Information about the Contra Costa County Superior Court.

Link: Contra Costa County Superior Court
Updated: 1 Sep 2009

“The Academy seeks to provide support to other organizations serving seniors and people with disabilities. NAELA also examines and advocates on public policy issues facing seniors and people with special needs, but does not provide direct legal services. If you are seeking legal advice, please contact an Elder Law Attorney in your community. You can access a list of our members here.”

Phone: (520) 881-4005
Link: National Academy of Elder Law Attorneys, Inc. (NAELA)
Updated: 1 Sep 2009

Probate Help for Adults and Elders

Phone: (408) 882-2700
Link: Santa Clara County Probate Court Help for Adults/Elders
Updated: 1 Sep 2009

“Free legal advice and representation, Medicare health insurance counseling, and community education presentations.”

Phone: (510) 832-3040
Link: Legal Assistance for Seniors
Updated: 1 Sep 2009

Let’s presume that you are anticipating a parent will be entering a skilled nursing facility and wants the Medicaid program to pay the cost of that care. In California, where I practice, the Medicaid program is called “Medi-Cal” and it is the Medi-Cal program that I will be talking about.

Planning with Medi-Cal in Mind

The first issue that should be addressed in doing Medi-Cal planning is ensuring that the parent receives the care the parent needs for the remainder of the parent’s life. If the parent is not yet in a skilled nursing facility (SNF) or is not in a satisfactory SNF, attention must be paid to ensuring the parent’s acceptance at an acceptable SNF.

Sometimes admission to a SNF is not a problem, such as when the parent is admitted to a SNF with Medi-Cal paying the cost. But if this is not the case, the SNF’s approval of the parent’s financial situation will almost certainly be needed in order to gain admission. And, the SNF may have a waiting list, so the cost of the parent’s care during the wait should be allowed for. A SNF receives more money from private-pay patients, that is, patients who are not receiving Medi-Cal. Therefore, a SNF faced with a choice of a private-pay patient or a Medi-Cal patient to fill an empty bed, will choose the private pay patient. The parent will have a better chance of entering a good SNF if money is available to the parent to pay for the parent’s care, for about 9-12 months or so.

Given the current economic climate, the continued viability of the Medi-Cal program, is uncertain. This, too, should be considered when planning for the parent’s care and what can be done, if anything, to pass along an inheritance to the next generation.

Although there are many similarities among the Medicaid programs from state to state, there are also many differences. For example, there are periods of ineligibility for Medi-Cal if a person gives away countable assets to qualify for Medi-Cal. The Deficit Reduction Act of 2005 (DRA 05), a federal law, enacted very stringent penalties for giving away countable assets in order to qualify for Medicaid for skilled nursing care. However, in California, DRA 05 has not yet been implemented, as California has yet to create implementing regulations. Until it does, Californians will continue to operate under quite different rules than the rest of the United States. At this time, it appears that the regulations will be implemented some time in 2010.

Special Needs Trusts

With this in mind, an SNT to provide for the parent during the parent’s life would be preferred to outright gifts which are more likely to deprive the parent of funds needed for the parent’s care. However, creating a special needs trust for a person age 65 of over and who is either on or anticipating receiving Medi-Cal for SNF care raises the following issues, among others: capacity, financial elder abuse, and ineligibility periods for the benefits sought.

So, will it work to supplement a SNF Medi-Cal beneficiary’s care with their assets which somehow make their way to a SNT and avoid a reimbursement claim from California? It might be possible, depending on how it is done and when it is done. But this is a very risky endeavor and legal assistance should be obtained in developing and executing a possible plan.

The above is of course, intended as general information. Anyone wishing to implement this sort of planning should definitely retain an attorney knowledgeable in this area of the law as this sort of planning is complicated.

Includes a detailed description of many aspects of conservatorship and a link to the Conservatorship Handbook.

Link: California Superior Court’s conservatorship page
Updated: 1 Sep 2009

“CEI’s program is specially designed to offer an alternative to those elders who prefer to remain in their own home, but whose medical problems make it impossible for them to live at home without assistance from doctors, nurses, social workers, and other caregivers. Your care is planned and provided by a interdisciplinary team of specialists working together with you. When necessary, services may also be provided in your home, in a board and care or other group housing, in a specialist’s office or in a nursing home. Our primary care physician will manage your hospital care.”

Phone: (510) 433-1150
Link: The Center for Elders Independence
Updated: 1 Sep 2009

“Since 1983, California Advocates for Nursing Home Reform (CANHR), a statewide nonprofit 501(c)(3) advocacy organization, has been dedicated to improving the choices, care and quality of life for California’s long term care consumers. Through direct advocacy, community education, legislation and litigation it has been CANHR’s goal to educate and support long term care consumers and advocates regarding the rights and remedies under the law, and to create a united voice for long term care reform and humane alternatives to institutionalization.”

Phone: (415) 974-5171
Link: California Advocates for Nursing Home Reform (CANHR)
Updated: 1 Sep 2009

“Part of our mission is to protect, support, and advocate for an aging population, particularly those with disabilities. This is done through various programs: Adult Protection, In Home Support, Veterans Services, Area Agency on Aging, and Long Term Medical Care.”

Phone: (510) 577-1900
Link: Alameda County California Social Services
Updated: 1 Sep 2009

“Founded in 1977, Family Caregiver Alliance was the first community-based nonprofit organization in the country to address the needs of families and friends providing long-term care at home. FCA now offers programs at national, state and local levels to support and sustain caregivers.”

Phone: (415) 434-3388
Link: Family Caregiver Alliance (FCA)
Updated: 1 Sep 2009