This is the Whole Care Network. Music Helping you tell your story one podcast at a time. Content presented in the following podcast is for information purposes only. Views and opinions expressed in this podcast are solely those of the host and guest and may not represent the views and opinions of the Whole Care Network. Always consult with your physician for any medical advice and always consult with your attorney for any legal advice. And thank you for listening to the Whole Care Network. Music We don't know what we don't know. They do and it's really important. In this episode, we're talking with Beth Prather and Courtney Lovejoy, elder law attorneys with the firm Green, Schoenfeld and Kyle. We're talking about the importance and positive impact of working with elder law attorneys. Today we're sharing four tips. Let's get started. Music Welcome. We are Sue Ryan and Nancy Treister. This podcast brings our years of experience in a variety of family caregiving roles to prepare you to navigate your caregiving journey. We're sharing our personal experiences, not medical advice. And because it's our passion to support you on your journey, we believe no topic is on limits. Let's get started. Music Whatever country you're listening from, today we're talking with legal professionals who help the elderly and their families navigate legal issues. In the United States, these are called elder law attorneys. Beth and Courtney, welcome. Please introduce yourself to us and share when you think it's the best time for somebody to initially reach out to elder law attorneys. Courtney Lovejoy. I'm an elder law attorney at Green, Schoenfeld and Kyle, as Sue mentioned. Beth and I practice and Medicaid planning, VA planning, estate planning, probate and trust administration and guardianship. And we're both Lee County, Florida natives. I went to University of Florida for my law degree and I have my LLM or Masters of Law and elder law. My name is Beth Prather. I'm a board certified elder law attorney. I've been practicing 32 years here in Lee County, as Courtney said. This is the only place I've ever lived other than my college years. I did my undergraduate at Emory University. I have an MBA from Nova University and I have my Juris Doctorate from the University of Maine School of Law. So when's the best time for someone to initially reach out to an elder law attorney? I think the quick answer is if you have a diagnosis, you should have seen an elder law attorney yesterday. Most people understand what an estate planning attorney does when you're healthy. You do wills, you do trust, durable powers of attorneys. Elder law attorneys do that too. Again, when you're healthy, most people understand what a probate attorney is or an estate attorney. After death, estate attorneys help you administer a trust or administer a probate estate. Elder law attorneys do that as well. But our primary focus is in between being healthy and being deceased where someone in the family unit is sick. That's where we concentrate and specialize. So it could be Medicaid benefits. It can be VA benefits. It can be guardianship for people who failed to plan. And so that's kind of the difference that sets us apart. So our first tip is how to find an attorney who focuses in elder law. So as we mentioned, Beth is board certified in elder law. I have my masters of law and elder law. Speaking to the masters of law, that's generally an hour or a year of extra schooling after your law degree where you specialize in something, whether that's tax wills trust in the states elder law. Those are the common ones in our field, but there's a whole bunch of different masters in law. Beth is going to speak to the board certification process. Board certification. A lot of people understand you have doctors that are board certified attorneys and our practice have board certifications in certain areas. You have to be a practice bent in practice doing elder law, not just an attorney, but doing elder law for a certain period of time. You have to take exams. You have peer reviews to be board certified. And here in Florida, there's approximately 114 people that are board certified in elder law. So there is a stringent qualification to become board certified, but basically it's setting you apart where you are specializing in that in elder law. If we're going to talk about seeking an elder law attorney, it isn't necessarily that they have to be board certified or necessarily that they have to have a masters in elder law. That shows their specialty because it's a requirement to be able to have those designations. The primary concern is you need to ask them how many Medicaid applications that they filed last year. Because even if you're board certified or have an LLM in elder law, if you filed one Medicaid application last year, the practical experience is not there. And or guardianship cases. If you, there are some board certified elder law attorneys that don't do Medicaid or that don't do guardianships. So you need to ask those questions. It's not just the designation, although that is a good starting point, but you still need to ask those questions. Not all states have a certification process for elder law, Florida does. But we do in the United States, and I'm calling it nationally in the United States, there is an ability because there's, as I said, there's many states that don't offer that to get certified nationally. It's a little bit different standard. It's a little bit different testing, but you can get certified by NALA. And I think Courtney, you speak a little bit about that, but there are other options for people that are not in Florida or in a state that doesn't have certifications for elder law. So, so 2 really good resources that we recommend a lot are 2 websites. 1 is called NALA.org N A E L A. That is and the National Academy of Elder Law attorneys. They have a really good search function on there where you can type in your zip code and, you know, 15 miles away from me, et cetera. And that's a good way to find people who classify themselves as elder law attorneys that are members of NALA. So I'd probably start there to find a couple people, see if they're board certified, if they have their masters of law and elder law, and then maybe when you have a consultation with them, inquire about how many Medicaid applications that be filed. When it became the right thing for my husband and me to do in finding an elder law attorney, I reached out to members of the support group for the diagnosis we were part of. I reached out to our attorney and our financial advisor. I reached out to members of our church congregation and friends in the community who we knew and say you give us names who have you worked with. And we were given a variety of names and Beth, you are right here and I've shared this with you before I will share it again. Other people gave me names and yet so many gave me your name and when they did, they said enthusiastically Beth Prather and she's the best. And we began working together and over the years Courtney, you have begun working together as a team and the two of you definitely are the best and just great. So as you're looking for the elder law attorney you're going to work with, you're looking for the ones where they say and they're the best. Tip 2 prioritize these things first. So, I think Beth and I agree the single most important thing you can do to plan for Medicaid or to plan for an illness is to have a good durable power of attorney. When I say a good durable power of attorney, I mean a durable power of attorney that has Medicaid planning language in it and VA planning language in it. You can have a power of attorney that works great at the bank or to sell real estate, but if it doesn't have that good Medicaid and VA planning language in it, we're in big trouble. When now there's been a diagnosis and now the person is no longer confident and makes it extra tricky to get them qualified for an extra expensive. Yes. So, and I'm going to share. Expound on that because Florida has very strict rules with regard to durable powers, attorneys and crisis Medicaid and VA benefits planning. I've been doing this a long time and I have not yet seen a durable power attorney from another state that has higher requirements than Florida does. So, people here in Florida, you have to have specific language that authorizes crisis Medicaid planning tools and those paragraphs have to be initial. It's four and a half pages of our durable power attorney is just the Medicaid and VA benefits language that we need. So, other states don't have that requirement. So, you depending on where you are. The other thing is Medicaid. A lot of people think that Medicaid is a federal program. Well, it's part federal and that's the floor or the minimum, but then it's also state specific. So, what we do here in Florida may not work in Georgia or New York. So, it's, I think it's. We talk about that's what the elder law attorney is going to look at. You may have had a durable power attorney from 10 years ago. But it may not have the language needed for illness or planning for care. So that's where the elder law attorney can help out. I'm going to talk about a little bit different. I'm a huge proponent of long term care insurance. If you can afford it and you're well enough to get it. We don't sell long term care insurance. We're not licensed. We're just big proponents of it because it gives you some flexibility. I think some people think that Medicare, not Medicaid, but Medicare is going to pay for care in your home. That's a short term rehab solution. Other people think, oh, Medicaid will pay for 24 hour care in your home. They do not. It's going to provide some help. Our goal is to keep people out of nursing homes if at all possible where Medicaid pays the big bucks. So long term care insurance can help. And the, I've had clients on both long term care insurance and Medicaid at the same time to help keep their loved ones out of a nursing home. So I got my long term care insurance when I was 40 years old and it's probably because of what I do. But my father had a major stroke. And so if you wait too long, then you may not be eligible for it because you have diagnosis. So I'd say another thing to prioritize if you've a diagnosis or if you see Medicaid on the horizon and Beth and I like to say, no one has that crystal ball to know when you're going to die or when you're going to get sick or if you're ever going to get sick. But if you have a diagnosis and you see that Medicaid may be on the horizon limit your gifting or if you can make no gifts at all. So a lot of us have heard about the 5 year look back period with Medicaid. When you what that refers to is when you apply for Medicaid, Medicaid looks back 5 years to see if you've given your money away to get qualified for Medicaid. So that's buying your son a house. That's a big gift. That's obvious, right? But also $100 to your grandson or $1000 for a graduation present. If any of that gifting has been done within the last 5 years, we can fix it a lot of the time. But it's going to have to be reported to Medicaid and your elder law attorney is going to have to fix it. So if that gifting is limited or if there hasn't been any gifting, it's a heck of a lot easier to get Medicaid. I'm going to piggyback on that and say that trying to do it yourself. The social worker at the hospital or your next door neighbor said, you can't have any money. And so you give it all to your kid. It's it's much harder for us to fix things than it is to come see us and plan correctly. And so here in Florida, we have a hodgepodge of people from all over the United States. And so they equate what happened in Missouri or what happened in California or Ohio. And they think that we have to do that before we go see the elder law attorney. You need to see the elder law attorney before doing any planning on your own and let them help you to plan for that. And touching on that too. We hear this a lot. Well, I need to I need to protect my assets. I need to hide them from Medicaid. But that's that's not true. We show Medicaid everything we do. There's no hiding. There's no lying. We just make your assets and your income work within Medicaid's rules. Okay, I'm just one word we hear a lot is you've got to spin down to get Medicaid. I will say Florida is very, very liberal when it comes to Medicaid rules, probably one of the most liberal states in the United States. We don't have to spin down. We have lots of crisis Medicaid planning options. Some states are horrible. And it's very difficult. It's just been my practice. I can't say this is true, but just in my practice in years, Ohio and Connecticut are very difficult. So by seeing an elder law attorney, some of these states you have to do a five year pre Medicaid plan. And that's why it's important that you see the elder law attorney at the beginning of a diagnosis rather than when you get at what's in that you need health with care. So now we're going to introduce our tip three, which is an explanation a little bit about Medicaid and VA benefits and what type of help we can get from those agencies. We've been talking about Medicaid, but our primary discussion in this is long term care needs. And so Medicaid and VA are a financial resource to help pay for that care journey. So Courtney, you want to talk about Medicaid? Sure. So I think maybe it'd be helpful to share some of our Medicaid myths to explain this concept. So in Florida specifically, and in some other states, you can get Medicaid at home or assisted living or a nursing home. So one myth that we hear a lot of the time is I can only get Medicaid if I'm in a nursing home. Well, in Florida and some other states, that's not true. You can get Medicaid at home or assisted living as well. Beth touched on one of our other myths, which is you got to spend down all your money to get Medicaid. That's not true in a lot of states, Florida specifically. And then another myth that we hear a lot is if I'm on Medicaid in a nursing home, I have to go to a state Medicaid nursing home. That's not true. There's in this area, there's a ton of nursing homes and all but two except Medicaid and the three fanciest nursing homes in this county that I can think of all except Medicaid. So don't just wait to call an elder law attorney if your loved one is having to go to a nursing home. It's possible that we could get Medicaid to help pay for care at home or assisted living as well. Do you want to add anything to that? I just add that I have seen through national conferences where some states you may only get care at home in a nursing home through Medicaid. Some states are similar to us where you can get it in all three levels, meaning at home, assisted living or nursing home. I will say that I've seen some states where you can get a lot more care at home than you can in Florida. So every state has different rules and different benefits that Medicaid provides. So, you know, an elder law attorney is going to know that based on the state. And so I know what Medicaid provides in Florida, regardless of whether you live in Tallahassee or you live in Fort Myers. And the same with an elder law attorney in another state, they're going to know what type of Medicaid benefits you can get. The other area we wanted to talk about in this tip is VA benefits. And so a lot of our veterans, first off, were very thankful for their service, but there is VA benefits called aid and attendance. A lot of our veterans think they had to have been injured in service to be able to get benefits. That's not what we're talking about. We're talking about VA aid and attendance, which is helping families, veterans, and surviving spouses of veterans with long term care needs. Yes, there's some requirements about service, but they don't have to have been injured in their line of duty. And so you want to ask an attorney if they assist with VA benefits. It doesn't mean an elder law attorney has to do an application. So here locally, our veteran service office does applications for aid and attendance for free. So we would not be doing an application for a client because they can get it done for free with our local veteran service office, but that's a resource that we help them with. But the elder law attorney can help you with the planning to get eligible just like with Medicaid. So it's, I will say that there's one other area that might be location specific, state specific, but not just state specific, but a town or city within a state. And sometimes some of our clients here, if they're enrolled in the VA medical side, so VA has two branches, a medical side and a financial side. When I talked about VA aid and attendance, it's the financial side, but we in our area have some benefits that are available for veterans that are enrolled in the medical. If you don't, if you're not already enrolled in medical here locally, it's difficult to get enrolled in the VA medical side because unless you fit a certain high category, Bronze star, you know, something prisoner of war, something like that, then they start looking at assets and income. So we're always encouraging our clients who served in the military to at least try as they age, get, try to get enrolled in the medical side, because we in our area have some benefits that are available, meaning in home care. We have self directed benefit VA benefits where the VA will assist with paying for care in your home. And this is different than aid and attendance, but you have to have been enrolled in the medical side of VA. So that's what I mean about an elder law attorney can assist you with those types of resources, have knowledge of it. It might not be in your particular area. We don't have it in every place in Florida. But that's something that the elder law attorney in your state can assist with as far as resources. So this leads us to tip four, which is that use this time when there's been a diagnosis or when you're talking with an elder law attorneys for the first time, use this time to get on top of other important areas. So, for example, when Beth and I are having a consult with a family to talk about Medicaid and options with care for the future. We're also looking at are there beneficiaries named on your accounts? Are we avoiding probate when you pass away? And one thing I wanted to comment on that a lot of people don't know is a lot of people think I have a will. So there's not going to be a probate when I pass. Well, that's not true. A will actually only speaks to probate assets. So if I want the food bank to get all of my money when I pass away, but if I have my niece as beneficiary on all of my accounts, well, guess who's getting all my money when I pass away? The niece, not the food bank. So make sure that you have beneficiaries that you want to receive your assets when you're gone. So, talk with your elder law attorney or a state planning attorney, whether you do need a will or perhaps a trust. This is also a good time to make a list of what you own. Oftentimes your elder law attorney is going to need that to properly advise you. The institution where you have your money, whereas you're checking and savings account, what's the ownership of that account? Is it a joint account? Do you have beneficiaries named on that account? And then the approximate value. So your attorney is going to want that, but that's also helpful for your loved ones. If you get sick or when you pass away, that's very helpful. So I would use this time to make lists like that. Make sure you have beneficiaries. Sometimes this is a good opportunity to consolidate accounts. There's oftentimes no need to have 8 different checking accounts or savings accounts. So this is sometimes a good opportunity to consolidate to make things easier for potential eventual Medicaid or just to make things easier for your loved ones when you get sick or when you die. One thing that we haven't mentioned, I think that's very important and then I have an extra tip is we haven't talked about medical decisions. In Florida, we call it a healthcare surrogate. In a lot of states, it's called durable power of attorney for healthcare. There's also living wills. And the healthcare surrogate is medical decisions during life if you're unable to make them and a living will is an end of life decision. Am I going to be hooked up to machines? If I am brain dead, it's called a persistent vegetative state or not. And many of your listeners will probably remember Terry Shivaugh, the Terry Shivaugh case, which happened to be here in Florida. She was 37 years old once again. She was not old. So it wasn't that she necessarily needed an elder law attorney, but an event happened to her. And so here she was in St. Pete here in Florida and she did not have a living will. And we had decent people disagreeing about what her wish was, meaning her parents and her husband. And it was litigated for 13 years in the courts about whether she should continue to be kept alive on machines or not. So it's important to discuss that as part of your estate planning. And we do that with all of our clients. It depends on your family situation and your state laws. But that's very important too, as part of this overall review of your circumstances. The other thing that I see and I would discourage it is people planning themselves without the use of an attorney and don't start adding kids to your accounts. Courtney had a very good reason and I've seen this too, is you have a kid that lives here where you live. Oh, I'm going to add her name to the account, but yet her will says it goes to three kids. And that's in her mind what she thinks is going to happen. But she named her kid as a joint owner on all of her assets. Well, here in Florida when she passes away, it's going to the joint owner, her kid that lives here, not her other two kids, meaning the three kids equally. So that's part of the self help. That is not wise. The other thing is I see people adding kids names to houses, not just bank accounts. Bad things happen to good people. Look at 2008. I know it was horrendous and homes were upside down. So, and people lost jobs. So you want to be very careful is that what about if you add your kids name to an account or to your house. What if something bad happens to them, for example, they're driving down the road, they have an aneurysm and they hit and kill people is, are you going to lose your assets because your child's name is on it. You know, so you need to be very careful. And that's why this we talking about don't do the self help is you need to have the advice of an attorney to assist with that. And this is also a good time to talk with your loved ones about what you want to happen when you've passed away. Do you want to be buried or cremated. Do you want to have a funeral service. What are your expectations with that. And then Beth touched on this earlier, but in what do you want in regards to care at end of life. Do you want that hydration or nutrition or do you just want pain management. So these are all things to talk to your loved ones about and put in writing with your estate planning or elder law attorney so that there's no question about it when you're sick or dying or when you're gone. Beth, when we began working together before we even had our first meeting, you gave us homework. And today we're talking about things that make a positive impact. One of the really positive impacts that that lasted throughout the remainder of our entire journey together was the homework you gave us when we were at our first meeting where you said hey we're going through all these details here. So it's a good time to look at all the other areas you've got and be making choices and decisions about those. And we looked at how are the houses, you know, houses, how are the cars, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how are the houses, how哎哎哎哎哎哎哎哎哎哎哎哎哎哎哎哎 more. And so the work that you did specifically in the elder law area as well as the surrounding area, your lens on that is hugely valuable as an elder law attorney. And I encourage everyone to participate in the work with elder law attorneys. So thank you again very much for that. Okay. Let's summarize our four tips. Number one was how to find an attorney that focuses in elder law. We talked about board certification and LLMs, but also asking about how many Medicaid applications or guardianships they filed. And then we shared some resources, online resources to find an elder law attorney. We talked about things to prioritize like durable powers of attorney or long term care insurance if you can afford it. That was tip two. Tip three, we talked about Medicaid and VA benefits, things to think about when those things may be on the horizon. And tip four, using this time to prioritize other important areas and get on top of other important areas. Beth and Courtney, thank you so very, very much. Please tell our listeners how they can find your firm when they are looking for an attorney in the state of Florida. And add anything else you'd like to share. We want to thank you, Sue, for having us on the podcast and to let listeners know how we can be reached. The firm is Green, Schoenfeld, and Kyle. We can be reached. The phone number is 239-208-3050. We're in Fort Myers, Florida, but we serve the five county area, not just Lee County. And we do appreciate you taking the time to speak with us. Beth and Courtney, your messages are incredibly helpful and very, very valuable. And thank you again so much. For our listeners, if you have tips, in addition to the tips we've already shared, we'd love to hear them. Please go out to our Facebook and our Instagram pages. The links are also in the show notes and put your tips out there for other people to see. If you like this podcast, please subscribe or follow on whatever platform you listen to the podcast on. Please rate and review the podcast as well as sharing it with others. The links Beth and Courtney have shared and their contact information will all be in the show notes. We're all on this journey together.
