Overview

In this episode of the Family Legacy Podcast, Michael Rutkowski and Kerry Guard discuss the intersection of Medicaid planning and estate planning, offering insights into navigating elder care challenges during the holiday season. As families gather, it's a crucial time to assess the well-being of loved ones, have meaningful conversations about future care, and explore Medicaid options. Michael highlights the importance of proactive planning, including setting up powers of attorney and understanding Medicaid placement processes.

Episode Summary

Michael and Kerry emphasize the significance of Medicaid and estate planning as families come together for the holidays. They discuss how to spot early signs of a loved one's need for additional care, such as changes in their living conditions or cognitive abilities. Michael provides actionable tips for initiating conversations with aging family members and stresses the importance of establishing powers of attorney and estate plans before emergencies arise. He also sheds light on how the Rutkowski Law Firm supports families by simplifying Medicaid applications and facilitating care placement through their in-house social workers. The episode wraps up with practical advice on leveraging technology, like Zoom, to bring families together for estate planning discussions regardless of location.

Whether you're starting to explore care options or tackling last-minute needs, this episode provides valuable insights to help secure your family's future.

For assistance with asset protection or legal guidance, please contact Rutkowski Law Firm at 248-955-2842.

Transcript

Kerry Guard 0:00
Michael, welcome to the family legacy Podcast, the podcast that goes beyond legal jargon and gets the root of how to ensure your past, present and future are protected. This episode is brought to you by the rotosky Law Firm, Michigan's leading asset protection estate planning, Medicaid and Elder Law Firm. And here's our host, Michael rotoski, Michael, welcome to the show.

Michael Rutkowski 0:22
Hey Kerry, good seeing you again. Happy Tuesday.

Kerry Guard 0:25
Happy Tuesday. Election Day. Tuesday. Yeah, it is a big one. It's big, important day. Yeah, we are recording, folks, you're probably listening to this a few weeks after but we are recording this on the fifth of November. And yeah, did you get Did you Rock the Vote?

Michael Rutkowski 0:44
That's my plan right after this. So it's, you know, it's only in the morning right now, so gotta get the kids situated, and then we're heading there right after this. But everyone get out there and do your your duty and vote open

Kerry Guard 0:57
Pennsylvania. And so at the time we were, you know, had to stand in line, and you couldn't vote. And then I moved to Washington, and Washington, everything was mail in, even before COVID. What's it like in Michigan in terms of, you know,

Michael Rutkowski 1:09
interestingly, I heard a statistic yesterday that already almost 50% of the state has voted through early voting options, you know, absentee ballots, whatever, all those different things. Almost half the state has already voted. So it's crazy. So maybe the lines, fingers crossed, the lines are going to be low. Yes,

Kerry Guard 1:31
here's a speedy voting day for you. I appreciate it. Let's talk real quick. We'll do a follow up, folks, once we have more information around who the candidate is going to be and how that's going to impact the state of Michigan and taxes overall. But what are some things we we should be low on the lookout for in regards to the election and estate planning? Great, great

Michael Rutkowski 1:54
question. Kerry, you know the federal estate tax thing is going to be something we're going to talk about all year. So stay tuned as we update you on that. But that's, you know, that's heavily weighted on what's going on in the White House. So regarding who's elected into the house, and then also on the state level, we have to be aware that there is still a state tax in some states, and so depending on whether that state, you know, changes from Republican to democratic or whatever happens. There's just going to be a lot of movement this year when it comes to taxes. Another big thing to be mindful of, especially in our elder law and asset protection practice, is just health care and Long Term Care rules. You know, how, how are people being covered for long term care? What are our options when it comes to Medicaid, VA in attendance? You know, there's just a lot of lot of moving parts right now, to be honest. So it'll be interesting to see how this next, I would say, three to six months, plays out. But this is the place to get your updates. So hope you guys keep tuning in, and we'll keep you updated as as we're hearing whispers of what the changes are going to be. Okay.

Kerry Guard 3:07
So that's really helpful. The other thing that's coming up, because it's November, and by the time people are actually listening to this, it will be kick off of the holiday season, Thanksgiving. I have to say Thanksgiving is actually my favorite holiday. It's like the best of all the holidays in terms of amazing food and family without,

Michael Rutkowski 3:31
yeah, I mean, I'm right there with you between Thanksgiving and Christmas, it's just such a great time. Probably,

Kerry Guard 3:38
what's one of your traditions?

Michael Rutkowski 3:42
Um, so you know, in Michigan, Lions football all day long. You know, if you're, if you're, if you're listening to this, in Michigan, you know, we have the football game. So it's always football game. Family overeat, nap on the couch. Lines are losing, but you know what, we're turning the corner. We're Super Bowl bound this year, so that's going to be great. Yeah. I mean, that's probably the biggest thing is, you know, what's always hard in having families is just dividing it all up and seeing everyone right? And so it's kind of like my family does the Thanksgiving side. My wife is more of like the Christmasy Christmas side, so we kind of divided up. Fortunately for us, everyone is local, so that's amazing, but it's just getting together with family and just slowing it down work slow but I'm about to tell you, it's not here in just a second, just that week particular, right around Thanksgiving, slows down. Right around Christmas slows down. But you know what? It's really, honestly, some of the busiest time of the year for us, because everyone's seen family again, and so often, family members get together and we see mom or dad, and we just didn't really know that their health has declined at all until we. See them in person. And so we typically have a really big uptick around the holidays in our Medicaid placement practice, elder law, estate planning too, because we're just having those conversations. It's just a really busy time of year for us.

Kerry Guard 5:16
I have to imagine, from a Medicaid standpoint, that if you have a busy season and everyone's trying to get placed, I mean, that sounds really, really tricky, if it's all happening at once. I mean, is that the case? So if you're if you're saying estate planning is busy for Medicaid, then my intuition says that part of that challenge is actually getting those family members into a comfortable place where they take care of

Michael Rutkowski 5:49
Yeah, it's a great it's a great point, if family needs help, and we're to the level of needing help outside the home, so we're going to maybe move to assisted living, skilled nursing, whatever, if we're private paying, there's all the availability in the world. You know, most places have rooms or places to go when we're trying to utilize the VA in attendance or Medicaid benefit. There's only so many, so much funds allocated per location. So you might hear the term like we only have so many Medicaid beds. What they're really saying is we're only allotted based on our total occupancy. We're only allotted so many state funds and federal funds for the Medicaid to cover someone's care. So they might only have six to eight beds, depending on the size of the facility, or six to eight placements. Call it. They're not. They don't necessarily have to be beds. They're just acceptable places. But so yes, you're right. When there's an uptick in the need, then it's harder to find places that we truly love, because just like in private pay, there's great places and there's places that look like a 1980s nursing home. And so I think Medicaid gets a bad rap, because so often people are in such an emergent state to do the planning, and there's just not the availability where, if we're kind of aware of this, and we know it's coming, we can kind of get on the list at the places near us that we like, that we are as are acceptable to us. So yes, with an uptick in the need, there's going to be less availability. But always know this too, although it can be challenging, you can start somewhere, and as soon as the spot becomes available at where you want to eventually be, you know, you can be on their list. So we don't love to move around the elderly or people in need, just because it's a lot to them emotionally too. But sometimes, you know, it's sometimes it's what we have to do to get, finally get our loved one at the place that you know we eventually want them at. Does that make sense?

Kerry Guard 7:58
It does. So I have two questions for that. One is how I mean we're talking about I'll give you an example. So my grandmother was she had fallen and broken her oh gosh, like her shadow, like her whole right side, and needed surgery and all sorts. And she was in rehab for that, and then afterwards, she essentially had to move in with my dad because they didn't have anywhere for her to go yet, and it took two years to get her into a place for Medicaid and near my dad. And so is that standard, or is that just because we were being really, really picky,

Michael Rutkowski 8:35
you know? And we're talking about Pennsylvania, yeah. Okay, so every state is a little bit different. You know, I talk to attorneys around the country, and they don't even do Medicaid planning, because the state just doesn't have great programs. When it comes to Michigan, you know, I would say 80 to 85% of every place has Medicaid availability. So no, there's really only wait lists that that extensive for in home care Medicaid, which is something in Michigan called Mi waiver. So there's long wait list for that, but usually we can get someone placed almost immediately in a place that accepts Medicaid. And I would say there's a 50% chance that it's where the person wants to be. There's there's availability. So

Kerry Guard 9:24
you just said we can place them. Are you talking about the law firm health, yeah,

Michael Rutkowski 9:28
yeah. We actually have, we actually have social workers on staff that help with the placement. And that's not typical of a law firm. We do it because it's just clients love it, and so we brought on a social worker. We actually have a couple now that help with that part of the process. So not only do we do the legal piece of it to get someone qualified, but then we actually have relationships in the community to help with placement. There's no additional charge for that. It's just something that we feel is kind of necessary. Because when we started the practice of doing Medicaid and Elder Law, we used to just do the legal side, and then we'd say, okay, clients now go find somewhere to go, and they'd be in limbo for like, four to six months trying to figure it out. And it just it, you know. So the second someone engages our services, we're already working on the placement, something that's pretty unique to our firm.

Kerry Guard 10:24
I knew that already, but I wanted you to be able to say it to everybody, because I think it's pretty magical, and the team's wonderful. Leah is magical, for sure, in terms of what she's been able to help people with. Let's talk about order of operations when it comes to this, because as people are listening, and they get into the crunch of the holiday season, where they are seeing their family, and they are noticing that they're, you know, older loved ones are having a you know, are having some struggles, and might need this. Let's talk about what happens. Is it that they need to get placed first? Is it that they need to do the estate planning first. And why do you need estate planning for this at all? Yeah,

Michael Rutkowski 11:05
yeah. And you know what? I'm going to take you one step before that, when you're visiting your loved ones. Let's talk through maybe just some simple things you can do to see to get a gage of, like, what's going on around the household. We get a lot of families who will do, like, an inventory of the if still driving. So if your parents are still driving, you know, do a quick once around to the car, go in the car, just kind of see what's happening. We've found a lot of families have noticed damage to the vehicle, so maybe it's at a point in time where we need to take away the keys from mom or dad. That's an important one for not only their safety, but the safety of others. Another good one is do an inventory of the fridge. See what's all expired. That's usually a clear giveaway something's going on when there's like, expired milk and expired everything, you know, they're starting to just not take care of themselves as well. Do a little inventory of their medication, you know, make sure that they're taking it. That's a big one, where individuals will stop taking their medication, not intentionally. They just kind of, you know, lose track of things and whatever. So do do a little walk through around the house with those kinds of things to get a sense of like, Hey, is mom and dad taking care of themselves well enough? Do we need to bring, you know, some help into the home, because, because there's so many levels of this. I mean, we could do five shows on this, of like, the levels of care that we can provide to our loved ones, anything from someone coming in one day a week to just do a sweep and clean and see what's going on, if we're, if we don't have a loved one, local to, you know, full blown skilled care in a facility. But so that's always great. Just, just do a, you know, a once over. You're obviously going to talk to your loved one quite a bit, so you're going to get a good sense of their cognitive abilities. If you notice any changes there, you know, ask them questions. Really engage them and ask them. You know, we ask simple questions like, you know, who's the president that's that might change today. But, you know, but you know, just engage them to check cognitive ability. Do a little once over of the house to see if, you know everything still seems in order. But that's kind of a great starting point to know if you should, you should start having conversations, because that's the important part. Is you want to go into it, not in a crisis mode where like, Oh my gosh. You know, mom can't take care of herself, and now tomorrow, she needs to be in a home. Let's have these conversations. Let's talk to people about, what options do we have to pay for care? What are you know, go meet with different facilities in your area, their area, so you know what you're getting into. That's so much, so much better and calm, a calmer way to do it, to do this in advance, versus like they, you know, they fall because they're unable to, you know, really get around and now they cannot return home, and they have to be placed that's just not a great situation for anyone.

Kerry Guard 14:00
Let's talk about, yeah, before we get into the nuts and bolts of it, let's talk for a second about those conversations, because that's tricky business, and you know how you approach that's really it sounds really hard and daunting, especially for the loved one who might need the care, who is a very independent person who maybe doesn't want, yeah, yeah.

Michael Rutkowski 14:24
I don't know that there's a great way to do it. You know, having conversations about reducing someone's freedom, taking away their independence, it's just always a tough thing. So, you know, just depending on where it's at, the conversations are always different. If you see a bunch of dings, dents and everything on mom's car that have happened since the last time you were over. You know, it's probably a good time to just take away the keys. You might just have to tell them you're doing it, but it's never fun. You know those things, those things are never fun. What's also important is catching the ability to put in place. Things like powers of attorney or an estate plan prior to their cognitive ability declining to the point where they can no longer sign legal documents because, you know, we've talked about this in the past, but you never want to go down the guardianship route. It's just so much more costly, time consuming for the whole family and everyone involved.

Kerry Guard 15:19
Okay, so let's talk about order of operations now, of like, what can you do now, before you even need to think about the Medicaid side of it, and then once the once you do need the Medicaid and you do need to get someone placed, what do you need to do? First get them placed, and then do the estate planning, to the estate planning, and then get them placed. So, but, yeah,

Michael Rutkowski 15:41
great question. You know, priority one from my side would be having a solid set of powers of attorney in place so both a medical and a financial so that if someone can't help themselves, they've appointed someone else to do it for them. Because with really well drafted powers of attorney, we can do all the Medicaid planning in the world. We can help with everything. We just don't want to get to a point where someone's declined and they can no longer make decisions for themselves or sign legal documents. That's the most important. I mean, you know, obviously we can have conversations all day about trusts and these things and what would happen if mom or dad passed to make sure we avoid probate. But for me, like priority one is getting in, getting that person to sign some legal documents so that someone else can help if things get really set so, you know, that's probably a good a good starting point is to have those conversations. Obviously, if they're open to it, let's talk about, you know, who gets what, and all those things after someone passes. But really, those powers of attorney give us the ability to do anything at any time that's from the legal side. You should also start, you know, searching the area in which you're you want Mom and Dad, if it's closer to a child, you know, go meet with some places around your area. There's actually some really great placement services when we're talking about private pay also that can, can guide you with all of this, you know, they can tell you the good, the bad and the ugly of all the places in your area. And we'd be happy to share that information, you know, just depending on where you live, we can get you hooked up with someone that's good, that can you know those are it's just like anything else, educating yourself is so powerful in all of this, just to be prepared,

Kerry Guard 17:30
so important to get out in front of it as much as you can. But we also know that if you walk into Thanksgiving, you might find some surprises. So let's talk about that.

Michael Rutkowski 17:42
That's the important thing here, is that we're going to be around family. So this is we're all together, so we can all kind of assess what's going on. You know, there's usually, typically a big uptick in in demand for estate planners around this time of year, because, you know, we're having those whether mom or dad is declining or not, we're still having those kinds of conversations. You know, talk to your mom and dad about, you know, what kind of estate planning do they have? Do they have a will or a trust they are it's if they only have a will, the kids are all going to be end up in probate. And that's, you know, that's no fun. So be talking to your parents about what estate planning they've done, if they've done some, you know, get the contact information of the attorney that they use so that they can communicate with that law firm after, you know, something goes south. So these are really good conversations while we're watching the lions win on Thanksgiving Day.

Kerry Guard 18:39
Yes, yes. Well, I think it's, it's important conversations, and what better time to do it than when we're all together? So, and it doesn't need to be hot and heavy or, like, making a plan. It's just like, hey, if we thought about these things and, and what, you know, has anybody done this before? And what's your consideration on it? And it's just good to just get the ball rolling,

Michael Rutkowski 18:59
yeah. And what it would essentially look like is, you know, scheduling, scheduling some meetings, schedule a meeting with your with an estate planning attorney to just go over, like, what are our options? Here's what's essentially going on. You know, every estate planner does, typically, an initial consultation to see what's what's happening. And you know, how, what options do you have? So I think again, it's like, educate yourself. Even if you don't take action today, you at least know, like, what's the plan going forward? When do we need to do? What knowledge is power, and it's just it makes things so much easier on the family

Kerry Guard 19:34
that it does and everyone's situation is different. So it's hard for us to sit here today and tell you exactly what to do, because it really is, to Michael's point, depends on what you got going on, and you need somebody who can, you know, work with you in regards to what your needs are. Because, as we've said, there's lots of options in terms of the types of Kerry you might need, in terms of how you might want to approach estate planning, of what you already have versus what you don't have. But. So definitely taking that initial call is is a great starting point, and we'll be sure to share our details in case you want to give us a call and set that up. Any last words of wisdom here for Mike, Michael, as people head to their you know, to watch the lions and overeat.

Michael Rutkowski 20:18
What else is very which is so beneficial to families. It's just the ability to do zoom these days. I was just meeting with a family last night where we had two people on Zoom. We had mom and daughter in person, and we worked through all these great things, like, who's going to hold on to the estate plan? You know, who's whose roles and responsibilities are, you know, everyone was just so on the same page, and that is just something that didn't happen pre COVID. That I just love is that when, when all the family members are part of the meeting, even if they're just listening in to everything that happened, it just makes things so much easier for us, for the family. I just love everyone being on the same page. So take advantage of those options too. You know, don't feel like you have to wait until everyone's back in town to meet with an estate planner. If you all want to be part of it, you can just, you know, couple people, typically, I hope, like lawyers, can zoom in a couple people and have some people in person, or do it all by zoom. It's just great technology that has made estate planning so much better than it used to be. That's all again,

Kerry Guard 21:25
I think that's so helpful. You know, I'm here in the UK. My dad and my mom are in Pennsylvania, and I got brothers and sisters all over the country, and so to be able to all get together on the same page over zoom sounds, oh. So helpful. Incredibly helpful. So thank you for that. Absolutely wonderful. If you want to ensure that your state plan doesn't become an emergency over Thanksgiving and you'd like to get ahead, be sure to give us a call at 248-955-2842, that's 248-955-2842, or you can email MLR of Toski law firm.com before we go. Michael, we got a week here the fifth we're going to start. We're going to talk again in seven days. What are you most looking forward to in the next seven

Michael Rutkowski 22:20
days? You know what we didn't talk about today, not so much. What I'm looking forward to. But I went to a Michael Jackson show last weekend, and it was incredible downtown Detroit at the Fisher theater. It was awesome. I love Michael Jackson, and it was very cool to watch, like his story of his life. So if it comes to a city near you, go check it out. It was great. Other than that, I got dance competitions all weekend, so I'll be dancing.

Kerry Guard 22:46
Yes, well, you should be inspired after watching them. You gotta get your get your mood dance going.

Michael Rutkowski 22:53
I got a cool shirt that says she gets it from me.

Kerry Guard 22:58
Yes, so good. Yeah, so good. I'm so grateful, Michael. Thank you again for your for all your wisdom. Well, you enjoy your weekend, Michael, with all those dance competitions and rock and your Michael Jackson moves, and we'll be seeing you next week. Thank you to our listeners, and if you like this episode, please like subscribe and share this episode was brought to you the ratoski Law Firm, Michigan's leading asset protection, estate planning, Medicaid and Elder Law Firm. And again, if you'd like us to help with your estate planning or asset protection needs, please call 248-955-2842, again, that's 248-955-2842, thank you again. All right. Happy

Michael Rutkowski 23:33
holidays, everyone.