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Will Minnesota Finally License Assisted Living Facilities?

“The Minnesota House passed a bill Friday that would license assisted living facilities across the state. Minnesota is currently the only state in the country that does not do so.”

Right now, Minnesota is the one remaining state that does not license assisted living facilities.

A House bill calls for an end to this, but the Senate’s version of the legislation was still not scheduled for a vote, worrying advocates who have spent two years fighting for reform.

KARE 11 in Minneapolis recently posted the article “Elder abuse bill passes MN House.” According to the report, with just days left in the legislative session, groups like AARP and Elder Voice Family Advocates fear politics could once again stop actions designed to protect seniors.

Those groups and families of seniors rallied outside the House chamber in support of the bill. In addition, those families have testified repeatedly at legislative committees. They’ve told their painful stories of family members who were abused and neglected in Minnesota’s senior homes.

Two families shared a similar horror story. No one checked on one man’s father, who had died in his room. His body was neglected for seven days. The same thing happened to a woman, who died and was not checked on for at least two days.

Both political parties agree that reforming elder care is important, but they, along with Governor Mark Dayton, couldn’t agree on reforms last year. There are also a few obstacles to moving the bill through the state legislature.

First, there is a wide gap between the two sides on the amount of funding needed to begin licensing assisted living facilities. The House plan includes millions of dollars more than the plan in the Senate.

Second, Republican senators are strongly against any changes to the law that would make it easier for seniors and their families to sue facilities.

The AARP and Elder Voice support what they see as a stronger version of the bill that passed the House. However, they want both bills to get a vote because they fear if they don’t, for a second year in a row budget battles will leave seniors unprotected.

When asked who will take the blame if efforts fail, Mary Jo George with AARP said, “I hate to say it, but I do think the Senate really, a lot of this rests on the Senate.”

With thousands of new abuse and neglect cases reported each year, families say they just can’t wait.

Reference: KARE 11 (May 10, 2019) “Elder abuse bill passes MN House”

What’s Going on in Congress with Alzheimer’s Legislation?

“Bipartisan legislation that would amend the Older Americans Act to allow individuals aged less than 60 years, who have a diagnosis of younger-onset Alzheimer’s disease, to access the support programs of the act, was featured Tuesday at a hearing of the Senate Special Committee on Aging.”

McKnight’s Senior Living reports in the article “Bill would aid those with younger-onset Alzheimer’s disease” that Senate Bill 901, also known as the “Younger-Onset Alzheimer’s Disease Act,” was introduced in the Senate by Senator Susan Collins (R-ME), chairman of the committee, Senator Bob Casey, ranking member, and Senators Doug Jones (D-AL) and Shelley Moore Capito (R-WV). Representatives Kathleen Rice (D-NY), Pete King (R-NY), David Trone (D-MD), Elise Stefanik (R-NY), Maxine Waters (D-CA), and Chris Smith (R-NJ) introduced the bill as H.R. 1903 in the House of Representatives.

Nutritional programs, supportive services, transportation, legal services, elder-abuse prevention and caregiver support have been available through the OAA since 1965. However, under the current law, only individuals over 60 are eligible.

“These programs would make a huge difference in the lives of individuals living with younger-onset Alzheimer’s disease, who don’t have support services available to them,” said hearing witness Mary Dysart Hartt of Hampden, ME, a caregiver to her husband, Mike, who has young-onset Alzheimer’s.

About 200,000 individuals aged less than 65 have younger-onset Alzheimer’s disease, according to hearing witness Clay Jacobs, executive director of the Greater Pennsylvania Chapter of the Alzheimer’s Association, North Abington Township, PA.

“The need to reach everyone affected will grow significantly in the coming years,” he said.

Senator Collins was a founder and co-chair of the Congressional Task Force on Alzheimer’s Disease. She noted that she and Casey are leading this year’s OAA reauthorization efforts.

Senator Collins said she was also introducing the “Lifespan Respite Care Act” with Senator Tammy Baldwin (D-WI) Tuesday “to help communities and states provide respite care for families.” This legislation would earmark $20 million for fiscal year 2020, with funding increasing by $10 million annually to reach $60 million for fiscal year 2024. The program lets full-time caregivers take a temporary break from their responsibilities of caring for aging or disabled family members.

“Whenever I ask family caregivers, which included my own mother, about their greatest needs, the number one request that I hear is for more respite care,” Senator Collins said.

Reference: McKnight’s Senior Living (April 3, 2019) “Bill would aid those with younger-onset Alzheimer’s disease”

Why is TennCare Asking Seniors to Move Out of Their Homes?

“According to TennCare, since 2014, the number of estate recovery cases across the state has gone up 30 percent, while the amount of money recovered has more than doubled, jumping from just under $13 million to nearly $27 million.”

TennCare is the state of Tennessee’s program that covers medical care for the poor. It provides free care in many cases, but in some cases, it must be paid back. For example, Mary Musgrave lived in her home for many years, and at one point her daughter Lisa moved in to help take care of her. However, Lisa may be about to lose the home.

After Mary was in a car accident, she was forced to go on TennCare, after ending up in a nursing home. She lived there for five years, Musgrave explained to News Channel 5 Nashville in the article, “Daughter to lose home after mother's death due to money owed to TennCare for nursing home care.” She died in the nursing home, and afterwards, the family got a bill from TennCare for more than $171,000.

This is what's called an estate recovery. State law requires the government to collect what the TennCare program spends on long term care for anyone 55 and older, after they die.

TennCare isn’t a government benefit program. It's not a grant or a gift. Rather, it's a loan and the loan is required to be paid back after death. While estate recovery isn’t new, three years ago, the program dedicated more resources to it.  It has become more aggressive in pursuing its rights to recovery.

When Musgrave said she couldn't pay what was owed, she was informed by the program that she would have to sell Mary's home to come up with the money.

There are some situations in which TennCare will let a family stay in the house, such as when there's a surviving spouse, a child under 21, or a disabled child. Adult children are permitted to remain in the house, if they lived with the parent and helped care for them for at least two years before the parent moved into the nursing home. However, in this instance, TennCare says Musgrave did not meet the requirements.

TennCare spent more than a billion dollars on nursing home care in 2018, and the state says estate recovery is critical for the program to continue.

The best way to protect your house from estate recovery, is through estate planning. This should be done well before a parent or any individual requires nursing home care. Experts recommend at least five years. Be sure that you talk with an attorney who specializes in elder law.

Reference: News Channel 5 Nashville (March 18, 2019) “Daughter to lose home after mother's death due to money owed to TennCare for nursing home care”

What’s My Plan If I’m an “Elder Orphan?”

“’Elder orphans’ is a new term coined to describe 22 percent of Americans over the age of 65 who lack someone, like a family member to take care of them.”

Roughly 66% of those over 65 need some form of long-term care help, and the majority will depend on a spouse, partner, or their children for assistance.

WFMZ TV’s recent article, “The single senior life: Elder orphans,” asks “what if they have none of the above?”

While you're still healthy, you should make plans, in the event you find yourself in need of the help that is traditionally provided by a family member. There are solutions, but they require planning.

The first step is to hire an elder law attorney to create the documents to protect you, if you become incapacitated. Designate a friend, a physician, or clergy member to make medical decisions and detail your wishes for your healthcare.

Anyone 18 years or older should have at least a durable power of attorney and a healthcare surrogate.

The next task is to consider where you want to live, like a neighborhood that is near public transportation, so you are not housebound. Begin looking at senior communities or assisted living facilities, and home-help services.

A somewhat unique strategy is to “adopt” a family, where a single elderly person agrees to leave his assets to a family who will help as they age and until they pass. Be careful about the family you select, to avoid any elder financial abuse.

Another way to stay connected is via social media, like Facebook. Carol Marak, the editor of SingleCare, started a group for elder orphans. The group already has more than 35,000 members.

It's critical that you develop a social network. Think about becoming a member of a class, volunteering somewhere, or taking up a hobby—something that will give you regular exposure to a new group of people on an on-going basis.

Some people who do have families lack close connections with their own flesh and blood, and if that is the case, while you may not be an elder orphan, you still need to create a plan to protect yourself as you age.

Reference: WFMZ TV (March 7, 2019) “The single senior life: Elder orphans”

Iowa Senator Sponsors Elder Abuse Prevention and Prosecution Act

“Iowa Senator Charles Grassley is among those in Congress calling for a crackdown on elder abuse crimes in the country.”

The witnesses of loved ones affected by elder abuse incidents testified at a recent Senate Finance Committee hearing in Washington.

Those witnesses included Pat Blank, longtime Iowa Public Radio host, and past winner of the Iowa Broadcast News Association's Jack Shelley Award. Blank's mother, Virginia Olthoff, died in an Iowa nursing home in February 2018, because of alleged neglect.

Another witness was Maya Fischer, her 87-year-old mother—an Alzheimer's patient—who was allegedly raped by a nursing aide.

Grassley said that in these cases, the victim's trust was betrayed by those entrusted to care and protect them, reported KMA in the article “Grassley hearing targets elder abuse issues.”

"Sadly, these are not isolated cases," said Grassley. "They could happen to anyone. According to the Inspector General, a whopping one-third of nursing home residents experience harm while under the care of federally-funded facilities. And, in more than half of these cases, the harm was preventable."

Grassley sponsored the Elder Abuse Prevention and Prosecution Act. This is legislation that calls for the training of elder abuse investigators, the collection of data on elder abuse and collaboration among federal officials tasked with combating seniors' exploitation.

Even with the bill's passage in the last session of Congress, Senator Grassley says the work in this area isn't done.

"Hardly a week goes by without seeing something about nursing home abuse or neglect in the national news," he said. "Every family has a loved one—a mother, a father or a grandparent—who may someday need nursing home care. That makes this a topic of enormous concern to every American."

Grassley said that the Inspector General's alert issued two years ago, cautioned the public about deficiencies cited at nursing homes in 33 states.

Many of the cases involved sexual abuse, substandard care and neglect.

As finance committee chair, Senator Grassley says he'll continue to ensure the elderly have access to quality long-term care in an environment that is "free from abuse and neglect."

Reference: KMA (March 6, 2019) “Grassley hearing targets elder abuse issues”

What is Tennessee Doing to Combat Elder Financial Abuse?

“Last week’s actions by legislators—which are just now getting underway—seek to increase the penalty for those who are financially exploiting Tennesseans through telephone and electronic scams.”

The Cleveland (TN) Daily Banner’s recent article, “Elder financial abuse leads recent legislation,” reports that one of the Tennessee 111th General Assembly’s major actions was the elder financial abuse and fraud bill. The new bill would increase the penalty for those financially exploiting Tennesseans through telephone and electronic scams.

House Bill 799 intensifies the state’s focus on crimes against the elderly.

“House Bill 799, as it was introduced, increases the penalty and broadens the offense of financial exploitation of an elderly or vulnerable person to include the use of a telephone or other electronic or communication device,” state representative Dan Howell (R-Georgetown) explained.

The legislation identifies as its target the use of these devices with the intent “… of fraudulently or deceptively obtaining, or attempting to obtain … money, property or anything of value from the victim,” Howell said.

Mark Hall (R-Cleveland), who represents the 24th Legislative District, agreed with Howell’s interpretation and stressed that these types of crimes, or attempted crimes, are being reported statewide.

“According to media reports, law enforcement officials have been warning Tennesseans, especially our elderly and vulnerable adults, about potential scams targeting these groups during tax season,” Hall stressed. “Some of these scam artists will call or email, and pose as an Internal Revenue Service official, asking for sensitive information.”

Howell and Hall cautioned all state residents, “Don’t be fooled by these callers. Ask for a name, title and phone number, but don’t call back. Report any suspicious activity to the proper authorities.”

Tennessee is one of many states now addressing elder abuse legislation.

One of Tennessee’s biggest advocates against these types of crimes is the Tennessee Bankers Association. For the past several years, the TBA has pushed for stronger laws governing the financial abuse of senior citizens.

Reference: Cleveland Daily Banner (February 18, 2019) “Elder financial abuse leads recent legislation”

How Does a Senior Qualify for a “Senior Freeze” in New Jersey?

“The term `freeze’ is somewhat of a misnomer, because the program does not freeze a senior’s entire property tax payment.”

Think of a situation where an adult child and her elderly mother own a home together and both live in it. What happens in New Jersey, if the child takes her name off of the deed? Will that allow her mother to eventually apply for and possibly receive a “Senior Freeze” for the property taxes? If the child’s name is kept on the deed, could she still qualify?

The New Jersey Division of Taxation explains that the Senior Freeze Program reimburses eligible senior citizens and disabled persons for property tax or mobile home park site fee increases on their principal residence. To qualify, an individual must meet all the eligibility requirements for each year, from the base year through the application year.

nj.com’s article asks and answers this question: “I own a home with Mom. Can she qualify for the Senior Freeze?” The article explains that a senior is eligible for participation if she’s over 65, has continuously lived in the state for the past ten years and has owned and occupied her current home for the past three years. The property tax due on her home also must be paid in full.

If a senior is seeking eligibility for the 2018 tax year, she must have met the eligibility requirements in both 2017 and 2018 and her annual income in each year can’t have been more than $87,268 and $89,013, respectively. Applications for the 2018 tax year must be filed by October 31, 2019.

Eligible seniors are reimbursed for the amount by which their current annual property tax amount is greater than the property tax amount in her first year of eligibility for the program.

Therefore, if the mom in the initial scenario satisfies the eligibility requirements for the program, the fact that she co-owns the home with her adult child won’t disqualify her from receiving a reimbursement. However, she’ll only be entitled to partial reimbursement of the tax increase, in proportion to her percentage of ownership in the home.

If the child conveys her interest in the home to her mother, making her the sole owner of the property, she’d be eligible for the full reimbursement amount for the first tax year that she is sole owner for the entire year. The Senior Freeze Program doesn’t pro-rate reimbursements for mid-year changes in ownership.

It’s important to remember that conveying the child’s interest in the home to her mother, could have unrelated legal and tax consequences that could outweigh the savings from the reimbursement. This situation would be best resolved by sitting down with a local estate planning attorney who is familiar with the laws of the state and the issues that might arise from changes in the ownership of the home.

Reference: nj.com (March 27, 2019) “I own a home with Mom. Can she qualify for the Senior Freeze?”

Credit Union Association Supports Fights Against Elder Fraud

“CUNA strongly supports efforts to help protect seniors from financial exploitation and to empower seniors to make responsible financial decisions, it wrote to the Senate Special Committee on Aging.”

CUNA delivered a letter for the record of the committee’s hearing on combating elder fraud.

“Many credit unions provide a full range of financial services such as financial management, retirement planning, and credit counseling to their members,” wrote CUNA President/CEO Jim Nussle. “The cooperative relationship between a credit union and its members often puts credit union employees in a vital position to detect suspicious financial activity related to seniors’ accounts, because employees tend to know their members well and are likely to recognize when something is amiss.”

CUNA also noted in the article “CUNA: CUs positioned to combat elder financial abuse” that it thanked committee leadership, Senators Susan Collins (R-Maine) and Bob Casey (D-Pa.), for their leadership in sponsoring the Senior$afe Act in that last Congress.

The bill protects the reporting of suspected elder financial abuse. It was signed into law as part of the Economic Growth, Regulatory Reform and Consumer Protection Act (S. 2155).

“Senior$afe represents an important step toward improving the ability of credit unions to protect seniors from unscrupulous activity, by providing limited immunity for properly trained financial employees who disclose concerns about financial exploitation of senior citizens to the appropriate authorities,” CUNA President/CEO Nussle wrote.

“This safe harbor, which applies only when reporting suspicions of exploitation to a class of covered agencies, such as financial regulators or law enforcement, is a vital component of the legislation and will give greater leeway to those individuals who have the most power to detect and prevent the financial abuse of those most vulnerable to it.”

Senator Collins, who sponsored the Senior$afe Act in several Congresses, has partnered with the Maine Credit Union League on several occasions on the topic of senior abuse.

Reference: CUNA (January 16, 2019) “CUNA: CUs positioned to combat elder financial abuse”

Do You Want to Live to be 100?

“How do you feel about living until 100?”

Most people would love to live to be 100… provided they get to keep a good quality of life.

 However, with an aging population—including many Baby Boomers—and with genetic testing becoming more available, these people are facing the tough reality about what their elder years might look like. For some individuals, that could include dementia.

The (Bryan TX) Eagle’s recent article, “Alzheimer’s disease: Five common myths, busted,” reports that, according to the Alzheimer’s Association, one in three seniors dies with Alzheimer’s or another type of dementia. There are up to 5.7 million individuals who live and die with the disease, which makes it the sixth leading cause of death in the United States. The article provides five common myths about Alzheimer’s disease.

Myth # 1: Memory loss is a normal part of growing older. A slip of the memory may well be a normal part of growing older. While these forgetful moments may cause a bit of frustration and embarrassment, they don’t affect our ability to live an independent life. However, if a loved one has trouble remembering commonly used words or loses the ability to communicate, it could be a potential symptom rather than a natural senior side-effect.

Myth # 2: Alzheimer’s can be reversed, if it’s diagnosed early. No. Unfortunately, there's no treatment that will reverse the progress of Alzheimer’s disease. However, although there are therapies and drugs that can slow down the neurodegeneration associated with Alzheimer’s, there is no known cure. Even so, early diagnosis has its benefits, like better symptom management, a safer patient environment and the ability to plan for the future.

Myth # 3: Alzheimer’s just affects older people. Some Alzheimer’s patients can get diagnosed in their 40’s or 50’s. The early onset Alzheimer’s is uncommon (just 5% of patients are diagnosed before age 65); an accurate diagnosis is important to help the family cope with the realities of the disease.

Myth # 4: A diagnosis of Alzheimer’s means your life is over. Many people live years or even decades, before the disease claims their lives. Alzheimer’s effects each patient differently. The disease is commonly divided into three stages. The first or “mild” stage is where the patient is able to live a mostly normal life. The middle or “moderate” stage requires more extensive care. And in the late or “severe” stage, the patient needs 24/7 supervision and medical assistance. Life many never be the same with an Alzheimer’s diagnosis, but it’s far from over.

Myth # 5: There’s little you can do to protect yourself financially, if you are diagnosed with the disease. A serious diagnosis of any type can drastically impact a family, but it’s important to understand that there are things you can and should do to help your loved ones manage what comes next, emotionally as well as financially. Look at these ways you can help:

• Create a list of all financial accounts;
• Review the titles and names on each account;
• Look at your options for paying for medical care, such as existing insurance policies, Medicare coverage, or other sources of funding;
• Consider designating a Durable Power of Attorney for Healthcare, so that a trusted person can make decisions for the patient if there’s an accident or incapacitation;
• Communicating preferences for living arrangements, medical assistance and end-of-life care; and
• Be sure your will is up to date.

Don’t think you have to manage the diagnosis alone. An elder law attorney can help you with your questions, as well as planning and recommend resources for care.

Reference: The (Bryan TX) Eagle (October 4, 2018) “Alzheimer’s disease: Five common myths, busted”

More Ohio Officials on Guard for Elder Abuse

“Real estate agents, CPAs and firefighters are part of the expanded list of professions now required to report, when they suspect a case of elder abuse.”

There are new requirements now in effect in Ohio that expand the definition of a “mandatory reporter” to add more professions with the ability to spot issues from different perspectives. These include pharmacists, dialysis technicians, firefighters, first responders, building inspectors, CPAs, real estate agents, bank employees, financial planners and notary publics.

The expansion of the definition of mandatory reporters shows the wide range of ways that seniors can be abused, from being financially taken advantage of to living in neglect, officials said.

The Dayton Daily News’ recent article, “This new law means many more Ohio officials are watching out for elder abuse. Here’s why it was passed,” explains that elder abuse can include exploiting another person’s resources; physical, emotional, or sexual abuse; or neglecting to meet a person’s basic needs. There were more than 16,000 reports of abuse, neglect, and exploitation of Ohio adults aged 60 and older in 2017. However, only one in 14 cases is reported, according to National Institutes of Health estimates.

“This expansion of mandatory reporters will help us in our goal of protecting our vulnerable family members, friends and neighbors from harm,” said Cynthia Dungey, director of the Ohio Department of Job and Family Services, which supervises Ohio’s Adult Protective Services program.

Financial institutions are one of the main places where exploitation can be recognized. Officials are educating tellers to identify the signs, such as an older customer appearing confused or distant or withdrawing unusual amounts of money.

Other signals of elder abuse can include seniors living in isolation, missing appointments, appearing frightened or avoiding specific people.

Victims can also suddenly withdraw from regular activities or interactions, change their mood or temperament, change their personal hygiene or become resistant to human contact. Some of the factors that raise the risk of elder abuse include dementia, poverty, declining health, previous experiences with domestic violence or other traumatic events, a lack of a support system and no access to community services.

Reference: Dayton Daily News (September 29, 2018) “This new law means many more Ohio officials are watching out for elder abuse. Here’s why it was passed.”