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ELDER LAW
At Booth Harrington & Johns, we are dedicated to ensure delivery of quality legal services for the elderly and to advocate for their rights. Elder law attorneys focus on issues unique to the elderly and work as advocates for their senior clients.
For many, the senior years represent the reward and fulfillment of years of hard work - a new beginning with less financial pressure and fewer responsibilities. For others, the senior years are marked by apprehension, fear and loneliness. Pressures build as aging folks struggle to maintain independence. New laws, rules and bureaucracies can make this struggle more difficult. Proper planning and legal counsel can help seniors make the right decisions about financial security, healthcare, and the protection of their rights. We can help guide you through these legal decisions.
Elder Law encompasses areas such as the following:
•Medicaid and asset protection planning
•Medicare, managed care, and payment for health care
•Social Security and retirement income planning
•Disability planning
•Long-term care and nursing home care; housing options, such as assisted-living and residential homes for the aged
•Guardianship, financial and health care decision-making through the use of durable powers of attorney
•End-of-life decision-making through the use of living wills and health care powers of attorney
•Probate and estate administration
•Revocable living trusts, special needs trusts and wills
•Planning for family business succession
Our law firm is an active member of the National Academy of Elder Law Attorneys (NAELA), and our attorneys attend national and state conferences as well as chair elder law committees on national and statewide levels. We closely monitor elder law legislation and its impact on the lives of seniors. Through proper planning and action, we can help seniors reduce the stress of uncertainty and improve their quality of life. Booth Harrington & Johns has developed significant expertise in the field of Elder Law.
Elder Law's Distinctive Differences
The distinctions in the practice of elder law are first found in how the elder law attorney functions in relation to elderly clients. Elder law is singular and plural. It is legal service beyond counseling the individual, inviting joint, multiple, family and unitary representation. A second distinction of Elder law is its analytical and intuitive scope of counseling. It is representation beyond estate, trust and financial planning, inviting personal, health care and family counseling and planning. A third distinction of Elder law is its holistic and multidisciplinary approaches to client needs. The holistic approach takes the whole client, whether individual, multiple or family unit, and plans for the total environmental and personal needs, as well as the asset and financial needs of the client. The multidisciplinary approach extends beyond the legal profession, inviting professionals from other professions serving the elder care industry to participate in planning and counseling in a holistic method.
Singular and Plural Representation
Seasoned elder law attorneys know they must confirm who their clients are during initial consultations. Easy enough when it is one person, however elder law attorneys often find that they are being engaged to address the legal needs of spouses, children, parents and even extended family members. Legal counsel of multiple clients within the family is possible when there are no conflicts between them. The elder law attorney may be engaged by the family as a unit. In elder law, this is becoming more the rule rather than the exception.
The Impact Of Plural Representation On Elder Care
As the demographics of aging begin to make the significant impact on society that has been forecast for many years, the needs of the patriarchs and matriarchs of American families will demand counseling and services that positively embrace the family as the client. Elder law attorneys receive children seeking legal advice and services for their parents. Often, one of the children presents an active durable power of attorney, confirming that the parent is the client and seeking legal advice and services. Just as often, the family collectively discusses asset transfers or divestments that benefit all of them, all the while declaring a priority of maintaining the quality of life of the parents and accessing governmental benefits. There being no direct or concurrent conflict among the family members, the family is advised that the panoply of services that would benefit the parents would benefit the children as well.
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MEDICAID PLANNING
Booth Harrington & Johns advocates the rights of seniors for Medicaid, Medicare and supplemental health insurance benefits.
In addition to planning for the possibility of long-term illness, we advise clients and their families after such illness occurs. The rules of Medicaid eligibility change almost daily, becoming increasingly complex. There are pitfalls for the unwary, but there are also opportunities for the astute planner. We can help guide clients through this maze. We help prepare the complex Medicaid application and guide our client through the often lengthy approval process.
State and federal officials often deny Medicaid and Medicare benefits to which applicants are entitled. We represent clients in the confusing administrative process to secure the benefits the system is supposed to provide. Health insurers increasingly deny coverage to which beneficiaries are entitled. We intervene through advocacy and careful analysis of insurance policies to gain coverage.
Planning
Medicaid rules and regulations are very complex and change on an unpredictable and rather frequent basis. Asset preservation strategies must be carefully planned and implemented because certain asset transfers may cause ineligibility during a penalty period and trigger a tax to be due. It is very helpful to have a skilled attorney guide you through the process of obtaining benefits for someone in care without the need to spend every last dime. Attorneys at Booth Harrington & Johns have significant experience advising families how to change the status of assets, to acquire or fund assets that have exempt status, and to make appropriate transfers to create the best benefit for the client.
Three-Part Test
An applicant for Medicaid (program for nursing home coverage) or Special Assistance (program for assisted living coverage) must pass the following three-part test to qualify for benefits:
1. Income
The income limit for Special Assistance is $1,238.50* a month unless the individual resides in a dementia/Alzheimer's special care unit which allows the monthly income to reach $1,580.50. The maximum allowable income for Medicaid is tied to the reimbursement rate at the facility in which the individual resides. It is important to note that once an application is approved for benefits, the person's entire net monthly income (less $30.00 for personal expenses) must be paid to the nursing home to cover a part of the bill for the resident's care (called a patient's monthly liability or PML). The benefits cover the rest.
*Please note that the income limit applies to the individual applying for benefits, not his or her spouse. Furthermore, the Medicaid program allows the "community" spouse to keep a portion of the applicant's income if the community spouse's income does not reach a basic threshold.
2. Medical Need
The individual must need the level of medical care provided. Medical need is determined by a physician and is indicated on what is called an FL-2 form. For Special Assistance, the individual must need the assisted living level of care; whereas the individual must require skilled or intermediate nursing care to qualify for nursing home care under Medicaid.
3. Resources
To qualify for either program, an individual applicant must not own more than $2,000 worth of countable assets. Resources or assets are characterized as countable or non-countable.
Examples Of Non-Countable Or Exempt Assets
a. Household goods and furnishings.
b. One motor vehicle, regardless of value, used for medical transport.
c. The home, as long as the person in care declares in writing the intent to return home.
d. Irrevocable pre-need funeral contracts.
e. Annuities that have been annuitized in accordance with Medicaid requirements; however, the income stream might push the income beyond the income cap. Furthermore, the monthly annuity payments are applied to the patient's monthly liability to the facility.
f. Term life insurance polices. Whole life policies with a combined face value of $10,000.00 or more are fully countable.
Examples Of Countable Or Non-Exempt Assets
a. Cash
b. Stocks, Bonds, Mutual Funds, CDs, Savings Bonds, IRAs, 401Ks, 403Bs, investment accounts, etc.
c. Trusts, depending on the terms
d. Additional automobiles, boats, recreational vehicles, etc.
Treatment of married couples' assets differs between the programs. The Special Assistance program excludes any asset titled in the community spouse's name alone from the $2,000 limit, whereas, Medicaid looks at all assets owned by one or both of the spouses. However, if applying for Medicaid, the couple can use the Community Spouse Resource Allowance (CSRA) to avoid impoverishment of the spouse living in the community.
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ADVANCE DIRECTIVES
Five Important Advance Directives
1) Financial Power of Attorney ("POA") - A Financial Power of Attorney appoints an agent and empowers that person to handle all of your financial affairs. A Financial Power of Attorney can be immediately active or it can be springing, meaning that your designated agent can only act after two physicians agree that you do not have the capacity to manage your own affairs.
2) Health Care Power of Attorney ("HCPOA") - A Health Care Power of Attorney appoints an agent and empowers that person to make important decisions about your medical treatment if you are incapacitated or otherwise unable to make such decisions.
3) Natural Death Act - Living Wills - A Living Will instructs your doctor as to your wishes about extending your life or, in the alternative, withholding extraordinary measures and/or artificial nutrition and hydration when you are terminally ill or in a persistent vegetative state.
4) Do Not Resuscitate ("DNR") - A Do Not Resuscitate directive is a request that your doctor not perform cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing.
5) Palliative/Comfort Care - Authorizes a comfort response to medical decline.
Selecting A Financial Agent (Attorney-In-Fact)
The single most important factor in designating an agent is to choose someone that you trust. Sometimes family members are a great choice, but not always. You might consider selecting any of the following:
• Spouse
• Children
• Best Friends
• Friends of Faith
• Professionals providing services, specifically Bank Trust Departments and Non-Profit groups
To learn more about how Booth Harrington & Johns can assist you or a loved one with your decision to develop Advance Directives, please contact us toll free at 877.503.5337 or request a consultation with one of our associates by clicking here.
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ESTATE PLANNING
Helping clients accomplish sound financial and life planning through carefully developed estate plans is the goal of Booth Harrington & Johns. Effective estate planning requires careful attention to the needs and long-term goals of each client, ensuring that the plan established works now and in the future.
Equally important to this process, are our understanding and thorough knowledge of the tax consequences of various financial transactions and of the probate system. Whether the client requires a simple will to transfer property at death, or a complex financial plan that allows for the gradual distribution of assets to family members, charitable organizations or other beneficiaries, Booth Harrington & Johns ensures that the outcome is what was intended.
Clients benefit from the firm's expertise in estate planning, elder law, taxation and probate. Active membership in the North Carolina Bar Association's Estate Planning and Fiduciary Law Section, and in the Greensboro Estate Planning Council, further enhances our skills and knowledge in this important area of practice. With our other areas of expertise, including trial practice and family business counseling, Booth Harrington & Johns is able to offer its estate planning clients the complete range of services necessary to fulfill their goals.
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ASSET PLANNING
The attorneys at Booth Harrington & Johns can assist you, your attorney-in-fact, or other loved ones, to help protect and preserve your assets so those assets can be used to sustain and improve your quality of life. Whether you are pre-planning for care or in a long-term care crisis, we can assist you and your family in obtaining assistance, if needed, to finance the needed level of care. This includes assistance from the following programs:
Veteran's Benefits:
We will put you in touch with the workers at the Veteran's Administration to determine if you are eligible for any veteran's benefits that may be available to assist in paying for your long-term care costs.
Special Assistance:
We will work with you to determine if you qualify for assistance with assisted living or rest home care through the Special Assistance program. This program has a restrictive income cap and covers various forms of assisted living centers, including those known as Memory Care Units or Alzheimer's programs. There are ways to protect certain types of income that may exceed the cap to gain eligibility. Finally, we will assist you in gaining eligibility and applying for benefits, once you meet the tests for Special Assistance qualification.
Medicaid:
We will work with you to determine if you qualify for assistance with nursing home care through the Medicaid program. The income cap for Medicaid benefits is more generous than the Special Assistance income limit, but many people have more resources than are allowable under the Medicaid regulations. In full accordance with Medicaid rules, we will help you with strategies to gain eligibility, which will protect and preserve as much of your assets as possible to sustain and improve your quality of life in the future.
The attorneys at Booth Harrington & Johns are nationally recognized for assisting clients with the asset preservation process. Our involvement in the National Association of Elder Law Attorneys and local groups such as the Triad Retirement Living Association provides the resources and knowledge that you will need during the asset preservation process.
If you are seeking assistance to pay for care through government programs like the Veteran's Administration, Special Assistance, or Medicaid, our attorneys can help guide you through the confusing rules and regulations to obtain the results you desire.
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PEACE OF MIND
The Senior Years. For some, a dream come true. For others, a nightmare of difficulties. The law firm of Booth Harrington & Johns has extensive experience and valuable insight in a practice area called Elder Law as advocates for seniors and their families.
For many, the senior years represent the reward and fulfillment of years of hard work - a new beginning with less financial pressure and fewer responsibilities. For others, the senior years are marked by apprehension, fear and loneliness. Pressures build as aging folks struggle to maintain independence. New laws, rules and bureaucracies can make this struggle more difficult. Proper planning and legal counsel can help seniors make the right decisions about financial security, healthcare, and the protection of their rights. We can help guide you through these legal decisions.
If you are dealing with any of the issues associated with transitioning into your senior years and feel you need legal advice, please contact us toll free at 877.503.5337 or request a consultation with one of our associates by clicking here.
In preparation for your initial consultation, we recommend you complete one of the following forms below, and bring it with you so we can concentrate more on your goals and reduce the amount of time necessary for gathering important information on you, your spouse and other key family members.
Elder Law Planning Questionnaire
Estate Planning Client Questionnaire for Married Persons
Estate Planning Client Questionnaire for Single Persons
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