50 The QUEE NS Courier • health • AUGUST 6, 2015 for breaking news visit www.queenscourier.com ▶health The Elder Law Minute TM Questions frequently asked of an elder law attorney By Ronald A. Fatoullah, Esq. and Stacey Meshnick, Esq. Planning for a loved one can often be overwhelming. Seeking the advice of an elder care attorney can help to allay concerns and allow for appropriate planning. The following are some of the questions that clients typically ask elder law attorneys. Q: My mother is aging and her health is declining. What sort of issues should I be thinking about? A: As Mom ages it is important to think about who will handle her financial and medical affairs if and when she becomes incapacitated. Mom can execute a well drafted power of attorney appointing individuals who will handle her affairs. This document should include the ability to handle all types of planning as well as the authority to gift assets to effectuate such planning. A health care proxy appoints someone to make health care decisions, including those regarding artificial nutrition and hydration, in the event that Mom is unable. elder law Q: My father is preparing to apply for Medicaid, and he wants to gift assets to me, but I was told that he can only gift $14,000 annually. A: Medicaid planning and estate planning are two totally different arenas. Medicaid will impose a transfer penalty for assets previously transferred for applicants applying for nursing home Medicaid. This has nothing to do with the $14,000 annual gift tax exclusion, whereby individuals are permitted to gift $14,000 per recipient without the requirement of filing a gift tax return. Q: I am a joint owner on all of my mother’s joint accounts. She wants to leave one of the accounts to my sister. Should she sign a will in which she leaves the account to my sister? A: While your mother should have a will that designates her dispositive wishes upon her death, if all of her accounts are jointly held with you, the assets will pass to you irrespective of what her will indicates. Q: What is the difference between a will and a trust? A: It is necessary to prove (“probate”) a will once a person has died. Probate entails providing notice to those who would inherit assets. It must be proven that the will was signed in accordance with state law. Once the will is approved and all necessary steps are taken, including marshalling the assets, the executor may distribute the estate assets. A trust is an agreement wherein an individual the trustee - (either the creator of the trust and/ or another person) is entrusted with holding assets of an individual. The trust indicates to whom assets are to be distributed (unless held in further trust) upon the death of the grantor. It is not necessary to prove a trust. There are several other advantages to a trust that are beyond the scope of this article. Q: Are there different types of Medicaid for my 85 year old ailing parent? A: If your parent can remain in the home, community Medicaid is an option as long as your parent’s income and resources are within allowable levels. There is no lookback period for community Medicaid. Thus, prior transfers will not create a penalty period. If your parent needs nursing home care, then institutional Medicaid is an option. There is a lookback for all transfers made within 60 months prior to the application. The rules differ significantly between community Medicaid and nursing home Medicaid. An elder care attorney can review your particular situation and advise what may be best. Ronald A. Fatoullah, Esq. is the principal of Ronald Fatoullah & Associates, a law firm that concentrates in elder law, estate planning, Medicaid planning, guardianships, estate administration, trusts, wills, and real estate. Stacey Meshnick, Esq. is a senior staff attorney at the firm who has chaired the firm’s Medicaid department for over 15 years. The law firm can be reached at 718-261-1700, 516-466-4422, or toll free at 1-877-ELDER-LAW or 1-877-ESTATES. Mr. Fatoullah is also the co-founder of JR Wealth Advisors, LLC. The wealth management firm can be reached at 516-466-3300 or 800-353-3775. ROnald Fatoulah, ESQ, CELA* Local hospitals on the ‘March’ for healthy babies by the QUENS COURIER STAF editorial@queenscourier.com @QueensCourier The March of Dimes hosted a special event recently at York College in Jamaica to celebrate the launch of its Queens Healthy Babies are Worth the Wait community program. Elmhurst Hospital Center and Jamaica Hospital Medical Center were chosen as the official hospital sites to implement the program, which aims to prevent preterm birth. The March of Dimes Healthy Babies are Worth the Wait program provides the framework for communities to work together to prevent preterm birth by applying the “five P’s”: partnerships, provider initiatives, patient support, public engagement and progress measurement. Demonstration projects conducted by March of Dimes showed that the application of Healthy Babies are Worth the Wait community program could successfully integrate public and clinical health, improve systems of care and reduce preterm birth. The March of Dimes has implemented Healthy Babies are Worth the Wait programs at 30 sites across five states: Kentucky, Texas, Kansas, New Jersey and New York. “In my experience, most women who become pregnant expect the best possible outcome even when there exist significant risk factors in their personal medical history, past obstetrical and social history that may lead to a poor outcome,” said Dr. Sandra McCalla, chair of the March of Dimes New York Division Program Services Committee and vice chair of obstetrics and gynecology at Maimonides Medical Center. “Though the prematurity rate in New York State is about 10 percent and significantly greater in some New York City neighborhoods and among disadvantaged women, there is a gap in knowledge among patients and a disparate offering of available interventions known to modify the risk of recurrent or initial preterm births. The Healthy Babies are Worth the Wait program aims to combine clinical, community and innovative patient education efforts to promote awareness especially among patients; facilitate implementation of existing interventions; and thereby reducing the number of preventable premature births.” Elmhurst Hospital Center and Jamaica Hospital Medical Center signed participation agreements and have begun working with their implementation teams to select interventions. The Elmhurst team will focus on women at increased risk of preterm labor/preterm birth and ensure access to 17P (a form of progesterone to help prevent preterm birth), cervical length assessments in the second trimester, and periodontal disease treatment in a setting devoted to patients with a history of premature births. These patients will receive enhanced care including pharmacological treatments, preventative therapies and stress reduction therapy. At Jamaica, the medical center plans to enhance their preexisting group prenatal care/ CenteringPregnancy programs by enhancing preconception and interconception care and using an innovative approach to educating patients by partnering with a digital technology designer group. Interactive digital programs will be created with specific content about preterm labor prevention and available interventions meant to empower clients. All patients will be given digital tablets loaded with pertinent medical information, taking into account cultural competence, health literacy and linguistic competence of its constituents. “Jamaica Hospital is very excited to be a partner in the March of Dimes Healthy Babies are Worth the Wait Program,” said Mitchell Cornett, administrator of Jamaica Hospital’s Department of OB/GYN. ”We are equally excited that we have successfully initiated group prenatal care. Mothers participating in the program are dedicated to ensuring the best possible outcomes for their babies. By including the multifaceted concept of CenteringPregnancy as a growing part of our prenatal care services, Jamaica Hospital is fulfilling its goal of increasing the rate of full-term deliveries in the communities we serve.” “Partnering with the March of Dimes for the Healthy Babies are Worth the Wait initiative allows Elmhurst to continue advancing maternal and infant health to make sure pregnant women and their babies get the health care they need right from the start,” said Chris Constantino, senior vice president of the Queens Health Network and executive director of Elmhurst Hospital Center. “The staff at Elmhurst Hospital Center is committed to reducing preterm births in Queens by educating pregnant women in our community about the importance of prenatal care, and helping them access the services they need.” Photo courtesy of Jamaica Hospital Pictured from left to right: Dr. Steven Inglis of Jamaica Hospital; Doctors Scott D. Berns and Sandra McCalla of the March of Dimes; Dr. Tamara Magloire of Jamaica Hospital; Bruce J. Flanz, president and CEO of Jamaica Hospital; William Lynch, executive vice president and COO of Jamaica Hospital; and Mitchell Cornett, administrator of OB/ GYN at Jamaica Hospital.
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