New York Estate Planning & Elder Law Blog

Creating a New York Health Care Proxy

Published on: April 13, 2017 | by Ettinger Law Firm

Comprehensive estate planning involves more than just creating a Last Will and Testament and possibly a trust for your heirs. Estate planning is also an opportunity for you to make sure that your wishes for end-of-life care and other related decisions are known to those who will administer your estate, your loved ones, and your estate planning attorney. For many people, part of end-of-life planning and care often includes nominating a Health Care Proxy. The State of New York Office of the Attorney General offers individuals some clarification and advice related to a New York Health Care Proxy.

Health care Proxy: An Introduction

In New York, a Health Care Proxy is available to anyone over the age of 18. The purpose of a Health Care Proxy is to allow you to appoint a trusted person to make health care decisions for you should you be unable to make such decisions yourself. The inability to make health care decisions could arise because you are being kept alive via artificial means such as life support machines or even because you are unconscious for certain medical reasons. When a health care agent has been entrusted with the authority to remove you from or prevent you from undergoing potentially life sustaining treatments or procedures, New York requires that a second doctor must confirm the original doctor’s determination that you are unable to make your own health care decisions.

Dental Care and Old Age

Published on: April 13, 2017 | by Ettinger Law Firm

As we continue to age, there are a number of ailments that develop and health issues that we are forced to address and adapt to. While we anticipate problems such as achy joints and the occasional stiff legs, we do often forget about the continued upkeep associated with dental hygiene. Dental checkups are easy to forget about and avoid, especially when you do not feel like anything is wrong, however, as soon as something starts to ache, the check up can turn into a very expensive visit. Many elderly individuals avoid going to the dentist due to the associated fear of costs and lack of coverage.

Medicare does not provide dental care coverage for their insured beneficiaries, which leads many to either go without coverage or to retain an independent plan that could cost them more than they can afford in their budget. Millions of elderly Americans rely on Social Security and Medicaid or Medicare to support them in their old age, however, these programs continue to shrink in size and will not be able to provide for all of those soon to be retirees. Medicare does provide dental care for some chronic medical conditions such as reconstruction following an accidental injury, or extraction due to radiation exposure for neoplastic diseases of the jaw, a very specific list. Even with those exceptions, the reimbursement rate is so low that some doctors will not accept Medicare coverage in their offices because they know how difficult it becomes to get paid.
The National Center for Health Statistics has found that 20% of Americans over 65 years old have cavities that are currently going untreated, with the numbers steadily increasing with old age. With teeth becoming more brittle and procedures performed decades earlier needing maintenance, many elders find themselves in the Emergency Room due to the pain. There are a number of nonprofits however across the nation that offer free or discounted dental cleanings for elderly patients that do not have dental coverage and cannot afford it. Additionally, many universities offer discounted cleanings as well as procedures by having elderly patients be seen by their class of graduating dentists. They will offer up front costs of services as well as payment plans in an effort to avoid having the individual rack up debt.

Meals on Wheels Funding Gets Threatened

Published on: April 11, 2017 | by Ettinger Law Firm

Meals on Wheels is a government program that started in the 1950s that has assisted elderly citizens by delivering food to them when in need, either by providing the meals in the elderly individual’s home or in a community senior center. They not only provide the meal but also provide safety checks and visit with the senior, critical actions that have been shown to help elders live longer. There are over 5,000 independent organizations across America that help administer the program, and it has for decades, had much success. In order to receive funding local communities as well as the Older Americans Act help to keep the program afloat.

As the new budget is proposed, many programs are in jeopardy of being cut. One program that is may see a threat to funding is Meals on Wheels, due to the program not providing results. However, the nature of the program is not a results oriented initiative. The program services 2.4 million Americans, a number that will undoubtedly grow in the coming decades due to the large number of baby boomers beginning the retirement age. These cuts are the result of discretionary spending decisions related to the Community Development Block Grant that allocates a portion of the block grant money to elderly through Meals on Wheels. There have been numerous studies conducted that have showed the effectiveness of Meals on Wheels decreasing loneliness scores and also decreasing reliance on traditional care, while allowing elderly individuals to remain in their homes longer.

However, there are conflicting opinions about how much influence this will actually have on the institution. From financial statements released last year, only about 3% of the total funding was made from the block grant. On a local level, there is much more monetary influence, with federal funds accounting for 30% of the expenses relating to the home delivered meals. While the program’s costs and returns are currently being debated, it is evident that although it may not be the most lucrative on it’s face, Meals on Wheels can provide a number of benefits. One study even found that if there was a 1% increase in elderly individuals receiving Meals on Wheels, states would saved over $109 million, due to reductions in need for nursing home care.

Estate Planning Reminder – Planning for Pets

Published on: April 8, 2017 | by Ettinger Law Firm

Dogs, cats, parakeets, horses, iguanas, ferrets…no matter the pet you have in your life, chances are you treat them more like family than just a possession. We want to make sure our pets are comfortable, have the best food, have plenty of entertainment, are healthy, and enjoy a long, happy life. It is possible to make sure that those conditions exist for pets even after pet owners pass away. By utilizing a trust, you can help make sure that your best friend is well taken care of.

Pet Trusts

A recent article in USA Today talks about the function that a pet trust can serve. Pet care can be very expensive. There are grooming costs, medical costs, food costs, and other costs related to keeping a pet. Generally, the bigger the pet, the greater the cost of care can be. In fact, the article notes that Americans spent roughly $62.8 billion on pet care in 2016. While pet trusts are certainly less common than trusts created for human heirs, they can serve an important purpose in making sure that any pets you have can enjoy the same quality of life after your passing that you were able to provide for them.

The Future of Medicaid

Published on: April 7, 2017 | by Ettinger Law Firm

One of the biggest promises in the Trump candidacy was repealing Obamacare, a promise he attempted to follow through on within the first few months into his presidency. Speaker of the House, Paul Ryan, was a widely known proponent, who worked to rally votes and repeal Obamacare in order to get The American Health Care Act implemented in it’s place. While the vote was called off before a final count was made, the American Health Care Act still has some changes to make before there will be bi-partisan agreement. It is not a surprise that this program was one of the first to be reconsidered for funding, the program covers 74 million people alone.

Lawmakers were drastically divided on the topic, with those focused on public health benefits contesting the bill due to the cut in benefits that those most in need would experience, Once Obamacare was fully implemented, Medicaid programs across the nation greatly expanded, giving coverage to 11 million Americans opting for coverage under the federal program, which in turn assisted states who were not able to pay for the health care expansion for their citizens on their own. Medicaid was able to expand coverage to so many Americans by qualifying low income individuals for the program and paying through state and federal funding. Governors in Alaska, Arkansas, Colorado, Michigan, New Hampshire, Nevada, and Ohio all oppose any kind of restructuring for their Medicaid programs. Kansas and North Carolina are currently attempting to expand their Medicaid in light of the recent bill failure.

On the other side of the debate, critics of the mandatory health care system feel that it has left states and citizens ‘hooked’ on the federal government supplying funds for health care now. The states that receive federal assistance with Medicaid cannot sustain losing the funding while still providing coverage to all their citizens. While some states are starting to cover some costs associated with their Medicaid expansions, the federal government in 2017 is still covering at least 90% of the costs associated with the expansion, which is projected to continue through 2020. Critics continue to note the declining insurance provider participation in Medicaid and Obamacare services which fails to provide medical specialists.

GRATs and GRUTs

Published on: April 6, 2017 | by Ettinger Law Firm

If you have assets that will likely appreciate in value, including property that provides income or stocks that demonstrate growth potential, there are ways you can plan accordingly to help you avoid severe tax consequences that might otherwise be related to retaining these assets or allowing them to become part of your general estate.

Two potential vehicles for you to explore are grantor retained annuity trusts (GRATs) and grantor retained unitrusts (GRUTs). With both of these options, you retain an interest in the income from assets placed in the trust. While there are taxes associated with each of these, they may be less costly than other options depending on your individual circumstances.

The Basics

Protecting Your Assets from Creditors

Published on: April 4, 2017 | by Ettinger Law Firm

For most people going through estate planning, the goal is to pass on as many assets and as much wealth as possible. Most people don’t engage in estate planning with the goal of paying the most taxes possible or distributing assets to creditors. In fact, creditors can take a bigger chunk out of your assets than taxes can, so if you want to avoid costly claims during your lifetime and upon death that could significantly impact your estate it is important to take proactive steps to protect your assets from creditors as part of a comprehensive estate planning strategy.

In fact, there are several strategies that could help you save on taxes while keeping your assets secure from creditors, though it is important to make sure that whichever actions you choose comply with the Uniform Voidable Transactions Act that covers the transfer of assets in an attempt to defraud existing creditors. Some options for protecting your assets from creditors that comply with the provisions of this act might include:

Gifting

Family Members Acting as Paid Caregivers

Published on: April 4, 2017 | by Ettinger Law Firm

The demand for caregivers will begin to far exceed the amount of elderly individuals who need caring for in the United States, as our elderly population will grow substantially in size by the year. As the caregiver network continues to dwindle, there have been efforts made throughout the country to retain those caregivers leaving the field for other opportunities, regulate the field more to better advocate for caregivers rights, and to consider alternatives for care and treatment for the elderly community. This job of being a professional caregiver can be physically and emotionally taxing and for those who cannot afford assistance, these responsibilities can begin to fall on the loved ones that surround them.

The role of caregiver has been assumed by more than 65 million people who provide care for a chronically ill, disabled or aging family member in United States. Many of these family member caregivers care for their loved ones upwards of 20 hours a week, without compensation. This role can take a toll on their personal lives and impact their ability to perform at a full time job throughout the week. As a response to this, lawmakers in some states have begun to offer family members who act as caregivers compensation for their time spent with their elderly loved one. Compensating the family member helps offset the time set aside as well as the expenses incurred by traveling or giving time to other areas.

While the name varies between the states, programs that compensation family members include consumer directed care, cash and counseling, and family member caregivers. The regulations differ between the states as to who will qualify as a caregiver, what they are compensated, how much and what benefits they may possibly have. Those who have a loved one who is also a veteran may qualify for aid and the attendance pension benefits through the Veteran’s Administration. If you are in a state without these benefits or would like to form a private agreement, many families draw up a personal care agreement.

Navigating Special Needs Trusts

Published on: April 2, 2017 | by Ettinger Law Firm

A growing family often includes children. Sometimes, children come with special needs that need to be attended to throughout their lives. These special needs can include physical, mental, emotional, and/or developmental disabilities. When such needs arise, they can cost a great deal of money on a regular basis. A common concern parents or family members of individuals with special needs often have is how those individuals with special needs will be taken care of later in lifer when parents or family members have passed on. For these families, a special needs trust might be the answer.

An Introduction to Special Needs Trusts

A special needs trust is a trust established to address the long term needs of an individual with a disability that may require lifelong care. Many individuals with disabilities may qualify for state benefits and assistance to help offset the cost of long-term medical care and other costs that may arise. If the parents or family members of a person with special needs were to leave assets to the person with special needs, the inheritance may cause the individual to lose benefits provided by the state because the inheritance could cause their income to surpass the level under which a person is eligible for state benefits.

Different Ways to Title Property in Estate Planning

Published on: March 31, 2017 | by Ettinger Law Firm

When titling property pertaining to estate planning, there are many considerations to make in order to properly distribute assets and property to your loved ones upon your death. Depending upon your estate planning measures, you make seek to title property in order to pass automatically to a lineal descendant, in order to avoid probate, or in order to allow your executor to sell, gift, or transfer your interest in property.

Ownership

Sole ownership, the title position in which you are the sole owner of the property, is the most common form of ownership for single individuals. They have full rights to property while alive and also to pass at death. This type of title will pass subject to probate, by the decedent’s will or if they fail to execute a will, by intestate, also known as the process by which a court will determine your estate execution.