Eldercare law issues change every year

If you tried reaching me at the office last week and found me out, you should know that my time away was useful and enjoyable but not all fun. Twice a year the Pennsylvania Association of Elder Law Attorneys that is comprised of somewhat more than 100 attorney members holds its meetings to inform, educate and bring up to date elder law attorneys on matters affecting our clients. This year the meeting was held in Lancaster.

PAELA is for people who live, breathe, and sleep elder law. We hear reports on pending and recently passed legislation, court decisions, and other matters affecting our clients.

On the two days following the PAELA program, the Pennsylvania Bar Institute holds its annual Elder Law Institute, also in Lancaster this year, that I playfully title “Elder Law Bootcamp.” There from about 8:30 in the a.m. to about 4:30 or 5 p.m. we attend about a dozen programs on everything from Business Succession Planning to Trust Drafting to scheduled Managed Care for Medicaid recipients known as Community Health Choices, to new Orphans Court Rules, to Senior Financial Abuse, current issues on guardianships, Social Security strategies, technology tips, veterans benefits planning, living wills and end of life care, and marriage (for seniors) Vs. cohabitation – discussing which is better for planning purposes without considering religious and moral beliefs.

If there is any concern it is that I cannot attend every session and do not want to miss anything. In the coming weeks the information and discussions from these sessions that most affect my clients will be shared in Daily Local News columns so be prepared.

As another interesting point, in checking out the materials I realized that this past week’s program was in its 19th year. I attended every year from the first one, having decided to limit my practice to elder law some 20 years ago. From time to time I have said to myself – I know this. Why should I attend again? Then each year a new idea, a change in a program or in a planning strategy or a change in the law tells me why I keep com-

ing.

The “Year in Review” given by Marielle Hazen, a Harrisburg elder law attorney and former president of PAELA and Rob Clofine, a York elder law attorney, also former president of PAELA cannot be missed. Marielle covers statutes and regulations. Rob discusses cases.

One subject of concern this year is a program being rolled out statewide in Pennsylvania known

as Community Health Choices or the jaw-breaking title, Medicaid Managed Long Term Services and Supports (MMLTSS). To understand how this system will affect both at-home services for seniors under Medicaid (currently known as the “Aging Waiver”) and nursing home Medicaid residents takes some time. It is introducing managed care to long term care both for at-home recipients and for nursing home.

Community Health Choices is described both as a “service delivery system” and a “financing arrangement.”

A private provider known as an MCO (Managed Care Organization) will be paid a fixed fee per member per month to provide members with all medically necessary covered services regardless of cost. Think HMO.

A matter of immediate concern is whether the provider will be incentivized to reduce the level of care in order to reduce its costs and improve its profits. There have been problems already with the independent enrollment broker, a company known as Maximus, the outfit that is charged with assisting

persons to enroll. Maximus has received correspondence regarding this and has indicated it has hired new staff and engaged in more training. The speed of implementation is a major concern since many questions have yet to be answered.

For residents who are currently living in nursing homes and receiving Medicaid it is not anticipated that they would lose these benefits but they would still be considered to be under the new system.

One positive note for residents in the Philadelphia area and its surrounding

suburbs is that the program will first be implemented in the western portion of the state where it is likely that issues regarding implementation will be addressed but implementation here is expected in 2018. Attorneys who practice in this field will need to be ready to advocate for their clients needing long term care assistance.

For more, listen on Wednesdays at 4 p.m. to radio WCHE 1520, “50+ Planning Ahead,” with Janet Colliton, Colliton Elder Law Associates, and Phil McFadden, Home Instead Senior Care. Live

streaming is available at that time on www.wche1520.com.