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Paying for Home Health Care

David Silver teaches The Legal Environment of Business in ECU's Department of Finance. Dave is also a Partner with The Graham.Nuckolls.Conner Law Firm in Greenville, concentrating in Elder Law

Dad passed a few years ago and mom has lived alone in the house since then. Lately, the kids have noticed that mom isn't eating well, the house is not as clean as it used to be, and there is some concern that mom isn't taking all of her medication properly. None of the kids are able check in on mom as often as they think is necessary, and it is too expensive to hire someone to provide homecare for mom. The kids are worried about mom's safety, but no one wants to "stick mom in a nursing home." Does this sound familiar? If this scenario hasn't happened in your family, it has probably happened to someone you care about. If you or a loved one is in this scenario, there could be some help available if dad was a wartime veteran.

Most people want their parents to be able to stay in their homes for as long as possible, but everyone will likely need some assistance in order to remain at home at some point. This assistance is called Home Health Care or homecare. The state of North Carolina does not offer practical help to its citizens to help pay for this type of care (there is something called a CAP/DA program, but the waiting list is usually too long to make it an option). However, there is a program available to wartime veterans and their spouses through the Veterans Administration called "Aid & Attendance."

Aid & Attendance pays up to $2,019 per month to an eligible veteran (or up to $1,094 per month to the widow/widower of a veteran) who is in need of Home Health Care. This amount of money is often enough, coupled with mom's (or dad's) regular income, to allow mom (or dad) to stay safely at home for an extra few years.

As with everything, there are eligibility rules and limitations. First, the veteran (or the spouse or widow) must actually be in need of aid and attendance from another person. It is okay if the aid and attendance is being provided to a parent by a child as long as there is an adequate written caregiver agreement between the parent and child.

Second, the veteran must have been discharged other than dishonorably and served at least 90 days of active duty with at least one of those days being during wartime. The official wartime dates are as follows: 12/7/1941 - 12/31/1946, 6/27/1950 - 1/31/1955, 2/28/1961-8/4/1964, 8/5/1964 - 5/7/1975, 8/2/1990 - present. There is no requirement that the veteran had to be in battle on the front lines, peeling potatoes in North Carolina would be sufficient. However, for the 2/28/1961 - 8/4/1964 time period, the veteran had to actually have been in Vietnam.

There is also an asset limit. You are allowed to have $80,000 of countable assets (this number could be less than $80,000 depending on your age and the mood of the VA employee that day). Not all assets are "countable" towards that $80,000 limit. For a detailed explanation of the rules surrounding "countable" assets, you should consult with an attorney accredited by the Veterans Administration.

If you or your loved one clearly meets these criteria, you should begin the application process. Rather than attempting to contact the Veterans Administration directly, I suggest you contact an accredited Veterans Service Organization or your county's Veterans Service Office (whose purpose is to help their county's citizens apply for and obtain veterans benefits). The later organizations will be your advocate in obtaining the Veterans Benefits earned by the veteran. I have yet to speak with someone who uses the word "advocate" to describe how they are treated by the Veterans Administration.

The rules surrounding the $80,000 asset limit can be complicated, especially when you take in to account the rules for Medicaid eligibility. Therefore, if you or your loved meet the other criteria but appear to have too many assets, I strongly suggest you speak with an attorney accredited by the Veterans Administration and familiar with Medicaid eligibility requirements to discuss the potential for becoming eligible for this program. An extra one to two thousand dollars a month to pay for home health care could go a long way in enabling your parent to safely remain at home.

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