1. Planning for Long-term Care & Avoiding Elder Exploitation Carol Mena Quick, M.A., J.D. Debra K. Schuster & Associates 2015 VOYCE Long Term Care Conference June 12, 2015

2. How Do I Plan for Long-term Care Assemble/Prepare Documents You Need:  (Durable) Power of Attorney (For General/Financial Powers)  Health Care Directive -(Durable) Power of Attorney for Health Care and Living Will

3. Advance Directives 1. Durable Power of Attorney for Health Care  Allows Principal to delegate to Attorney-in-Fact all health care powers Principal could perform (such as hiring, firing of health care personnel, nursing home placement, right to consent/refuse treatment, right to review and obtain copies of medical records)  Should include authority to consent to psychiatric treatment 2. Durable Power of Attorney for General/Financial Decisions Person creating the DPA is the “Principal” – The Principal MUST have capacity to create these documents. Person creating the DPA is the “Principal” – The Principal MUST have capacity to create these documents. Delegates authority to Attorney-in-Fact to make financial decisions for Principal Delegates authority to Attorney-in-Fact to make financial decisions for Principal Can become effective immediately (“Continuous”) or upon certification of incapacity (“Springing”) Can become effective immediately (“Continuous”) or upon certification of incapacity (“Springing”)

4. Durable Power of Attorney (for Financial/General Powers) The Principal may grant any financial powers he/she could do for him/herself, but must specify:  Signing, amending, revoking Trust or funding someone else’s trust with Principal’s funds  Gifting/Transfer of Assets  Survivorship and beneficiary designations  Guardian/Conservator nomination  Designation of Successor Agent

5. Durable Power of Attorney (for Financial/General Powers)  No Co-mingling of funds  Maintain Records  Attorney-in-Fact acts in fiduciary capacity, must communicate with Principal  Standard of care – If Attorney-in-Fact acts, he/she must act in best interest of Principal and must avoid conflicts of personal interest - SHOULD INFORM OTHER FAMILY MEMBERS OF ALL TRANSACTIONS - SHOULD INFORM OTHER FAMILY MEMBERS OF ALL TRANSACTIONS

6. Financial Protection  Appoint individuals you TRUST and are financially responsible  Consider bonding for appointees  Avoid putting appointees names on Principal’s bank accounts as Co-owners (manage as Attorney in Fact; add POD)  If no effective General Durable Power of Attorney is in place at time of incapacity- a Conservatorship may be needed to manage incapacitated individual’s financial affairs

7. Trusts  Purpose?  Revocable Living Trust  Irrevocable Trust  VA/Medicaid Asset Protection Trust  Special Needs Trust

8. Trust Assets  Special Needs Trusts  May use these assets to pay for care for disabled/elderly person that public benefits (Medicaid/Medicare) does not cover  Certain requirements for creation of trusts – 1 st party vs. 3 rd party  For spouse, must create through Last Will and Testament – ALLOWS Medicaid eligibility while preserving SNT assets

9. Long-Term Care Insurance  Long-Term Care Insurance (LTCI)   LTCI generally covers home care, assisted living, adult daycare, respite care, hospice care, nursing home and Alzheimer's facilities.   Premiums can be high so consider whether you have enough savings and income to afford the premiums.   If you decide LTCI is appropriate for you- it is better to purchase it sooner than later. Premiums increase as you age and you may run the risk that a health care event will make you ineligible for LTCI.   Missouri Long-Term Care Insurance Partnership program – “asset disregard”

10. Protecting Seniors from Fraud Common Scams aimed at the Elderly: Common Scams aimed at the Elderly: Fake Lottery/Sweepstakes Fake Lottery/Sweepstakes Discount Prescription Scams Discount Prescription Scams Credit Card Company Fraud Calls Credit Card Company Fraud Calls Fraudulent Charity Scams Fraudulent Charity Scams Homeowner/Reverse Mortgage Scams Homeowner/Reverse Mortgage Scams Grandparent Scam Grandparent Scam

11. Recent Scams Unwanted Medical Alert Devices scam in which callers bullied and tricked elderly consumers into paying for unordered medical alert devices. Unwanted Medical Alert Devices scam in which callers bullied and tricked elderly consumers into paying for unordered medical alert devices. Court orders Defendant company to pay $3.4 million in “unjust gains.” 4/23/15 Court orders Defendant company to pay $3.4 million in “unjust gains.” 4/23/15 A “Pay to Play” Sweepstakes Operation based in Fort Lauderdale, FL took more than $28 million from consumers throughout the U.S.A. and other countries. A “Pay to Play” Sweepstakes Operation based in Fort Lauderdale, FL took more than $28 million from consumers throughout the U.S.A. and other countries. FTC has temporarily halted its operation, seeks to end its illegal practices and return money to victims. 5/21/15 FTC has temporarily halted its operation, seeks to end its illegal practices and return money to victims. 5/21/15

12. Thank you! If you have additional questions about advanced directives, guardianships, or estate planning, Call Carol Mena Quick, Esq. or Debra K. Schuster, Esq. at (314) 991-2602