1. Institutional Care Program (ICP)
2. Home & Community Based Services (HCBS)

The application for Florida Institutional Care Medicaid Program (ICP) is filed when a person is in a “Skilled Nursing Facility or Healthcare & Rehabilitation Center”. This is a facility that provides rehabilitation services after hospitalization and long-term care for those who can no longer live in their home or in a community setting.

The application for Florida Home & Community Based Services (HCBS) Medicaid Program is filed when a person is living in the community. That can mean they live in their own home, they may live in someone else’s home, or perhaps they live in an Assisted Living Facility (ALF).

There are 3 eligibility requirements for either of these Medicaid programs: 1. Income; 2. Asset; and 3. Level of care Needed. When a person is over income or over asset, an attorney can assist them with income and/or asset protection so they can meet the Medicaid eligibility requirements and receive the services of these programs.

Skilled nursing/long-term care facility costs range from $9,000.00 to $15,000.00 per month. Generally, the person receiving Medicaid ICP benefits will pay their monthly income to the long-term care facility and Medicaid ICP will pay the balance of the facility invoice every month as long as the person is asset eligible and requires the level of care.

Assisted living facility costs range from $3500.00 to $7000.00 per month. Generally, the person receiving Medicaid HCBS benefits pays for the room and board at the facility from their income and the Medicaid HCBS program pays the level of care amount which is between $1300.00-$1800.00 per month in addition to covering a myriad of other medical expenses.

For individuals who wish to remain in their homes, Medicaid HCBS pays for the Suncoast Pace Program which provides home services and day programs for individuals who are income, asset and level of care eligible. The same eligibility criteria applies and the goal of the Suncoast Pace program is to help the applicant remain
in their home for as long as possible.

Please do not rely on legal advice regarding these income and asset matters from friends or other well-meaning individuals. The legal rules are complex and ever-changing. The Florida Supreme Court ruled that only attorneys are permitted to give legal advice on Medicaid planning. So many people have been misguided
and suffered great harm because of non-attorneys who give legal advice on Medicaid income and asset issues. Please do not rely on the legal advice given to you by non-attorneys.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

Being married does not “automatically” mean that probate won’t be required and it does not mean that your spouse will inherit your assets.

Assets titled to a decedent, must be re-titled after death with or without a Last Will &
Testament. This can include bank accounts, automobiles, homes, real estate, boats, investment accounts, retirement accounts and life insurance policies without named beneficiaries, or retirement accounts and life insurance policies with named beneficiaries who predeceased.

A Last Will & Testament will be filed with the court and a probate case will be initiated for the re-titling of the assets in accordance with instructions in a valid will created by the decedent.

If there is no Last Will & Testament, the Florida Intestacy Statute 732.101 – 732.111
prescribes who will inherit the assets. 732.102(3) indicates that if the decedent has lineal descendants that are not descendants of the surviving spouse, then the surviving spouse’s share of the intestate estate is one-half. If the decedent and the surviving spouse have descendants together and the surviving spouse has descendants that are not descendants of the decedent, the surviving spouse’s share of the intestate estate is one-half.

732.102 Spouse’s share of intestate estate. —The intestate share of the surviving
spouse is:
(1) If there is no surviving descendant of the decedent, the entire intestate estate.
(2) If the decedent is survived by one or more descendants, all of whom are also
descendants of the surviving spouse, and the surviving spouse has no other descendant, the entire intestate estate.
(3) If there are one or more surviving descendants of the decedent who are not lineal
descendants of the surviving spouse, one-half of the intestate estate.
(4) If there are one or more surviving descendants of the decedent, all of whom are also
descendants of the surviving spouse, and the surviving spouse has one or more descendants who are not descendants of the decedent, one-half of the intestate estate.
732.401 Descent of homestead. —
(1) If not devised as authorized by law and the constitution, the homestead shall descend in the same manner as other intestate property; but if the decedent is survived by a spouse and one or more descendants, the surviving spouse shall take a life estate in the homestead, with a vested
remainder to the descendants in being at the time of the decedent’s death per stirpes.
(2) In lieu of a life estate under subsection (1), the surviving spouse may elect to take an undivided one-half interest in the homestead as a tenant in common, with the remaining undivided one-half interest vesting in the decedent’s descendants in being at the time of the decedent’s death, per stirpes.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

Least restrictive manner means the approach to providing services or resources that allows an elder the maximum INDEPENDENCE AND FREEDOM from intrusion consistent with the elder’s needs by requiring that the least drastic method of intervention be used when intervention is necessary and that only those services or resources that are reasonably necessary to protect the elder are provided.

Florida Medicaid coverage is NOT just for Nursing Home Care.

AT HOME or in an Assisted Living Facility: Florida Medicaid assists functionally impaired elderly persons in living dignified and reasonably independent lives in their own homes or in the homes of relatives or caregivers through the development, expansion, reorganization, and coordination of various community-based services. Functionally impaired elderly persons age 60 and older may be assured the least restrictive environment suitable to their needs.

Florida Medicaid covers community care services whose primary purpose is the prevention of unnecessary institutionalization of functionally impaired elderly persons. This is done through the provision of community-based core services.

Suncoast PACE (Program of All-Inclusive Care for the Elderly).

Suncoast PACE aims to fully support and care for Pinellas County seniors 55+ achieve a healthy quality of life, stay active and socially connected and live safely and independently in their homes and in the community. Additionally, they provide education, guidance and relief for the caregivers.

The Suncoast PACE services include primary care, physical, occupational, and speech therapies, skilled care, social and emotional support and day care at our Suncoast PACE Day Center and Medical Clinic; in-home care and support; and transportation to and from Suncoast PACE or other PACE-approved specialists.

For more information, call PACE at (727) 289-0062, (866) 458-2933 (toll free) or
(800) 955-8771 (hearing impaired).

If you are over income or over asset eligibility for Florida Medicaid, call my office and I will provide an analysis and consultation on your situation and your ability to obtain Florida Medicaid because there are legal avenues with which these eligibility issues can be addressed.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

The FBI reports notable increases in fraud perpetrated against older Americans.
Common fraudulent scams reported include tech support scams, confidence and
romance scams, investment scams, and government impersonation scams. I encourage you to watch the YouTube video of William Webster, former director of the FBI and CIA as well as a former federal judge, reporting that he had been the target of a lottery scam in 2022. See the video at:
https://www.fbi.gov/video-repository/webster-scam-final-021919.mp4/view

“Elder Orphans” are persons of advanced age who don’t have anyone who they can
name as Power of Attorney or Successor Trustee. The elder orphan is considered
particularly vulnerable to confidence scams, especially if that elder does not maintain an
active social life. The scammer builds a relationship with the older individual over time,
slowly gaining their trust. Once trust is established, the scammer exploits the
relationship in a financial manner.

Protect yourself against scams with Advance Planning

1. Create a Medical Power of Attorney with HIPPA releases prior to advanced age or
diminished capacity designating a trusted contact OR a professional fiduciary and
have it made effective immediately so that you have advocacy from someone you
trust during your time of illness when you most need it. Be sure the document
accurately describes your directives for future medical care.

2. Create a Durable Power of Attorney, prior to advanced age or diminished capacity,
designating a trusted contact OR a professional fiduciary.

3. Transfer assets to a living trust that names a trusted person or a professional
fiduciary as successor trustee or co-trustee.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

Power of Attorney (POA) is a legal document delegating authority.

Powers of Attorney can be limited or broad. A limited POA can be executed to grant the authority to sell a car or a home or some other specific act. A general POA can be executed to grant Broad authority to act in most aspects of one’s financial matters. A Medical or Healthcare POA typically grants authority to act in all aspects of medical and healthcare.

The “Durable” power of attorney indicates that the authority granted in the document survives the incapacity of the principal. This means that if the person granting authority becomes incapacitated, the document is still valid, and the agent retains the ability to act on behalf of the principal. If the power of attorney is “non durable”, the authority ends when the principal becomes incapacitated.

In Florida the POA is a “fiduciary” under the law. A fiduciary relationship is one of trust. If the agent violates this trust, the law may punish the agent both civilly and criminally.

A valid durable POA executed before the principal became incapacitated avoids guardianship proceedings.

POAs created in other states are subject to Florida’s Power of Attorney Act and other state laws. POA created by preprinted forms typically fail to provide the protection or authority desired.

Authority granted in a POA ends when the principal dies or when the authority is otherwise terminated by the terms of the document or an order of the court. Authority ends with revocation by principal and
resignation by agent.

REVOCATION

The Power of Attorney can be revoked at any time by the principal. The revocation must be in writing and is required to be executed with the same formalities as the original power of attorney document and the agent
must receive notice. 709.2110 Florida Statutes.

RESIGNATION

A person named as Power of Attorney may resign at any time. The Resignation must be in writing and Notice must be given to the principal. 709.2118 Florida Statutes.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

HERE ARE FOUR THINGS TO PREPARE FOR A VISIT TO AN ATTORNEY:

1. Make a list of all your assets. Be sure your list includes everything you own.
Examples: Bank accounts, investment accounts, retirement accounts such as IRAs, 401Ks, all property owned in part or in full, boats, automobiles, life insurance policies, businesses, patents, debts owed to you.

2. Choose a successor trustee to manage your property if you become unable to do so due to illness or mental incapacity. Choose someone you trust 100%.

3. Choose the beneficiaries who will inherit your property after you die.

4. Choose a guardian for your minor child(ren) and/or for your pet(s)
Ø You will be the Settlor, the Trustee, and the Beneficiary of your Trust.
Ø You are the Beneficiary for as long as you live. After you die, the Beneficiary(s) is/are
whomever you name in the Trust document.
Ø Typically, the Revocable Trust becomes Irrevocable upon your death and the Successor Trustee Distributes the Trust property according to the terms that you detailed in the Trust document.
Ø A Trust gives you the ability to make provisions for beneficiaries whom you do not wish to give a large lump sum to. You can make provisions that direct them to receive smaller amounts over time. The Trustee(s) or Successor Trustee(s) would administer the Trust property according to the directions that you have given for this in the Trust document.

Once the Trust is fully executed, appropriate assets are re-titled to your Trust. You continue to own them as Trustee of your Trust. If you become incapable of managing your Trust assets, your successor Trustee would be able to take over for you under the terms described in the Trust document.

A Trust document along with a Durable Power of Attorney and Medical Power of Attorney provide the necessary elements to avoid winding up in Guardianship proceedings if you become physically and/or mentally incapable of managing your own assets and caring for yourself.

After passing away, assets titled to a revocable trust can be administered without the need for protracted and expensive probate proceedings.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

There are several types of trusts. Some examples are:

Special Needs Trust (SNT): Also called a Supplemental Needs Trust. One
must never leave a lump sum inheritance to a recipient of Public Benefits such
as SSI or Medicaid. They may lose the SSI and/or Medicaid benefits and the
amount inherited is subject to Medicaid Recovery. However, it is permissible
to provide inheritance to an adult with special needs using a SNT.

Testamentary Trust: A Trust created by your Will. A Testamentary Trust does
not exist until you die, and your Will indicates the Trust to begin. It is possible
to create an SNT this way.

Pooled Trust: Helps people with disabilities qualify for programs such as SSI
and Medicaid by placing their assets which are over the limit into a pooled
trust.

Irrevocable Trust: Cannot be changed, reversed, or recovered; final.
Example, Irrevocable Burial Trusts are a useful tool for Medicaid Planning
purposes.

Other examples: Charitable Trust, Constructive Trust, Spendthrift Trust,
Tax By-Pass Trust.

Revocable (Inter-Vivos) Living Trust: This is a common estate planning
Trust

A living trust is created to provide you with the tools to manage your assets
while you are alive and seamless distribution of your assets after you die.
Along with Power of Attorney documents this is a good tool to use to avoid
both Guardianship and Probate proceedings.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

“Who will make healthcare decisions for you when you cannot make them for yourself?” and “Who will pay your bills and manage your money if you cannot do that for yourself?” and Who will apply for public benefits such as Medicaid for you if you cannot do that for yourself?”

Many people are unaware of the tragic circumstances that happen to people who do not have legal documents in place when they become ill.

During my years of practice as a Registered Nurse I was often faced with providing CPR and other life saving measures to people that only served to prolong the natural process of dying. Things such as ventilators for breathing and tube feedings. How often is the decision maker ill equipped and confused about what the right thing to do and what the person would have wanted. How often I have sat with individuals who were required to make decisions who still suffer with guilt, anxiety, and a deep sense of
remorse because they are not at all certain that they did what the dying person would have wanted them to do.

Difficulties arise when patients in need of public benefits such as Medicaid have not appointed a Power of Attorney to handle these matters for them. Sometimes life-long family hurts and feuds result when adult children do not agree on the course of care for their parents and there is no document giving authority to any of them. It is these cases that seem to involve the most suffering for everyone involved and the deepest hurts among family members.

Estate Planning is often thought of as providing for the distribution of one’s assets after death. Key to the Estate Plan is providing for what will happen to the person and their assets while they are still alive. I cannot stress this point enough. All too often people who neglect this aspect of their planning end up requiring Court appointed Guardians and Court proceedings to manage their care. Terri Schiavo is just one example of many.

Health Care Power of Attorney: Appoint the Person most able to make decisions in accordance with your own wishes.

Advance Directives: Give the Health Care Power of Attorney written directions as to your wishes to alleviate confusion during the decision-making process and eliminate guilt and remorse.

Durable Power of Attorney: Appoint the Person and give the authority for them to handle your financial affairs as needed while you are still alive but unable to do this yourself. This includes the long-term care provisions required for Medicaid and other public benefit applications.

Living Will: Tells others what your personal choices are about end-of-life medical treatment.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.
For more information, visit our website at

Mangsen Law in Largo, FL

or call (727) 888-6282.

Florida Long Term Care Medicaid Programs

1. Institutional Care Program (ICP)
2. Home & Community Based Services (HCBS)

The application for Florida Institutional Care Medicaid Program (ICP) is filed when a person is in a “Skilled Nursing Facility or Healthcare & Rehabilitation Center”. This is a facility that provides rehabilitation services after hospitalization and long-term care for those who can no longer live in their home or in a community setting.

The application for Florida Home & Community Based Services (HCBS) Medicaid Program is filed when a person is living in the community. That can mean they live in their own home, they may live in someone else’s home, or perhaps they live in an Assisted Living Facility (ALF).

There are 3 eligibility requirements for either of these Medicaid programs: 1. Income; 2. Asset; and 3. Level of care Needed. When a person is over income or over asset, an attorney can assist them with income and/or asset protection so they can meet the Medicaid eligibility requirements and receive the services of
these programs.

Skilled nursing/long-term care facility costs range from $9,000.00 to $15,000.00 per month. Generally, the person receiving Medicaid ICP benefits will pay their monthly income to the long-term care facility and Medicaid ICP will pay the balance of the facility invoice every month as long as the person is asset eligible and requires the level of care.

Assisted living facility costs range from $3500.00 to $7000.00 per month. Generally, the person receiving Medicaid HCBS benefits pays for the room and board at the facility from their income and the Medicaid HCBS program pays the level of care amount which is between $1300.00-$1800.00 per month in addition to covering a myriad of other medical expenses.

For individuals who wish to remain in their homes, Medicaid HCBS pays for the Suncoast Pace Program which provides home services and day programs for individuals who are income, asset and level of care eligible. The same eligibility criteria applies, and the goal of the Suncoast Pace program is to help the applicant remain in their home for as long as possible.

Please do not rely on legal advice regarding these income and asset matters from friends or other well meaning individuals. The legal rules are complex and ever-changing. The Florida Supreme Court ruled that only attorneys are permitted to give legal advice on Medicaid planning. So many people have been misguided and suffered great harm because of non-attorneys who give legal advice on Medicaid income and asset issues. Please do not rely on the legal advice given to you by non-attorneys.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.

Protect your assets, the person you are appointing to handle them and the beneficiaries of your estate.

State and Federal Laws effect access to these assets while the owner lives and transfers of these assets after the owner dies.

Examples of Digital Assets: Online brokerage account, online bank account, digital wallet, cryptocurrency wallet, Facebook, LinkedIn, PayPal, Amazon, Google, Yahoo, iTunes, domain name, online business, Bitcoin, and digital photographs.

Examples of Firearm distinctions that effect planning: Title I. Title II. Some Firearms and other weapons are subject to the National Firearms Act (NFA).

Step 1: Start with an Inventory. Identify and create an inventory of all your assets. Regularly update the list with current username, logins and passwords for digital assets.

Step 2: consider who you would place in the position of handling your assets if you were to become physically or mentally incapacitated and someone must step in and take over.

Step 3: consider what will happen to your assets after you pass away. A last will and testament or a trust can specifically devise digital assets and certain firearms. You might consider a Gun Trust if you own Title II firearms.

Step 4: explore your options carefully and choose the best ones for your situation. Review your current documents for sufficiency in these areas.

Avoid unintended negative consequences such as:

-Gifting, a firearm to a non-Florida resident without going through a Federal Firearms Licensee is a federal crime whether done outright while owner is alive or through a last will or a trust after death.

-Accessing someone’s digital assets without proper authorization can lead to charges of fraud, theft, identity theft and hacking.

-Terms of Service agreed to when opening digital accounts may prohibit access to the account by anyone other than the owner. Does anyone read this agreement before clicking to agree?

-Funds within a bitcoin account with no estate planning and no information about the private key are inaccessible after the account holder’s death and lost forever.

-A caregiver, hired by a POA, is shot and harmed (maybe killed) by a mentally incapacitated person with access to a gun. The assets of a mentally incapacitated person are subject for a lawsuit and the assets belonging to the POA may be attached as well.

Diana Mangsen focuses her practice as an elder law attorney in Clearwater, Palm Harbor, Largo, Dunedin and the Tampa Bay area.

For more information, visit our website at
https://www.mangsenlaw.com/
or call (727) 888-6282.