congress Does Unthinkable by NOT Addressing Estate Tax

Who wants to ring in the New Year with uncertainty? Well, that’s what Congress did by not getting around to extending the estate tax before December 31, 2009. Many experts believed this would NEVER happen. I discussed this in several past blog entries in September and December of last year.

Flashback to 2001: At that time, a largely Republican coalition in Congress tried to repeal the estate tax completely, but they were unable to get past a filibuster. So, instead, the changes were put into the tax code when then-President George W. Bush signed a bill that was designed to phase out the estate tax so that by January 1, 2010, the estate tax would no longer exist. However, since this was done through the tax code, Congress would have to revisit the changes within ten years, or the estate tax would come back into effect on January 1, 2011, at a higher rate. Generally all experts in the field believed that Congress would act and not allow the estate tax to disappear completely in 2010. But, Congress was so busy debating health care reform this fall that we have entered 2010, and the estate tax is temporarily gone.

So what will happen now? As of right now, if someone dies in 2010, his or her heirs will not owe any taxes on the estate. Sounds pretty good right? Well don’t go “pulling the plug” on Great Uncle Henry just yet. One also has to consider changes to the capital gains tax. Attorney Deirdre Wheatly-Liss wrote a fantastic blog on this topic.  If that same person dies after December 31, 2010, however, with an estate of 1 million dollars or larger, those same heirs will pay a 55% tax. This means that in 2011, a one million dollar estate will be reduced to $450,000, after taxes are paid. Considerinig your life insurance policies are countable in your overall estate, many more middle-class americans will be subject to estate taxes in 2011 if Congress continues to fail to act.

This uncertainty continues when Congress resumes session this year because our representatives may decide to draft a retroactive law reinstating an estate tax that would extend back to January 1, of this year! (Don’t go spending that windfall inheritance quite yet). No one knows howlong it will take Congress to act or what Congress will do. If Congress does act, then the question will be whether a retroactive law would be upheld in court. Unfortunately, it could be a long time, filled with much speculation, before Congress acts and whether that action is deemed constitutional.

While this uncertainty may exist for quite a while, some steps can be taken to protect your family. Please check in with your elder law attorney to learn about potential planning opportunities and to stay up to date on what Congress is doing with regard to the estate tax.

Astor Matter Reminds Us that Trustworthiness is Essential When Nominating Substitute Decision Makers

Lately, the matter of Brooke Astor’s estate has been covered in the media. Like many people she had an estate plan in place which included a Durable Power of Attorney and Health Care Proxy, which nominated subsituted decision makers in the event she would lose the capacity to make important financial and/or medical decisions at some point during her elder years. She did not want to burden her family with obtaining a Guardianship and/or Conservatorship through the courts. She did end up suffering from Alzheimer’s disease and her son took over her financial powers. He just didn’t do a very good job…

The following is an exerpt from this week’s AZCentral.

Anyone who has signed a financial document has to be squirming a bit over Brooke Astor’s estate case.

Her son, Anthony Marshall, recently was convicted of stealing millions of dollars from Astor while she suffered from Alzheimer’s disease before her death. Although the case largely centered on a contested will purportedly signed by Astor, other estate-planning issues also came into play.

One was a financial power of attorney signed by Astor that gave Marshall authority to direct her affairs if she became incapacitated - and the means to steal from her.

The episode provides a wake-up call for people who use financial powers of attorney. These legal documents can be highly effective in ensuring that someone else will be around to handle financial matters for you if you’re alive but unable to do so - as in the case of mental incapacity.

A power of attorney can be as short as a page or much longer, depending on the detail desired. They’re often included with a trust, will, health power of attorney (addressing medical issues) and other estate-planning documents.

For all the benefits of using a power of attorney to avoid a potential court-supervised conservator situation, there are pitfalls, too.

In particular, you need to trust the person whom you designate to act on your behalf. And you should make sure he or she is responsible, diligent and reasonably astute.

“They really are documents that people should pay attention to,” said Denise McClain, a financial principal and attorney at wealth-management firm Lowry Hill in Scottsdale. “You’re potentially passing along a lot of power.”

Senior Centers:The Importance Elders Staying Active & Social

I’ve been trying to come up with a new slogan for area senior centers. So far I’ve come up with Senior Centers: come for the free food, stay for the crafts! or Senior Centers: It’s WAY more than BINGO!

But seriously, senior centers offer independence for aging adults. They play a very important role in the lives of elders today by encouraging them to become and remain social.

Socializing can help seniors with depression, dementia, or alzheimers. I know, you will say, Mom or Dad will not go to a senior center. Then make it easy for them. Go along with your parent for the day. Make it an outing and then take them to lunch. In most communities any aging adult who is 60 years old or older can join a senior center. You can also see the things that a senior center has to offer that Mom or Dad might be interested in or enjoy.   Knowing that your parent is at a center, or on an escorted day-trip can reduce the stress and anxiety you may have about your parents sitting home watching television all day or being alone. The main thing is to get them out and about.

Senior centers allow elders to develop a social network by making and meeting new friends. Senior centers offer programs and services like crafts, bingo, fitness, dances classes, travel to museums, computer classes, health screenings, informational speakers, daily meals, birthday luncheons to celebrate each member’s birthday and much more. Many senior centers also offer outings to do things such as live performances, fall foliage tours, and tours of Newport Mansions. Your loved one gets out of house, has an opportunity to socialize, while getting some light exercise and enjoying a good meal with great friends. Each senior center usually publishes a monthly calendar with a schedule of daily activities or programs.

To get your elder started, sign them up at your local center and tell them that they do not need to go everyday. They can start once a week, playing bingo, let’s say. This way they will not feel pressured. You will see that before you know it, Mom and/or Dad will be visiting the senior center on a daily basis. Suddenly catching up on their favorite television program may not be a priority anymore. (But hey, that’s what TiVo is for!)

So what if your parent/loved suffers from Alzheimers/Dementia and is too far gone to meaninfully participate at a Senior Center? Why not explore Adult Day options? These programs offer the socialization that some say is vital to keeping the disease at bay while also providing a safe, secure environment, specifically catered to your parent’s needs.

Check out this listing of Worcester area senior centers.

Thank you to Senior Living for contributing material for this blog.

Elder Mediation: A Great Option to Diffuse Family Tensions When Planning for Elder Care

Can’t we all just get along?  

I see it more and more and it really saddens me: families unable to “get along” when it comes to decision making for elder loved ones. It can be as simple as whether Mom and/or Dad need to meet with an Elder Law Attorney, to concerns over finances and inheritance issues, to whether siblings agree on who should serve as primary caregiver, and/or to whether assisted living/nursing home care is necessary.

Often as family members age, family dynamics can become more complicated. Conflicts that have simmered below the surface can boil up and make conversation impossible. Sometimes the elders are involved in the discussions, but unfortuntately sometime they are too far gone to meaninfully participate.

Either way, even the most harmonized family can sometimes hit a bad note or two and require some assistance.

(Dun, dun, dun, dun!) Enter the Elder Mediator. Mediation provides an opportunity for the Elder and all concerned members of the family to participate in creating a thoughtful plan for future. In most cases Elder Law Attorneys can act as Elder Mediators with certain issues. However the scope of the disagreements can often rest in other issues that are not related to the elder law topic. An Elder Mediator, working closely with your Elder Law Attorney, is trained to assist families in identifying the real issues, separating them from the crucial issues of planning for elder care, and developing the best plan of care.

National Public Radio has recognized the usefulness of elder mediation for families dealing with aging issues.

As baby boomers age and options for their care increase, we will all face many difficult choices concerning how we handle transitions during our elders’ declining years. Families will have to be able to evaluate resources, options and develop flexible strategies to support their elders. Even when not legally competent to make decisions, it is important to include an elder’s wishes and expressed preferences when putting a plan into place. Elder mediation is a rational first step for families to help them address their changing needs while enhancing problem solving/communications skills and avoiding messy litigation.

States Moving to Expand Long-Term Care Insurance

Have you ever considered purchasing Long-Term Care Insurance (LTCI) but were unsure because of the seemingly high cost? Have you ever decided that you were willing to fund a LTCI policy just to find out that you were no long eligible? Several States across the nation have been working on expanding LTCI in their jurisdictions to increase coverage and make it more affordable and accessible. Hopefully Massachusetts will follow shortly.

Check out this article where Kaiser Health News reports on States Moving to Expand Long-Term Care Insurance.

MassHealth to Update Regs to Include Same-Sex Marriage Language

The Executive Office of Health and Human Services, Division of Medical Assistance, commonly known as MassHealth is making a much overdue amendment to their existing regulations. Finally same-sex marriages, which have been recognized in the Commonwealth since late 2003, will be officially recognized by MassHealth. Governor Deval Patrick also signed the MassHealth Equality Bill nearly one year ago.

So what does this mean to spouses in same-sex marriages? They can now receive the same benefits as heterosexual marriages when applying for MassHealth for longterm care, meaning their assets can be considered jointly for eligibility purposes and MassHealth will also not penalize transfers between spouses in same-sex situations, as they currently do for traditional marriages. The definition of “family member” is also slated to be amended under the change.

The full text of the memo can be found below.

COMMONWEALTH OF MASSACHUSETTS

EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES

DIVISION OF MEDICAL ASSISTANCE

NOTICE OF PROPOSED AMENDMENT OF REGULATIONS

The Division proposes to amend its regulations under the authority of M.G.L. c. 118E, ss. 7 and 12 and pursuant to M.G.L. c. 30A, s. 3. The Division describes the substance of the proposed actions as amendments to regulations found at 130 CMR 408.000: Adult Foster Care; 130 CMR 414.000: Independent Nurse; and 130 CMR 422.000: Personal Care Attendant.

On July 31, 2008, Governor Deval Patrick signed into law the MassHealth Equality Bill, which requires MassHealth to recognize state marriage laws when determining member eligibility for MassHealth programs. Accordingly, as stated in recently issued Eligibility Operations Memo 09-02, the definition of “spouse” in MassHealth regulations at 130 CMR 501.001 and 515.001 has been revised to include persons in same-gender marriages.

As a result of the above changes, a revision to the definition of “Family Member” for Adult Foster Care regulations under 130 CMR 408.000 and for Personal Care Attendant regulations under 130 CMR 422.000 is required, as is the definition of “Caregivers” for Independent Nurse regulations under 130 CMR 414.000. These revisions adjust the definition of “Family Member” and “Caregiver” to include a spouse “as defined at 130 CMR 501.001 and 515.001.”

It is anticipated that these amendments will not go into effect before September 1, 2009.

All persons desiring to submit data, views, or arguments concerning these proposed actions may submit them in writing to the Medicaid Director, EOHHS, One Ashburton Place, Room 1109, Boston, Massachusetts 02108, or e-mail them to masshealthpublicnotice@state.ma.us. E-mailed comments should contain the sender’s name, mailing address, and organization or affiliation, if any. Comments will be accepted through July 31, 2009.

All persons desiring to review the current draft of the proposed actions may go to http://www.mass.gov/masshealth/proposedregs or request a copy in writing or in person from the MassHealth Publications Unit, 600 Washington Street, Boston, Massachusetts 02111.

The Division may adopt a revised version of the proposed actions taking into account relevant comments and any other practical alternatives that come to the Division’s attention.

By Order of the Division of Medical Assistance

TOM DEHNER, MEDICAID DIRECTOR July 10, 2009