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.

Widows of Veterans who remarried are eligible under certain circumstances.

BASIC PENSION: Eligibility Requirements

➢ discharged from service under other than dishonorable conditions, AND
➢ served 90 days or more of active military, naval or air service with at last 1 day during a period of war, AND
➢ his or her countable income is below the Maximum Annual Pension Rate, AND
➢ meets the net worth limitations, the current net worth limit amount is $155,356.00. The home, automobile and personal belongings are exempt, AND
➢ is age 65 or older OR is shown by evidence to have a permanent and total non-service-connected disability, OR is a patient in a nursing home, OR is receiving Social Security disability benefits.

AID AND ATTENDANCE: Residing in Assisting Living Facilities or receiving Home Care services by an agency or an individual or family member. Eligibility Requirements:

➢ eligible for basic pension benefits as above,
➢ AND
➢ requires the aid of another person to perform activities of daily living, such as bathing, feeding, dressing, toileting, adjusting prosthetic devices, or protecting from the hazards of daily environment, OR
➢ bedridden, in that the disability or disabilities require remaining in bed apart from any
prescribed course of convalescence or treatment, OR
➢ patient in a nursing home due to mental or physical incapacity, OR
➢ corrected visual acuity of 5/200 or less, in both eyes, or concentric contraction of the visual field to 5 degrees or less.

HOUSEBOUND: substantially confined to home. Eligibility requirements:
➢ eligible for basic pension benefits AND
➢ a single permanent disability evaluated as 100-percent disabling AND another disability or
disabilities, independently evaluated as 60-percent or more disabling. (Age 65 is equal to disabled for this item). These disabilities do not have to be service connected.

Information regarding these benefits and how to apply for them is available at VA.gov. If you are over the net worth amount, consult with an attorney for legal advice on the ways to protect assets and meet the net worth requirement.

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.

A. Bob and Susan are married. Bob has 2 children and Susan has 2 children. They don’t have any children together.

B. Dick and Jane are married. Dick has 3 children and he and Jane have 2 children together.

C. Rex and Lisa are married. Lisa has 1 child and Rex and Lisa have 2 children together.

In Florida, INTESTACY Law applies if there is no Will or if the Will is invalid:

(1) If there is no surviving descendant of the decedent, the surviving spouse’s share is 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 surviving spouse’s share is 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, the surviving spouse’s share is 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, the surviving spouse’s share is one-half of the intestate estate.

In the above Examples:

If Susan leaves no Will or an Invalid Will, Bob’s share is one-half of her intestate estate.
If Dick leaves no Will or an Invalid Will, Jane’s share will be one-half of his intestate estate.

If Rex leaves no Will or an Invalid Will, Lisa’s share will be one-half of his intestate estate.

Florida’s Constitution restricts a married person from making a gift by will or trust of HOMESTEAD property or primary residence without the consent of the owner’s spouse.

(1) If the surviving spouse is left with the homestead, they will receive a life estate, which means they can live in and use the property for the rest of their life.

(2) Within six months of the deceased spouse’s death, the surviving spouse can choose to take an undivided one-half interest in the homestead instead of a life estate.

(3) A surviving spouse can waive their homestead rights.

In the above Examples:

Bob Dies. The Homestead property Deed has only Bob’s name on it. Result: Susan has a life estate; or she can choose one-half interest, or she can waive.

Jane Dies. The Homestead property Deed has only Jane’s name on it. Jane has a Will that leaves her homestead property to her 2 children. Result: Dick has a life estate, or he can choose one-half interest, or he can waive.

Rex and Lisa are both on the homestead Deed as husband and wife (tenants by the entirety) and Rex Dies. Result: Lisa owns the property 100%

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.

Recent Surveys find that about 40% of adult Americans own a gun or live in a household with someone who does. Read the article titled “Key Facts About Americans and Guns” by Katherine Shaeffer at the following link: https://www.pewresearch.org/facttank/2021/09/13/key-facts-about-americans-and-guns/

The American Public Health Association found that a firearm is the most common means of suicide in the United States and that rates of firearm suicide are highest among those age 75 years or older. Read the article titled “Current Considerations About the Elderly and Firearms” by Brian Mertens and Susan B. Sorensen, PhD at the following link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3487668/

Each of us must consider the mental status of every household member. We should
engage in discussions with our family members or with trusted friends or professionals
about guns in the home and any risk to household members and caregivers.

It is important to discuss your gun ownership with your attorney to determine the best
course of action regarding your guns and your estate plan in consideration of your own
individual circumstances.

You might consider using a Florida Gun Trust which can purchase and own Title II
firearms. A Florida Gun Trust helps avoid the criminal liability of owning, using, and
sharing a Title II gun. Title II firearms can be used by any of the qualified trustee members that are not prohibited from owning a Title II firearm.

If you don’t have a Florida Gun Trust, consider whether the person you named as your
power of attorney is legally authorized to possess and transfer weapons. Is that person
aware that you have weapons? Consider what will happen to your guns after you pass
away. What do you want to happen to them? Is the person you named as personal
representative of your Will someone who is legally authorized to possess and transfer
weapons? Is that person aware that you have weapons? Is that person comfortable with
distributing weapons to your beneficiaries? Are your beneficiaries legally authorized to
possess firearms? Are your intended beneficiaries in other states? State laws vary on this topic and it’s something that needs to be explored.

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 many reminders for supplies during Hurricane season such as: keep a Full tank of gasoline or a fully charged electric vehicle, bottled water, flashlights and batteries.

Consider ways to keep your important documents.

Consider keeping Estate Plan Original documents such as Power of Attorney documents, Trust documents and Last Will and Testaments together in a waterproof, fireproof container in your home. Kept in your home, it is handy for the occasions when the documents are needed, and it should be a size that makes it easy to pick it up and take it with you if you must evacuate.

Consider keeping PDFs of these important documents on your phone and on your computer. That way no matter where you are, you can access those PDFs and share them with family members, medical providers or financial institutions.

Consider keeping PDFs of all your insurance and flood policies on your phone and on your computer also. You might consider keeping the hard copy summary pages of your insurance policies in your waterproof, fireproof container with your estate plan documents.

Take photos of your property, inside and out before the storm hits and email the photos to yourself to get the timestamp. Some insurance companies are very good, and others push back hard on these claims.

Maintain a list of your digital assets including passwords so that you or a person named to act on your behalf can access your accounts. Would you or anyone else be able to recover your Bitcoin wallet if your cell phone and computer were unusable? Put the list in your waterproof, fireproof container.

Put your passport, social security card and birth certificate, and military discharge paperwork in a waterproof/fireproof container. Make sure that you can access it easily for those occasions when you need the documents and that you can take it with you easily in the event of an evacuation.

Let’s prepare for the worst and hope for the best.

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.

430.202 Florida Statutes: Community care for the elderly; legislative intent. —The purpose of ss.430.201-430.207 is to assist 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. The Legislature intends
that a continuum of care be established so that functionally impaired elderly persons aged 60 and older may be assured the least restrictive environment suitable to their needs.

430.204 Community-care-for-the-elderly core services; departmental powers and duties. — (1)(a) The department shall fund, through each area agency on aging, at least one community care service system the primary purpose of which is the prevention of unnecessary institutionalization of functionally impaired elderly persons 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 them at (727) 289-0062, (866) 458-2933 (toll free) or (800) 955-8771 (hearing impaired).

Florida Medicaid can be obtained to pay for the Suncoast PACE program. If you are over income or over asset eligibility caps for Florida Medicaid, call my office and I will provide an analysis and consultation on your situation and obtaining Florida Medicaid because there are legal avenues with which these eligibility issues can be addressed, and Medicaid can be obtained.

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 PACT Act is perhaps the largest health care and benefit expansion in VA history. The full name of the law is The Sergeant First Class (SFC) Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act.

The PACT Act brings these changes:

▪ Expands and extends eligibility for VA health care for Veterans with toxic exposures and Veterans of the Vietnam, Gulf War, and post-9/11 eras.
▪ Adds 20+ more presumptive conditions for burn pits, Agent Orange, and other toxic exposures.
▪ Adds more presumptive-exposure locations for Agent Orange and radiation.
▪ Requires VA to provide a toxic exposure screening to every Veteran enrolled in VA health care.
▪ Helps the VA improve research, staff education, and treatment related to toxic exposures.

If you’re a Veteran or survivor, you can file claims now to apply for PACT Act-related benefits.

To get a VA disability rating, your disability must connect to your military service. For many health conditions, you need to prove that your service caused your condition. But for some conditions, the VA automatically assumes (or “presumes”) that your service caused your condition “presumptive conditions.”

If you have a presumptive condition, you don’t need to prove that your service caused the condition. You only need to meet the service requirements for the presumption.
VA Health Care under the PACT Act: You’re eligible to enroll now—without needing to apply for disability benefits first—if you meet the basic service and discharge requirements and any of these descriptions are true for you:

▪ You served in the Vietnam War, the Gulf War, Iraq, Afghanistan, or any other combat zone after 9/11, or
▪ You deployed in support of the Global War on Terror, or
▪ You were exposed to toxins or other hazards during military service at home or abroad.

Specific toxins and hazards include burn pits, sand and dust, particulates, oil well or sulfur fires, chemicals, radiation, warfare agents, depleted uranium, herbicides, and other occupational hazards. More information at www.va.gov

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 THREE MAIN REASONS TO USE A REVOCABLE TRUST FOR YOUR ESTATE PLANNING:
1. You continue to be the owner, manager, and decision maker for your assets.
2. A Trust along with a Durable Power of Attorney and Health Care Surrogate 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.
3. After you die, your assets will be administered without the need for protracted and expensive probate proceedings.

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 beneficiaries who will inherit your property after you die.
4. Choose a guardian for your minor child(ren) and/or for your pet(s)
➢ You will be the Settlor, the Trustee, and the Beneficiary of your Trust.
➢ 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.
➢ 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.
➢ 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 direct that they receive smaller amounts over time. The Co-Trustee(s) and/or Successor Trustee(s) would administer the Trust property according to the directions that you have given them in the Trust document.

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.

We receive calls at Mangsen Law from friends and family members reporting that their loved one has been the victim of financial exploitation. Anger, outrage and disbelief are just some of the feelings that the callers express. They want to do something to help, and they don’t know what to do. We offer the following suggestions to anyone who finds that a vulnerable friend or family member has been the victim of financial exploitation (improper taking of money/property):

.

1. Immediately call Adult Protective Services to report suspected abuse, neglect, or
financial exploitation 1-800-96-ABUSE (1-800-962-2873) and report the same to the local police.
2. If your friend or family member has capacity but is a vulnerable adult, they can sue for undue influence and exploitation of a vulnerable adult because they have a cause of action against the perpetrator and may recover actual and punitive damages and they can sue for theft and they have a cause of action for threefold the actual damages, reasonable attorney’s fees and court costs.
3. If the vulnerable adult is believed to have been incapacitated at the time of the
transactions, an incapacity petition could be filed to determine your friend or family member’s incapacity and extrapolate back to the date of the transactions and have an expert give an opinion that the victim was probably incapacitated at the time of the transactions. That would be evidence to use to unwind the transactions that were done.
4. Depending on the facts, perhaps claims for embezzlement, fraud, fraud in the
inducement, misrepresentation, misappropriation, and a host of others could be made and proven to unwind transactions that took place and to hold the perpetrator accountable.
5. Using a Power of Attorney (POA) document does not in any way exempt a perpetrator who has committed any of these offenses.

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.