There was an article in the Tampa Bay Times on Sunday, February 24, 2013 – (view article) discussing DCF’s proposal of a bill that targets Florida Medicaid fraud among those trying to hide their assets. Once again, DCF is trying to use scare tactics to hurt the most vulnerable population and would attempt to make legislators believe that individuals regularly transfer hundreds of thousands of dollars in order to get into the long term care Medicaid program. This is simply not the case.
Florida Medicaid: Options for Nursing Home Care
Adult children are the largest single group of caregivers in this country. I see children of clients who regularly sacrifice their time and sometimes even their employment in order to become caregivers. Think about it – it is cheaper to pay a family member $20 per hour to care for their family member, than a stranger from a home health care company $75 per hour to do so. Additionally, just as you worry about your own children being cared for by strangers, adult children worry about their parents’ care and want to be sure that services are performed correctly. Also, with the major cuts that nursing homes and assisted living facilities are facing, the use of family caregivers provides better care for residents, which in turn, reduces lawsuits.
Florida Medicaid: Spousal Refusal
DCF is also targeting spouses’ ability to refuse to pay for the sick spouse’s care (which is allowed by federal law). In Florida, a spouse is not obligated to take care of the medical bills (or other creditor bills) of an ill spouse, even after death. This is not the case in states, such as Ohio, where spouses are actually required to get divorced in order for the well spouse to preserve some measure of assets to survive and continue to live.
A community spouse in Florida is only allowed to keep $115,920 worth of assets, in addition to their homestead and one vehicle, when their sick spouse requires long term care Medicaid. After working for decades, paying their taxes, raising families and being fiscally responsible, one catastrophic medical crisis, such as a debilitating stroke or diagnosis of dementia, can rob a senior citizen of their faculties and their dignity. Families who have worked hard are forced to spend all their hard-earned assets and make themselves destitute in order to obtain long term care for their sick spouse. Think about it – the cost for skilled nursing care currently averages approximately $7,500 per month and can force a couple to exhaust their nest egg very quickly. Medicare does not pay for more than 100 days of long term care and some cannot afford the cost of long term care insurance (or are already too ill to qualify for such benefits).
Florida’s elderly citizens deserve our protection, compassion and support. It is important to know that Florida Medicaid coverage is the last resort for our elderly citizens who have exhausted all their assets and have no other way to pay for their care. Caring for these seniors in the home or in assisted living would surely be less costly, however, DCF’s attempts to disallow family members to be paid to take care of their loved ones or to disallow for spousal refusal, only hurts these elderly citizens.
As a Florida Board Certified Elder Law attorney, I work with senior citizens to help them understand the laws surrounding Florida Medicaid coverage. Additionally, I help educate families to help them understand the limited services and providers available under Medicaid. The vast majority of these senior citizens have few assets and very limited income. Penalizing family members providing care at reduced costs and forcing well spouses to jeopardize their own health will ultimately create more citizens who become dependent on Florida taxpayers for assistance in the future.