Scott Solkoff addressing the Academy for Continuing Education (ACE)
Scott Solkoff addressing the Academy for Continuing Education (ACE) at the Mandel Jewish Community Center of the Greater Palm Beaches. Solkoff Legal, P.A. is the founding sponsor, having made an eighteen year commitment. After his children attended the pre-school, Scott served for eight years on the Board and served as Vice-President of the JCC.
For more information about the very successful ACE Program at the Boynton Campus of the JCC, click here-
http://www.jcconline.com/index.php…
With the Supreme Court extending marriage equality to same sex couples, comes all of the majesty, blessing and challenges of marriage. What does this new constitutional precedent mean for seniors? For elder rights, this means that same sex spouses will now join other married couples in enjoying the following rights, among others:
- The right of a spouse to receive their deceased spouse’s social security check if it be the larger of the two.
- The right to have precedence in appointment as guardian if the other spouse becomes mentally incapacitated.
- Inheritance “elective share” rights which, in most states, including Florida, means that a spouse cannot be disinherited absent a marriage agreement otherwise.
- The highest priority right to serve as Health Care Proxy for a spouse who has not appointed a surrogate health care decision maker.
- The highest right of inheritance should a deceased spouse die without leaving a Will.
- Parental rights for an adopted child since before the Court’s ruling, in many states, only one of each of a man or a woman were allowed to be the parent in a same sex union.
- The right to spousal benefits of a Veteran including money to pay towards care of a surviving spouse of any Veteran who served during wartime.
- The dignity to be listed as “spouse” on a death certificate. The lead plaintiff in the Supreme Court case sued for this reason. James Obergefell, the Court noted “[b]y statute, they must remain strangers even in death, a state-imposed separation Obergefell deems ‘hurtful for the rest of time.'”
- Absent a marriage agreement, the right to support in the event of divorce.
- A marriage performed in one state of the United States shall be honored in every state.
There are also some negatives:
- If one spouse needs to qualify for government help that is based on financial need, including Medicaid and certain VA benefits, the spouse’s assets now will be counted against the applicant spouse.
- Absent a marriage agreement, the obligation to pay alimony in the event of divorce.
- Absent a marriage agreement, the requirement to provide for one’s surviving spouse even if one desires, for example, to leave all of one’ assets to one’s own children.
- Unless legal documents are prepared, the spouse will have priority to serve as one’s health care and financial agent even if an incapacitated spouse would rather have a different person in charge.
- Financial aid programs of any kind typically count both spouses’ assets. This would mean a same-sex married senior who wishes to go back to college, obtain need-based services from a social service agency, get food stamps, housing assistance or apply for any other assistance that is based on financial need may no longer qualify.
The institution of marriage is no longer a right exclusive to men and women. Soon, we will lose the term “same-sex marriage” because we will recognize that these rights and responsibilities apply to all people regardless of gender. There is now just marriage.
The Patient Protection and Affordable Care Act (“ACA”) has been the law of the land since March 23, 2010 and has been fully implemented since January 1, 2014. On Friday, the United States Supreme Court upheld the constitutionality of the ACA for the second time, thereby assuring the ACA’s future ability to provide effective and affordable health care to all Americans. But what does this mean to you? To your parents? To people with disabilities? To all Americans who have a hard time affording to stay healthy? If you are not already conversant with the law and your rights, now is the time …
I do not pretend to be a disinterested reporter. I have believed in and fought for universal health care since before I went to law school. I am one of the early attorneys to have studied the Act and have spoken across the country to lawyer groups and others in the care professions. My article on how the Affordable Care Act affects the elderly and people with disabilities was just published in the most recent edition of the peer-reviewed NAELA Journal. Bottom line … I believe in the purpose of the ACA. I understand it’s weaknesses. I have witnessed its strengths. It is not perfect but for tens of millions of Americans who have already shifted from no health insurance to being insured, it means a higher quality of life and has often been the difference between life or death.
Before I start with statistics, please try to remember that these are not just numbers but human lives. Each digit represents parents, sons, daughters, babies, or someone’s grandmother or grandfather. These are are real lives. Here are some key facts:
• Your health insurance can no longer have annual or lifetime limits. You may have never known it, but before the ACA, your insurance would cut off completely and suddenly once you reached its limit. This limit would typically only be reached if you were unfortunate enough to have had a serious illness or catastrophic injury. For millions of people, this meant such horrors as losing all coverage in the midst of cancer treatments or other expensive and essential care. This led to unnecessary deaths and financial ruin. No longer is this the case. If you get horribly sick, your coverage is for life due to the ACA.
• Prior to the ACA, if you had been diagnosed with an illness or any disability, the insurers could deny enrollment to you. “Go away. We want only healthy people.” With the ACA and its continued constitutionality, no insurer can deny coverage based on disability or prior conditions. I speak from personal experience when I say that I have seen hundreds of my clients now be able to qualify for real health insurance for the first time in their lives.
• Last Tuesday, the federal government released the latest data on the affect of the ACA on the percentage of Americans having health insurance. 12.6 Million Americans went from being uninsured to insured in just 2014, the first year of the ACA’s full implementation.
• Subsidies and tax credits allow people to buy insurance when they could not otherwise afford to do so. The latest (and likely last major) challenge to the ACA attempted to remove these subsidies. The Supreme Court upheld the constitutionality of the subsidies.
• Prior to the full implementation of the ACA on January 1, 2014, polls showed that as many as 68% of Americans were against the ACA. Last week, after just seventeen months of seeing what the ACA really means, all polls (except one reported on today by FOX News) show that more Americans were for the ACA than against it and the majority of Americans said the Supreme Court show vote to uphold the law.
• Non-elected Democrats and Republicans have begun to reach consensus on support for the ACA’s key provisions even while elected representatives continue to show more division.
• Women can go to a gynecologist or obstetrician without a referral from a primary care doctor due to the ACA.
• You now have the right to a federally guaranteed internal and external appeals process if your insurance company denies coverage for your care.
• Your children can stay on your health insurance until the age of 26 regardless of what is going on their life.
• You can now access preventive care programs through your insurance that were never required to be covered before. More preventive care means healthier families.
• Cost of insurance is down nationally but certain insurance markets can be higher than others. Prices vary depending on where you live, your family income and whether you smoke.
• It is impossible to compare the cost of insurance today to insurance before the ACA because pre-ACA insurance was totally different. Insurance that covers pre-existing conditions with no lifetime or annual limits and with all the new appeal rights and consumer protections should cost a lot more.
• As of February 2015, the average premium before subsidies or credits was $361/month.
• The average employer-provided health insurance plan costs $6,119 per year. The average gold and platinum policies (the two highest categories) purchased through the ACA exchanges is $5,844.
• You now get a check back from your insurance company every year if the insurance company spends less than 80% of the premiums on direct health care. The ACA therefore curbs runaway insurance company profits at your expense. Tens of millions of dollars have already been returned to people (and business) like you and me.
• Medicare has new preventive care and a new welcome healthy check-up process.
• The Medicare prescription drug program has been strengthened by eliminating the coverage gap or “donut hole” by the year 2020.
• If you or a family member have a disability, you have been transformed from being a recipient of Medicaid, the only insurance-like product you could probably get, to having the choice of both or either Medicaid or private health insurance.
• If you are an adult and living in a state which has voted to follow the ACA’s Medicaid expansion, you can now qualify for Medicaid if you cannot afford subsidized health insurance.
• If you are an Elder Law and Special Needs Attorney like myself, you get to see many of our clients get covered healthcare for the first time in their lives.
It’s an amazing time to be alive! It’s an amazing time to be a lawyer helping people access care.
To read my full article “Report on the Affordable Care Act” published by the National Academy of Elder Law Attorneys, click here: https://www.naela.org/public/library/publications/publications_main/naela_journal_archive/naela_journal_2015/spring_2015/solkoff.aspx
Home health aides provide caregiving services to help keep people in their own homes or to provide attendant care services in a facility. Home health aides and certified nursing assistants are often the front line in long-term care and yet home health aides are paid relatively little money for doing highly personal, tough work. People often complain about the cost but few of my clients would want to do the tasks these caregivers do for $12-$25/hour. Still, even at those rates, the cost adds up and can seriously impact savings or wipe people out.
There are three primary venues for securing home health aides. From the lowest hourly rate to the highest, they are: (1) finding someone by word-of-mouth; (2) going through a “registry” or (3) going through an “agency.”
Hourly Rates
Hourly rates are not the only cost that must be taken into consideration when hiring a home health aide. There are insurance, tax and other liability issues, safety and reliability that should be considered.
Word of Mouth
Many of my clients come to me already having hired a caregiver based on a referral from someone they know. A neighbor, friend or relative might have worked with this caregiver in the past and given his or her name to my client. These workers can be very reliable because they may have already been vetted by someone you trust. Because they do not come through a registry or agency, all the money you pay the caregiver goes to the caregiver and you have cut out the middleman. This can be a cost-effective solution if it were not for certain hidden costs. For one, if the independent caregiver gets sick, moves away or just does not show up for work one day, it may be difficult or impossible to arrange for a quick replacement. Some people cannot risk even a day without care. Good home health companies would be ready with a quick replacement right away. Independent caregivers are generally not insured for malpractice. If something goes wrong, there is usually no recourse. Independent caregivers are generally not insured for risk should they become injured on the job; that could be a liability of yours as the employer and/or homeowner. You could do your own criminal background check on a caregiver but I find that few people actually take this step. Some independent caregivers are independent because agencies and registries will no longer hire them due to past violations of trust. Another “hidden” cost to the independent caregiver is that you are the employer and this means that you must deal with withholding taxes.
Registry
A home health registry is like an employment agency for home health aides, a matchmaker service which places home health aides with people who need them. The caregivers are not employees of the registry but instead act as “independent contractors.” The employer is typically the person receiving the care or some family member or fiduciary acting on behalf of the person receiving the care. A good registry attempts to make the best match based on personality, health and other factors. Because a good registry will have many home health aides to call upon, the registry can be effective in quickly getting another person to the client if the prior aide is not working out. Registries typically perform background checks, provide some training and most require the caregiver to carry a minimum amount of malpractice insurance. Still, the caregiver is not an “employee” of the registry and so the responsibility and liability of being an employer still rests with the person receiving the care or that person’s agent. Registries will pay a percentage of the fee they collect to the caregiver but the registries do not withhold taxes. Also, since the registries do not provide workers compensation insurance, bonding or full liability insurance, the client takes on that risk and the financial jeopardy. Because the registry has lower costs and takes less liability and responsibility, not being the employer, registries can charge less than agencies and therefore provide a lower hourly rate.
Agencies
Agencies have a true employer-employee relationship with their caregivers. The agency does all that a registry does including training, background checks and malpractice insurance but also takes on all the responsibility of an employer. The agency deals with all withholding and tax matters, pays for a bond, workers compensation insurance and sometimes other employee benefits. The cost is higher with an agency because the agency is taking on these other costs and responsibilities.
I have clients who have secured aides using all three of the above venues. Each has pros and cons. Like all businesses, there are good and bad. Talk to your advisors in the elder care world before hiring a caregiver and gather the best information before making a decision. What is right for one family may not be right for your family. If you are using a registry or agency, ask the company about what it provides and does not provide as there are differences. Talk to us at Solkoff Legal, P.A., for a referral.
For the first time in 25 years, Nursing Home Medicaid recipients in Florida have gotten a raise in their personal needs allowance! Beginning today, instead of retaining $35 per month, residents will now retain $105 per month to pay for personal needs such as clothing, haircuts, personal grooming supplies, and other personal items. This change will enhance the lives of tens of thousands of nursing home residents across the state.
Please check your mail for a “Notice of Case Action” from the Department of Children and Families documenting the change and accompanying reduction in patient responsibility.
If you have questions about this change, or would like to meet with a Solkoff Legal, P.A. attorney to address your long-term care needs, please call us at 561-733-4242.
Please click on this link to read the article.
http://m.apnews.com/ap/db_289563/contentdetail.htm?contentguid=c2KQiB7G
Heidi Friedman from Solkoff Legal, P.A. will be speaking on The New Health Care Law at the JCC/Academy of Continuing Education Program. This is held November 5, 2013 at 2PM
Scott Solkoff from Solkoff Legal P.A. will be co presenting with David Lillesand, Esq at the National Aging and Law Institute in Washington, DC at the Omni Shoreman Hotel at 11:30am
Scott Solkoff from Solkoff Legal, P.A. will be speaking on Medicaid and Veteran’s Benefits at the Elder Planning Symposium for the Florida Institute of Certified Public Accountants. November 7, 2013 at the Embassy Suites in Fort Lauderdale at 3:30pm.
On August 6,2013, the State of Florida released the Final Report of the Purple Ribbon Task Force detailing a state report and plan for dealing with Alzheimer’s Disease and related dementia’s. The eighteen Task Force members, including our own Scott Solkoff, were appointed by Governor Rick Scott and former Senate President Mike Haridopolis. The law required the Senate and Governor’s office to agree on one Elder Law Attorney and we are proud that Scott Solkoff was nominated and ultimately appointed. The Task Force met for over a year and dealt with many aspects of dementia including how state laws and public benefit programs affect dementia patients and their families.
