What is Medical Assistance
Medical Assistance (MA) is a federal and state program that is administered to the states. In Minnesota, the program is called Medical Assistance. Included are other programs that can help Minnesota families. To be eligible for the following programs, an applicant must be MA eligible.
Alternative Care is a state funded program that supports home and community based services for persons 65 and over. The program provides services to prevent and delay transitions into nursing facilities. The program prevents the impoverishment of eligible seniors and shares the cost of care with clients by maximizing use of their own resources. The program covers trained caregivers, including respite care and home-delivered meals, adult day care, chore services and more. To apply for the Alternative Care program, call a Long Term Care Consultation Intake Worker in the county where you reside.
Community Alternatives for Disabled Individuals
This waiver is known as the CADI waiver. It provides funding for home and community based services for people that require the level of care provided in a nursing facility. CADI services can be provided in an applicant’s home, the applicant’s family’s home, a relative’s home, a family foster care home or corporate foster care home, a board and lodging facility or an assisted living facility.
Medical Assistance Elderly Waiver
The Elderly Waiver is a program that helps people 65 years or older pay for services that allow them to remain in their home or an assisted living facility. (Please see the July 2012 blog for a complete discussion of the Elderly Waiver.)
Medical Assistance for Employed Persons with Disabilities.
his is a work incentive program that promotes competitive employment and the economic self sufficiency of persons with disabilities by assuring continued access to MA for necessary health care services. MA-EPD allows working people with disabilities to qualify for MA under higher income and asset limits than standard MA. The goal of MA-EPD is to encourage people with disabilities to work while enjoying the money that they earn.
Community Alternative Care
This waiver provides for funding for home and community based services for persons with chronic illness. The CAC waiver is designed to serve persons with disabilities that require the level of care provided in a hospital. A person can apply for the CAC Waiver at their local county social service agency.
This waiver provides funding for home and community based services for people with developmental disabilities. These services may be performed in an applicant’s home, in the family home, in a relative’s home, in a foster care home or corporate foster care home.
The Brain Injury waiver provides funding for home and community based services for people who have traumatic brain injury. The services under this waiver may be performed in the applicant’s home, the family home, in a relative’s home, in a family foster care home, in a corporate foster care home, a board and lodging facility or in an assisted living facility. A person can apply for the BI Waiver at their local county public health or social service agency. The Department of Human Services Division administers the BI Waiver.
For more detailed information, please call WL Brown Law Office and click the following link to the Department of Human Services: www.dhs.state.mn.us
Answer Your Medical Assistance Question: 612-309-9184
Elderly Waiver is an alternative to nursing homes
The Elderly Waiver program is authorized by a waiver to Minnesota’s Medical Assistance (Medicaid) program. The waiver allows Minnesota to receive federal funds to help pay for home and community based alternatives to nursing facility care. It’s designed to serve people who are 65 years of age and older that require the level of care provided in a nursing facility.
To receive Elderly Waiver, an individual must:
- Be 65 years of age or older;
- Have a long term care consultation screening;
- Require a nursing facility level of care;
- Be able to remain in the community, rather than a nursing facility;
- Choose to remain in the community;
- Be able to receive services in the community that are less than a nursing facility; and
- Be eligible for Medical Assistance.
How to calculate Elderly Waiver eligibility
An applicant can have no more than $3,000 in available assets. The applicant can have any amount of unavailable or excluded assets. If the applicant is married and both spouses are applying for Medical Assistance, the couple may have only $6,000 in available assets.
When calculating income eligibility for the Elderly Waiver program, the same deductions to income as in the Medical Assistance program are used. The Elderly Waiver program provides “extended” services that exceed the amount, duration and scope of the services eligible for Medical Assistance.
What Elderly Waiver services are allowed?
The following is a list of the extended services available through Elderly Waiver:
- Adult Day Care Services
- Adult Day Care Bath
- Adult Foster Care
- Family Foster Care
- Corporate Foster Care
- Assisted Living Services
- Assisted Living Plus Services
- Caregiver Training/Education
- Case Management Services
- Chore Services
- Companion Services
- Environmental Modifications
- Home Delivered Meals
- Home Health Services
- Homemakers Services
- Personal Care Assistant Services
- Residential Care Services
- Respite Care Services
- Supplies and Equipment
- Consumer Directed Community Supports
For more information on the Elderly Waiver program, please contact WL Brown Law Office.
Answer Your Elderly Waiver Question: 612-309-9184
Medicaid And Medical Assistance Are Need Based
As we noted last year, What You Need To Know Right Now About Medicaid And Medical Assistance, Medical Assistance is a need-based program. Every state has its own Medicaid program. Minnesota calls its Medicaid program Medical Assistance. Medical Assistance provides health care coverage for financially eligible Minnesota residents who meet one or more criteria.
These criteria are evolving to better keep up with our times. This article updates those criteria so that you can better serve your family and loved ones.
The current income limit for a one-person household is 100% of the Federal Poverty Guidelines (FPG,) which is currently $908 per month. People with income over 100% of the FPG may yet be eligible by spending down to 75% of the FPG, which is currently $681 per month. The income limit for a household of two is currently $1,227 per month. Households of two with income over 100% of the Federal Poverty Guidelines may still be eligible by spending down to 75% of the FPG, which is currently $920.
A resident of a long term care facility must:
- Pay all of his/her income to the nursing home
- Less allowable deductions
- Including a $89 personal needs allowance ($90 for certain veterans and spouses of veterans,) and
- An allowance for payment of medical insurance premiums
A community spouse is entitled to a spousal allocation to bring his or her income to $1,040 a month, or up to $2,739 if shelter costs are greater than $552 per month. Medical Assistance pays the rest of the long term care costs.
Medicaid And Medical Assistance Can Be Confusing
We are here to make the confusing understandable. WL Brown Law is available to answer your questions and to help you make sound decisions regarding elder law.
Answer Your Medical Assistance Question: 612-309-9184
Who would make health care decisions for you if you were unable?
Health related decisions are more and more in the news. Would you like to have input into your own health care? A Health Care Directive allows you to direct another person to make the decisions you want.
Health care decision making tools in Minnesota
The Health Care Directive allows you to designate a person or persons to carry forth your own health care wishes. These people are called health care agents. Some of the powers of a health care agent are to:
- Make health care decisions for you when your doctor believes you lack the decision-making capacity to make them
- Give consent or not to any treatment, service or medical procedure
- Withhold or stop health care necessary to keep you alive
- Receive, review and obtain copies of your medical records
- Act consistently with your wishes
The Health Care Directive empowers you
Some of your wishes included in the Health Care Directive are:
- The choice to be kept alive through artificial means or to pass naturally
- Whether or not you would like to donate organs, etc.
- Whether or not you would like cremation or a traditional burial
Health Care Directives must be well organized
There are a few requirements for a Health Care Directive to be valid. The Health Care Directive must:
- Be in writing
- Be dated
- State your name
- Be signed by you when you have the capacity to do so
- Have your signature verified by a notary public or two witnesses
- Include health care instructions or a health care agent or both
Answer Your Health Care Directive Question: 612-309-9184
William Brown is accredited to prepare, present and prosecute claims for veteran’s benefits
On January 14, 2011, William Brown received his accreditation from the U.S. Department of Veterans Affairs, Office of General Counsel in Washington, D.C. He has the ability to prepare, present and prosecute claims for veteran’s benefits before the Department of Veteran’s Affairs.
William Brown can help you receive Aid and Attendance pension
William also works with Minnesota financial planners and counselors to enroll veterans and/or their spouses in the Aid and Attendance pension program. The American Association for Wartime Veterans (AAWV) provides essential information on the program. If you are a veteran with one dependent you could be eligible to receive $23,388 annually.
William Brown preserves assets while applying for the pension
Most of the people WL Brown Law Office helps are World War II veterans, who preserve their assets while applying for the pension. To get a better understanding of the war, William and his wife visited Pearl Harbor in Oahu, Hawaii in January 2012. He visited the U.S.S. Bowfin — a Balao-class submarine commissioned on May 1, 1943 and used in the Pacific.
Our veterans defended our country & we defend your pension
William and his wife also visited the U.S.S. Arizona Memorial. The memorial is a floating monument to the men that lost their lives on December 7, 1941. He also toured the battleship, U.S.S. Missouri which was commissioned in 1944 and last saw action in Operation Desert Storm. William and his wife stood on the spot where the Empire of Japan surrendered to the allies on September 2, 1945.
William Brown wants to answer your Veterans Benefit questions
The pension may be available to the men, women and spouses of Pearl Harbor, WWII and subsequent United States wars. Please contact WL Brown Law Office to help you understand this veteran benefit pension.
Answer Your Veterans Benefit Question: 612-309-9184
Who Is a Vulnerable Adult?
Any person 18 years or older who is a:
- Resident or inpatient of a licensed facility.
- Recipient of care from a licensed adult day care or services program.
- Recipient of services from a licensed home care provider.
- Recipient of personal care assistant services under the Medical Assistance program.
- Any person 18 years of age or older who, regardless of residence or whether any type of service is received, possesses a physical, mental, or emotional impairment which limits that person’s ability to provide adequately for his or her own care without help.
AND, who has an impaired ability to protect himself or herself from harm.
Those who cannot take care of themselves are at risk. Unfortunately, our opportunitistic world includes those who will prey on them. The Vulnerable Adult Justice Project is our effort to protect those who can’t provide adequate care for themselves. Join us, won’t you?
How can you help? Please, read our pamphlet, WL Brown Law Office Is A Key Player In The Vulnerable Adult Justice Project, to learn more. Call WL Brown Law Office with your questions. We are in business to help you make the right decisions.
William Brown is active in our community providing the information you need to know in planning for the future. Late summer 2010, he lectured on estate planning concepts through Marketing B.O.N.U.S. Understanding Medical Assistance planning as it relates to estate planning is a vital tool in the state of Minnesota.
This talk was attended by two Vikings players, including Fred Evans. Also in attendance was a financial planner and several hospital representatives. Marketing B.O.N.U.S. was a great way for attendees to get business marketing support and the resources to effectively run a business.
Contact William Brown to discuss opportunities for him to come and speak with your organization. What do you want to learn about successfully planning for your retirement? What do you need to know about retirement years for your elderly family and friends?
Upon becoming an elder law attorney, I approached my mother and asked her if she had a will. My mother is a hard-working, black woman from Alabama. She answered, “What do I need a will for? I don’t have much.” I shook my head and reminded her of what happened when her mother passed. She remembered the sibling scramble and squabble over my grandmother’s heirlooms and remarked, “Well, I’ll get to it sometime.”
Is Creating A Will A Bother?
Sadly, my mother’s reaction is far too common. Many people don’t create a will, because they think they don’t have enough to leave behind. Why go to all that trouble if you’re not rich? Too many people of color fail to use estate planning tools to keep their hard earned wealth within their family. It is exactly these legal tools that you should use to pass what you have accumulated to future generations.
Creating A Will Simplifies The After Life
She asked, “Why do I need a will?” I decided to use this opportunity to discuss the importance of a will. A will is important for several reasons — one of them being that you can control how your assets will be disposed. If you die without a will, the state of Minnesota has intestacy laws that will dispose of your property, regardless of your intentions. When the state decides how to distribute assets, probate and administration costs can consume far more of your estate than having your will distribute assets. With a will, you can designate a personal representative who will represent your wishes and execute your will. A will simplifies estate administration and reduces post-death costs, which means more is likely to stay in the family.
Creating A Will Can Be Simple
Mother looked more intrigued as I spoke. She got off the couch and showed me her special gold bangles that I remembered from childhood. She told me to make sure her grand daughter, my daughter, got them after she died. “Is creating a will complicated?” I assured her that creating a basic will is not at all complicated. Creating a basic will can be as simple as:
- Identify yourself as Testator
- Appoint a personal representative with powers to execute the will
- Create instructions for payment of debts, taxes and expenses
- Create specific bequests to beneficiaries
- Create a residuary clause disposing of all other property
- Create a general governing provision including definitions, protective provisions and a tax allocation clause.
Is Creating A Will Revokable?
She then asked, “What if I create a will, but later I want to change it?” I replied, “You can revoke it or change it at any time.” “How?” There are three ways to revoke a will:
- Physically destroy the will (with the intent to destroy it)
- Write a document to revoke the will
- By changed circumstance (for example, divorce)
Alternatives To Creating A Will
My mother then stated that she might not need a will because she has various accounts that have named beneficiaries. I agreed. There is no legal obligation to create a will. I said, “Mom, if you die without a will, Minnesota has one created for you.” There are will “substitutes” that dispose of certain property and assets in particular ways without a will. I gave her four examples of how assets and property can pass to another person without a will:
- Intestacy laws in Minnesota will dispose of your assets by dividing the estate in probate proceedings.
- When people have joint ownership with right of survivorship — for example, when one spouse dies the house goes to the survivor.
- Pay on death (P.O.D.) accounts with beneficiary designations can pass to beneficiaries without a will.
- Revocable living trusts can avoid a lengthy probate process but don’t avoid federal or state taxes.
Does Creating A Will Bring Death Sooner?
She told me that all the talk about a will made her feel as if death was right around the corner. I told her that many of my clients have this unsubstantiated fear. “Mom, creating a will is not planning for your death. A will is only one tool that you can use to control how your property and assets are disposed after your death.” Wills, trusts and estate plans are methods available for people to have control of their assets and give to the next generation. This should bring peace of mind, rather than worrying about death. Putting a reasonable plan in place now gives you a voice whenever death comes. It allows you to enjoy the fruits of your labors today. People of color should use these tools to preserve the wealth that we are creating. All too often we do not.
Creating A Will Brings Peace Of Mind
I created a will for Mom and it was a simple process. She is now comfortable that she has decided who will get her things and that there will be no squabbling. Creating a will eliminated one more worry from her esteemed life. Her family is comfortable knowing that Mom has her house in order. My mother has a plan. How will you distribute your assets?
Answer Your Creating A Will Question: 612-309-9184
In Minnesota, the Health Care Directive has simplified complications involved in legacy powers of attorney. It allows you to appoint another person, your agent, to make health care decisions for you if you become unable to do so. You give written instructions about what you want done under which conditions and your agent implements them as required. Health Care Directives simplify the process of fulfilling your wishes even when you are not able to decide at that time for yourself.
Clarify Your Wishes With A Health Care Directive
Can you imagine the peace of mind in your loved ones if you are suddenly struck down and facing complicated health care decisions, but your health care agent directed them with your written directives? Suppose, however, that your ex-wife wants to visit you and your agent favors your current wife and she doesn’t want to allow the visit. What happens if your agent simply dislikes somebody come to visit you? Just how far does the health care directive extend? What are the rights of the visitor?
Nursing Homes And The Health Care Directive
Residential rights in nursing homes are governed by the Title 42 of the Code of Federal Regulations (CFR) Section 483.10:
(j) Access and visitation rights.
(1) “The resident has the right and the facility must provide immediate access to any resident by the following: … subject to the resident’s right to deny or withdraw consent at any time, immediate family or other relatives of the resident; and … subject to reasonable restrictions and the resident’s right to deny or withdraw consent at any time, others who are visiting with the consent of the resident.”
Health Care Directive And The Health Care Agent
If you do not choose a health care agent, and you become too sick to make your own decisions, your doctors will ask your closest family members to make these decisions for you. This is why it is so important for you to name the person you want to be your agent. Your health care agent can:
- agree to
- say no to
any of the following:
- doctors, nurses, social workers
- hospitals, clinics, care facilities
- medications, tests, treatments
- what happens to your body and organs after you die
Visitors And The Health Care Directive
What rights does the visitor have? The health care agent may know the rights or may not be clear on the limitations of your health care directive. Nevertheless, what if he still does not allow a visitor to enter? Most of us are not likely to know our visitor rights either. Clearly, an elderly visitor might not know or might be unable to remember their access and visitation rights.
The Health Care Directive Directs Health Care
The definitive recourse for the visitor is the health care directive itself. Health care directives allow agents to make health care decisions for the grantor. If a visit from an individual is not detrimental to the grantor, the agent must allow the visit to take place. The agent does not have the power to forbid visitation.
Hospital Visitation And The Health Care Directive
Rules for hospitals are governed by Title 42 CFR Sections 482 & 485. There are some recent changes in the federal rules regarding the rights of non-traditional family members visiting patients in hospitals. These rules require hospital policies to assure patients that they can be visited by the people to whom they are closest, even if there is no formally recognized relationship.