When people think about long term care, the conversation inevitably brings up a few questions: How will I pay for it? What services are really out there for me? Where do I start?  Those who plan ahead consider what care will be needed long before those needs increase beyond what the family and support systems can offer. Over the past several decades, the number of multi-generational families living under one roof has significantly decreased. Children move away from home and live hours away in another city, state or even country. For aging folks who just need a little extra help with day to day chores or errands this can mean the difference between losing their independence at home and having no other option but to move into a facility.

Medicaid is Washington’s long term care benefit program. The program offers a way to pay for the rising cost of care when people have no other means or plan to pay for their care. The average monthly rate in an assisted living facility may exceed $7,000 and in nursing homes or rehabilitation centers, this cost may exceed $10,000. Given these types of monthly costs, it is no wonder that people often turn to Medicaid as a way to pay for their care. The number of people needing care in a facility type setting has increased dramatically because they lack the traditional support and services needed which could otherwise allow them to stay in their own homes, longer and safely. Washington State, by and through the Department of Social and Health Services (DSHS), recognized this problem and implemented a temporary five (5) year trial program called the “Medicaid Transformation Demonstration” (MTD) which runs from 2017 to 2021. The goal is to make various types of care and support services available to folks who live in home, before they move into a facility. The program broadens access to state-paid services for both the unpaid family caregiver as well individuals living alone who need limited care. Ultimately, this should allow people to stay home longer, avoid moving into a facility before it is truly necessary or desirable, and increase the quality of life for both our aging population and the family members who support them. At the same time, the program is also designed to reduce unsustainable facility costs the state is covering under traditional Medicaid programs. Specifically, the MTD has developed two new types of services explained below.

Medicaid Alternative Care (MAC):

MAC is available for those who are already eligible for Medicaid, but can provide safe ways to stay home including errand services, support groups, adult day care, medical equipment and minor house improvements such as handrails, etc.

Tailored Supports for Older Adults (TSOA):

TSOA, covering the same services as above, as well as some limited services for the unpaid family caregiver, is available for those who are close, but do not yet meet the financial eligibility requirements of Medicaid and still need some care.

These programs are worth exploring as MAC and TSOA do not require a “participation” payment (monthly premium to access benefits) and the state will NOT impose estate recovery on any of the services provided. A handout provided by Washington State which describes these in more detail can be found by Clicking This Link.

Our law practice centers around those who are aging and we strive to assist families before they need Medicaid. Let’s put the “planning” back in Long Term Care Planning. If you or your loved ones are in need of care, or you want to plan ahead and learn about the possibilities, we are here to help guide you.

As always, thanks for reading!

The Team at the Elder Law Offices of Meyers, Neubeck & Hulford, P.S.

Barry M. Meyers

David M. Neubeck 

Sara LC Hulford

Elder Law Offices of

Barry M. Meyers, P.S.

 DISCLAIMER: The content of this newsletter is: for information purposes only, subject to change by government agencies, should not be relied upon as current, and, does not constitute legal advice. Reading this newsletter does not establish an attorney-client relationship.