Legislation aimed at providing guardianship protection and protection from unqualified individuals selling living trusts, as well as the biennial battle to procure more money for health-care providers, top the retirement-related agenda at the Washington Legislatures 2007 session.


Richard Sayre, a principal in the law firm of Sayre & Sayre PS, of Spokane, says a proposal to form a state-run public guardianship program, similar to such programs in many other states, would benefit senior citizens who need, but cant afford, a guardian, and also would save money for the state.


Guardians often are employed to help the elderly take care of their health and financial affairs.


With the program we have now, the court appoints a guardian for elderly individuals who have no children around and no money to pay for a guardian, says Sayre, whos a trustee for the elder-care section of the Washington State Bar Association. Because of that lack of money, not many guardians will do it.


The association supports the proposed legislation. Last month, the Seattle-based Public Guardianship Task Force created by the bars elder-care section released a statement saying, In addition to being at increased risk of institutionalization, people who need, but dont get, guardianship services are at risk of abuse or exploitation.


The same statement says the state of Virginia, according to a national study published by the American Bar Associations Commission on Law & Aging, has documented more than a $12,000 annual savings for each participant enrolled in its public guardianship program.


Sayre says states like Washington, without such a program, have experienced escalating health costs in that area because seniors without guardians often go without medication, become mentally ill, and end up at hospital emergency rooms where the state pays for their care.


Tom Culbertson, an attorney whos the head estate planner for the Spokane-based law firm Lukins & Annis PS, endorses another piece of proposed legislation that would limitto attorneys and those employed by attorneysthe marketing of legal estate-distribution documents, such as living trusts. Many others market such documents now, and the services they provide are being challenged as unprofessional and not in the best interests of the senior citizens who buy the trusts, say lawyers here.


Sayre says a living trust is designed to enable seniors to pass assets along to others after their deaths without having their estates go through probate, as typically occurs with a will.


Yet, Culbertson says, living trusts sold by people other than lawyers often dont achieve that intended goal.


I have many clients whove run into problems in regards to living trusts written by unqualified individuals, says Culbertson. Ive seen the whole range (of living trust salespeople), from those who are outright fraudulent to some who do a half-decent job. But even those people are usually focused on volume and dont provide much service on a personal level.


Unqualified sellers of living trusts often go beyond the setting of trusts and use information gained selling the trusts to sell senior citizens annuities or life insurance they might not need, Culbertson says.


Washington Attorney General Rob McKenna calls such unprofessional presentations to senior citizens trust mill scams. In a news release supporting the proposed legislation, he says, Trust mills are used by salespeople who prey on seniors and convince them through scare tactics and deception that they need a living trust.


Sayre says unqualified salespeople often provide free seminars and free meals, then sell living trusts to senior citizens. In support of the legislation to require that an attorney be involved in such transactions, he says, Living trusts must be drafted carefully.


Health-care funds


Meanwhile, state reimbursements for health care provided to the elderly also is an issue.


Gary Weeks, executive director of the Washington Health Care Association, which mostly represents for-profit health providers in the state, says Washington Gov. Chris Gregoires proposed biennial budget seeks far less money than is needed to cover health-care costs for those seniors who receive care through state programs.


Bill Ulrich, president of Consolidated Billing Services Inc., of Spokane, which helps long-term-care facilities navigate the complexities of the Medicare and Medicaid billing processes, says, Were looking for payment reforms. Many entities are working to get more money than the governor allocated in her budget.


The governors budget seeks about $70.9 million for increased wages and benefits for home health-care workers under a collective bargaining agreement and to home-health workers not represented in that agreement, says Rick Hall, executive director of the states Home Care Quality Authority office.


Weeks says such funds typically are matched with federal money when home-care workers provide care to Medicaid patients.


He says the governors budget also would authorize Medicaid rate increases of about $15 million that would be paid to nursing homes and $9.2 million that would go to assisted-living facilities and adult family homes. Those dollars, too, likely would be matched by federal money, he says.


Were happy about the $15 million for nursing homes, but thats far short of what we need to keep Medicaid beds online, says Weeks. In reality, the money we have to run the Medicaid program in nursing homes falls about $60 million short of what we need each year, and the money to operate assisted-living facilities falls about $50 million short each year as well.


He says many assisted-living facilities are turning away potential Medicaid residents in favor of private-pay residents who are charged higher rates. He says Medicaid patients who are turned away, even if they dont require the higher level of care provided at nursing homes, often end up in nursing homes that cant legally turn them away if beds are available.


Ulrich says that in assisted-living facilities with a high percentage of Medicaid patients, youre essentially taxing private-pay seniors through increased rates to compensate for the shortfall caused by inadequate Medicaid reimbursement for the other patients there.


Contact Rocky Wilson at (509) 344-1264 or via e-mail at rockyw@spokanejournal.com.