Your Legal Hour – February 24, 2014

Welcome to Your Legal Hour!

This week’s topic is Trust Design (Part 2).

Questions about the materials presented? Contact us at info@lawyerswithpurpose.com

Supporting Materials from This Session

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Medicaid: Understanding The Six Activities of Daily Living Standards (ADL’s)

Many times in complicated Medicaid planning cases, the attorney is trying to work out the funding plan before figuring out what rules apply.  Before you go any further, you've got to determine whether the client is eligible, and what the qualification standards are.

Everyone focuses on the assets and income test, but that's not the only test. Number one is, does the client meet the needs test? By that we mean the “Activities of Daily Living,” or ADL's. They are necessary in determining eligibility for Medicaid.

Bigstock-The-Number-Six--Red-Plastic-46672468The six ADL standards for Medicaid clients are whether they can:

  1. Bathe themselves.
  2. Dress themselves.
  3. Transfer from a bed or chair, which usually means from a sitting position to a standing position.
  4. Walk.
  5. Feed themselves.
  6. Toilet themselves.

If your client is unable to do one of those six things, the client would be considered in need of adult care, which is the lowest level of care. If the client is missing two of the six, that would earn a rating of assisted living. If the client needs help in three or more of those areas, that would be considered chronic care need or nursing home need, which in most states is the threshold that qualifies the client for Medicaid.

There is a major exception to the ADL standards, however: severe dementia. Usually severe dementia will inhibit the client's ability to do one or two of the six ADLs, but not always. If you can bathe and dress yourself – and you can do all six of these things, but you don't know why you’re doing it or how to do it or when to do it, then you will be considered to have severe dementia, which is an automatic qualifier for chronic care or nursing home care.

One other note: Traditionally, Medicaid only covers the chronic care level. Some states, including New York, will cover assisted living, but those rules are dependent on your state.  Most states do not cover assisted living. So knowing your state's standard is essential to serve your Medicaid clients.

David J. Zumpano, Esq, CPA, Co-founder Lawyers With Purpose, Founder of MPS, Founder and Senior Partner of Estate Planning Law Center

 

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Financial Abuse of Elders & Other At Risk Adults – Part Six

Adult Protective Services: First Responders for Reporting Elder Financial Abuse

All 50 states and the District of Columbia have an Adult Protective Service (“APS”) agency to investigate reports of elder abuse, neglect or exploitation, as required by Title XX of the Social Security Act.  The stated mission of an APS program is generally “to ensure the safety and well being of elders and adults with disabilities who are in danger of being mistreated or neglected, are unable to take care of themselves or protect themselves from harm, and have no one to assist them.”  The primary guiding value of an APS program is as follows: “every action taken by Adult Protective Services must balance the duty to protect the safety of the vulnerable adult with the adult’s right to self-determination.”

Bigstock-Abusedpiggy-6651443The general process for generating an APS investigation of alleged financial abuse of an elder includes the following steps.

 

  • A report is made to APS by someone who suspects elder abuse, exploitation, or neglect.  The reporter may call an abuse “hotline” or a state APS office.  The National Center on Elder Abuse maintains a database of all state APS contacts, which can be accessed by calling the Elder Care Locator Service at 1-800-677-1116 during regular business hours, or by visiting https://ncea.acl.gov/Resources/State.aspx.  The reporting person is protected from both civil and criminal liability.If the case meets all eligibility criteria, (e.g. age of victim, type of abuse, victim’s vulnerability), APS assigns a priority response time to the report based on the level of victim risk; involves emergency responders, if necessary; and assigns the report to APS for investigation.
  • APS staff contacts the elder victim within the state regulated timeframe (keyed to the urgency of the situation) to assess any immediate risk, and to investigate and substantiate the alleged abuse (with the assistance of law enforcement, if necessary).  Caseworkers then assess the current risk factors for the victim, including her ability to understand her risk and to give informed consent to further investigation and provision of protective services.If the victim consents, the APS caseworker develops a service plan, which may include both short-term emergency services (shelter, meals, transportation, home health services, medical or mental health services) and long-term services that are monitored by APS to assure that the risks to the victim are reduced or eliminated.  Substantiated criminal activity is referred to the prosecuting attorney.If the victim has the capacity to understand her circumstances and refuses an investigation or protective services, the APS caseworker may refer her to other resources before closing the case.  However, if APS has been able to substantiate if an elder has been abused, neglected or exploited by another person, it is required to report this to law enforcement even if the victim does not consent to the report.
  • While the demand for APS services has increased dramatically, program funding has either remained level or decreased in recent years.  In Georgia, APS case referrals in 2012 were up 22% from 2011 and up 67% from 2008.  Nevertheless, funding has not increased to meet this demand.

Part 7 of this series will discuss the Long-Term Care Ombudsman programs mandated by the Older Americans Act for addressing the elder abuse complaints of persons residing in nursing homes or other long-term care settings.

Kristen M. Lewis, Esq., Member of the Special Needs Alliance and Fellow of the American College of Trust and Estate Counsel.

 

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February 2014 Member of the Month – Alan Hougum / Wausau, WI

Member-of-the-month-alan-hougumWhat is the greatest success you've had since joining LWP?

Our greatest success since joining LWP™ has been to move our team forward from basic tax and estate planning to being able to provide comprehensive asset protection and elder law solutions, as well as being able to serve veterans and their families.

What is your favorite LWP tool?

Our favorite tool is the underappreciated Estate Plan Audit. Other tools may get the headlines, or get invited to the glamorous parties, but we get the most mileage from the Estate Plan Audit because it helps us to further identify and clarify client goals and convert those goals into definable solutions as we transition to the Vision Clarifier.

How has being part of LWP impacted your team and your practice?

Being part of LWP™, including the retreats and the team coaching, has made our team a much more cohesive unit. The coaching has been instrumental in helping us to think and act with one voice working toward a common goal rather than as individuals performing separate, unrelated tasks. In addition, the support from LWP™ member firms is unsurpassed through the listserv,
phone conferences, or site visits from our favorites.

Your Legal Hour – February 17, 2014

Welcome to Your Legal Hour!

This week’s topic is Trust Design.

Questions about the materials presented? Contact us at info@lawyerswithpurpose.com

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Community Means Being There

Our latest Enhancement Retreat brought home a powerful message: Community can be a difference-maker. I simply cannot articulate the sense of community that we all felt there;  you had to experience it firsthand.  I have personally attended all nine of our Enhancement Retreats, and this year we are kicking it up a notch. 

Over thirty five elder law and estate planning firms from across the nation, along with their dedicated team members – 125 people – in a room together for two and a half days, three times a year.  We were sharing values and goals with other like-minded entrepreneurs, law students, paralegals, client service coordinators, marketing coordinators – all of these different roles coming together to make their firms shine.

Members were blow away with what they have accomplished since our last retreat in October – just four short months ago. 

Bigstock-Light-Bulbs-Teamwork-Concept-21698504Community played a big role in making that happen. It’s important to be able to communicate what community is.  People join clubs and organizations on some level for the community they get.   If it’s a gym, you get the accountability of people saying “Where were you on Tuesday?  We missed you at cycling class!” People are dependent on you and they feed off of your energy and the excitement you bring.  The collaboration and accountability that comes from community meant the goals that were set in October were going to get met.  No.  Matter.  What. So being in the room is key; that's a message we can't articulate with a marketing piece.

Being there means you hear things from other members – we call them your Board of Directors – like “You have to slow down and manage that growth,” or “You have to speed up.”  It means you can talk more and share what has worked and what hasn’t.  One of our  members declared in the room that he would be launching consistent workshops starting in April.  His Board of Directors responded, “You can’t wait!  You’ve got to do it now to leverage your time!” 

These conversations with others support you with controlled and consistent growth.  Most people are afraid of growth and success.  It’s scary.  They don’t know if they are doing it right.  They are afraid they are going to blow up what they’ve done before. Community can be the antidote for those fears.

And it goes way beyond the attorneys. For the perfect storm, we also have your team centric. It’s great that you're getting ideas from other attorneys, but the beauty is that they have teams together that are on the front lines.  They’re talking, sharing, gaining confidence and getting fired up!  I was hammered with emails when I got back asking how they can get their hands on tools, webinars and training pieces, to get whatever they need in their bones to support the firm with reaching its goals.

Our attendees are definitely on a high this week – so come April they may gap out.  But June is just around the corner, and they’ll be back in the room for the next Enhancement Retreat.  That will bring accountability.  Collaboration.  Meeting with their Board of Directors.   You will only get so much from the ListServ, the Live ListServ, Your Legal Hour, member webinars, marketing roundtables, etc.; they are no substitute for being in the room.

Molly L. Hall, Co-Founder, Lawyers with Purpose, LLC, and author of Don’t Be a Yes Chick: How to Stop Babysitting Your Boss, Transform Your Job and Work with a Dream Team Without Losing Your Sanity or Your Spirit in the Process.

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This Has To Work

It's Super Bowl week, and as you can imagine, the energy in the Mile High City is infectious. Community is brewing, and the birthplace of “America the Beautiful” is a giant love fest. The grocery stores, offices, banks and bus stops are all buzzing with “We got this!! Right?” For the past17 Sundays we’ve devoted our sacred recipes, handcrafted microbrews and family days, which took on a whole new religious zeal.  All anybody can talk about the past few weeks is spreads, odds and luck. I have to say, as a born and raised Buffalo Bills gal, it warms my heart to be “part of” a Super Bowl team (hold the Norwide jokes please).

 

Bigstock-Football-Fan-Celebration-21038801It’s been said that fear is the flip side of excitement. I am seeing evidence of this; the verve of January 1st is slowly fading as we approach flipping the calendar past the first month of the New Year.  Weekly football stakes, new budgets, revenue goals, and health goals are all officially moving from “game on” and resolutions to tenacity and inevitability. Something about February brings a purposeless calm to the calendar as a whole. The buzz is stripped harshly from the air once the Monday after Super Bowl hits. It really doesn’t matter if you follow football or not, it’s the reality of too many days ahead to count until the next excitement (socially acceptable distraction). There’s a melancholy stillness.

Just like the excitement/anxiety coin tossing around in Colorado right now, I see so many law firms experiencing the same emotions of “This has to work out.” The circumstance might be that you just hired your very first employee, or set a revenue goal that you have never set before, or committed to new office space that you are not certain you can afford.  When the hype and excitement is stripped away, we find ourselves in the quiet of “this has to work out,” and that is honestly never a feeling we want to have, especially when it's not “just a game.”  So when you find yourself with that feeling, ask yourself, is the “have to” feeling truth?  WHY does what we are doing right now have to work?  Am I putting the intentional time and intention in (training that new employee), or is the “have to” because I don’t want to go back to the locker room, huddle, engineer Plan B and then recourse.

It is just like the two-minute warning: If you are willing to declare that something just isn’t working, to confront the brutal facts of your current reality, in the face of absolute fear, you can find the courage to stop, recourse and commit to ending the insanity. That’s the beauty.  At the end of the game, nothing has to work other than your willingness to let go of “this has to work” and call another play when “Omaha” is no longer going in the right direction.

Molly L. Hall, Co-Founder, Lawyers With Purpose, LLC, and author of Don’t Be a Yes Chick: How to Stop Babysitting Your Boss, Transform Your Job and Work with a Dream Team Without Losing Your Sanity or Your Spirit in the Process.

Your Legal Hour – January 27, 2014

Welcome to Your Legal Hour!

This week’s topic is Boost Your Closing Rate with the Vision Clarifier (Part 2).

Questions about the materials presented? Contact us at info@lawyerswithpurpose.com

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Do You Know Lorraine?

Bigstock-Beautiful-Portrait-Of-An-Elder-5884730Recently, while reading the obituaries, I saw that Jeff, my neighbor’s father, died at the age of 78. While viewed as somewhat ordinary, it immediately made me flash back to my childhood and growing up in a neighborhood of over 25 kids, ten of which were myself and my siblings and seven were Jeff and his wife, Lorraine’s, all the same age as one of us.

We grew up in the 70s playing kick the can, red rover, red light/green light and many other outdoor games to keep ourselves busy (there were no video games in those days). With Jeff dying, it symbolized the end of an era we see as the “good old days” where you can relate back to where you came from and appreciate the simple things. I made it a point to visit Lorraine and her children, several of whom I was still casually in touch with, to express my condolences.

Unfortunately for Lorraine, she not only had to deal with the loss of her husband of 55 years, but also had to deal with the tremendous unknown of having to maintain her life without him. You see, Jeff did everything; he paid the bills, managed the finances, and handled all the financial responsibilities of the household, while Lorraine managed the family. Lorraine did not even know how much money they made each month. She was unsure of what bills had to be paid and she was scared to figure it all out now, without her most important ally with her. As an estate-planning attorney, the family naturally started to ask me questions, which began with, what we in the business often refer to as, “the morbid scavenger hunt” – that is, the hunt for information after someone has passed to try and figure out what was being done. They were unaware of insurance policies, financial accounts, bank accounts and, in fact, Lorraine did not even have power of attorney for Jeff in his final phase of life.

This very stressful time leading up to Jeff’s death and after his passing was exacerbated by the unknown and the additional fear created by it. Do you know someone like Lorraine? The truth is estate planning is ensuring you have a plan in place to handle the legal and financial matters while you are alive and healthy, after you become disabled, and after you pass. Ultimately, a properly drawn estate plan will also provide for a smooth transition after the second passing and, most importantly, avoid the family fights.

Lucky for Lorraine, I am an estate-planning attorney and do this every day of my life. And because I have a strong affinity to her, I was willing to sit in her kitchen and go through information with her and her children to try to assemble the past, resolving all the unknowns. We began calls to the insurance companies and some miscellaneous names she had given me all to try to discover all the pieces and parts that made up her financial life. The good news is we are making headway; but it didn’t have to be this stressful.

I feel for Lorraine and I encourage those of you who are not actively involved in your estate to begin the journey of knowledge now to alleviate the unnecessary pain created by the unknown after the pain of losing your loved one.

David J. Zumpano, Esq., CPA, Co-founder Lawyers With Purpose, Founder of MPS, Founder and Senior Partner of EState Planning Law Center.

Your Legal Hour – January 20, 2014

Welcome to Your Legal Hour!

This week’s topic is Boost Your Closing Rate with the Vision Clarifier.

Questions about the materials presented? Contact us at info@lawyerswithpurpose.com

Supporting Materials from This Session

Supporting Materials from Prior Sessions