Highlights from this newsletter:

• From the Executive Director
• Ask the Expert
• Learn about becoming an Alzheimer's Advocate
• Preparing for the Future

In addition to the articles highlighted here, you can also learn more about these upcoming spring events by following these links:

• Steppin' Out for Memories - Abilene (event held on April 11, 2008)
• Thanks for the Memories - Fort Worth (event held on April 24, 2008)

From the Executive Director

Sometimes I’m asked about how our organization is structured.  Our chapter is a non-profit organization (the IRS identifies us as a 501 C 3), incorporated in the state of Texas and governed by our own board of directors, all of whom are volunteers.  I’m proud to explain that we are affiliated with the national Alzheimer’s Association, the oldest and largest national voluntary health organization committed to combating Alzheimer’s disease.  Covering a service area of 40 counties, we are one of five chapters in Texas and one of 78 in the country.  Our mission is to advance Alzheimer research and help those confronted by the disease with support and education.  With over 5 million Americans suffering from Alzheimer’s disease and the anticipated explosion in the number of people who will be diagnosed in the near future, our local and national work has never been more important.

Here in North Texas, our chapter staff and volunteers work hard everyday to support those in our communities who call us, participate in our support groups, attend our education programs, check-out materials from our libraries, visit us online or seek our help in other ways.  Our hope is to be the “go to” source for information and support related to coping with Alzheimer’s disease.  Repeatedly, we are told by those who have sought our help that we made a difference for them during difficult times.

I hope you will read this newsletter cover to cover to benefit from the helpful information it contains.  Our Ask the Expert column in this edition addresses in detail a topic we often receive questions about - eligibility requirements for long term care Medicaid.  A new set of national online tools, CareSource™, is a now available to help families at the point of seeking long term care.  Learn more about CareSource™ here.  Also, note the many upcoming education programs throughout our service area, including our major spring conference in Fort Worth on March 26.

Finally, thank you for supporting us in any way you can.  Our fund raisers enable us to continue to keep our programs available and grow them to meet the growing need.  As a longtime country music fan, I’m especially looking forward to our two April events.  The return of The Almost Pasty Cline Band for Abilene’s fund raiser on April 11 should be a great night of music and dancing.  And what a feat to have a singer the caliber of Gary Morris to entertain us at our dinner/auction in Fort Worth on April 24!  It is an added joy that we’ll give special recognition to our friend and the friend of so many, Roz Rosenthal, at this year’s dinner/auction.

Thank you for your interest in knowing about the Alzheimer’s Association.  If we can help you, please call us day or night.  Someone is always available at 1.800.272.3900.

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Ask the Expert

By Jan Henning, M.A.
Benefits Counselor
North Central Texas Area Agency on Aging

Question:  My mom’s condition is deteriorating, and it’s getting more difficult to take care of her at home.  She may need nursing home care soon.  I’m not sure she has enough money to pay for it.  What should I do?
Answer:  Be sure to find out about government programs that can help pay for ongoing care, especially long-term care Medicaid.

Question:  I already know that Medicare pays for skilled care after a hospital stay.  But that benefit is limited isn’t it?
Answer:  Yes, Medicare only pays for 100 days of skilled care during a benefit period.  And for 80 of those days, the Medicare beneficiary is required to pay a daily co-payment of $128.

Question:  How is long-term care Medicaid different?
Answer:  It’s based on providing ongoing care to help a person with the typical activities that make up his daily routine.  These activities include walking, getting up from a bed or chair, taking a bath, getting dressed, grooming, using the toilet and eating.

Question:  My mom’s physical health is good, but she does need help with some of those activities.  How does her diagnosis of Alzheimer’s affect Medicaid rules?
Answer:  Approval for long-term care Medicaid is based on meeting medical and non-medical requirements.  In your mom’s case, a diagnosis of Alzheimer’s in combination with specific care needs helps establish her medical eligibility.

Question:  What are the financial qualifications?
Answer:  Your mother’s income and assets must be within certain limits.  In 2008, her monthly income cannot exceed $1,911.  And, she cannot have more than $2,000 in assets.  If she has a spouse and both are going into a nursing home, their monthly income limit is $3,822 and their asset limit is $3,000.

Question:  What if she’s over the income limits?
Answer:  A Qualifying Income Trust can be used as a temporary holding account for your mom’s excess income.  Each month, the money in the trust would be withdrawn to help pay for her nursing home care.

Question:  How does the government define income and assets?
Answer:  Income is money received on a regular basis, such as Social Security checks, pensions, interest and rental payments, annuities, mineral rights and gifts.  Assets are resources such as checking and savings accounts, cash, investments, certificates of deposit and life insurance policies.  Property that is not part of the homestead is also considered an asset.

Question:  So my mom’s house is not counted as an asset?
Answer:  That’s correct.  In Texas, a person can own a home of any value.  If, however, your mom’s equity is more than $500,000, she cannot qualify for long-term care Medicaid.  She may be able to make a financial arrangement to reduce the amount of equity, though.

Question:  Is there anything else that’s not counted?
Answer:  Your mom can keep household possessions, a vehicle, a limited amount of life insurance and a burial policy.

Question:  If she has more than $2,000 in assets, can she give some to me?
Answer:  Extra assets have to be spent before a person can qualify for long-term care Medicaid.  Using your mom’s extra resources to pay for her care is the safest way to spend the money.  Any use of funds as a gift or give-away delays your mom’s starting date for Medicaid.  The State currently reviews a person’s expenditures for the three years prior to the date of Medicaid application, but starting in March of 2009 will gradually increase the look-back time period to five years in order to comply with federal law.

Question:  Are there other ways my mom can spend some of her extra assets?
Answer:  Yes, she can make home repairs or pay off debts, such as a mortgage.  She can also purchase personal property, such as a television, radio, books or clothing.  If she has not taken care of burial expenses, she can use her money to make those arrangements.

Question:  When the person in the nursing home is married, the spouse who stays home has a protected level of income and assets, doesn’t he?
Answer:  Yes.  The State would like to make sure the spouse at home has a minimum level of income and assets.  For example, the current monthly income of the spouse at home may be increased to an amount between $1,711.25 and $2,610, depending on the income of the nursing home spouse.  The amount of assets kept by the spouse at home may be increased to an amount between $20,880 and $104,400, depending on the nursing home spouse’s countable assets.  In some cases, a portion of the assets can be converted to income so the spouse at home will have a higher income.

Question:  Are there any other non-medical eligibility rules in Texas?
Answer:  A person must be a Texas resident, as well as a U.S. citizen or qualifying alien.  A person must also spend at least 30 consecutive days in a nursing home before the Medicaid application can be approved.

Question:  What will happen to my mom’s house after she dies?
Answer:  Depending on the circumstances, the State of Texas may have the right to recover some or all of the money Medicaid has spent on the cost of your mom’s care.  She is exempt from these rules if she has a surviving spouse, if she is less than 55 years of age, if the homestead is valued at less than $10,000, if attempting to recover expenses is not cost-effective for the State, if she has a minor surviving child or blind or disabled child of any age, if she has an unmarried adult child who lived in her house and helped care for her during the two years prior to her move to a nursing home or if estate recovery would cause undue hardship for her survivors.

Question:  Who can help with the application for long-term care Medicaid?
Answer:  Nursing home social workers are familiar with long-term care Medicaid and can help you with the process.  Applications are filed at the local Health and Human Services Commission office.  Keep in mind that some nursing homes are private pay only and do not have Medicaid-certified beds.

Question: Anything else I need to think about?
Answer:  With any government program, requirements are subject to change.  The information provided here is not a substitute for the advice of an attorney.  We’ve covered many of the requirements, but your situation involves specific details that we may not have discussed.

For more information, you can reach Ms. Henning at the North Central Texas Area Agency on Aging at 817.695.9197 or 1.800.272.3921.

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Needed:  Advocates for Alzheimer Issues

Alzheimer advocates flooded the White House phone lines on December 12th  and 13th, generating thousands of calls urging the president to support increased funding for Alzheimer research at the National Institutes of Health (NIH) as Congress finished work on the federal budget.  Advocates made a real impression on the White House comment line until the switchboard was unexpectedly closed mid-day on the 13th.  The Alzheimer’s Association sincerely appreciates the outstanding response from advocates to the call-in, including those who sent e-mails when the lines went down.

Congress approved an omnibus bill (H J Res 72) on December 19, 2007, that combined the 11 unfinished appropriations bills (including those that fund Alzheimer research and care programs).  President Bush signed the bill into law.  Unfortunately, Alzheimer issues were caught up in a larger political dispute over domestic spending.  As a result, there is a combination of bad and good news for Alzheimer advocates.

We are extremely disappointed that the approved bill does not provide more funding for Alzheimer research at NIH.  Overall, NIH received approximately $29 billion - an increase of 1.1 percent ($329 million) over 2007 funding.  The 1.1 percent increase for NIH in the omnibus effectively means that funding for Alzheimer research will remain flat.

In more encouraging news, the omnibus bill contains funding for key Alzheimer care programs:

We will need to fight even harder for our priorities because there is a growing number of lawmakers who want to continue to reduce spending on domestic programs such as medical research. 

We should congratulate ourselves on a tremendous year of advocacy that included thousands of in-person meetings with members of Congress, three high profile Senate hearings on Alzheimer issues, thousands of e-mails sent to Congressional offices and a record number of letters-to-the editor placed in major newspapers across the country. 

Your advocacy did make a difference.

Save the date for the 20th Annual Public Policy Forum on May 12th - 14th in Washington, D.C.  Attendance at this year’s forum is critical to our cause.  Please join us!  A personal connection to the disease is what weaves together forum attendees and is what drives them to fight Alzheimer’s.  They have seen their mothers, fathers and other loved ones slip away from the disease - and they are determined to not let their children and grandchildren grapple with the same fate.  If you are interested in joining us at the Annual Public Policy Forum in Washington, D.C., visit the national web site for more information.  If you want to work with our chapter to make a difference through advocacy, please contact Libby Connally at 325.672.2907 or Theresa Hocker at 817.336.4949.

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Preparing for the Future

While it is important for everyone to prepare for the future, legal and financial plans are especially vital for caregivers and those with dementia.  Planning now will help you avoid rushed decisions or crises later.  This March and April, our support group discussion topic will be “Legal and Financial Issues.” 

As your loved one’s dementia progresses, you will face many financial challenges and will need to know ways to help cover costs associated with the disease.  We will provide information on what legal documents are necessary and how to make plans for finances, health and long-term care coverage.  This information can help you be better prepared for the many changes ahead and give you greater peace of mind as you continue on this journey.

Our support groups are offered free of charge in a variety of locations at different times to accommodate those that attend.  For further information and a complete listing of our support groups, please call 800.272.3900.

To read our entire newsletter, click here for the PDF version.

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