Announcing VPLC’s New Senior Legal Helpline!

sr hotlineThe Virginia Poverty Law Center is pleased to announce our new Statewide Senior Legal Helpline.  The helpline is made possible through a partnership with the Department for Aging and Rehabilitative Services.  Funding was made possible through the Legal Assistance Systems grant from the Administration on Community Living.

The toll-free number (844-802-5910) is now available for Virginians aged 60 and older and for those calling on their behalf. We will seek to advise seniors on the following topics:

  • long-term care issues
  • public benefits (including Medicaid, SSI, and Social Security, Medicare)
  • guardianship and alternatives to guardianship
  • financial exploitation
  • adult abuse and neglect
  • age discrimination
  • as well as some limited consumer issues.

Our desire is that the Statewide Helpline will enable seniors around the state to obtain quality legal advice easily from the comfort of their homes.  VPLC will assess when further legal assistance is needed and to make referrals when appropriate.   Please direct any questions or suggestions about the helpline to VPLC elder law attorneys Kathy Pryor (kathy at vplc.org) and Davis Creef (davis at vplc.org).

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Virginia Legal Aid Programs Kick Off Expanded Services to Victims of Crime

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On June 13th, new and experienced legal aid staff members funded by grants from the federal Victims of Crime Act (VOCA) will converge in Richmond to share information, resources and obtain training. Through VOCA funds newly made available to legal aid programs, Virginia’s legal aid agencies will provide increased and more comprehensive services to domestic violence, sexual assault, trafficking and stalking victims, including divorce, custody, child support, spousal support, financial exploitation defense and immigration assistance. VOCA funds not only allow us to provide more comprehensive services to a greater number of eligible low-income victims of crime, it supports outreach to the most vulnerable among these, including the elderly, disabled, children, teens and LGBTQ.

We are extremely grateful to the Department of Criminal Justice Services, Virginia’s State VOCA Administrator, for recognizing the need for and funding comprehensive services that we hope and expect will transform the landscape of victim service provision in Virginia.

A new rule that became effective on August 8, 2016, allows state VOCA Administrators more flexibility in distributing funds to serve victims of domestic violence, sexual assault, trafficking and stalking. VOCA funds, for the first time, may be used for legal services beyond emergency services immediately following the crime (such as protective orders for victims). Virginia’s state VOCA Administrator, the Department of Criminal Justice Services (DCJS), distributed funding for comprehensive legal services such as divorce, custody, immigration visas and housing.

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“Aging Together” With Your Parents

Q. My husband and I are in our mid 60’s. Our kids are married with their own children, and we are ready to retire. Fortunately, my mother is still doing well at the age of 85, but she needs assistance with certain things and gets lonely easily. She was living with us, but we are now ready to sell our large home, and to downsize. After 40 years of working, we want to have fun in retirement and travel, but still be there for my mother. Do you know of a good compromise for a family in our situation?

A. Americans are living longer than ever before and there are consequently a growing number of older Americans facing your exact situation – a senior with a living parent – which means retirement years now often include  years of parental caregiving. How can you be there for an aging parent while still enjoying your own retirement and balancing your own life?

What was once coined as the “sandwich generation” is different than it used to be in many situations. It used to be that people were squeezed between aging parents and young children. Those folks still exist, but now an older population exists of children who are on the verge of retirement or who have retired and are still have responsibility for taking care of older parents.

A New Plan of Action

Seniors who are caring for aging parents might have a new plan of action to consider. Some seniors actually move into assisted living facilities, independent living communities, or Continuing Care Retirement Communities (CCRCs, which encompass both independent and assisted living, and usually nursing care also), alongside their parents. It can work out well for people in situations similar to yours, because they are reveling in the newfound ease of caregiving in such an environment and reaping the benefits of the facilities themselves, if they need them.

“It’s remarkably common for adult children to make big adjustments to take care of an aging parent,” says Philip Sloane, co-director of the program on aging, disability and long-term care at the University of North Carolina at Chapel Hill. Therefore, living in the same “elder” community represents “a new but logical aging services model.”

Let’s take Allen Geitwitz, for example. He is a 71-year-old retired computer programmer who moved into a nonprofit CCRC in suburban Baltimore just months after his mother entered the same facility. Geitwitz now lives in a separate one-bedroom independent living apartment down the hall from his mother, a starkly different living situation from the three to four days a week he had previously spent at his parents’ place and the home maintenance he managed on his own. “Either I was going to have to start paying people to do those things, or I’d have to sell the house and move into an apartment,” he said. “I thought, I’ll jump past that interim place.”

The Benefits of Co-Residence

When accessible, the benefits of co-residence are substantial. Here are some of them:

·         It’s a real comfort for an aging parent to know that a child is nearby when needed.

·         It can bring great peace of mind for the child knowing you’re there for your parent.

·         You can keep an eye on your parent and don’t have to travel a distance to see her. You can just walk over to visit.

·         There likely are activities available that you and your parent will enjoy.

·         You can be a companion to your parent when needed, and do activities you both enjoy together to combat loneliness.

·         You can escape from the worries, costs, and maintenance associated with a larger home.

·         You can still travel and do the things you want to do, knowing your parent has the care needed at the community.

Are you considering moving to the same CCRC as your parent?

CCRCs generally feature a combination of independent living apartments and/or cottages, assisted living, and nursing care, and many offer memory care and other specialty care arrangements. They also provide residents with 24-hour security, social and recreational activities, attractive dining options, housekeeping, transportation, and wellness and fitness programs. They are designed to allow residents to age-in-place, just not in their own homes. As residents progress from independent living to assisted living to nursing care within a CCRC, they can ideally continue their existing relationships with their spouse and friends, avoid the stress of multiple moves, and receive the long-term care they need, should it be needed, in an environment they know and trust.

However, there are significant financial risks associated with CCRC’s. One major drawback of moving into a CCRC is that you almost always sign away your right to do asset protection in connection with obtaining Medicaid and or Veterans pension benefits, so you must complete your asset protection planning before moving to a CCRC. Read more about this in our blog post, here.

I hope you find a living arrangement that suits your needs and your mother’s needs, and that you have a chance to relax during your retirement. You’ve worked long and hard for it, and you deserve to enjoy this time. You also deserve to protect the assets that you have worked so hard to earn all these years. if you and/or your mother have not done Long-Term Care Planning, Estate Planning, or Incapacity Planning (or had your Planning documents reviewed in the past several years) or if you and/or your mother are considering moving to a CCRC, please call us today to make an appointment for a no-cost consultation:

Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797

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Critter Corner: Advice for Male Caregivers

 

Dear Angel,

I am a caregiver for my dad and I am a man. When I tell people about it, they seem surprised. But, times have changed and I’ve read there are more male caregivers out there than people think. Sometimes, my role can be challenging, especially since I am not familiar with how to handle certain medical things. Do you know of any support programs or training videos available for men like me

Thanks!

Mel Kayrtaker

—–

 Dear Mel,

You are correct that there has been a notable increase in male caregivers, and it reflects the changing demographics in our country and the evolution of gender roles. Just as more men have increasingly become primary caregivers for children as their wives assume the family breadwinner role, now they are also becoming primary family caregivers for aging or ill loved ones. 

Jean Accius of AARP believes that what men need is “recognition they exist” and training for their role.

Homewatch Caregivers is an international home care agency that started the first online male caregiver support community in 2012. However, after four years they found men did not want to share their experiences and talk to other men online. Instead, they really needed help in managing their caregiving tasks and finding community resources. Homewatch Caregivers now works closely with numerous disease specific organizations, such as the National Multiple Sclerosis Society and the Alzheimer’s Association, to be able to provide the emotional support men need, and is now more focused on online training and “how-to” videos.

AARP has also created educational videos to help all caregivers, especially with tasks for which they are not trained. Click here (http://www.aarp.org/home-family/caregiving/qa-tool/info-2016/caregiver-workshops-and-training.html) for details.

Hope these resources are helpful for you!

Angel

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HAV Statement on passage of the American Health Care Act by the U.S. House of Representatives

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The American Health Care Act adopted by the U.S. House of Representatives would have a devastating impact on Virginians if it becomes law.

With no independent analysis of the most recent version, the House rushed this through without a full idea of its cost or how many people will now lose coverage. But with many of the provisions of the first version still intact, we know that the cost of Marketplace insurance will increase to unaffordable levels, especially for older Virginians. We also know that the bill still decimates Medicaid, cutting more than $800 billion over 10 years. Altogether, it will result in at least 341,800 more uninsured Virginians within a decade.

It will put many of our most vulnerable residents at risk, including children, people with disabilities and pregnant women. And it places a cap on federal funding for Medicaid, blowing a hole in state budgets and leaving state and local taxpayers to foot the bill. This arbitrary cap on Medicaid will put 1 million people on Medicaid in Virginia in harm’s way.

In addition, Virginia now stands to be punished further for its fiscally irresponsible decision not to expand Medicaid and pull down the available federal dollars to bring health care to hundreds of thousands of uninsured Virginians. Not only will those without insurance continue to suffer, the state will see its block grant or per-capita cap dollar amount set at the level of current enrollment, which is a reflection of Virginia’s parsimonious approach to health care rather than to the real needs of the state’s residents.

This measure also opens the door for insurers to deny coverage for pre-existing conditions, putting people with asthma, diabetes, heart defects and other conditions at risk. The recent addition of $8 billion to fund high-risk pools comes nowhere close to covering the cost of care for people suffering from pre-existing conditions. The bill even turns back the clock to a time when insurers could deny coverage for life-saving treatments by imposing annual and lifetime caps.

It’s now up to our senators — Tim Kaine and Mark Warner — to stand up for Virginia’s children, seniors, people with disabilities, pregnant women, families and those with pre-existing conditions who will be paying a dangerous price if this ill-conceived bill becomes law.

–Jill Hanken

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This Virginia Law Makes It A MUST to Do Medicaid Planning for Married Couples

Louise and Mark were married 50 years when Mark fell and broke his hip. Following hip surgery, Mark went to a nursing home for routine therapy. A previous stroke a few years before this had significantly weakened his body; thus, he was now unable to rally and achieve mobility again. For the past several years, Louise had physically and emotionally stood by Mark through a myriad of serious and even life-threatening medical issues following his stroke. Sadly, this final incident was the impetus for their physical separation and Mark would ultimately need skilled care in a nursing home. Unlike my pro-active clients and other regular readers, Mark and Louise had never even heard of Medicaid planning until she was luckily referred to me by the nursing home. Before coming to see me, she feared that she would be stuck privately paying all of Mark’s medical debt, including the $12,000 a month bill that the nursing home charges, and she knew that this would have depleted everything they have in less than 18 months.

According to the “doctrine of necessaries,” a law that is active in Virginia (Va. § 8.01-220.2), spouses have liability for the emergency medical treatment for the other, including follow-up care as long as they are not separated. In other words, as long as the marriage subsists, the financial resources of both spouses should be available to pay a creditor who provides necessary goods and services to either spouse.

History of the Doctrine of Necessaries

More than three centuries ago, English courts developed the doctrine of necessaries as a means of enforcing a husband’s duty to support his wife.  This rule permitted a woman whose husband refused or neglected to provide for her to buy her necessaries on credit, and the provider of necessities would be able to collect from the husband. The doctrine was regarded as a woman’s only legal means of enforcing her husband’s obligation to support her. The doctrine survived into the 20th century in both common law (meaning court cases) and statutory forms.

After a 1983 Virginia Supreme Court decision found the doctrine of necessities to be unconstitutional for discriminating unfairly against the husband, the Virginia law was modified to make the doctrine apply to both husband and wife, unless they were “living separate and apart.”

However, another mid-1980’s Virginia law made spouses “jointly and severally liable for all emergency medical care furnished to the other spouse by a physician licensed to practice medicine in the Commonwealth, or by a hospital located in the Commonwealth, including all follow-up inpatient care provided during the initial emergency admission to any such hospital, which is furnished while the spouses are living together. Several Virginia hospitals have unsuccessfully sued to try to force the healthy spouse to pay for inpatient medical care not related to emergency medical treatment. However, in those same cases, where the treated spouse had died, and the surviving spouse was the executor of the estate, judges have ruled that the hospitals have a case against the estate.

If one spouse is in a nursing home, is he or she considered “living separate and apart” from the other spouse?

To answer this question, I had to do some research on the definition of “separation” or living “separate and apart” in Virginia, in terms of divorce law. Separation, also known as “living apart,” occurs when a couple stops living together as husband and wife. If you or your spouse are in a nursing home, it is true that you are living “separate and apart,” but typically you still consider yourself to be a married couple. While parties are still legally married to each other and consider themselves to be together, state laws, including the Doctrine of Necessaries, generally require that they support each other.

Liability under the Doctrine of Necessaries

In Doctrine of Necessaries cases, the creditor has the burden of showing the necessities were furnished to the non-debtor spouse. To prevail under the Doctrine of Necessaries, most state courts require the provider of the necessary services or goods to show:

1. Services or goods were provided to the spouse;

2. Services or goods were necessary for the health and well-being of the receiving spouse;

3. The person against whom the action is brought was married to the person to whom the necessary services or goods were provided at the time such services were provided; and

4. Payment for the necessaries has not been made.

What if you are in a Different State?

These are the Doctrine of Necessaries rules in the DC Area:

District of Columbia: The Doctrine of Necessaries applies equally to both spouses and to domestic partners. Either spouse or partner may be held liable for a debt incurred by one of them or their dependent child for necessaries.

Maryland: The Maryland Court of Appeals has abolished the Doctrine of Necessaries.

Virginia: In Virginia, as already explained, the doctrine applies to both spouses, but only if the parties are not separated; if they were permanently living separate and apart prior to the event causing the medical bills and or nursing home bills to accrue, then neither can be held liable to a third party for the other’s necessaries.

When a couple moves from the Metro area after retirement to another state, or if a spouse receives expensive health care in a state other than that of his or her residence, the couple will be confronting the laws of their new state of residence relating to liability for necessaries, or of the state where the health-care provider is located.

What if You Have a Prenuptial Agreement in Place?

A prenuptial agreement will not assure that when one spouse moves into a nursing home, the other spouse is off the hook if the ill spouse’s resources run out. The ill spouse would typically need to apply for Medicaid at that point. However, the Medicaid program requires that the resources of both spouses be taken into account. Regardless of any agreement between them to the contrary, the application cannot be filed until the total pool of available resources is below a certain maximum.

Particularly in later-life second marriages, these issues need to be thought about. The main point is you cannot assume that your prenuptial agreement will supersede the requirements of the Medicaid program when it comes to a married applicant.

Medicaid Planning for Married Couples is a Must

For married couples in states where there is a Doctrine of Necessaries in place, the only way to make sure you do not fall victim to any support action is by planning ahead. Spouses need to be proactive regarding how their partners are financing their long-term care. Many families mistakenly assume that Medicaid will cover a spouse’s cost of long-term care once that spouse has depleted his or her savings and other resources. But you must remember that Medicaid does not only look at the assets of the nursing home spouse; rather, Medicaid looks at the assets of both spouses, regardless of how they are titled.  It’s also a huge mistake to assume that Medicaid will be easy to obtain.

Medicaid laws are the most complex laws in existence, with 8 separate bodies of law (4 at the Federal level and 4 at the state level) dealing with Medicaid and Medicaid eligibility.  To do proper Medicaid asset protection planning, families need the help of an experienced elder law attorney, preferably a Certified Elder Law Attorney such as myself.  If you or your spouse is over 65 or suffering from any sort of serious health condition, the best time to do Medicaid Asset Protection planning is now.  Whether you or your spouse is years away from needing nursing home care, is already in a nursing facility, or is somewhere in between, the time to plan is now, not when you are about to run out of money.  Please don’t hesitate to call us at any time to make an appointment for a no-cost initial consultation:

Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797

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VPLC’s Kathy Pryor received the Darrel Tiller Mason Excellence in Advocacy Award

kathy award upcloseVPLC’s own Kathy Pryorreceived the disAbility Law Center’s highest award at their Liberty and Justice for ALL Annual Gala. Kathy received the Darrel Tiller Mason Excellence in Advocacy Award tonight for her advocacy on behalf of the elderly and disablede’re proud to work with such an amazing attorney advocate and leader.

Read Kathy’s gracious and wonderful acceptance speech:   kathy speech with sign interpreter

I am so honored to receive this Darrel Tillar Mason Excellence in Advocacy Award.  Thank you!  As I look around this room, I see so many people who have been doing the hard work of advocacy for many years—advocating for the poor, for the disability community, for nursing home residents, and others.  I am honored to be among this group of caring committed people and I share this award with so many—

  • I share this award with my wonderful colleagues at the Virginia Poverty Law Center who, each year, tirelessly fight the good fight at the General Assembly, advocating on behalf of Virginia’s poor in a forum where the poor aren’t particularly popular but often have no one else to advocate for them—in seeking Medicaid expansion, working against predatory lending, ensuring that those receiving public benefits are treated with respect.
  • I share this award with those in the legal aid community around the state who advocate on behalf of their many low-income clients, saving clients from eviction, abusive relationships, predatory loans, nursing home discharges, termination of public benefits.
  • I share this award with the long term care ombudsman around the state who I am privileged to work with.  The ombudsman work tirelessly for nursing home and assisted living residents many of whom have complicated and seemingly intractable problems; and they have to face off against corporate administrators who too often seem to care more about the bottom line than the people they serve.
  • And I share this award with the advocates at the disAbility Law Center and other organizations around the state who advocate for those who are physically or intellectually challenged.

As I thought about saying a few words tonight, I tried to decide what excellence in advocacy means.  And what came to me is not actually the definition of advocacy, but I think it IS what all you who share this award have in common. What you all share is the idea of standing with and giving voice to those who may be unable to stand up for themselves or effectively give voice to their own needs or concerns.  Our efforts may not always be successful—certainly many of my efforts have not been.  But we do have some successes along the way.  And perhaps the act of presence with and standing up for vulnerable individuals and giving voice to their rights and needs is at least as important as whatever we might actually accomplish for them.

For those issues we address which seem to be insolvable, at least in our lifetimes, I leave you with this story from Following the Path by Joan Chittister:

“Tell me the weight of a snowflake,” a coal mouse asked a wild dove.

“Nothing more than nothing,” the dove answered.

“In that case I must tell you a marvelous story,” the coal mouse said. “I sat on a fir branch close to the trunk when it began to snow.  Not heavily, not in a raging blizzard.  No, just like in a dream, without any violence at all.  Since I didn’t have anything better to do, I counted the snowflakes settling on the twigs and needles of my branch.  Their number was exactly 3,471,952.  When the next snowflake dropped onto the branch—nothing more than nothing—as you say—the branch broke off.”  Having said that, the coal mouse ran away.

The dove, since Noah’s time an authority on peace, thought about the story for awhile.  Finally, she said to herself, “Perhaps there is only one person’s voice lacking for peace to come to the world.”

 

That is why we do advocacy—surely it is to help individuals today and to improve things incrementally along the way.  But we also hold onto that hope that ours might be that one voice which had been lacking for peace…or Medicaid expansion…or quality nursing home care…to finally come to Virginia.

Thank you for all your work and, on behalf of all of you, thank you for this award.

Kathy and mom

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New VPLC Study Released: The Myth of Virginia’s Rate Utopia

 Report Release

Report Cover

Today VPLC’s Affordable Clean Energy Project released its first report “The Myth of Virginia’s Rate Utopia: A Comparison of Rates, Bill, and Riders”

This report grapples with the disconnect between Virginia’s low electric rates, but the feeling many people have of high electric bills. We created this report to help ourselves and others understand this complicated area a little bit better.

Read the Media Advisory

Read the Report

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