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Stressed52 Asked April 2014

Will Medi Cal count it against us, if my sisters, my daughter and I have to begin paying ourselves to care for Mom?

My two sisters work presently, I have been my mothers unpaid caregiver for 8 years. That was okay as I had my daughters child support but that has not been the case now for quite a while. Mom's care has become overwhelming for me and I need assistance or I will lose my mind and I am serious!

I began paying my 22 yo daughter (college student) to watch Mom while I run errands to the doctor or to the store but there are times I really just need to get out of this house. I have become anxiety ridden and sometimes it is panic and anxiety. I have been caring for Mom for 8 years but I have been in this house caring for 3 others who were ill for 17 years, all the while I am sick and on disability for panic and anxiety and seizures. I actually never took this on of my own free will, it was expected because I was at home due to my own condition.

One sister will be losing her job in about 2 1/2 months, and may be home for a while, or not depending on how her job search goes. She cannot live on her very small social security check. I am wondering how Medi Cal views the family caregivers being paid should Mom require Medi Cal in the future. Do they count it against you?

Are there unseen pitfalls to doing this? Has anyone done this and regretted it or not done it and later wished they had?

igloo572 Apr 2014
gladinhere has given you very good advice.

You need to keep in mind that if you need to place mom in a NH and apply for Medicaid, that mom will need to fill out an application and provide documentation to show that she qualifies for Medicaid. Medicaid is an "at-need" entitlement and they need to show the "need" both financially & medically. For the financial, this is done by the state (all states not just CA) being able to do up to a 5 year look-back on all their finances and assets. If in that 5 years, there is money that has been gifted or transferred to others, mom can have a transfer penalty inquiry done by Medicaid.

Now yes we know you & your family have been paid for caregiving, BUT for the Medicaid reviewer all they see is money being paid by mom to you all. It is considered gifting and mom could have an issue with her Medicaid application. Transfer penalty inquiries are super sticky to deal with and really either it's pay for an attorney now to do a caregiver agreement BEFORE you have to apply for Medicaid or pay for one when you are under the gun once mom is in a NH and faces Medicaid transfer penalty. Understand?

Now it will cost but you can decrease the expense by your putting together all the financials for the past 3 years to take to the elder law attorney. So get the last 5 years of mom's banking. Then for the past 3 years go through and do a ledger for each of family who was paid to take to the attorney. Also realize that caregiving means you are working and as such mom pays you and it is income for you. You have to pay taxes on income. The attorney will likely have options for you to consider how to handle all this especially for the daughter who is a student.

If you don't do this and then mom goes into a NH and the $ transfer comes up, it will be a really PIA to deal with. Especially with the NH as they will come after someone to pay for mom's care if she is declined for Medicaid OR if when they review the document to determine if they (NH) will take mom as "Medicaid Pending" they notice the potential for gifting or transfer penalty. The NH does not have to take a resident as Medicaid Pending, they can require a big deposit before mom can move in. Really pay for an attorney now it will make your life so much less stressful. Mom gets SS, use her money to pay for the attorney. Good luck

gladimhere Apr 2014
S52- you have done plenty, your mom knows that, she is just frightened of the unknown.

Yes Medicaid needs to be able to see the agreement and it needs to be in compliance with their rules, the reason for an attorney. Even home care agencies will provide a contract, they require a deposit to begin services, that also is probably required by law. You have been through plenty, you do not want Medicaid to begin questioning you about how money was spent. And you definitely do not want any penalties invoked because of money you and others got for mom's care.

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Stressed52 Apr 2014
gladimhere: I had heard about a care agreement before, but do attorneys have to make one up for you? And do you happen to know if you have to have one for each family member? If Mom has dementia does she still sign or do I if I am the POA?

I am curious about why you need the caregiver agreement but If I go to Comfort Keepers or Visiting Angels and get them to send in some one for double the price I don't need one..... maybe I should ask that as a question. Is it Medi Cal who requires the caregiver agreement or who?

All I know is that I need to get my mother correctly medicated, see an Elder Law Attorney and hire in home help or my mother is going to have to go into a Memory Facility because I can NO LONGER DO THIS ON MY OWN. I know many times we make statements like that but continue to carry on, I CANNOT DO IT ANY LONGER AND I NEED HELP IMMEDIATELY, OR I HAVE TO LEAVE OR SHE HAS TO BE PLACED IN A FACILITY.

I told Mom tonight after one of her blow ups, that I was sorry but I would no longer be able to care for her and I was really sad about that. I told her that there was no one other than me who was available to care for her but our situation was not working out therefore I was going to have to place her in the care of professional doctors and nurses who could care for her better than I can.

She called me every name in the book basically and told me that she thought I had more gumption than to turn my back on her like this, I was a pathetic excuse for a daughter. Then she went on to yell at me telling me that all I wanted was her house and her money. She was actually quite eloquent in telling me off for a person with moderate+ dementia.

Telling her after an argument probably was not the best time, but things had cooled down and I told her that I was not telling her this to be mean or ugly but I just could no longer be her caregiver. I have agonized over this for so very long and it was actually better than what I thought and I feel like a burden has been lifted from my shoulders. So if I have to get outside help for now, I will and I guess I will need to begin my search for a memory facility

gladimhere Apr 2014
Wow, HC, you have a lot on your plate. I do not know anything about California laws. But in my state a care agreement is required to be in place prior to any payment being made. Contact an elder law attorney that specialized in Medicaid planning to get this straightened out ASAP. Any checks written to family members will be considered gifts and subject to penalty without an agreement, at least in my state.

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