NCAL recently commented on a
proposed rule that impacts the Aid & Attendance (A&A) benefit program for veterans residing in assisted living communities. Published on Jan. 23, 2015, the proposed rule establishes new requirements pertaining to the evaluation of net worth and asset transfers and identifies medical expenses that may be deducted from countable income for eligibility purposes.
Under the proposed rule, the means-tested A&A program, which the VA also calls “pension benefits,” will require a three-year look-back assessment when determining eligibility. The rule also establishes a clear net worth limit as the sum of assets and annual income. Although the rule would tighten eligibility for the program, NCAL, as well as many other veteran advocacy organizations, support the basic tenets of the proposed rule because it protects veterans from predatory practices of financial planners who appear to have profited from helping veterans become eligible for the benefit.
NCAL did, however, take issue with the proposed rule’s definition of ADLs as unreimbursed medical expenses. According to the rule, the definition of ADLs eliminates two of the most frequent reasons elders move into assisted living: the inability to self-administer medications and the inability to ambulate on their own. In its comments to VA, NCAL recommends that the rule be amended to include in its definition of ADLs, the following: assistance in walking, getting in and out of bed, bathing, dressing, feeding, and using the toilet, preparation of special diets, and supervision of medication that usually can be self-administered.
The rule comes some two years after the Government Accountability Office (GAO) made similar recommendations based on the results of its investigation, which found that financial planners had suggested that veterans purchase inappropriate products and services, exposed them to misleading marketing, gave veterans misleading and inaccurate information about VA benefits and Medicaid eligibility, and provided inadequate service, in some cases.
The proposed rule calls for the following additional changes:
- A claimant’s primary residence and two acres of land would not be considered assets;
- Homes that are sold are assets unless another primary residence is bought within a year;
- Defines what “medical expenses” are for VA purposes;
- Establishes a three-year look-back and penalty period for claimants who transfer assets before applying for pension to create the appearance of economic need where it does not exist;
- Net worth can decrease if funds are spent on food, clothing, shelter or health care;
- Establishes a penalty period of up to 10 years, depending on how much an individual transfers.
A House bill containing provisions similar to the proposed rule passed last January (2104) with overwhelming approval, by a vote of 404 to one. If you have any questions, please contact NCAL's
Dave Kyllo or
Meg LaPorte.
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