Articles Posted in Healthcare

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When it comes to the part of your financial plan related to health, things such as insurance premiums and copays might be what come to mind.

These expenses are important. However, according to certified financial planner and physician Carolyn McClanahan, founder of Life Planning Partners in Jacksonville, Florida, your health should influence many other parts of your financial plan.

“It’s way more than that,” McClanahan says. “A healthy person needs a totally different [financial] plan from someone who has health issues.”

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Last week I began writing about what hospice care is, who can benefit from it, and when this type of care is recommended. Today I will continue on this topic, including who makes up a hospice care team, who pays for hospice home care, and determining if in-home hospice is right for you.

Who Makes Up a Hospice Care Team?

A number of different types of people can make up a hospice team, including various professionals and volunteers who are involved in end-of-life care. A hospice care team may include:

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Hospice care is a type of health care for those with terminally ill conditions as they near the end of their lives. The focus of hospice care is on the management of pain as well as emotional, spiritual, and familial support for the patient.

For patients receiving hospice care, there are a number of different options, including being cared for at home. The type of intimate care someone received while in hospice fits well with being given in the peaceful environment of a patient’s own home.

This week I will write about who can benefit from this type of care and when hospice is recommended, and next week I will write about who makes up a hospice care team, who pays for hospice home care, and determining if in-home hospice is right for you.

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A provision in a recent coronavirus relief package prevents states from terminating Medicaid benefits during the pandemic.

The Families First Coronavirus Response Act (“CV Response Act”) was signed into law on March 18, 2020 and prevents states from terminating any Medicaid recipients who were enrolled in Medicaid on or after March 18, 2020, including in circumstances where there is a change that would normally cause their coverage to be terminated. Medicaid coverage for all recipients must continue through the end of the month during which the public health emergency declared by the Secretary of Health and Human Services for COVID-19 ends.

The state must make a good faith effort to contact recipients whose Medicaid benefits were terminated after March 18, 2020 and encourage him or her to reenroll. States are, however, able to terminate coverage for people who request to be terminated or who are no longer residents of that state.

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The Center for Disease Control and Prevention (“CDC”) and the Illinois Department of Health (“IDPH”) have set guidelines for healthcare facilities, including nursing homes, and other long-term care facilities amidst the current COVID-19 pandemic we are experiencing. These guidelines include visitor restrictions for the facilities. In a nutshell, if you are not considered an essential healthcare employee or a compassionate care visitor for end of life situations, you are not going to get near one of these facilities until…well we are not sure.

These guidelines have been put in place for the safety of the residents and employees, and understandably so. On the other hand, this guidance is missing clarity. The states (including Illinois) and, in-turn, the facilities are left to interpret what the definition of an essential healthcare employee and a compassionate care visitor means. Is a third-party caregiver an essential healthcare employee? Is being placed in hospice, in and of itself, considered an end of life situation? Based on experience over the past few weeks, the answer is no. It should be noted, though, that there is no real legal authority stating such. We are facing a time where loved ones could pass away alone because a facility did not interpret the guidelines to allow a visitor in such a situation. Seeking the courts guidance on the matter may be necessary. Until then, the facilities are given the freedom and flexibility to interpret the guidelines as they see fit.

What can you do until then? Often times, loved ones of the residents of nursing homes and long-term care facilities provide care, love, and encouragement to them. During this time, more than ever, this encouragement and love is essential to the resident’s well-being. If you have a loved one in a facility, what can you do during this critical time? Technology has allowed us to connect with people in ways we never could before. Calling and video chatting with loved ones can provide them with the emotional support they need. Just the sound of a loved one’s voice can bring a smile to a resident’s face.  Online games can be played together as well. While we are getting back to the basics during this time, writing a good old fashioned letter is a great option as well.

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Our firm is always stressing the need for Healthcare Powers of Attorney and Living Wills which are examples of healthcare directives.   Remember, that the Healthcare Power of Attorney is a document that names an agent to make healthcare decisions for you should you lack capacity to make those choices.  It not only pertains to decisions concerning life sustaining treatment if death is imminent, but also pertains to those situations where death is not imminent.

By contrast, the Living Will is a document which is restricted to those situations when death is imminent.  It is basically a written pronouncement by you that you do not want life sustaining measures taken if those procedures only delay the dying process. Unlike the Power of Attorney for Healthcare, an agent is not appointed and the health provider must continue to administer food and water.

But what if you have neither  a Power of Attorney for Healthcare nor a Living Will, your death is imminent and you lack the capacity to make medical treatment and life sustaining decisions? This is when the Illinois Healthcare Surrogate Act will apply. The Act generally allows for family members, friends, guardians and other named persons to make these type of decisions.

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