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Adult Siblings of Special Needs Individuals Find Considerations and Resources in California

Advances in medicine and expanded support services have allowed many individuals with disabilities to live longer than ever before. As a result, an increasing number of siblings will replace their parents in caring for and supporting special needs adults.

While many resources exist for the parents of adult children with disabilities, new resources specifically designed for adult siblings can be found as well.

Perhaps the most important search for the adult sibling of a disabled individual is for the right support and information. Connecting with others locally who are dealing with similar practical and legal complexities can help. In the Bay Area, Parents and Caregivers of Adult Children with Disabilities (PACDD) offers a siblings-only support group that meets in person on a monthly basis. The group discusses both practical issues and personal concerns of those involved in the care and support of a brother or sister with a disability. 

PACDD also offers a wealth of online resources and information for any adult closely involved with helping a special needs individual.

Another key consideration is advance planning for medical care. Many adult siblings will have more peace of mind knowing that their disabled brother’s or sister’s wishes and values will be taken into consideration when critical or end-of-life medical decisions must be made. The Coalition of Compassionate Care of California (CCCC) has created a workbook called “Thinking Ahead,” which includes illustrations, stories and worksheets to help anyone discuss medical care and end-of-life wishes with a disabled adult.

Finally, a letter of intent is an essential guide for adult siblings in a support role. If the letter of intent already exists, a review of the letter can be a good place to start a discussion about the future with parents, other adult siblings and any other parties closely involved. 

If the letter does not exist, the Vanderbilt Kennedy Center has created a tip sheet called “Adult Siblings of Individuals with Disabilities” that includes a basic overview of the letter of intent.

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Talking to Dad about his driving: the surprising side of difficult conversations

Do you think it will be tough to ask Dad to hand over the keys? 

Surprisingly, a recent study from Liberty Mutual showed that 84 percent of seniors are open to talking about the safety of their driving, but that only six percent have actually had the discussion. As Liberty Mutual put it, “Seniors are open to driving conversations, but their children are avoiding it.”
Straightforward conversations about so-called "difficult" topics can alleviate misunderstanding, and they may help families avoid future litigation. Family members often welcome the opportunity to discuss important, if sensitive, issues more than you might expect.

Many families also have Advance Health Care Directives in place – and if you are not sure whether or not your family members have one, you've found a good place to start the discussion. If your parents or family members are open to it, ask them to explain their wishes, motivations and concerns to you. Be prepared to discuss a range of specific medical topics.

Aging parents also need to take initiative to spark these conversations when they can. Estate plan conversations, for example, can seem daunting, but parents need to talk to their adult children about their plan. They have created it carefully. Now, to help ensure that the estate plan goes according to plan, parents should consider talking with their families about how to distribute assets and why they have made certain choices.

Some parents anticipate that the conversation might be difficult now, and that is a reasonable concern. But just imagine what emotions and conflicts could arise if a child or family member is shocked when the will is read. Explaining motivations and allowing discussion in a supportive environment can help everyone accept and prepare for the future.

The conversation itself may be difficult, but it can avoid adding stress, surprise or uncertainty at a later, more challenging time.
For more than 30 years, Gilfix & La Poll Associates LLP has innovated creative legal solutions to help you manage and plan the future of your estate.

To contact an estate planning attorney, visit or call (800) 244-9424.

Setting up a special needs trust: three reasons to start sooner

When preparing for the future of a child or family member with a disability, many parents and guardians plan to set up a special needs trust. 

This unique kind of trust can provide for many of the supplemental needs of a disabled person without jeopardizing that person’s eligibility for vital government benefits, including Medi-Cal and Supplemental Security Income. However, few know that there are concrete benefits to setting up such a trust sooner rather than later.

Start growing now.
When parents or grandparents set up and put money into a special needs trust during their own lifetimes, it can start to grow immediately. From the time the trust is established, anyone can contribute to it – uncles, godparents, friends – creating an especially beneficial way for loved ones to contribute to your child or family member’s future.

Ensure that the trust has the most beneficial structure.
Some special needs trusts, especially those created for assets already belonging to the beneficiary, mandate that funds remaining in the trust after the death of the beneficiary must first go to pay back Medi-Cal for all expenses covered during the beneficiary’s lifetime. When a trust is set up within the parents’ lifetime, by contrast, it can be established before any assets pass on to the beneficiary. A correctly drafted third-party special needs trust need not have a payback provision.

Give yourself time to change the trustee(s) or remainder beneficiaries.
The administration of a special needs trust can be complicated. Many parents or guardians entrust this responsibility to a professional trustee, who can ensure proper disbursement that does not endanger benefits eligibility. Other parents select a family member. Regardless, a properly constructed third-party special needs trust can give parents the flexibility to change trustees over time as needs change.

For more than 30 years, Gilfix & La Poll Associates LLP has innovated creative legal solutions to help you manage and plan the future of your estate. To contact an estate planning lawyer, visit or call (800) 244-9424.

For a copy of Michael Gilfix’s guide, Special Needs Trust Creation and Management, visit the same website or call the number above.

Michael Gilfix discusses Medi-Cal asset seizure in Mercury News

A growing number of older Californians are concerned about Medi-Cal asset seizure, according to a new article from the San Jose Mercury News.

The California State Assembly recently passed a new bill designed to limit Medi-Cal’s ability to recover assets from the estates of deceased Medi-Cal beneficiaries. As the law stands currently, Medi-Cal can seize a substantial portion of an estate -- including a residence -- to recover the benefits used to cover medical care through Medi-Cal.

But Governor Jerry Brown’s advisors are encouraging a veto of the bill in order to avoid revenue losses that would hurt the state’s budget, as reported by the Mercury News.  

Even if Governor Brown does sign the bill, the new law would limit but not entirely prohibit Medi-Cal asset recovery.

The Mercury News turned to Michael Gilfix for comment on the growing concerns surrounding Medi-Cal asset seizure.

Gilfix pointed out that whether or not the bill is vetoed, Californians can take steps to protect their estates from Medi-Cal recovery. In the article, he commented that assets, and residences in particular, can be protected through proactive estate planning.

According to the Mercury News, many older Californians who already benefit from Medi-Cal are surprised to learn that their estates, which they hoped to pass down to their heirs, are at risk.

Gilfix & La Poll helps clients plan for Medi-Cal eligibility in a way that legally protects assets to the greatest extent possible and minimizes the impact of taxes on the estate.

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Long-Term Care Insurance: Options Abound, As Do Complications

Long-term care insurance has become a critical topic as health care costs continue to rise. 

The U.S. Department of Health and Human Services estimates the average annual cost of U.S. nursing home care to be $74,820. But in California, the Department of Health Care Services estimates that cost to be $91,250. 

Recently, public debate about long-term care insurance has intensified, with news outlets including the Los Angeles Times, CBS and USA Today and organizations such as the American Association of Retired People (AARP) and the SCAN Foundation weighing in on the subject.

Much of the debate centers on whether consumers can adequately understand the opportunities and risks that long-term care insurance offers.

One often-cited issue is inflation. Many long-term care insurance policies offer a fixed, daily benefit amount (often between $50 and $300). On average, a day of care in a California nursing home costs $250, according to the Department of Health Care Services. But, as AARP warns, the rising costs of health care may cause daily costs to rise significantly as well.

If that happens, the contractual policy benefits would cover a lower percentage of the cost of care in ten or twenty years, when the policy would be most needed. 

AARP also notes that some insurers offer inflation protection at an extra cost.

Many states, including California, offer a state-sponsored partnership program that, in some situations, allows consumers to pay into a long-term care insurance plan that will provide later benefits without affecting eligibility for Medicaid (in California, Medi-Cal).

California Health Advocates, a non-profit advocacy group, recommends that anyone planning to purchase long-term care insurance consult with an accountant or elder law attorney before doing so.

For information and advice about planning – with long-term care insurance or by other means – contact Gilfix & La Poll Associates, LLP.

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