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CANHR CALIFORNIA ADVOCATES FOR NURSING HOME REFORM

CANHR CALIFORNIA ADVOCATES FOR NURSING HOME REFORM. Low Wealth Seniors. What is low wealth?. Having a house and less than $101,640 (CSRA). FEAR: 1. Going into a Nursing Home 2. Outliving your assets. Anger: The Govt. won’t tell you about Medi-Cal. Greed:

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CANHR CALIFORNIA ADVOCATES FOR NURSING HOME REFORM

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  1. CANHR CALIFORNIA ADVOCATES FOR NURSING HOME REFORM

  2. Low Wealth Seniors

  3. What is low wealth? Having a house and less than $101,640 (CSRA)

  4. FEAR: 1.Going into a Nursing Home 2. Outliving your assets

  5. Anger: The Govt. won’t tell you about Medi-Cal

  6. Greed: You can keep everything and qualify for Medi-Cal

  7. Paying for Long-Term Care • Medicare • Private Pay • Long-Term Care Insurance (LTCi) • Medi-Cal

  8. Long Term Care Acute Care Hospitals Medicare - HMO Nursing Homes(SNF/NF) Private Pay / LTCi Medi-Cal Residential Care Private Pay / LTCi

  9. MEDICARE Nursing Home THREE NIGHTS STAY

  10. MEDICARE HICAP Health Insurance Counseling and Advocacy Project

  11. LTC Medi-Cal 1. Qualifying 2. Share of Cost 3. Estate Claim

  12. Qualify withExempt Assets The Home All Personal Property Vehicle (one of any value) Burial Contract - Fund Retirement Accounts - IRAs

  13. TROUBLE WITH THE DRA THE HOME EQUITY $500,000 $750,000 (CA not before January 1, 2009)

  14. Reverse Mortgages Low Wealth Seniors • Home • Cash less that $101,640

  15. Insurance Agents & Reverse Mortgage “Seminars” • Pulling equity to purchase annuities • Pulling equity to purchase LTCi

  16. Exempt Assets Recipient’s Cash $2000 Spouse’s Cash $101,640

  17. Non-ExemptAssets CASH Stocks/Bonds Other Real Property Notes Receivable Some Annuities

  18. Non-Exempt Asset Solution 1. Transfer 2. Spend Down 3. Gift

  19. Transfer Transfer or convert the excess property into an exempt asset

  20. Spend Down Making purchases for fair market value

  21. Gifting APPR $5,101 LOOK BACKS 30 Months -California (Federal 36 mos.) (DRA 60 months)

  22. SHARE OF COSTThe recipient’s income “First day of the month Keeps $35 - the rest goes to the facility”

  23. Income of the“at home spouse” SHARE OF COST Minimum Monthly Maintenance Allowance $2,541 For the year 2007

  24. SHARE OF COSTProblems Windfalls - Inheritance (asset or income?) Income Tax Withholding Payee Representatives

  25. ESTATE RECOVERY NAME ON THE PROPERTY AT THE TIME OF DEATH

  26. ESTATE RECOVERY AMOUNT OF THE CLAIM vrs. VALUE OF THE RECIPIENT’S ESTATE

  27. ESTATE RECOVERY THE HOME: LIFE ESTATE No recovery if Irrevocable

  28. ESTATE RECOVERY Exempt Survivors • Blind • Disabled • Minor Child • Spouse

  29. ESTATE RECOVERY Annuities of the Medi-Cal Recipient

  30. Selling Trusts Practicing Law Without a License

  31. PENAL CODE § 368 ELDER ABUSE “Any person who steals or embezzles from an elder is subject to fine and or imprisonment.”

  32. PENAL CODE § 459 BURGLARY “Every person who enters any house with intent to commit grand or petit larceny or any felony is guilty of burglary.”

  33. PENAL CODE § 484 THEFT DEFINED “(a) Every person who shall feloniously steal, take, … or knowingly and designedly, by any false or fraudulent representation or pretense, defraud any other person of money, labor or real or personal property … is guilty of theft.”

  34. PENAL CODE § 532 FALSE PRETENSES “(a) Every person … who knowingly and designedly, by any false or fraudulent representation or pretense, defrauds any other person of money, labor or real or personal property … is guilty of theft.”

  35. INSURANCE CODE § 785 SENIOR INSURANCE - DUTY OF HONESTY, GOOD FAITH AND FAIR DEALING “All insurers, brokers, agents and others engaged in the transactions of insurance owe a prospective insured who is over 65 a duty of honesty, good faith and fair dealing.”

  36. INSURANCE CODE § 789.8 Disclosure Statement Notice Regarding Standards for Medi-Cal Eligibility

  37. INSURANCE CODE § 789.10 Written Notice 24 hours before the scheduled meeting in the senior’s home

  38. INSURANCE CODE § 790.03 ENGAGING IN UNFAIR TRADE PRACTICES “No person shall engage in trade practices, which are unfair or deceptive.”

  39. INSURANCE CODE § 1724 Fee Splitting with Attorneys Prohibition Why in the Insurance Code?

  40. REGIONAL OFFICES COMMERCE FRESNO MARTINEZ ORANGE RANCHO CUCAMONGA SACRAMENTO SAN DIEGO SAN JOSE INSURANCE CODE § 12921.3 COMPLAINTS INQUIRES INVESTIGATION PROSECUTION CALIFORNIA DEPARTMENT OF INSURANCE INSURANCE FRAUD

  41. BUSINESS & PROFESSIONS CODE § 6125 -FELONY DISBARRED ATTORNEY PRACTICING LAW WITHOUT A LICENSE “No person shall practice law in California without being an active member of the California State Bar.”

  42. BUSINESS & PROFESSIONS CODE § 6126MISDEMEANOR OTHER THAN A DISBARRED ATTORNEY PRACTICING LAW WITHOUT A LICENSE

  43. BUSINESS & PROFESSIONS CODE § 6126.5REMEDIES

  44. BUSINESS & PROFESSIONS CODE § 6152 ILLEGALLY SOLICITING BUSINESS FOR AN ATTORNEY “It is illegal for any person to act as a runner or capper for any attorney.”

  45. BUSINESS & PROFESSIONS CODE § 6450 ILLEGAL PARALEGAL “It is a misdemeanor for any paralegal to offer legal advice to the public or induce a person to make an investment, purchase a financial product or service, or enter a transaction from which income or profit may be derived.”

  46. BUSINESS & PROFESSIONS CODE § 17200 UNFAIR COMPETITION “Unfair competition means any unlawful, unfair or fraudulent business act or practice or any unfair, deceptive, untrue or misleading advertising.”

  47. BUSINESS & PROFESSIONS CODE § 17500 FALSE OR MISLEADING STATEMENT “It is a misdemeanor for any person to induce a sale through an advertisement that is untrue or misleading information.”

  48. B & P § 17500.3 SOLICITATION AT THE RESIDENCE OF A PROSPECT “It is unlawful for any person to solicit a sale at the residence of a prospective buyer without clearly revealing, before making any statements other than a greeting, that the purpose he or she has of being there is to effect a sale.”

  49. WELFARE & INSTITUTIONS CODE § 15656(c) FINANCIAL ABUSE BY A PERSON WHO STANDS IN A POSITION OF TRUST WITH AN ELDER OR DEPENDENT ADULT “…who violates any provision of law prescribing theft or embezzlement … is punishable by imprisonment … and by fine …”

  50. WELFARE & INSTITUTIONS CODE § 15610.30(a)(2) FINANCIAL ABUSE “(a) ‘Financial Abuse’ of an elder occurs when a person or entity does any of the following: (2) assists in taking, secreting, appropriating, or retaining real or personal property of an elder or dependent adult to a wrongful use or with intent to defraud, or both.”

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