How To Afford Homecare
No one wants their loved ones to end up in a nursing home. The pandemic has made it painfully clear that other care options are preferable, and potentially far safer. Home care is the preferred choice even though it has its own problems. One of these is how to afford the cost when the statewide average is $271 per day for a live in. Families using adult day care at a facility pay an average of $92 per day, and then take care of their elders themselves the rest of the time. These costs are beyond the reach of most families, as it exhausts their life savings long before the need for homecare ends. And many people need those savings to supplement their monthly incomes.
The first place to look for help is a program for wartime veterans called Aid and
Attendance. The VA requires a person to be a wartime veteran. This does not mean the veteran served overseas or in combat. It just means that active-duty service (not reserves) was for 90 days, with at least one of those days during dates set by Congress. A single veteran can get up to $1911 per month, and a widow of a veteran up to $1228 per month. A married veteran can get up to $2266 per month. This can go a long way toward paying for home care.
The next source of help is the Connecticut Home Care for Elders Level II. To qualify
physically the person must miss two activities of daily living, such as help with bathing, dressing, feeding, toileting or transferring. There are asset limits of $37,426 for a single person, and $50,568 for a couple and the maximum aid per month is $2,973. This may be just enough of a safety net to keep the elder at home.
The highest level is Medicaid (Title 19) and to physically qualify, the individual must
miss three activities of daily living listed above or be an overall safety risk. That means serious risk of falling, or wandering, or cannot remember to do basic functions. If a person can physically and financially qualify, Medicaid will pay up to $5,945 per month toward care, which is $71,340 per year. That is substantial. In some cases, the state may approve a 24 hour live in, but to qualify for it is difficult because the caretaker must get 5 hours of uninterrupted sleep every 24 hours.
Everyone applying for homecare will be evaluated by a company hired by the state to do the evaluation, and to monitor the care if approved by the Department of Social Services. In the central Connecticut area, that company is Connecticut Community Care Inc. In other areas it may be an Area Agency on Aging. These days that evaluation may be done over the phone to avoid direct contact.
The good news is that Connecticut has given decent funding for home care, although
there is worry that may be reduced. The not so good news is that Connecticut has some of the strictest rules in the country to qualify financially. At national conferences, lawyers are often surprised by the strictness of Connecticut rules. For example, in some states, an IRA doesn’t count toward the asset limit, which for the applicant is $1600. In Connecticut the IRA counts whether owned by the applicant or a spouse. Suffice it to say, complying with the regulations can be like running a maze. One wrong turn can take days or weeks to correct. It is critically
important to have as an elder law attorney who regularly does Medicaid, and who understands not only the written rules, but how they actually work when the state evaluates the physical needs, the assets and the income limits.
That last part about income is a big surprise for many people, but for most, there is a way to solve the problem of too much income. Federal law and Connecticut regulations allow a person who is over the income limit of $2,349 to put the excess income into what is called a pooled trust, because it is pooled with other people’s money. In Connecticut a nonprofit called Plan of Connecticut runs those trusts. Each month PLAN receives the excess income, and with a plan of spending, such as for house taxes, or rent or other expenditures that exceed the income of the person needing care, it pays the extra income toward those costs. These rules are strict, and Plan of Connecticut requires anyone needing a pooled trust to engage an attorney who knows how to comply with the rules and develop a plan of spending that satisfies the legal requirements.
This past year has made everyone focus on how they might avoid institutional care.
Although the path is not always easy, homecare can then be affordable.
The first place to look for help is a program for wartime veterans called Aid and
Attendance. The VA requires a person to be a wartime veteran. This does not mean the veteran served overseas or in combat. It just means that active-duty service (not reserves) was for 90 days, with at least one of those days during dates set by Congress. A single veteran can get up to $1911 per month, and a widow of a veteran up to $1228 per month. A married veteran can get up to $2266 per month. This can go a long way toward paying for home care.
The next source of help is the Connecticut Home Care for Elders Level II. To qualify
physically the person must miss two activities of daily living, such as help with bathing, dressing, feeding, toileting or transferring. There are asset limits of $37,426 for a single person, and $50,568 for a couple and the maximum aid per month is $2,973. This may be just enough of a safety net to keep the elder at home.
The highest level is Medicaid (Title 19) and to physically qualify, the individual must
miss three activities of daily living listed above or be an overall safety risk. That means serious risk of falling, or wandering, or cannot remember to do basic functions. If a person can physically and financially qualify, Medicaid will pay up to $5,945 per month toward care, which is $71,340 per year. That is substantial. In some cases, the state may approve a 24 hour live in, but to qualify for it is difficult because the caretaker must get 5 hours of uninterrupted sleep every 24 hours.
Everyone applying for homecare will be evaluated by a company hired by the state to do the evaluation, and to monitor the care if approved by the Department of Social Services. In the central Connecticut area, that company is Connecticut Community Care Inc. In other areas it may be an Area Agency on Aging. These days that evaluation may be done over the phone to avoid direct contact.
The good news is that Connecticut has given decent funding for home care, although
there is worry that may be reduced. The not so good news is that Connecticut has some of the strictest rules in the country to qualify financially. At national conferences, lawyers are often surprised by the strictness of Connecticut rules. For example, in some states, an IRA doesn’t count toward the asset limit, which for the applicant is $1600. In Connecticut the IRA counts whether owned by the applicant or a spouse. Suffice it to say, complying with the regulations can be like running a maze. One wrong turn can take days or weeks to correct. It is critically
important to have as an elder law attorney who regularly does Medicaid, and who understands not only the written rules, but how they actually work when the state evaluates the physical needs, the assets and the income limits.
That last part about income is a big surprise for many people, but for most, there is a way to solve the problem of too much income. Federal law and Connecticut regulations allow a person who is over the income limit of $2,349 to put the excess income into what is called a pooled trust, because it is pooled with other people’s money. In Connecticut a nonprofit called Plan of Connecticut runs those trusts. Each month PLAN receives the excess income, and with a plan of spending, such as for house taxes, or rent or other expenditures that exceed the income of the person needing care, it pays the extra income toward those costs. These rules are strict, and Plan of Connecticut requires anyone needing a pooled trust to engage an attorney who knows how to comply with the rules and develop a plan of spending that satisfies the legal requirements.
This past year has made everyone focus on how they might avoid institutional care.
Although the path is not always easy, homecare can then be affordable.
Attorneys Halley C. Allaire and Stephen O. Allaire (Retired) are partners in the law firm of Allaire Elder Law.
Attorneys Stephen O. Allaire (Of Counsel) and Halley C. Allaire are members of the National Academy of Elder Law. Attorneys, Inc.
Allaire Elder Law is a highly respected, and highly rated law firm with offices in Bristol, CT.
We can be contacted by phone at (860) 259-1500 or by email.
If you have a question, send a written note to us and we may use your question in a future column.
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