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What is Elder Law Care Coordination?

It is hard to miss Stuyvesant Town-Peter Cooper Village, where 80 acres of conforming red brick apartment buildings sit on the east edge of Manhattan like a giant drop of ketchup on a hamburger.

On a nippy autumn Saturday morning, a young elder law clerk was assigned to conduct a home visit at a couple’s apartment in Stuy Town. Two memories from that long-ago day have stayed with me: standing in the middle of a group of buildings for 5 minutes, eyes searching for an entrance with the correct number, having no idea which building was the right one; and being served eggs and fruit by the clients while having a conversation about their lives and declining health.

They were concerned with leaving a legacy to their adult children. I was concerned about how to arrange care in the apartment. Both concerns mattered. That’s elder law.

Once the photo albums came out, attempts at professionalism merged with a better understanding of the stakes involved with helping families.

Elder law care coordination is the process of providing estate and Medicaid planning and post-Medicaid approval care advisement as part of a unifying framework. Protecting assets and filing a Medicaid application are the necessary preliminary steps in care coordination. Obtaining a Medicaid approval is only part of the equation.

The reason families seek out eldercare professionals is to find a workable solution to a loved one’s living difficulties. An adult child wants to know that their parent is receiving quality care with few interruptions, no logistical headaches, while resources remain protected.

We are constantly asking questions. Is a home health agency the way to go, or is there a person close to the family willing to work with consumer directed? Is your loved one receiving enough care hours, or has their condition worsened so they may be a candidate for the Nursing Home Transition Waiver? Are there concerns that the home is not suitable for long-term care, and an assisted living facility may be more appropriate?

You can see how elements of legal planning and social work get paired together during this process.

Care coordination also involves the care facilities – hospitals, rehabilitation centers, nursing homes and assisted living centers. Knowing how these institutions arrange admissions and discharges, billing and Medicare/Medicaid/private pay is a major part of care coordination. Smooth transitions between facilities and home go a long way toward eliminating a family’s anxiety.

We cannot forget managed long-term care agencies and local Departments of Social Services. Although the Medicaid rules for New York State are generally consistent, each county’s social services department handles Medicaid applications in their own distinctive manner.

Managed long-term care agencies are tasked with performing assessments and recommending time allotments for Medicaid recipients. Again, each agency is unique. Familiarity with these nuances can mean the difference between a favorable outcome or something else.

Alan D. Feller, Esq., is managing partner of The Feller Group, located at 625 Route 6, Mahopac. He can be reached at alandfeller@thefellergroup.com.

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