We were invited to give an update for our Law School’s alums — and our goal was to make the program relevant regardless of their own fields of practice. How could that be true? Well, whether or not we want to admit it, all of us should be prepared for concerns about adaptive housing, finances, planning and care concerns as we get a bit older.
I first met Jared Childers, who is a 2008 graduate of Penn State Dickinson Law while he was a first year law student. He showed up at a Pennsylvania Bar Association (PBA) annual meeting and let me know he was already “interested in Elder Law.” After law school, he completed his LLM in Tax at NYU. Now he is the head of his own law firm and has the added status of being a Certified Elder Law Attorney (CELA). Jared takes on leadership roles in the PBA, regularly teaches, mentors, or supervises students in a variety of programs, and I suspect many on our staff over the years have had reasons to seek out his wise counsel as their lawyer.
I think this was the first time Jared and I have made a joint presentation. The audience seemed to notice that we having fun.
We began with an overview of options for long-term living, with an emphasis on how it might work in Pennsylvania. Independent living in the home — is that realistic and for how long? With the help of spouses, children, neighbors? And will you need a personal services contract? We contrasted “personal care homes” with “assisted living residences,” and, of course, the dreaded skilled nursing facility, a/k/a “nursing home.” And then we discussed one of Pennsylvania’s “big” options, choosing from one of some 265 continuing care retirement communities, a/k/a “life plan communities.”
The first stop for a lot of the comparisons is with marketing materials plus the “contracts” being used by any location. Do the materials clearly identify the operating company, and are there separate management companies and/or food service companies? How many people are actually employed by the operator, as opposed to being provided by staffing agencies? If you are planning on private hiring of “home help,” do you expect the staffing agency to handle all details of payment and insurance, or will you become the “employer.”
We encouraged attorneys to get to know their own local options, so as to be better prepared to respond when clients ask questions. We pointed to Medicare “star” ratings versus commercial websites, and how it is important to do comparative visits.
Probably the most eye opening portions of the presentations came from Jared as he ran through several “real life” fact patterns where you will want to know factors affecting comparative pricing information for “private pay” arrangements versus public benefits. Jared outlined options that exist to protect significant savings and resources for a community spouse.
We closed with potential impacts from what we have seen as four big trends:
- the impact of private equity and REIT money investors in “senior living,”
- upcoming deep cuts in funding for Medicare and Medicaid,
- immigration and wage rate pressures for hiring of care-workers; and
- statistics about closures and bankruptcies of traditional options for care.
I’m relieved to report that plenty in our audience let us know later that the items we covered were not “too grim,” and that everything was “indeed” relevant. Our audience, which included several very experienced health care, estate planning and elder law specialists regularly weighed in to make the whole experience interactive. Thank you, all!
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