Elder Law FAX Blog

Where is your Health Care Advance Directive when you need it?

Advance Directives are a good idea but a great idea is making loved ones aware of your ideas related to end-of-life care. Discussions about end-of-life care and the personal values that shape those health care related ideas are vital to ensuring your desires are carried out if all possible. Sadly only 30% of Americans have had those types of conversations.  Documentation is an acceptable substitute. These important documents should not be tucked away in a file cabinet somewhere – out of sight and out of mind.  There are ways to work around this barrier, one of which is a new app launched earlier this year by the American Bar Association.

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Unreimbursed Medical Expenses and Veterans Pension Claims

Current Department of Veteran Affairs rules related to reimbursement of custodial care and assistance with Instrumental Activities of Daily Living (IADL) versus ADLs were clarified in Fast Letter 12-23 dated October 26, 2012.  IADLs are activities other than self-care that are needed for independent living, such as meal preparation, doing housework, and other chores, shopping, traveling, doing laundry, being responsible for one’s own medications and using a telephone.

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New Federal Rule concerning Home and Community Based Services

Centers for Medicare and Medicaid Services Home and Community Based Services Setting and Person Centered Planning rule was released in January 2014. There are two important aspects to this Rule: the Person Centered Planning Process and the Home and Community Based Services Settings.  The Person Centered Process is intended to increase the person's input in how services are planned and what is included in the plan of care.  While the Home and Community Based Services Settings (HCBS) rule "increases protections relating to where people receive Home and Community Based Services".  The goal is to ensure that every person receiving HCBS: has access to benefits of community living, has full opportunity to be integrated in their community and has enhanced protections.  They will apply to residential and non-residential services and setting. These rules will be applied to everyone receiving HCBS funded by Medicaid including people receiving HCBS in the CHOICES program.

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Feds Publish Guide to Preventing Financial Abuse of Care Facility Residents

Mr. R, age 77, suffered from Alzheimer’s and Parkinson’s diseases, diabetes and other ailments. His pastor persuaded the former church deacon to grant him authority to manage his finances and care decisions. The result of this misplaced trust included 130 ATM withdrawals from Mr. R’s bank account, nine months of unpaid nursing home bills, and the threat of discharge for nonpayment. The victim died at his facility. The perpetrator was charged and convicted of financial exploitation of a vulnerable adult.
Called the "crime of the 21st century" by a federal consumer agency, how can incidents of financial abuse of care facility residents be prevented?


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Medicare Special Enrollment

While we may be a few months away from Open Enrollment, which starts in October, for making Medicare related changes a Special Enrollment Period (SEP) may occur at any time. Special Enrollment Periods are triggered by special events or circumstances and while are not calendar driven may have time limitations. You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. Rules about when you can make changes and the type of changes you can make are different for each SEP.

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