Estate Planning Cases

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OUTCOME:

I include in all of my estate planning “packages” of trust, will, poa, and life support documents a personal service contract which appoints the health care attorneys-in-fact as health care agent for ... the estate holders. They can enlist, as health care agent, anyone who puts in time and expenses in providing the estate holder with assistance in managing their affairs due to declining health, as determined by those health care attorneys-in-fact, who keep a journal of the assistance provided by these different individuals. The contract authorizes the payment for such services to the estate holder’s living trust; and, to the extent that services are not reimbursed, they are to accrue on a personal revolving account at current interest rates. The rate of compensation is determined by review of the local customary rates charged by unskilled health care providers. The intent is that the Medicaid system expects the elderly to liquidate their life’ accumulated assets on skilled nursing home are until they reach $2,000 in net worth, which pitifully and ridiculously small. Instead of using outside third party health care providers to provide unskilled care, this approach allows family members who genuinely care about the estate holder to provide that unskilled care and to protect their inheritance, which is the clear desire of the vast majority of most estate holders as well. By allowing for accurate record keeping of such assistance at rates identical to what is provided by third -party providers, family members who were the original intended heirs of the estate holder to either earn their inheritance by providing services as consideration for that inheritance or liquidate it and give the proceeds to the nursing home. They have a choice to make it work. No one is defrauding the system or hiding assets. That transferred equity is not the government’s money or Medicaid’s money; but the elder person’s money, which they can allow their heirs to earn with some degree of dignity and care. I have used personal service contracts for 25 years; and I have believe it is the answer to the monetary crisis facing the Medicaid system as baby boomers begin the nursing home process.