Instead of my usual column about specific aspects of the elder law practice, I would like to take the opportunity to express my outlook on the new state budget.

New York State has finally passed its new budget for the year and it contains provisions which concern the elderly and their families. Like last year, this year's proposed changes were threatening because the state wanted to decrease the budget. However, no changes were made this year, which is an immense relief.

Allow me to editorialize and state that the problem with these budgets has been the reluctance to provide those burdened with the overwhelming responsibility of providing care for a gravely ill family member with a permanently thought-out health-care plan. Without a permanent plan, it can be difficult to acquire peace of mind as to what threats future budgets might contain.

There also appears to be a disturbing trend in this country and particularly in New York State to view the frail elderly and their families as trying to avoid all financial responsibility for health care costs. It is assumed that they are trying to "rip off" the system and are sheltering huge fortunes at the expense of the taxpayer. We who deal with these problems on a daily basis have come to the realization that the typical client is not concerned with avoiding all financial responsibility.

Rather they are concerned that all of the assets that took them a lifetime to save will be dissipated in a brief time leaving both the ill elderly person and possibly their spouse in an impoverished situation where they may have no choice but to enter an institution. The fact that our seniors are being typecast in this manner could have a very negative ramification on our society. Had this law been passed, more seniors would have had to enter nursing homes than ever before.

Specifically, some of the proposed changes in the new law would have enacted transfer penalties when applying for Medicaid home health care and eliminated the right of spousal refusal in the home health care scenario. Both of these changes would have possibly saved the State some money in the immediate future. However, for the long term they would have the horrendous effect of forcing families into placing loved ones in a nursing home for financial reasons. Obviously, having more people in nursing homes on Medicaid will cost the State significantly more than caring for them at home.

Fortunately, as I stated before, the threatened cuts were not applied to this year's budget. Therefore, with some expert guidance through such strategies as the "rule of halves" and spousal refusal, people are able to preserve some of their assets and still be eligible for Medicaid entitlements.

Reprinted with permission of the Suffolk Times © 1999

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