Guiding elders, special needs persons, and families by offering the experience and care clients need for thoughtful planning and peace of mind.

 

Reimagining Elder Care & Disability Care

June 4, 2021

Filed under: Community,Living at Home — Alexis @ 12:53 PM

We are in an exciting moment in history when it comes to reimagining elder care and disability care. The pandemic laid bare what many already knew – no one wants to live somewhere that feels like a facility, an institution, or a hospital. We would all prefer to live in and age in our own homes. And if staying in our own homes becomes impossible, we want to live somewhere that feels like a very close runner up.

What are your plans or maybe even daydreams for aging at home? In your current home, could you live on one floor? Do you have good neighbors, children, or other support nearby? Have you saved up to be able to bring in some care? Have you explored what help you may be eligible for through MassHealth or the VA?

What about building an addition at a child’s house? How about moving in with a best friend or sibling and sharing care costs? Would you be happier on a campus with lots of social opportunities? Are you a planner and want to move to a campus that provides increasing levels of care, should you need them?

When you think about what kind of life or care you might or might not want, have you thought through what matters most to you? And how do your thoughts on what matters most shape your thoughts on where you want to live as you age? And what kind of services you might or might not want?

Many advocates and legislators are working across the country to seize this moment to shift the possibilities for elder and disability care out of institutions and into the community. Elder law attorneys (including yours truly) are part of this conversation. I hope that in the next few years we will make meaningful change to the federal Medicaid system, the US tax code, and the overall elder care and disability care underpinnings and infrastructure.

In the meantime, please reach out to discuss how we can help you stay at home for as long as possible under the current financial rules – whether that home is where you are now or a new one. Let’s imagine the possibilities together.

– Alexis

Who Can Talk to Social Security on Your Behalf?

May 20, 2021

Filed under: Social Security — Alexis @ 12:49 PM

If you are on Social Security, then you know that sometimes there’s a need to talk to the agency.  Maybe you’ve changed your address, or perhaps a spouse died and you needed to adjust your monthly payment.

But what happens if you need to talk to Social Security, but you aren’t competent to do so?  In that case, Social Security has a process by which someone can apply to be your “representative payee.”  That’s the equivalent of a power of attorney to the rest of us; Social Security chose to call it something else.  Usually a family member will be the person to apply to be your representative payee.

At the time when someone other than you needs to communicate with Social Security on your behalf, there is a process for that individual to be appointed as representative payee.  But now, while you are competent, you have the opportunity to at least tell Social Security who you would want that person to be, should you ever need a representative payee.  You can do that by logging into your my Social Security account, by telephone, in person, or in writing.

For more information on advance designation of a representative payee, please visit the Social Security website.

And if we can help you with any other advanced planning – like naming a durable power of attorney and health care proxy, creating a will and trust, or generally getting your ducks in a row – please reach out to our office.

– Alexis

We’re Hiring an Associate Attorney!

April 30, 2021

Filed under: Uncategorized — Alexis @ 12:51 PM

Dear Friends,

Our firm is growing, and we need to hire an associate attorney.  If you know an attorney who would enjoy practicing elder law and special needs planning – and would love to spend time with yours truly 😄 – please pass this post on to them.

Thank you!

– Alexis & Doreen

Will Stimulus Payments Disrupt My Public Benefits?

March 24, 2021

Will Stimulus Payments Disrupt My Public Benefits?

If you are on public benefits and receiving a stimulus payment, then you are probably concerned about how the payment will affect your public benefits (ex. MassHealth or SSI).  In short, it will not.

Stimulus payments are not considered “income.”   They are also not considered “assets” UNLESS you are still holding the stimulus payment twelve months from now.

So what should you do with the stimulus payment?  One option, of course, is to spend it, and that’s exactly what it was designed for.  Another option is to deposit it into an ABLE account.  If you were disabled before age 26, it could make sense for you to have an ABLE account, if you don’t already.  You can read more about ABLE accounts here.

For more information on the stimulus payment and public benefits, see this article by Special Needs Answers.

As always, please reach out if you have questions about public benefits or other elder law and special needs planning topics.

– Alexis

Seeking an Associate

March 22, 2021

Filed under: Uncategorized — Alexis @ 9:04 PM

Seeking an Associate

We are an entrepreneurial elder law and special needs planning firm in Norwell that is on track for growth, and we need an experienced associate to join our team and work directly with the owner to help our clients.  Our team consists of one attorney/owner, one legal assistant, and one paralegal.

We are known for helping our clients to stay at home for as long as possible, find the care they need, and still leave something behind for their families – and for doing those things because we care.

We are growing fast, and we need an associate who can hit the ground running (or if not running, then at least jogging).  We are looking for a self-starter who will be able to work effectively without much supervision.  We need an associate with experience in some combination of elder law, special needs planning, veterans benefits, MassHealth planning, estate planning, and probate.  Please note that we do not do litigation.

The ideal candidate will be able to take initiative and complete tasks with minimal hand-holding.  Applicant must have at least one – three years of experience in any of our listed fields.  More years of experience also welcome!  Applicant must have a demonstrated commitment to elders and special needs individuals.  We love our work and are passionate about helping our clients – we are seeking an associate who feels the same way.

This position will be responsible for important work, including:

  • Working with clients to elicit their issues and goals.
  • Solving the puzzle of how to fund the care clients need, to stay at home for as long as possible, without burning through all of their assets.
  • Creating estate plans that make things as easy as possible for the heirs, maintain family harmony, and, for families with special needs heirs, protect the heir’s continued access to public benefits.
  • Managing all probates.
  • Understanding an array of programs, laws, and regulations, and applying them to each family’s unique situation. Namely, but not limited to: Medicaid, Medicare, health insurance, life insurance, long-term care insurance, drug plans, annuities, reverse mortgages, Social Security (SSI, SSDI, retirement), PACE, EOEA and ASAP programs, VA benefits, housing options and programs (both public and private), estate planning, trusts, probate, tax (income, capital gains, estate, gift), and real estate transfers.

If the statements below apply to you, then you may be our next associate!

  • Have a minimum of one – three years of experience in any of our listed fields. More years of experience also welcome and appreciated.
  • Are ready to work approximately 40 hours per week.
  • Can combine working from home with time in the Norwell office. Must be able and willing to work in our office two – three days per week (post-quarantine).
  • Are passionate about assisting clients and families with all facets of elder care and special needs planning, from financing home care, planning for nursing home care, planning for special needs children, creating estate plans, and more.
  • Have a demonstrated commitment to elders and/or special needs individuals.
  • Enjoy getting to know families one at a time and helping each work through their particular web of issues and goals.
  • Are happy to manage all probate matters.
  • Are able to work with people in crisis and/or with diminishing capacity.
  • Have strong verbal communications skills.
  • Have impeccable writing skills. Must write in “plain English” – no “legalese.”
  • Have down-to-earth, approachable personality.
  • Are exceptionally detail oriented.
  • Have ability and desire to work independently.
  • Enjoy puzzles or detective novels. (OK, so this one’s not a requirement, but it’s a helpful trait!)
  • Ask good questions.
  • Have a joy of learning.
  • Are familiar with Macs, or, happy to learn them.
  • J.D. with a Massachusetts license.
  • Are seeking your long-term “work home.” As a solo law firm, we are not in the position to invest time in an associate who seeks to gain some experience and move on.  We are looking for the right fit that will suit both you and the firm for many years.

Pay starts at $50,000 per year, to increase as certain benchmarks are met.

 

To apply:

Prepare a cover letter with no more than two paragraphs, plus a closing sentence.  In the first paragraph, explain what you believe are the three most important qualities needed in someone who works with elder law and special needs planning clients and why you believe these are the most important qualities.  In the second paragraph, explain why you applied to this particular posting.  As a closing sentence, please write, “I have read the instructions contained in the job posting and have followed the instructions.”

Do not send your materials through this website.  Email your resume and cover letter in PDF format to doreen@alexislevitt.com.  The subject line of the email should be your last name (all caps), followed by the position you are applying for (lower case), followed by one word that you would use to describe yourself (all caps).  For example: SMITH paralegal AWESOME.

We look forward to reviewing your application.

Applications received through Indeed.com, other job sites, or that do not conform to the instructions above will not be considered.

Please note that there is no public transportation to our area.

No telephone calls or third-party recruiters, please.

What Matters to Me Workbook

March 2, 2021

My favorite topic!

If you have been reading these newsletters, then you know that the subject that I return to over and over again (and again and again) is the health care proxy and the importance of advance care planning.  If you are ever in a situation where you are unable to make your own health care decisions, then your trusted decision makers will be able to speak for you only if you give them the authority to do so (that’s the health care proxy you signed).  But also, they will need to know what matters most to you, which turns on you knowing and conveying what matters most.

Well, you are in luck, because the good folks at Ariadne labs (that’s Atul Gawande’s lab – if you haven’t read Being Mortal, pick it up and start reading it now!) and the Conversation Project (remember Ellen Goodman from the Globe?  She’s been busy since “retirement) are here to help.  They have done the field research and reviewed the data, and they used these to develop a fabulous new workbook that helps you both think through what matters most to you and also to convey your thoughts to the people who matter most.

The new workbook is called “What Matters to Me.”  You can download it here, or contact our office and we will print one out and mail it to you.

Please take the time to complete the workbook, and then pat yourself on the back for a job well done.

– Alexis

Useful Info During COVID (v.6)

February 17, 2021

Filed under: Elder Abuse,Financial,Uncategorized — Alexis @ 1:49 PM

Scammers Gonna Scam

As we begin vaccinations, you can be sure that scammers will be coming up with creative ways to separate you from your money.  Per the FTC, keep the following in mind:

  • You likely will not need to pay anything out of pocket to get the vaccine during this public health emergency.
  • You can’t pay to put your name on a list to get the vaccine.
  • You can’t pay to get early access to the vaccine.
  • No one from a vaccine distribution site or health care payer, like a private insurance company, will call you asking for your Social Security number or your credit card or bank account information to sign you up to get the vaccine.
  • Beware of providers offering other products, treatments, or medicines to prevent the virus.  Check with your health care provider before paying for or receiving any COVID-19-related treatment.

If you get a call, text, email — or even someone knocking on your door — claiming they can get you early access to the vaccine, STOP.  That’s a scam.  Don’t pay for a promise of vaccine access or share personal information.  Instead, report it to the FTC at ReportFraud.ftc.gov or file a complaint with the Massachusetts Attorney General.

Our team is working mostly from home still.  As always, reach out with any questions related to elder law, veterans benefits, long-term care, estate planning, and special needs planning.  Get outside, and wear your mask!

– Alexis

Useful Info During COVID (v. 5)

August 15, 2020

Hello Friends!

I hope you have been enjoying / avoiding / surviving this heat, depending on your predisposition to such weather.  We live in a proper New England house with not enough storage and no A/C (just window units), so I have definitely been missing the luxurious central air conditioning in my office lately!  But we have been getting to the beach a bit, especially in the evening (the best time of day).  I hope you have too.  Don’t you just love living on the South Shore?

Let’s start at the top:

#1 If you have a loved one in a nursing home, then you know there are a lot of changes going on lately when it comes to procedures and protocols.   Here are a few places where you can go to keep up: Consumer Voice, MANR, Center for Medicare Advocacy, and mass.gov.  If you have an issue with a nursing home and you don’t feel like you are making headway, call your Ombudsman.  These are volunteers who genuinely love the role and usually want to help develop a solution that is win-win.

#2 Great news on qualifying for MassHealth home care!  As you may know, MassHealth has some programs that will pay to send home health aides into you home.  To qualify, you must (1) medically need a certain level of care, (2) be below an asset limit, and (3) be below an income limit of $2349/month.

Ironically, this last piece, the income requirement, has put home care out of reach for many over the years, needlessly forcing people into the nursing home, which MassHealth will pay for with no income cutoff.  For far too long, if an elder meets the other requirements for home care, but is $1 over the income limit, she must spend down, every single month, on medical care, every dollar over $542.  That means that she could use the excess over $542 to pay for health insurance, private aides, and the like, but then she is somehow supposed to pay for groceries, heat, home repairs, sundries, and all the rest on just $542 per month!  Impossible to do.  Most elders in that situation have no choice but to move to a nursing home (which can cost the state much more than a home care package!!).

But – great news.  On a temporary basis, during the state of emergency, MassHealth is CHANGING the rules for anyone over-income for home care.  Instead of spending down to $542, an elder can simply spend down to the actual home care income limit of $2349.  It will be very interesting to see the data as the months go by, to see how many more seniors were able to stay at home with this simple change.  But what about after the state of emergency, you may ask?  Well, there is a health care bill currently in conference at the state legislature.  Please call your state representative and your state senator, and ask them both to talk to their caucus representatives about making this change permanent.

#3 Last week I had my first telehealth appointment!  What a pleasure to not have to drive, navigate through a building, and then sit in a waiting room forever.  An added bonus was getting a glimpse into the doctor’s life and personality, as he was sitting in his studio at home, surrounded by musical instruments.  That added a new dimension to the relationship.  Congress is talking about making telehealth a more prominent part of our medical landscape post-pandemic – yes, please.

#4 This is your periodic reminder to keep your health care proxy and emergency contact information with you at all times!  If you are out and about, that could mean keeping copies in the glove compartment of your car or making up a card to keep in your wallet.  We enroll all of our clients in DocuBank, and they send you a wallet card that connects emergency responders to your key health information.  I keep my DocuBank card in my wallet, and if I am going off adventuring without my bag, I put the card in my pocket.  Like when I go rowing with the fabulous crew out of the Hull Lifesaving Museum.

#5 Along the same lines… your health care agent can do a better job for you if you have shared your care wishes.  There are some great tools out there to help you think through your priorities and wishes for yourself, and then share them with your health care agent.  One free option online is the Conversation Project.  We give our clients the Your Way Workbook.  If we gave you one and you have not completed it – go pull out your black folder with all of your estate planning documents, find the Your Way workbook in there, and fill it out!

As always, reach out with any questions related to elder law, veterans benefits, long-term care, estate planning, and special needs planning.  Get outside, and wash those hands!

– Alexis

Useful Info During COVID v.4

May 12, 2020

Dear Friends,

This is our fourth newsletter during these interesting COVID times.  It’s funny – my writing bug tends to come in waves and then go away for a while.  Apparently it’s been sticking around lately.  I’m sure you can relate when it comes to your writing, art, or hobbies.  This week I want to focus on what our office can do for you, right now.  You can revisit our prior newsletters here.

Get Your House in Order a/k/a Get Your Ducks in a Row

If you have time on your hands right now, maybe it’s a good moment to spend a few hours working out the what / who / how of your estate plan.  I can help you make sure that those who matter most know what matters most to you in terms of your health care.  We can think through and plan for how to make sure that you get the hands-on care you might need over the years.  We can figure out what the best vehicle is for you to create an inheritance process for your heirs.  We can talk through who the best people are to be your health care proxy, power of attorney, executor, and trustee.  We can wrestle with and work through the various components of getting your house in order (or, if you are sick of being at home – we can call it getting your ducks in a row).

Billing & Discharge Issues from the Hospital, Rehab, or Nursing Home

For anyone on Medicare (plus a supplement, or, on a Medicare Advantage Plan), you need to know that Medicare has strict billing requirements.  If the hospital, rehab, or nursing home bills incorrectly to Medicare and the supplemental insurance, the provider will be in trouble.  Not only will they not be paid for the particular service that they incorrectly billed for, but they may even owe a penalty.  If you are having billing problems with a provider, you need to understand this.  And, it gets tougher – during this state of emergency, CMS (the federal agency housing Medicare) has changed MANY of their billing and service requirements.  It is very understandable that some medical billing offices could be confused, receiving conflicting guidance, etc.  If you are having billing problems, first, be patient with the person on the other end of the phone, and second, feel free to call me for help.

MassHealth Applications

If you find out that your loved one needs to stay in a nursing home and you are worried about how to pay for that, please reach out and we can analyze whether it may be appropriate to apply for MassHealth.  If it is, then Doreen and I can handle the application for you.  Or, if the situation is sufficiently straightforward, I can give you some advice and then you can handle the application on your own.

Guardianship & Conservatorship

If your loved one has lost cognitive capacity and does not have an acceptable health care proxy or durable power of attorney, then you might need the probate court to appoint a guardian (to make health care decisions) and/or a conservator (to handle finances and real estate).  If you need this, you have two options: If a hospital or nursing home is telling you that you need a guardianship and/or conservatorship, they may have their attorney handle it, for free.  If that’s the case, just make sure that the attorney is naming someone that the family agrees would be a good choice.  If the free work is not an option for you, then call me and I can handle the guardianship and/or conservatorship for you.  (Pro tip: Don’t ever put your family in this position – instead get your ducks in a row now and sign a health care proxy and power of attorney!)

Stimulus Checks to the Deceased

Some of you have received stimulus checks made out to persons no longer living.  Turns out, you need to send those back.  If you still have the check, you can mail it to the IRS.  If you cashed it or received it by direct deposit, you will need to write out a check to mail to the IRS.  Here are the (very clear) directions from the IRS on how and where to mail it (see Q41).

Pick the Lawyer’s Brain

Go bold or go home.  Oh wait, I’m already working from home.  In any event, I’m trying something new: a Zoom call to ask me anything related to elder law, special needs planning, veterans benefits, or estate planning.  Let’s try this and see how it goes!  Thursday, May 14 from 2:00 – 2:30.  Limited to 15 people.  Reply to this newsletter, or email Doreen (doreen@alexislevitt.com), and we will send you the login information.

Also I am converting a playhouse into a chicken coop, so I am happy to receive any and all chicken coop construction advice!

Be good to yourself and each other, and get outside to enjoy this glorious spring.

– Alexis & Doreen

Useful Info During COVID v.3

May 11, 2020

Dear Friends,

This is our third newsletter during these interesting COVID times.  This one shares useful info, plus something beautiful.  You can revisit our prior newsletters here.

Share Your Care Wishes with the People Who Matter Most:

None of us knows when our health will take a turn.  The best gift you can give yourself and to the people who matter most is to think through and then share what matters most to you.  Your health care proxy can do the best possible job only if she or he knows what kind of care you want and don’t want.  An EXCELLENT springboard for thinking through, documenting, and sharing what matters most with the people who matter most comes from the Conversation Project.  Visit their site for an excellent worksheet.  While you are there, check out all the other resources on their website.

Excellent Community Resources

The Alzheimer’s Association 24/7 Helpline is open.  If you are feeling at the end of your rope, or even if you are well before that point, call them.  They can help.

Remember that your local Council on Aging is a bastion of information and resources!  If you need anything, call them and they will either solve your problem or refer you to someone who can.  Yes, your local senior is open for phone calls!  (But not walk-ins.)

Technical Stuff:

If you have medical billing issues related to Medicare, check out this amazing guide from the Center for Medicare Advocacy.  It’s technical, but readable.  There have been a LOT of changes to Medicare billing and requirements in light of COVID-19.  This guide provides excellent summaries of many of them.

A Reminder (Third Time – We are Serious about This Point!):

Keep your Health Care Proxy, HIPAA Statement, and medication list at your fingertips. 

(a) If you are a client of ours, then we enrolled you in DocuBank.  Take five minutes now to update your medication list.  (Really.  Five minutes.  I updated mine recently, it was very easy.)

(b) Keep copies on your phone.  You can save the documents to your Google Drive, you can simply keep them attached to an email, whatever you like, so long as they are accessible to you on your phone.  If you would like us to email PDFs of your signed documents to you, or to someone important to you, please call us or email us (doreen@alexislevitt.com).

(c) Keep copies on the back of your front door or on your refrigerator.  Many first responders will look in these places for emergency medical papers.

(d) If you do not have a health care proxy, download one today from Honoring ChoicesYou will need to witnesses – perhaps your neighbors can watch you sign through your glass door or window.

Something Beautiful:

Have you seen the Stephen Sondheim 90th birthday party?  It is so beautiful.  (Pro tip: It’s easy to skip around if you don’t like a particular song.)  Be sure to watch the closing remarks and final song – you just may cry from the beauty in this world.

And Remember:

Our office is open.  We are working from home, but if you need anything at all, just call or email, and we will get right back to you.

We had our first outdoor signing last week, and it was actually a bit of a party, since the Xfinity truck yard next door was playing some loud music!  We can also do video signings now, thanks to a bill that the governor signed this week.  We did our first one today.  It’s certainly been a period of firsts for a lot of things.

Hang in there, and get outside for plenty of fresh air and sunshine.  And wash your hands!!

– Alexis & Doreen

Our first outdoor signing!  That’s Doreen, Rich (Alexis’ spouse, pinch-hitting as a witness), and Alexis.  Photo used with clients’ permission.


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