Another Home Based Medicaid Option? Part 2
Last week I wrote about another possible home based Medicaid option in New Jersey beyond the traditional one. It’s called the Personal Preference Program or PPP. It gives the Medicaid recipient and his or her family members more control over the type of care the recipient receives. As I stated last week the application process is the same. One must meet the same financial requirements and produce 5 years of records, etc. Proof of the need for nursing home level care is also a requirement, however, once approved an application to the PPP program is made for self directed personal care assistance services. This application triggers a screening process to determine eligibility for the PPP program. Because this is a “self directed” program, meaning there is more autonomy in terms of choice, an authorized representative, who will assist in managing the services for the Medicaid recipient must be interviewed and approved for this role. For example, persons with a violent felony record or allegations of abuse of vulnerable populations cannot serve as authorized representatives. A consultant, who is an employee of a counseling agency under contract with the State of New Jersey or the Vendor Fiscal Employer Agent, conducts this evaluation. The consultant is also responsible for monitoring the care and
Another Home Based Medicaid Option?
In the past year we have probably handled more Medicaid home based applications than in the previous 5 years combined. Much of this has to do with the current pandemic and the reluctance of families to place their loved ones in facilities where maintaining Covid safety is more difficult than in one’s own home. The home based Medicaid program has its limitations. As I typically explain, it tends to be the least comprehensive of the 3 New Jersey programs that cover long term care. Once an applicant is approved, a caseworker evaluates the amount of care needed. Although one must satisfy the requirement of needing “nursing home level” care, on average the home based Medicaid program pays for about 30 hours a week of care. Once that determination is made the Medicaid recipient must then use a Medicaid certified aide which can be difficult to locate. Often families are already using an aide that their loved one is comfortable with. Change is not made easily. In many cases family members are providing much of the care but because they are not Medicaid licensed, they cannot be compensated under the home based program. For some, however, there may be another option. New Jersey has another program called the Personal Preference Program (PPP). It
Remote Notary Revisited
Last year in response to the COVID crisis, first New York and then New Jersey temporarily allowed for the execution of documents that must be signed before a notary to be done remotely. Legal documents such as powers of attorneys and wills could now be signed with a notary looking on via video as long as certain requirements were met such as keeping a recording of the signing. As social distancing and lockdowns became the new normal during the pandemic, relaxing the in person signing requirements was of critical importance in allowing people without important documents in place before the pandemic to execute them and carry on important aspects of their lives or allow designated fiduciaries to step in for them when needed. The temporary change was made by the governor of each state by executive order. Last month, however, Governor Cuomo ended New York’s State of Emergency which also ended the remote notary provisions. The assumption was that Governor Murphy would do the same in New Jersey. So far that has not happened. While Governor Murphy has lifted New Jersey’s public health emergency, the State of Emergency remains in effect and, at least for now, New Jersey continues to allow remote notarization of documents. There has also
Why a Will is so Important in a Second Marriage – Part 2
In my post last week I began telling you about Mary’s call. Her husband, John passed away without a will so for the probate assets - those held by John individually with no co-owner and no beneficiary upon death - New Jersey’s intestacy laws would control. As I explained last week, these laws determine who receives the assets. Most people would assume that a surviving spouse would be first in line. While that is true in many instances, unfortunately for Mary not in her case. That’s because Mary and John’s marriage was the second for both. Because they each had children from a first marriage, New Jersey’s intestacy laws say that John’s children are entitled to a share. Intestacy laws are state statutes so there isn’t a uniform answer to the question of who inherits. New Jersey has a formula in the case where there are children not born of the marriage between the decedent (the person who died) and the surviving spouse. The surviving spouse inherits a majority of the assets but there is a significant portion which will pass to the decedent’s children from other relationships. Mary was not happy when I explained this. She told me that she and John owned two homes, their primary residence and a
Why a Will is So Important for Spouses in a 2nd Marriage (Part 1)
I have often heard people say that they don’t need a will. “My wishes are known by my family”, they’ll say. But a recent call to our office shows how wrong that can be. Mary’s husband John had passed away from a long illness. Although he had time to prepare a will he never got around to it. John’s marriage to Mary was the second for both of them. They each had children from their first marriage. In John’s case he had 3. They had no children from their marriage to each other. Because John had no will, the determination of some of his assets would have to be made by the State of New Jersey according to what are called intestacy laws. The State has predetermined to whom assets are transferred at death when there is no will to give us any instruction. Except that not all assets pass in this manner. Only probate assets are distributed according to the guidance of a will and so only these types of assets are distributed by way of intestacy laws. What exactly are probate assets? It is easier to explain what non probate assets are. Any asset that has a designated beneficiary upon death such as an IRA or life insurance or a non retirement account
How Scrutinizing is Medicaid Really? Part 2
Last week I wrote about a question I hear often about Medicaid. Isn’t there a certain amount of gifting that is allowed under Medicaid regulations? The answer as I stated last week is that there really isn’t. Any gift or transfer for less than fair value is subject to a penalty. In practice, however, the answer may vary. Some states ignore nominal transfers, however the definition of what is nominal can be difficult to pin down. In the 25 years I have been filing Medicaid applications for clients here in New Jersey, that dollar limit has changed, although it has always trended downward. Back in the mid 1990’s Medicaid routinely ignored transfers less than $5000. Gradually that number was reduced to $500 in many counties. Now, however, in just about every county where I file applications, we are required to produce copies of every single check written by the applicant and spouse if applicable. This makes every transfer no matter the amount, subject to discovery by Medicaid caseworkers. In practice, there have been times when transfers have been overlooked. A penalty is calculated on transfers for less than fair value but only if the State finds and calculates the penalty. While I can never say with certainty whether a transfer was simply “missed”