Pat O’Dea-Evans, MS, RN, LCPC,CCMPat O’Dea-Evans, MS, RN, LCPC,CCMPresidentPresident

A SILVER CONNECTIONA SILVER CONNECTION

Paula SkweresPaula SkweresSenior Care ConsultantSenior Care Consultant

A Silver ConnectionA Silver Connection

Social and Financial Resources for the Elderly in Illinois

1. HOUSING AND CARE COSTS1. HOUSING AND CARE COSTS

2. DISCUSS GOVERNMENT FUNDED OPTIONS2. DISCUSS GOVERNMENT FUNDED OPTIONS

to pay for housing, care and/or assisted livingto pay for housing, care and/or assisted living MEDICARE/MEDICAID/SUPPORTIVE LIVINGMEDICARE/MEDICAID/SUPPORTIVE LIVING HUDHUD VA AID & ATTENDANCEVA AID & ATTENDANCE OTHER STATE PROGRAMSOTHER STATE PROGRAMS

3. PERSONAL FUNDED OPTIONS3. PERSONAL FUNDED OPTIONS REVERSE MORTGAGEREVERSE MORTGAGE HOME EQUITY OTHER OPTIONSHOME EQUITY OTHER OPTIONS COMPANION LIVINGCOMPANION LIVING SENIOR REFERRAL SERVICESSENIOR REFERRAL SERVICES

Costs are determined by:Costs are determined by:Location Location

The cost of senior housing can be comparable to that of other housing in the local The cost of senior housing can be comparable to that of other housing in the local market area. market area.

Size of residenceSize of residenceIf you explore independent living, you’ll find the accommodations vary from small If you explore independent living, you’ll find the accommodations vary from small

studio units in an apartment complex to large single-family homes in an studio units in an apartment complex to large single-family homes in an upscale retirement community. upscale retirement community.

Amenities or servicesAmenities or servicesSome communities are basic while some may have their own golf course, health Some communities are basic while some may have their own golf course, health

club, classes and other organized social activities.  For extra fees, housework, club, classes and other organized social activities.  For extra fees, housework, laundry, care assistance, shopping and transportation may be available. laundry, care assistance, shopping and transportation may be available.

Assisted Living is not “standard”Assisted Living is not “standard”““Assisted living” can be little more than providing communal meals or it could Assisted living” can be little more than providing communal meals or it could

include help with activities of daily living: bathing, dressing, grooming, toileting include help with activities of daily living: bathing, dressing, grooming, toileting from getting to custodial care. from getting to custodial care.

Medical needsMedical needsFor people with chronic illnesses or with significant disabilities, the care of trained For people with chronic illnesses or with significant disabilities, the care of trained

professionals may be a necessity, making housing more costly. professionals may be a necessity, making housing more costly.

The cost depends on the range of services you want or need.  The cost depends on the range of services you want or need. 

Continuing Care Retirement CommunitiesContinuing Care Retirement Communities (CCRCs) (CCRCs) Provide all options from independent living to skilled nursing care.  Provide all options from independent living to skilled nursing care. 

Buy in of $50,000 to way over $500,000 Buy in of $50,000 to way over $500,000

Monthly fee from $700 to $4000 depending on level of care, if any.Monthly fee from $700 to $4000 depending on level of care, if any.

Independent Retirement CommunitiesIndependent Retirement Communities

Allow for an independent lifestyle and may provide some light Allow for an independent lifestyle and may provide some light assistance as neededassistance as needed

Usually a rental apartment, doorman, check-in system.Usually a rental apartment, doorman, check-in system.

Range widely from 400 sq. ft. to over 2,000 sq. ft. Range widely from 400 sq. ft. to over 2,000 sq. ft.

Priced from the mid-$1000 to $5000+ monthly. Priced from the mid-$1000 to $5000+ monthly.

Typically offers from 1 to 3 meals but provides a full kitchen in the Typically offers from 1 to 3 meals but provides a full kitchen in the apartment.apartment.

Assisted LivingAssisted Living Provides light to moderate assistance in activities of daily living.Provides light to moderate assistance in activities of daily living.

Apartment or group home style for seniors with some medical needs or Apartment or group home style for seniors with some medical needs or independence/ADL needs. Medication assistance , activities, programs, full independence/ADL needs. Medication assistance , activities, programs, full or partial kitchens, laundry service, housekeeping, on-site nursing care, or partial kitchens, laundry service, housekeeping, on-site nursing care, scheduled transportation, and other features. RN is on call or 24hrs.scheduled transportation, and other features. RN is on call or 24hrs.

Private Pay $2500 - $6000 a monthPrivate Pay $2500 - $6000 a month

Supportive LivingSupportive Living Light assistance in activities of daily living.Light assistance in activities of daily living.

Most are studio apartment living for seniors with some medical needs or Most are studio apartment living for seniors with some medical needs or independence issues. Medication assistance , activities, programs, independence issues. Medication assistance , activities, programs,

partial partial kitchens, laundry service, housekeeping, on-site nursing care, kitchens, laundry service, housekeeping, on-site nursing care, scheduled scheduled transportation, and other features. transportation, and other features.

Private pay $3400 to Medicaid funded minimum $90 mo allowancePrivate pay $3400 to Medicaid funded minimum $90 mo allowance

Subsidized senior housingSubsidized senior housing—(sometimes called HUD housing or —(sometimes called HUD housing or Section 8 Housing) You pay part of the rent and government funding Section 8 Housing) You pay part of the rent and government funding covers the rest.  Rent is based on the ability to pay—usually 30% of covers the rest.  Rent is based on the ability to pay—usually 30% of your income.  Many of these programs have long waiting lists and your income.  Many of these programs have long waiting lists and you must have limited income and assets to qualify.you must have limited income and assets to qualify.

Over 55 Over 55 Below Market RentBelow Market Rent (BMR) also developed with HUD tax (BMR) also developed with HUD tax credits. Some of these apartments have short or no waiting lists and credits. Some of these apartments have short or no waiting lists and you must have limited income and assets to qualify, less than 60% of you must have limited income and assets to qualify, less than 60% of local income and housing costs $31,680 & 36,180 and $ 848.00 local income and housing costs $31,680 & 36,180 and $ 848.00 monthly for a 1-br.monthly for a 1-br.

Skilled Nursing –Skilled Nursing – Individuals requiring high-level medical care and are dependent on the Individuals requiring high-level medical care and are dependent on the

care provided by the nursing care provided by the nursing home staff. Dementia care. 2009 rateshome staff. Dementia care. 2009 rates

Regular Medicare After 3 day qualifying stay Medicare 1-20 @ 100% Regular Medicare After 3 day qualifying stay Medicare 1-20 @ 100% then $133.50 per day for days 21 through 100 each benefit period. then $133.50 per day for days 21 through 100 each benefit period. Must have pre-screenMust have pre-screenPrivate Pay range from $150 to $250+ a dayPrivate Pay range from $150 to $250+ a dayMedicaid – spend down then all income but $30 mo allowance. Medicaid – spend down then all income but $30 mo allowance.

Sheltered Care-Sheltered Care- Individual/shared or group home for seniors with some medical needs or

independence/ADL needs. RN Medication assistance , activities, programs, no kitchens, laundry service, housekeeping, on-site nursing care. Public Aid and Private Pay $2500 - $6000 a month

There are some government and community service programs that help There are some government and community service programs that help reduce expenses so your home continues to be affordable, but many of reduce expenses so your home continues to be affordable, but many of them are available only to seniors with very limited income and assets.  them are available only to seniors with very limited income and assets.  Some possibilities: Some possibilities:

You may be able to get reduced rates on utility bills and property You may be able to get reduced rates on utility bills and property taxes.taxes.Your local township or senior center may provide volunteers that help Your local township or senior center may provide volunteers that help seniors with a range of needs from transportation to gardening. seniors with a range of needs from transportation to gardening. Meals delivered through “Meals on Wheels” Meals delivered through “Meals on Wheels” If you need a few visits by a nurse or physical therapist following If you need a few visits by a nurse or physical therapist following hospitalization, Medicare is $130 then 20% co-pay medical insurance hospitalization, Medicare is $130 then 20% co-pay medical insurance may cover this cost. may cover this cost. If you have a terminal illness, Medicare or medical insurance may pay If you have a terminal illness, Medicare or medical insurance may pay for hospice care at home. for hospice care at home. If you have a disability or chronic illness, the Community Care If you have a disability or chronic illness, the Community Care Program may cover the cost of a limited number of hours per month for Program may cover the cost of a limited number of hours per month for someone to assist you with homemaking and personal care. someone to assist you with homemaking and personal care.

Medicare and Private health insurance - IMedicare and Private health insurance - Is strictly for medical care.  s strictly for medical care.  They do not pay for custodial care such as help with bathing, dressing, They do not pay for custodial care such as help with bathing, dressing, grocery shopping or getting around the house. After a hospital stay, grocery shopping or getting around the house. After a hospital stay, Medicare and private health insurance sometimes pay for follow-up care Medicare and private health insurance sometimes pay for follow-up care in a nursing home or skilled nursing facility for a limited period of in a nursing home or skilled nursing facility for a limited period of rehabilitation. rehabilitation. Coverage ends when there is a need for long term nursing careCoverage ends when there is a need for long term nursing careHome care is for a limited time as determined by need and/or progress Home care is for a limited time as determined by need and/or progress by the home care nurse or therapist.by the home care nurse or therapist.

Private Health Insurance and Medigap policies follow Medicare Private Health Insurance and Medigap policies follow Medicare guidelinesguidelines

Long term care insurance or Medicaid Long term care insurance or Medicaid do pay for custodial care do pay for custodial care costs but not all medical care. Often have many limitations and costs but not all medical care. Often have many limitations and restrictions to the coverage.restrictions to the coverage.   

Personal or family moneyPersonal or family money -- assets like stocks ,pensions, savings, plus income from -- assets like stocks ,pensions, savings, plus income from social security, job or investments. social security, job or investments. Pensions and Social Security retirement Pensions and Social Security retirement benefitsbenefits are the primary income source for many seniors that can cover rent or are the primary income source for many seniors that can cover rent or mortgage payments. mortgage payments.

Supplemental Security Income (SSI)Supplemental Security Income (SSI)--monthly public assistance checks for seniors and --monthly public assistance checks for seniors and the disabled who have very limited income and assets. the disabled who have very limited income and assets.

Reverse mortgage or home equity loanReverse mortgage or home equity loan--can be an income source to pay for services --can be an income source to pay for services to keep a senior in their own home, or to pay for nursing home care of a very ill to keep a senior in their own home, or to pay for nursing home care of a very ill spouse, or even pay for long-term care insurance. spouse, or even pay for long-term care insurance.

Long-term-care insurance Long-term-care insurance -- sometimes pays only for nursing home care, but some -- sometimes pays only for nursing home care, but some policies cover an array of services in a private home or in an assisted living type of policies cover an array of services in a private home or in an assisted living type of facility. facility.

MedicaidMedicaid --for people who have very limited assets and income, this coverage acts as --for people who have very limited assets and income, this coverage acts as health insurance for costs of hospitalization, rehab and medicine; also covers some health insurance for costs of hospitalization, rehab and medicine; also covers some custodial long-term care in a nursing home or supportive living program. custodial long-term care in a nursing home or supportive living program.

What types of senior communities can I What types of senior communities can I enter under Medicaid coverage?enter under Medicaid coverage?

Certain assisted living (Supportive Living) and skilled Certain assisted living (Supportive Living) and skilled nursing communities can accept residents who are on nursing communities can accept residents who are on Medicaid Medicaid

May only have a percentage of their total beds that can be May only have a percentage of their total beds that can be occupied by Medicaid residents.occupied by Medicaid residents.

You will need to check with the individual communities to find out if You will need to check with the individual communities to find out if they will accept Medicaid. they will accept Medicaid.

Some communities will make an arrangement that, if you can pay Some communities will make an arrangement that, if you can pay privately for 6 months to one year, they will assist you in converting privately for 6 months to one year, they will assist you in converting your payments to Medicaid. your payments to Medicaid.

Illinois developed the Supportive Living Program as an alternative to Illinois developed the Supportive Living Program as an alternative to nursing home care for low-income older persons and persons with nursing home care for low-income older persons and persons with disabilities under Medicaid. It is affordable assisted living model disabilities under Medicaid. It is affordable assisted living model administered by the Department of Healthcare and Family Services administered by the Department of Healthcare and Family Services that offers frail elderly (65 and older) or persons with disabilities (22 that offers frail elderly (65 and older) or persons with disabilities (22 and older) housing with services.and older) housing with services.

Each Medicaid-eligible resident must have income equal to or greater Each Medicaid-eligible resident must have income equal to or greater than the current SSI and must contribute all but $90 each month to the than the current SSI and must contribute all but $90 each month to the provider for lodging and meals. Additionally, a provider may become a provider for lodging and meals. Additionally, a provider may become a food stamp agent and receive food stamp allotments from residents as food stamp agent and receive food stamp allotments from residents as payment toward meal costs. payment toward meal costs.

• Limited Nursing • Social/Recreational Programming • Health Promotion & Exercise• Medication Oversight • Ancillary Services • 24-hour Response/Security • Meals

• Personal Care • Laundry • Housekeeping • Maintenance• Transportation• Apartment Style housing

Undergoes preadmission screening (individuals seeking assistance Undergoes preadmission screening (individuals seeking assistance through the Medical Assistance Program must be found in need of through the Medical Assistance Program must be found in need of nursing facility level of care according to screening guidelines); nursing facility level of care according to screening guidelines);

Is without a primary or secondary diagnosis of developmental Is without a primary or secondary diagnosis of developmental disability or serious and persistent mental illness; disability or serious and persistent mental illness;

Has income no less than the current maximum allowable amount of Has income no less than the current maximum allowable amount of Supplemental Security Income (SSI amounts for 2009 - $674 for a Supplemental Security Income (SSI amounts for 2009 - $674 for a single person; $1011 for a couple); single person; $1011 for a couple);

Tuberculosis test that indicates the absence of active tuberculosis. Tuberculosis test that indicates the absence of active tuberculosis. The test must be completed no more than 90 days prior to the date of The test must be completed no more than 90 days prior to the date of admission, or no more than seven days after admission; andadmission, or no more than seven days after admission; and

Is not participating in the Department on Aging Community Care Is not participating in the Department on Aging Community Care Program or the Department of Human Services Home Services Program or the Department of Human Services Home Services Program. Program.

VA Aid & Attendance is a special pension VA Aid & Attendance is a special pension program from the Veterans Administrationprogram from the Veterans Administration

This is not dependent upon service-related This is not dependent upon service-related injuries for compensation injuries for compensation 

Allows for War-time Veterans and surviving spouses Allows for War-time Veterans and surviving spouses who require the regular attendance of another person who require the regular attendance of another person to provide ADL’s. For in-home care, AL or skilled.to provide ADL’s. For in-home care, AL or skilled. In ‘09 a Veteran is eligible for up to $1,632 per In ‘09 a Veteran is eligible for up to $1,632 per month, while a surviving spouse is eligible for up to month, while a surviving spouse is eligible for up to $1,055 per month.  A couple is eligible for up to $1,949 $1,055 per month.  A couple is eligible for up to $1,949 per monthper month

www.seniorveteran.orgwww.seniorveteran.org

A life settlement is a financial transaction in which a life A life settlement is a financial transaction in which a life insurance policy is sold to a third party for more than the insurance policy is sold to a third party for more than the cash surrender value The purchaser becomes the new cash surrender value The purchaser becomes the new beneficiary of the policy at maturation and is responsible for beneficiary of the policy at maturation and is responsible for all following premium payments. all following premium payments.

A life settlement allows you to convert your life insurance A life settlement allows you to convert your life insurance policy into cash. policy into cash.

Rather than accepting the lower cash surrender value from Rather than accepting the lower cash surrender value from the issuing life insurance company. The proceeds are given the issuing life insurance company. The proceeds are given to the owner and used as they wish for retirement, to the owner and used as they wish for retirement, healthcare, vacations, investments, travel. healthcare, vacations, investments, travel.

Short and long term loansShort and long term loansLending institutions can provide loans for Lending institutions can provide loans for

seniors. The loan is an easy way to finance seniors. The loan is an easy way to finance senior living, eliminating for many, a significant senior living, eliminating for many, a significant obstacle to moving into a senior living obstacle to moving into a senior living community. This loan can be utilized to:community. This loan can be utilized to:Pay for rent while waiting for a home to sell Pay for rent while waiting for a home to sell Pay for rent while waiting for VA or other benefits Pay for rent while waiting for VA or other benefits Finance move-in fees Finance move-in fees Supplement monthly rent Supplement monthly rent

Friendship or Companion Suites are another Friendship or Companion Suites are another solution. Seniors are brought together to solution. Seniors are brought together to share an apartment and cost savings while share an apartment and cost savings while forming new friendships.forming new friendships.

Other options are community services that Other options are community services that provide home-sharing opportunities. provide home-sharing opportunities.

ILLINOIS Funded by AAAILLINOIS Funded by AAAIL funded Programs: financial net limit $17,500.00IL funded Programs: financial net limit $17,500.00 Meals-on-WheelsMeals-on-Wheels

Community Care Program Community Care Program

Adult Day Care Programs Adult Day Care Programs

Emergency home response Emergency home response

Home modifications (have various funding sources)Home modifications (have various funding sources)

Congruent Meals = at many senior centersCongruent Meals = at many senior centers

Money Follows the PersonMoney Follows the Person

No financial limitNo financial limit = Respite Care, = Respite Care, benefit check up, SHIP, benefit check up, SHIP, enhanced volume phones and most local senior transportation enhanced volume phones and most local senior transportation programs.programs.

Helping Elderly with FinancesHelping Elderly with Finances1.1. Talk to your parent about their financial welfare Talk to your parent about their financial welfare

and future planning.and future planning.

2.2. Help your parents to meet with an Elder-Law Help your parents to meet with an Elder-Law attorney to set up a financial plan, trust, will attorney to set up a financial plan, trust, will …..and …..and

3.3. Obtain a “Power of Attorney” for property and Obtain a “Power of Attorney” for property and for health care.for health care.

4.4. Make sure parents don’t need help with routine Make sure parents don’t need help with routine bills, (check on-line) that property taxes, bills, (check on-line) that property taxes, Federal/State taxes and that utilities are being Federal/State taxes and that utilities are being paid.paid.

Organizations provide free consultation, Organizations provide free consultation, assistance resource and referral services. assistance resource and referral services.

www.ASilverConnection.comwww.ASilverConnection.com

Helping to match seniors and families to a Helping to match seniors and families to a variety of senior resources, including assisted variety of senior resources, including assisted living, in home care and senior housing living, in home care and senior housing alternatives.alternatives.

Provide information on how to find funding for Provide information on how to find funding for housing or care options.housing or care options.

Paula SkweresPaula Skweres

Senior Care ConsultantSenior Care Consultant

Silver ConnectionsSilver Connections

paula@ASilverConnection.compaula@ASilverConnection.com

224-723-8858224-723-8858

www.ASilverConnection.comwww.ASilverConnection.com