New Minnesota Elder Care effective August 1, 2021
In 2019, the State of Minnesota passed the Elder Care Act which helped to address elder abuse situations that were cropping up in our state.
The law implements two additional changes which are going into effect August 1, 2021:
- Assisted living communities will be licensed by the state (previously consider housing with services)
- Each Assisted living community or nursing home must have an Elder Care Director on staff.
Then COVID happened
Last year, many seniors opted to Age in Place – staying in their homes—often isolated from their loved ones. The Minnesota Department of Health denied family members in-person visits or only supervised in an open setting. We learned many families lost a loved one who died alone and isolated. Antidotal stories I have been hearing is that many assisted living communities have many openings in their communities (as an example, a 100 bed community currently has about 30 clients living there and have a hard time staffing the community).
The other reality is that there are about 100 qualified Elder Care Directors in the state of Minnesota. If a facility must have a qualified Elder Care Director on staff, this limits the number of communities able to provide assisted living support (ie. experienced nursing care). You see, Minnesota considered our Senior Assisted living to be “Housing with Services”. The housing will not go away, but the services will. Memory care, independent housing, and federally owned communities are not impacted by these changes.
Requirements of this new law
Each community were required by the legislation to tell their residents by May 31, 2021 about their decision to be licensed and to have each resident sign a new contract detailing out the new requirements for being licensed (residents rights, new guidelines about eviction, services available, etc.). If a community decided to no longer provide services, they need to allow residents, their families, or representatives to make other arrangements. Housing moves require a 60 day notice rather than a 30 day to move Seniors. Some communities are offering alternatives to keep their residents living in their community by contracting with an in-home care agency to provide PCAs (Personal Care Assistants) to provide supportive services so residents so they can remain in their apartments.
If you have not heard from the senior community caring for your parents, please reach out to them TODAY to get an understanding of any changes to your loved one’s care.
Supportive Services can be provided by a PCA who goes into the homes of Seniors. The services are very specific per the new law: :
(1) assistance with laundry, shopping, and household chores;
(2) housekeeping services;
(3) provision or assistance with meals or food preparation;
(4) help with arranging for, or arranging transportation to, medical, social, recreational, personal, or social services appointments;
(5) provision of social or recreational services; or
(6) “I’m okay” check services.
PCAs cannot provide medications or any skilled nursing care. Also be aware that PCAs are often not paid very much – about $10 – $15 per hour and do not have benefits. This job attracts workers who may come from a different culture than the elders they are caring for, have language barriers or are close to retirement. Many use public transportation to get from their homes to the Seniors’ home to whom they provide care. If there’s concern about COVID spread again, this will make additional future challenges. They often have families of their own, so they cannot live onsite with the senior. Also note, that
What option remains?
Family members care for their loved ones is a growing trend. Interestingly, Minnesota does not have a filial responsibility law like many other states. The Filial Responsibility law generally says that children are responsible for the care and finances for their parents or loved ones. In Minnesota, we believe strongly in the use of community services to provide care for our loved ones. What we might forget is that the Senior community comprises of:
- 30% have the funding to provide care through personal wealth, long term care insurance
- 20% are dependent on Elderly Waiver
- 50% – or the Forgotten Middle – do not have the financial independence or qualify for Elderly Waiver until the end of their lives.
To address the Forgotten Middle, many homes are being remodeled to create a mother-in-law suite. This is the new feature in many new homes being built. Other homes are being redesigned to have dual master suites instead of master bedrooms and bedrooms. Converting a basement into an apartment is another alternative. This is great for Seniors with children. Solo Seniors need to plan in advance on their options for community housing like co-ops or we are recommending the design and remodel to support Golden Girl Style housing, of if a Veteran, see if PCA care can be swapped for housing for homeless veterans (something I am working on with the VA).
An alternative solution
I would like to propose a solution for families who might consider having their parents age in place or as an alternative to hiring a PCA:
Hire your adult children to provide the necessary care.
In Minnesota, immediate family members can be paid up to $30 an hour. By the way, this is how much the in-home care companies charge to provide the care for support services. If you choose to age in place, consider the following:
- Pay family members to provide your care instead of expecting them to volunteer their time
- Consider the tax advantages, wealth transfer and improved care as if it was a business entity.
- Pay as you go or defer payment until the settlement of the estate to compensate the family members who provide your care
- Have your funds stay within the family instead of going to a corporation
- Avoid impoverishing yourself and/or your spouse to meet spend down requirements for Medicaid or Elderly Waiver requirements.
- Remain living in your home as long as possible
- Engage your entire family instead of relying on one or two family members
- Improve quality of life and personal independence
- Assisted by a third party to navigate and guide financial and care-giving decisions
- Adult children employed as “small business owners” helps them reenter the workforce after caring for others
Every family member can, and are encouraged, to take part in the care of their loved ones. This process creates an FLLC (Family Limited Liability Corporation), which has a tool often offered to the ultra-wealthy, can be used by the Forgotten Middle Seniors to transfer wealth to those providing care while improving the quality of care and personal independence. If funds are deferred until the resolution of the parent’s estate, there are legal, tax, insurance and health benefits which need to be discussed and impacts the entire family.
Interested? Or would like to learn more about this program, please reach out to Amy at Our Family Encounter. I would love to meet and schedule a private consultation.