Life Care Planning:  a holistic approach

An Elder Law Attorney’s job extends beyond preparing legal documents.  After the estate documents are drafted, or the MassHealth application is filed, I remain involved and work with my clients’ family.  With assistance from licensed social workers I advise you on the appropriate residence for your parents and services specifically for seniors.  Whether your parents live at home, in an assisted living facility or in a nursing home, I advocate on their behalf to guarantee their needs are accurately being met.  This additional service is of the greatest importance as our loved ones’ health deteriorates and it gets increasingly more difficult for them to voice their concerns.

Our lives are busy, but now you can rest assured knowing that your loved ones have a protector and advocate.  Navigating the health care system encompasses a myriad of services.  Unless you work with these services daily, it is impossible for one to know the extent of resources available to senior citizens and their families.  Below is a sampling of the resources I can assist you in obtaining:

1.         Assistance in applying for Medicare. Medicare is the federal health insurance program for persons 65 and older and for some disabled individuals.  Part A covers hospital care, Part B is optional and pays for physician’s and outpatient services, Part C is Medicare Advantage, and Part D is the prescription drug coverage program.

The states are required to pay the deductibles, coinsurance and premiums for Medicare Part A and Part B recipients who are low income or disabled.   In Massachusetts these programs are called MassHealth Senior Buy-In and MassHealth Buy-In.

2.         Assistance in applying for Medicaid Benefits (MassHealth). The Medicaid program is jointly funded and administered by the federal government and the states.  For people aged 65 and older it is a needs based program offered to people with permanent or chronic disabilities.  In 2006, Congress, in the Deficit Reduction Act, extended the look-back period from three to five years.  This now presents different planning options for long-term care expenses.

The Personal Care Attendant Program (PCA) is a MassHealth program that helps people stay in the community by providing funds for them to personally hire and manage their own personal care attendants.

Adult Foster Care (AFC) is a MassHealth funded program.  It is a program for frail elders who cannot live alone safely.  AFC adults live with trained paid caregivers who provide daily care such as housecleaning and administering medications.  A caregiver may be a family member and can receive up to $1,500 a month depending on the services being provided.

3.         Assistance in applying for Group Adult Foster Care (GAFC). The Division of Medical Assistance will pay approved agencies to provide assistance with activities of daily living to elderly and/or disabled MassHealth recipients living in assisted living facilities.  These services can prevent the necessity of transferring into a nursing home.

4.         Assistance in applying for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Supplemental Security Income (SSI) is a needs based federal program which provides funds to low income seniors and some disabled and blind persons.  A person can be both eligible for Social Security and SSI.

Social Security Disability Insurance(SSDI) is a federal program administered through the Social Security Administration that pays benefits to people who cannot work because they have a medical condition that is expected to last at least one year or result in death.  Certain family members of disabled workers can also receive money from Social Security.

4.         Assistance in applying for Veteran’s Benefits. The Veterans Affairs (VA) and Veterans’ Services pays for nursing home care, disability insurance, medical insurance, burials and pensions for Massachusetts residents.  A surviving spouse and children of a veteran with service-connected disability may receive compensation or pension.

The Aid and Attendance Pension is a benefit paid to wartime veterans who have limited or no income and who are 65 or older, or under 65 with permanent disability.  The Aid and Attendance benefit pension is a useful resource which can be utilized to pay for Personal Care Attendant services in your own home or in an assisted living facility.

5.         Determining the Appropriate Facility. Assisted living facilities and nursing homes are developing at a rapid pace. They each offer different services and accommodations and are only available to care for people with certain needs.  I can help you avoid spending hours researching facilities and investigating if a bed is available.

6.         Assistance in securing Community Based Services. Non-profit organizations classified federally as Area Agencies on Aging (AAA) and state designated as Aging Service Access Points (ASAP) provide services to elders in their homes.  The facilities in Western Massachusetts include Highland Valley Elder Services, WestMass ElderCare, Franklin County Home Care Corporation and Greater Springfield Senior Services.