Upcoming Changes in the DSM-5 Spark Major Controversies – Part I

If you have a family member with autism, you have likely heard of the Diagnostic and Statistical Manual of Mental Disorders (DSM).   The DSM is published by the American Psychiatric Association and it is the primary manual used by clinicians to provide a formal diagnosis of autism and related disorders. 

The 4th edition of the DSM has been under revision for several years and a new edition, the DSM-5, will be released in 2013.  This is the first major rewrite of the DSM in nearly 20 years.  According to an Associated Press Article, the aim is not to expand the number of people diagnosed with mental illness, but to ensure that affected children and adults are more accurately diagnosed so they can get the most appropriate treatment.

Significant changes are being made:

• Changes to the criteria and categories of Autism Spectrum Disorders are planned for the new edition. One of the most hotly debated changes is that the separate diagnostic labels of Autistic Disorder, Asperger’s Disorder, and PDD-NOS will be replaced by one umbrella term “Autism Spectrum Disorder.” 

• Further distinctions will be made according to severity levels.  The severity levels (levels 1, 2, and 3) are based on the amount of support needed, due to challenges with social communication and restricted interests and repetitive behaviors. 

• The revisions have been made with the hope that the diagnosis of autism spectrum disorders will be more specific, reliable, and valid.  Despite these positive hopes, serious concerns have been raised regarding how these changes might impact people on the spectrum. One of the biggest concerns is that some who are higher functioning will no longer meet the more strict diagnostic criteria and will therefore have difficulties accessing relevant services.  Click here for an article explaining the rationale behind the changes.  Click here or here for articles giving reasons opposing the change.  

We here at The Law Firm of Evan H. Farr, P.C., know that the majority of American families who have a loved one with special needs require a Special Needs Trust.  A Special Needs Trust is a vehicle that provides assets from which a disabled person can maintain his or her quality of life, while still remaining eligible for needs-based programs that will cover basic health and living expenses.  Read more about Special Needs Trusts here.  We also invite you to make an appointment for a free consultation with the Fairfax Elder Law Firm of Evan H. Farr, P.C. to learn more about special needs planning.

Evan H. Farr on Google +

Rule change for V.A. Pensions and Pensions with Aid & Attendance

The Veterans Administration has tightened restrictions on the room and board a veteran may deduct from income when applying for V.A. pensions and pensions with Veterans Aid & Attendance benefits.  

For applications pending or submitted on or after October 26, 2012, room and board at a residential facility may be deducted as an unreimbursed medical expense, only if the facility provides the applicant with custodial care (assistance with two or more activities of daily living). The presence of 24-hour staffing and pull cords is insufficient to qualify a facility as a provider of custodial care. The new rule will propel many veterans over the income cap, disqualifying them from receiving benefits.

Ongoing changes and federal belt-tightening will make benefits more difficult to secure in the future.  Evan H. Farr is an Accredited Attorney with the U.S. Dept. of Veterans Affairs who understands the Veterans Aid and Attendance Benefit and the Medicaid program and the interaction between both benefit programs. Mr. Farr works with client’s to obtain the financial assistance to which they are entitled and enables veterans and their spouses afford the care that they need.

If you are a Veteran or spouse of a Veteran and you need assistance, be sure to make an appointment for a free consultation at the Fairfax Elder Law Firm of Evan H. Farr, P.C..  We can work with you to evaluate if you qualify for Medicaid and/or The Veterans Aid and Attendance Benefit and for help you file the paperwork. 

Evan H. Farr on Google +

Human Rights Week is December 10-17: Focusing on LGBT Elders

Human rights are the fundamental rights which every living person is entitled to, and are considered to be universal rights or laws regardless of age, gender, ethnicity, and sexual orientation. President Obama proclaimed this week, December 10-17, as Human Rights Week to encourage greater awareness of human rights and promote fairness and equality.
 

In light of Human Rights Week, today we will focus on lesbian, gay, bisexual and transgender (LGBT) elders and the struggles that they face.  Several federal programs and laws blatantly treat same-sex couples differently from married heterosexual couples.  For example:

• Social Security pays survivor benefits to widows and widowers but not to the surviving same-sex life partner of someone who dies.  This may cost LGBT elders $124 million a year in unaccessed benefits.
• Married spouses are eligible for Social Security spousal benefits, which can allow them to earn half their spouse's Social Security benefit if it is larger than their own Social Security benefit. Unmarried partners in lifelong relationships are not eligible for spousal benefits.
• Medicaid regulations protect some assets and homes of married spouses when the other spouse enters a nursing home or long-term care facility; no such protections are offered to same-sex partners.
• Surviving spouses in heterosexual marriages don't have to pay taxes on their deceased spouse's estate, while surviving spouses in a same-sex marriage must pay a 35% estate tax on anything in excess of the $5 million exemption (in 2012- Read more about the proposed 2013 Estate Tax Changes).  **The Supreme Court recently announced it will accept two cases involving married same-sex couples from New York and California.  The couple from New York had to pay an estate tax because the federal Defense of Marriage Act defines “marriage” as a union between a man and a woman.  The California case involves California's Proposition 8, which banned same-sex marriages in the state.  Read the New York Times Article. 

We here at The Law Firm of Evan H. Farr, P.C. have strategies in place to help LGBT elders and their family members. Visit our website at http://www.lgbtelderlaw.com to find out more.  With advance planning, each person, regardless of sexual orientation, can retain the benefit of the money, income and assets it has taken a lifetime to accumulate.

P.S. We invite members of the LGBT community to make an appointment for a free consultation with The Law Firm of Evan H. Farr, P.C. to learn more about our services. 

Evan H. Farr on Google +

States Must Expand Medicaid All the Way if They Want to Receive Full Affordable Care Act (ACA) Funding

After months of waiting for an answer about partial expansion of Medicaid, states received a reply from the Obama administration that if they partially expand Medicaid coverage, they will not receive the enhanced funding that would come with a full expansion.

The Health and Human Services Secretary wrote a letter to governors Monday about the Medicaid expansion and other aspects of the health care law and included a question-and-answer document touching on details.  There is no deadline for states to decide on the Medicaid expansion, and they can join at any time.

States can still seek partial Medicaid expansions under pre-ACA (also known informally as Obamacare) rules, but would receive less federal money.  The federal government pays an average of 60% of the costs for people already eligible for Medicaid and the states pay the rest.  The health care reform law may allow states to obtain the higher federal funding starting in 2017 but only as part of comprehensive overhaul of a state's health care system that must cover at least the same number of people as the ACA at the same cost to the federal government and to patients.  Read the Washington Post Article.
 
Taking the partial Medicaid expansion off the table could encourage more states to take the federal money and offer new Medicaid benefits to everyone eligible under health care reform. According to Jocelyn Guyer, the co-executive director of the Georgetown University Center for Children and Families, "Most states are going to look at this and eventually decide it's a good, smart investment for them to do the expansion."

We here at The Law Firm of Evan H. Farr, P.C. help clients ever day with Medicaid eligibility, and are delighted to share this encouraging news about the expansion of the Medicaid program. If you have a loved one currently in a nursing home, or who may need nursing home care in the near future, or who is worried about the possibility of needing nursing home care in the not too distant future, please call us today.  Medicaid and Medicaid Asset Protection are our firm’s specialties, and we will be thrilled to discuss Medicaid with you at any time.  Please call us at 703-691-1888 to learn more.

Evan H. Farr on Google +

The “Fiscal Cliff” and What it Means for Medicare

Medicare was established in 1965, providing health insurance for people 65 and older, regardless of income or medical history.  Throughout their working lives, people pay into Medicare based on the assumption that they will have secure health coverage when they retire.

Before Medicare, an estimated 50% of seniors had no health insurance, due to lower incomes and poverty among seniors and the higher premiums charged by private insurers for those over 65.  Since its inception, Medicare has reduced the poverty rate and has helped extend the life expectancy of retirees.  According to Bloomberg News, “Republicans favor a plan to raise the age of eligibility for Medicare from 65 to 67, a move that could save more than $100 billion but have other cost-raising consequences.”

Lawmakers on both sides agree that somehow reining in the cost of Medicare for the elderly and disabled is key to settling the budget problem. In the fiscal cliff negotiations, Obama and politicians of both big business parties claim there is “no money” for Medicare and other social programs. Americans are living longer. Chronic diseases are more common. The cost of medical care is rising in general with more drugs and innovations in treatment available.  Read the entire Bloomberg News Article.

We here at The Law Firm of Evan H. Farr, P.C. urge you to plan for these budget cuts. Many seniors what are affected may be eligible for other health-care programs, such as Medicaid.  Call 703-691-1888 and set up a free consultation to learn more.

Evan H. Farr on Google +

An Uncertain Tax Environment, and Medicaid Laws, Make it Tough to Plan Charitable Giving in 2012

With 2013 almost upon us, now is the time to act for matters like planning for your estate and gifts to loved ones.  Depending upon your goals and hopes for the coming year, it might still be time to wait when it comes to charitable gift planning.

If you’re one of the tiny percentage of folks who have several million dollars sitting around that you don’t need, you may want to give big now because the charitable gift tax write-off currently set at $5 million is scheduled to drop to $1 million next year.  But for most of us, given ever-present threat of needing future nursing home care, it's a good idea to hold off on gifting.

When it comes to charitable giving, we here at The Law Firm of Evan H. Farr, P.C., urge those people who may need nursing home care in the next ten years to keep in mind that gift giving can be a risky venture.  When making charitable gifts, be mindful that any large gifts was made within the last five years will be penalized by Medicaid because Medicaid assumes that all gifts are intended to spend down assets to qualify for Medicaid.

For more information about gifting and Medicaid eligibility, read “Medicaid: The Perils of Gifting FAQ” on The Law Firm of Evan H. Farr, P.C. website.

Evan H. Farr on Google +