Being Paid to Care for Your Parents
January 28, 2009
As their parents have needed increased hands-on care and errand-running, many “Boomers” have been squeezed trying to juggle caring for their parents and performing well at work. Our current economy has produced a mixed blessing for some – lost jobs means time to address their parents’ needs, but without economic security.
One solution is a “caregiver contract.” This is a written agreement between the parents and the adult children, laying out tasks the child will perform and a rate of pay. Set up along with worker’s compensation and the usual payroll deductions, this provides an income stream to the caregiver while giving the parent what most elders want – being cared for by her own family. Only an elder law attorney familiar with the ever-changing rules of Medicaid should draft a caregiver contract, so that it will protect the elder in the event she needs nursing home care in the future. If not done correctly, a caregiving arrangement can result in a later denial of MassHealth nursing home benefits.
Rising Unemployment Means Rising Uninsured
January 12, 2009
Rising numbers of unemployment inevitably lead to a significant number of people losing their employer sponsored health insurance. Where do these people turn for insurance? States provide Medicaid for people who meet their income and asset requirements. Medicaid is much more generous with children, even the children of parents who themselves have too much money or assets to qualify. So hopefully most kids will still have coverage. But what about the adults?
The Kaiser Family Foundation, a nonprofit that does extensive nonpartisan, high quality research into health care finance matters, including Medicare, Medicaid, and private insurance, recently released a daunting report. Their figures estimate in 2009, 5.9 people will lose their employer coverage, Medicaid and SCHIP (for kids) will pick up 2.4 million, and 2.6 million people will remain uninsured. State governments provide some assistance to hospitals who treat uninsured, but of course with declining tax revenues, there will be less funding available for such reimbursement (the “compensated care pool.”)
Where will the funding come from to cover the 2.4 million new MassHealth and SCHIP enrollees? And what about increasing funding to cover more of the people left uninsured? Medicaid (and Medicare) already make up unwieldy percentages of state and federal budgets. President Obama and his team have announced that they will take on these programs. It will be a difficult but very worthy project. I expect that NAELA, the organization supporting the nation’s elder law and disability law attorneys, will provide leadership on this issue. Our organization has many individuals well schooled in these issues and passionate about redesigning the health care system to make it serve more people more effectively.