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Elder Law Blog

Tuesday, August 28, 2018

Changes to Statutory Durable Power of Attorney


The Texas Legislature has approved major changes to the Statutory Durable Power of Attorney (SDPOA) - the form that allows you to appoint an agent to act for you in certain financial matters - making it imperative to review and consider updating your power of attorney.  Legislators expanded the instrument to include important new powers - including "hot powers" - which may be granted to your agent and may be especially useful for Medicaid Planning, Estate Planning, and Tax Planning purposes.  New agent duties and responsibilities were also added.

The so-called "hot powers" include authorities which may be essential in elder law situations:  for example, the authority to create a trust, to change a beneficiary designation, to create a right of survivorship, and to transfer property to the agent. 


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Monday, May 14, 2018

Nursing Home Rules Revised

The federal rules for nursing homes that participate in Medicare and Medicaid have been comprehensively revised, affecting requirements for admission contracts, care planning, resident rights, quality of care, transfer and discharge procedures, protections against abuse neglect, and exploitation, and other aspects of facility life.  Attorney Nancy Stone has co-authored a comprehensive article about the changes, which was published in the spring issue of the National Academy of Elder Law Attorneys (NAELA) Journal.  To go to our web page and read the article, click here.


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Wednesday, November 29, 2017

Tax Bill Cuts Medicare, Repeals ACA, Threatens Social Security and Medicaid


Senate leaders are working to ram through a tax bill this week which will greatly increase deficits, triggering $25 billion in Medicare cuts and leading to major cuts in Social Security and Medicaid to pay for the deficit.  The bill would chiefly benefit the highest earners while hurting the middle class, according to the Congressional Budget Office, the Joint Committee on Taxation, and other experts. In addition, the bill would repeal the Affordable Care Act's individual mandate to purchase health insurance, leading to higher health insurance premiums and making access to health care unaffordable for as many as 13 million. 


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Tuesday, September 19, 2017

New Bill Guts Healthcare, Medicaid


 

A new healthcare bill in the U.S. Senate would cap Medicaid spending per beneficiary, which means the program would no longer be an open-ended entitlement that covers everyone who qualifies for benefits.  Medicaid provides crucial funding of costly long-term care services for low-income elderly and disabled beneficiaries - services that Medicare does not cover.  The Graham-Cassidy bill would also "repeal and replace" key ACA provisions which ensure individuals, particularly those with a pre-existing condition, have access to adequate, affordable medical care.


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Tuesday, June 20, 2017

Senators Secretly Crafting Bill to Cut Eldercare

 

Following widespread protests at congressional town hall meetings over the American Health Care Act - the bill passed by the House which would repeal key ACA ("Obamacare") provisions, end Medicaid as an entitlement, and leave 23 million uninsured - Senate leaders are crafting their own version of the health care bill in secrecy, with no committee hearings, debate, or public input from stakeholders.   Only 10-12 Republican senators are writing far-reaching health care legislation to "repeal and replace Obamacare," which will instead deprive millions of people, including the sick, elderly and disabled, of access to needed, and in some cases life-saving, medical care.  Senate majority leader Mitch McConnell's goal is to have the full Senate vote on the bill before the July 4th recess, before other senators, the Congressional Budget Office, and the public have reviewed the sweeping legislation, and before the impact of the legislation on the American people can be analyzed and debated in a public forum.  


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Wednesday, December 7, 2016

Republicans Plan Eldercare Cuts

The Houston Chronicle published the following editorial on April 6, 2016: 

"Cutting the safety net: 

Republicans plan to reduce the federal government's contribution to health care. 

It's the time of year when we face, once again, the specter of Ebenezer Scrooge, that most parsimonious and black-hearted of, well, scrooges. This year, however, he has a modern counterpart whose heart may be even blacker: Speaker of the U.S. House of Representatives, Paul Ryan, R-Wis.


Read more . . .


Tuesday, November 15, 2016

Will Trump Dump Medicaid on the States?

How will elder care be affected when Donald Trump becomes president and a Republican-controlled Congress convenes in January?  We should prepare for potentially severe budget cuts in Medicaid and other programs affecting seniors and people with disabilities, according to news sources, experts, and advocates


Read more . . .


Tuesday, October 20, 2015

New Rules Proposed for Veterans Aid and Attendance Pension

New Rules Proposed for Veterans Aid & Attendance Pension

 

Sweeping changes to the Veterans Aid and Attendance Pension may be implemented soon.  The Department of Veterans Affairs (VA) has published proposed new rules that would clarify the amount of property and income a veteran or widow can have to be eligible for the pension.  In addition, the proposed rules would implement a look back period and a penalty for giving away property during the 36 months before applying for the pension. Transfers to trusts would also be penalized, with few exceptions.  Furthermore, the purchase of an annuity to reduce net worth could be penalized if the annuity would not have been in the claimant’s financial interest but for the claimant’s application for the pension.

 

The proposed rules would also limit the definition of Activities of Daily Living (ADL’s) for purposes of medical eligibility and unreimbursed medical expenses that can be deducted from income.  ADL’s would include assistance with dressing, bathing, toileting, transferring, and eating, but not medication administration and other instrumental activities of daily living.  The home care hourly rate would be capped at a national average rate.  Payments to independent living facilities would not be deductible medical expenses.

 

In response to the proposed rules, the Assisted Living Federation of America (ALFA) submitted comments to the VA, suggesting three changes to the proposed rules.  First, ALFA commented that the proposed rule regarding ADL’s is “excessively limiting by eliminating two frequent reasons seniors move into assisted or memory care communities:  the inability to ambulate on their own, and inability to administer their own medications “.  ALFA recommended that VA expand the definition of ADL’s and allow room and board at an independent living facility to be a deductible medical expense if certain conditions are met.  Finally, ALFA suggested that VA consider other sources in setting the limit for the home care hourly rate, including an industry cost survey and differences in rates across the country.

 

For several years, legislation has been filed in the U.S. Congress to implement a look back period for the pension, however the legislation has never been passed.  Instead, VA is using the rule-making process to implement a look back period and other far-reaching changes.  The final rules are scheduled to be published in fiscal year 2016, which began October 1st.  For more information, please contact The Stone Law Firm at 713.434.6310.


Monday, September 28, 2015

Conference Focuses on Special Needs Children Transition to Adult Care

Most parents of special needs children in the U.S. believe their children are not adequately prepared to transition to adult health care, work, and independence.  Consequently, the transition from pediatric to adult-based care for special needs children is the focus of the 16th Annual Chronic Illness and Disability Conference, Oct. 1-2, organized by Baylor College of Medicine and Texas Children’s Hospital, which will provide information on health care, legal, financial, employment, and residential issues.  The target audience includes youth/young adults with chronic illness and their parents/guardians, as well as physicians and health care providers.  The conference website and brochure are available at http://www.baylorcme.org/search/detail.cfm?cme=979

 


Tuesday, September 22, 2015

Recent Changes in Elder Law

On this first day of autumn, the Stone Law Firm is launching a new series of blogs on Recent Changes in Elder Law.

 

Veterans Aid and Attendance Pension

Proposed new rules for the Veterans Aid and Attendance Pension could make sweeping changes to the pension, if implemented.  The proposed new rules would add a 36-month look-back period and a penalty for gifting property, similar to Medicaid.  Another goal of the new rules is to clarify the maximum amount of assets that the veteran or widow can have in order to qualify.  Medical eligibility criteria may also be tightened.  The rules may be implemented as soon as October 1st or later in February, 2016.  We do not know what the final rules will be or whether pending applications will be grandfathered.

 

Texas Medicaid

With the legalization of same-sex marriage by the U.S. Supreme Court, the Texas Medicaid Nursing Home program has extended spousal impoverishment protections to all married couples, including same-sex married couples.  Spousal impoverishment protections are designed to protect the finances of the beneficiary’s spouse by providing a minimum monthly income to the spouse and allowing the spouse to keep one-half or more of the couple’s assets.

 

A Medicaid rule change has occurred in regard to Applied Income, or the co-payment that a beneficiary pays to the nursing home.  Medicaid will no longer exclude as an expense the withholding of taxes from Social Security and pension checks.

 

Estate Planning, Advance Directives, Guardianship

The Texas Legislature has enacted changes to the Statutory Durable Power of Attorney, Directive to Physicians, and Appointment of Agent for Disposition of Remains.  In addition, the Legislature added certain patient protections to the controversial futile care law by providing a medical standard for the withdrawal of pain medication and artificially administered nutrition and hydration. 

 

The Legislature also approved statutory changes that emphasize the use of less restrictive alternatives to guardianship, which deprives an incapacitated person of many legal rights.

 

Future blogs will provide additional details and updates on changes in elder law.  For more information contact Nancy Stone at 713.434.6310.

 

 


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Attorney Nancy Stone assists clients with Elder Law, Medicaid Planning, and Estate Planning throughout Harris County, TX. I am now based in Sugar Land and serve all of Houston, Harris County, Bellaire, Jersey Village, Cypress, West University, The Heights, Pearland, Alvin, Sugar Land, Missouri City, Kingwood, Humble, The Woodlands, Spring, Tomball, Richmond, Rosenberg Pasadena, Baytown, La Porte, Clear Lake, Texas City, Katy, Friendswood, Stafford, as well as Fort Bend County, Brazoria County, Montgomery County, Galveston County, Liberty County, Chambers County, Waller County and throughout Southeast TX.



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2245 Texas Drive, Suite 300, Sugar Land, TX 77479
| Phone: 713.434.6310 | 281.566.2500

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