Hillary Clinton announces plan to fight Alzheimer's

In December, Hillary Clinton became the first presidential candidate to make fighting Alzheimer's Disease a campaign issue. On December 22nd, she announced a plan to invest $2 billion per year until 2025 toward a cure to Alzheimer's. Clinton stated that 10 years was the minimum amount of time prominent researchers predict it will take to make significant progress. 

Alzheimer’s research received $588 million from federal funding in 2014, which according to Clinton is less than 1% of the yearly cost of the disease. While 2016's budget allocated an additional $350 million more toward the disease, Hillary argues this is not enough. To raise funds, she says she will close tax loopholes, although she does not say which ones. Hillary and Bill have personally taken full advantage of Estate Tax loopholes, so it will be interesting to see if she gets rid of those.

While the cost of research may seem high, Clinton hopes to offset the growing cost of caring for individuals with Alzheimer's or other kinds of dementia - much of which is borne by medicare. Treatments for Alzheimer's would also benefit family members and caregivers, who often find themselves completely unprepared to deal with the emotional and financial burden of caring for someone with severe dementia

According to The Alzheimer's Association, studies estimate that nearly 15 million people aged 65 and older will have Alzheimer's disease by 2050. Clinton notes that each of those individuals would need the support of caregivers and family. Clinton stated:

"We owe it to the millions of families who stay up at night worrying about their loved ones afflicted by this terrible disease and facing the hard reality of the long goodbye to make research investments that will prevent, effectively treat and make a cure possible by 2025," Clinton said. "The best scientific minds tell us we have a real chance to make groundbreaking progress on curing the disease and relieving the pain so many families feel every day."

Clinton had previously come out as an advocate for comprehensive Alzheimer's care planning services. When one receives a diagnosis of Alzheimer's or other form of dementia, the importance of planning cannot be overstated. There are two parts to care planning: the medical side and the financial side. In most cases, the two overlap. Clinton says she will focus on ensuring comprehensive care-planning sessions are covered by Medicare, along with promoting coordinated care among physicians. The financial part is something you'll want to discuss with an Elder Law attorney, as Medicare and Medi-Cal will often pay for long term care. The process of qualifying for Medi Cal is extremely complex however, and should be facilitated by an experienced California attorney who specializes in Medi Cal for long term care.

Clinton also wants to reauthorize the Missing Alzheimer's Disease Patient Alert Program, which helps locate patients who may be prone to wandering. Needless to say, those Alzheimer's patients who are prone to wander may be in need of a more comprehensive care facility, which can often be paid for by Medi-Cal. National statistics state that 6/10 sufferers will wander at some point in a state of disorientation. The risks posed by wandering are life threatening, and this is perhaps the most critical reason that care for individuals with dementia must be planned for in advance. 

Clinton also wants to increase awareness among seniors about Medicare (Medi Cal) benefits available to them. In my personal practice, I help families rearrange assets to qualify for Medi Cal, as well as advise them on how to avoid the state from seizing their assets when the individual on Medi Cal passes away. This is an excellent example of a benefit offered to Californians that is little known about. 

While I can't personally speak to the realities of finding a cure for dementia by 2025, I appreciate Clinton's efforts to bring more attention to a disease that continues to devastate the lives of so many who do not have the resources and tools to cope with it. 

If you have questions about Medi-Cal or other Elder law issues, contact my law office in Walnut Creek for your free consultation. 925-322-1763

 

How to Resolve a Conflict between a Healthcare Directive and a Power of Attorney

Does California Probate code make any allowances for differences or conflicts between an Advanced Healthcare Directive (California's version of a Healthcare POA) and Power of Attorney?

For example, a parent designates one child as their agent for the Healthcare Directive, and the other child as their agent for the Power of Attorney. The parent becomes incapacitated, and both children must step up to manage both the healthcare and finances of their parent. The child in charge of healthcare must place the elderly parent in a long term care facility, and needs funds from their parent's estate to do so. However, the child with the Financial Power of Attorney refuses to release any funds for a long term care facility.

Let's add a layer of complication that many children of parents with dementia in the SF East Bay must face. This is the question of Medi-Cal and long term care. In our example, above, the child with the financial power of attorney is refusing to release funds for care because they are aware that there are rules and regulations regarding qualifying for Medi-Cal's long term care coverage that may be violated if they begin paying for care prior to applying for Medi-Cal. The child with the Healthcare Directive suspects they may be correct, but is too confused by the Medi-Cal system, and does not want to spend money to consult an attorney. The siblings, already under immense stress because of their parent's failing health, find themselves at an impasse. What are their options?

When a Financial Power of Attorney and Medical Power of Attorney (or Advance Healthcare Directive in CA) have different agents who cannot agree, or have stipulations that conflict with each other, there are several ways the situation can be resolved. The first is perhaps the most simple, but I have seen it overlooked in my years as an Elder Law attorney in Contra Costa County.

1. Read the Documents with a Fine Tooth Comb: Does one or both of the documents contain a clause or section that accounts for the difference or conflict in question. If the documents were drafted by an experienced Estate Planning Attorney in the SF East Bay, there should not be any conflicts that are not resolved between the Power of Attorney and Healthcare Directive. 

2. Try to work it out: When emotions and stress levels are high, conflicts arise. Much conflict is born out of misunderstandings and lack of communication. Try to sit down in a neutral or public environment and talk it out. Bring a list of concerns, and try not to leave the conversation without a plan for the next step in place. 

2.  Consult an Elder Law Attorney: An elder law attorney who works in the county where the parent resides is best equipped to help you with your case. For example, I work with Elder Law clients in Contra Costa County and Alameda County. As an Elder Law attorney centered in Walnut Creek, I understand the procedures of both these courts and am well positioned to resolve issues quickly with minimal cost. If there is a Medi-Cal issue, as in the example above, look for an Elder Law attorney who specializes in both Probate Litigation and Medi-Cal matters.

3. Consider Mediation An Elder Law attorney can represent you in mediating the matter and coming to a swift resolution. While this can be costly, a good attorney can recommend a skilled mediator who can help you resolve the situation and avoid the much higher costs of going to court. 

4. Choose Probate Court Last Having a judge resolve your issue for you is often the worst situation you can find yourself in. In most elder law cases I deal with in the SF East Bay, there is often not one obviously wrong party (legally speaking). The cost of resolving your Power of Attorney and Health Care Directive issue in the Probate Court of Contra Costa or Alameda County is guaranteed to be expensive and exhausting. Often, the end result is either worse or the same for both parties as mediation, at 3-4 times the cost. A responsible and ethical Elder Law attorney will almost always recommend mediation.

I offer a free consultation from Elder Law and Trust and Estate Law Firm in downtown Walnut Creek. For questions about a Power of Attorney or Healthcare Directive, or other probate issues, call 925-322-1763