All That Jazz


Last weekend we spent an entertaining and productive four days in New Orleans. We made the trip to attend the National Academy of Elder Law Attorneys’ annual Institute, an intensive series of continuing education programs. Participants represented 37 states and the District of Columbia, and presentations ranged from Medicaid policy developments to issues of capacity and undue influence among the elderly.

In addition to the excellent seminar presentations, of course, there was wonderful food at Antoine’s and other New Orleans eateries, and the night life was exceptional. The principal reason for the trip, however, was continuing education, and the information was timely and relevant.

Sally K. Richardson, Director of the Health Care Financing Administration Medicaid Bureau, spoke to those in attendance. She signalled a new spirit of cooperation from the federal bureaucracy, raising hopes for more simple and understandable Medicaid/ALTCS regulations sometime in the future.

Denver attorney Jim Hill put on an entertaining and informative demonstration of a will contest case. It was interesting, but not surprising, to hear about family disputes over probate estates in other states.

Considerable discussion centered on the use of “Miller” trusts for nursing home residents with too much income to qualify for ALTCS. Fewer than half of the states have rules excluding patients with too much income, but the problems in those states are dramatic, and Arizonans took some perhaps perverse comfort from the shared difficulties. Several participants pointed out the absurdity of denying eligibility for excess income, but only until the applicant has paid an attorney to prepare an income trust; the effect is to take money from health care and send it to lawyers.

Sunday morning, Institute attendees awoke to a front-page spread in the New Orleans Times-Picayune on the devastation caused by Alzheimer’s Disease. The articles, the first in a multi-day series, effectively highlighted the change in public perceptions of Alzheimer’s generated by former President Ronald Reagan’s recent announcement that he has been diagnosed as suffering from dementia. The articles reinforced both the national prevalence of the problem and the need for financial and medical planning.

We picked up many tips for dealing with ALTCS, guardianship and conservatorship, and estate planning issues. Next week we will share a few.

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