On-line Workshops

Wed., April 30

Getting the Most from Your IPP

with guest speaker 

Jim Huyck, 

former Exec. Director of 

Alta Regional Center

To register, CLICK HERE

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Wed., May 28

Investment & Tax Strategies for Special Needs Trusts 

with guest Bradley J. Frigon, JD., LL.M, Englewood, CO

To register, CLICK HERE

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Wed., June 25

 To register, CLICK HERE

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 Each webinar is from 

6:30 p.m. - 7:30 p.m.

Pre-registration is required!  

Service is provided through GoToWebinar 

free of charge.  

Did you miss last month's webinar on 

"When Government Benefits Have Been Denied or Terminated"  

to view this and other past presentations, CLICK HERE!

Dear Reader:

Welcome to the Spring 2014 edition of The Achieving Independence Newsletter. 

We continue to reach out to our communities by highlighting various situations and needs.  This quarter's newsletter is going to discuss the needs of families dealing with Multiple Sclerosis or other neurological disorders, but much of the information contained in these articles can be helpful to everyone.

We have also included an announcement listing the next on-line webinars and in office trainings that we are providing (please look in the left hand column).  As always, these events are provided free of charge.

We hope you enjoy our newsletter.  If you have any questions or comments, please contact me at info@dalelawfirm.com.

Nina S. Jones, Editor 

The Achieving Independence Newsletter

*** Information contained in this newsletter is for educational purposes only and is not meant as a substitution for legal counsel.

Estate Planning 

for Persons with Multiple Sclerosis:

Making Sense of the Puzzle

By Stephen W. Dale, Esq., LL.M

All too often estate planning is considered death planning - but in many cases that couldn't be further from the truth.  In reality:

• Estate planning is taking control of your life
• Estate Planning is putting your instructions on your assets

An excellent example of this comes from my professional experience with clients who have been diagnoses with Multiple Sclerosis.  Let me provide three fictional case studies to illustrate how this works:

Case Study - The Jones

Sam and Beth were married 15 years ago.  They have one daughter - Barbara age 7.  Five years ago, Beth was diagnosed with MS.  Recently Beth had to quit her job and go on disability.

Sam has insurance for himself and his family but it does not cover long term care or attendant care services.  He wants to make sure that his family's needs are taken care of in the event of his incapacity or death. He also wants to make sure that his family's resources are not depleted leaving his family's needs unmet

Beth has many of the same concerns - but in addition, she is terrified that she will lose control of every aspect of her life and concerned that Sam might leave her (which is not an uncommon fear.)

Think of a trust as a contract that you create to control your assets.

• Trusts go into effect the moment you sign them;
• You can put your instructions on how your assets are to be managed directly into the trust;
• A trust centered plan should give you greater control, not only upon death, but more importantly upon your incapacity.

The Strategy

• Create a trust
• Focus on who will be in charge in the case of incapacity
• Position assets so that in the event benefits or asset protection becomes necessary, assets can be repositioned
• Create "Marital Special Needs Trust" in husband's will if he predeceases Beth
• Make the trust the owner and beneficiary of ALL their assets

John's Story - The House

John has MS and requires round the clock attendant care.   He receives SSI, Medi-Cal and IHSS.  SS provides 283 hours a month of attendant care, but he has two concerns.  283 hours of care provides only 9.4 hours of care a day.  IHSS workers are paid poorly and often don't show up.  

SSI limits a benefits recipient to only having $2,000 on the first day of the calendar month.  Any income, given to or earned by the benefits recipient reduces the beneficiary's SSI. 

John owns his home outright.  SSI allows a benefits recipient to own a residence of any value. Money borrowed from the equity of his residence is not income. 

John secures a line of credit on the equity of his home.  He borrows funds from the line of credit on the first of the month and spends it on his attendant care.  He is careful to make sure the money borrowed is spent in the calendar month it was borrowed from so that by the first day of the following month his resources are below $2,000.

Just don't forget that in the State of California, an unsecured claim can be made by Medi-Cal upon the death of a Medi-Cal recipient or their spouse against the benefit recipient's estate for benefits paid to them throughout the term of the support services.

Joni's Story - The Buy Down

Joni has Multiple Sclerosis, and owns a residence that she lives in valued at $400,000.  She wants to sell the home and purchase a smaller residence for $200,000. Joni would like to use the balance to pay for her care.

Both SSI and Medi-Cal allow a benefits recipient to own a residence of any value, but if Joni retains more than $2,000 in her own bank account, she will have a loss of eligibility.  If Joni does not have a parent or grandparent alive, she would be faced with a costly and time consuming legal procedure to authorize the establishment of a Self Settled Special Needs Trust. 

Joni could put the balance of the funds in a Pooled Special Needs Trust and then use the account to pay for her care that is not covered by Medi-Cal.

If the trust pays for her attendant care directly, there will be no loss of  benefits.

What Is In-Home Supportive Services?

IHSS, which is administered by each county Medi-Cal program in California is considered an alternative to out-of-home care, such as nursing homes or board and care facilities. The IHSS Program will help pay attendant services to person over 65 years of age, or disabled, or blind who want to remain in their community.  

What are the eligibility criteria for IHSS?

The recipient must:

1. Be a person over 65 years of age, or disabled, or blind;
2. Be a citizen of the United States, or a qualified alien, and a California resident; and
3. Live at home or an abode of their own choosing (acute care hospital, long-term care facilities, and licensed community care facilities are not considered "own home").

Additionally, the recipient must:

• Currently receive SSI/SSP benefits and Medi-Cal linked to SSI or 1619(b) Medi-Cal;
• Receive Medi-Cal with no share of cost including through institutional deeming, or the Continuous Eligibility for Children Program, or the Aged and Disabled Federal Poverty Level Program, or the 250% Working Disabled Program; and
• Receive Medi-Cal with a share of cost.

 How Do You Apply for IHSS?

You must call or visit the local county Medi-Cal office to fill out an IHSS application and verify your eligibility for the program.

A county social worker will come to your home to conduct a needs assessment to determine the IHSS services and hours needed.

Scope of IHSS Services

Services allowed under IHSS guidelines can include:

• Household chores such as cooking, cleaning, and laundry;
• Personal care services like dressing, bathing, and feeding;
• Transportation and accompaniment to medical appointments;
• Protective supervision; and
• Paramedical services as ordered by a physician.

Process for Obtaining IHSS

A county social worker will interview you at your home to determine your eligibility and need for IHSS. Based on your ability to safely perform certain tasks for yourself, the social worker will assess the types of services you need and the number of hours the county will authorize for each of these services. This assessment will include information given by you and, if appropriate, by your family, friends, physician or other health practitioner.

You will be notified if IHSS has been approved or denied. If denied, you will be notified of the reason for the denial. If approved, you will be notified of the services and the number of hours per month which have been authorized for you.

If you are approved for IHSS, you must hire someone (your individual provider) to perform the authorized services. You are considered your provider's employer and, therefore, it is your responsibility to hire, train, supervise, and fire this individual.

If your county has contracted IHSS providers, you may choose to have services provided by the contractor.  If your county has homemaker employees, you may receive services from a county homemaker.