Integrating LTC into the Older Client Advice Process

1. Integrating LTC into the Older Client Advice Process Personal Finance Society November 2008 Tish Hanifan Barrister Legal Support Services

2. Demographics [Source :office of National Statistics 2006] 

3. Legal Issues Who is my Client? Conflicts of Interest Capacity Issues Substituted Decision Making: Enduring Powers of Attorney/Lasting Powers of Attorney Role of the Office of Public Guardian Court of Protection Deputies Confidentiality

4. Legal Framework Who Pays For Care? National Health Service or Local Authority? Do you know? Eligibility Criteria for NHS continuing Care Applicant for Care: Assets and Charging Procedures (CRAG)

5. National Health Service Responsibility Access to Free Continuing Care National Service Framework for Older People . HSC 2001/007: LAC [2001] * Continuing Care: NHS and Local Councils Responsibility. 28th June HSC 2001/015:LAC[2001]18 effective Oct 2001 Replaced October 2007 :The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care

6. Decision Support Tool

7. Free Nursing Care Section 49[2] Health and Social care Act 2001 Defines Nursing Care Registered Nurse Care Contribution[RNCC] Lower Band �40 Middle Band �87 Higher Band �139 [effective April 2007] New Single Band �101 [effective October 2007] Transitional arrangements Effect on Care Homes. [contracts]

8. Free Nursing Care Health and Social Care Act 2001 Section 49[1] Removes LA responsibility for providing Nursing Care Registered Nurse Care Contribution [RNCC] Section 49[2] Defines Nursing Care Definitions and Implementation GP Registration

9. Care Provision and the Local Authority National Health and Community Care Act 1990 Residential Care Domiciliary Care

10. Local Authorities and Residential Care National Health and Community Care Act 1990.section 47 Care bed provision and funding National Assistance Act 1948 section 21 Applicant for Care : Assets and Charging Procedures for residential Care [CRAG]

11. National guidelines for contributions for care in a residential or nursing home �Revised Capital disregard�limits of �13500 (lower capital limit) �22,250 (upper capital limit), � Under �13500: full benefit �13500 -�22,200: reduced benefit Over �22,250: no entitlement to benefit Scotland : Lower Capital Limit �13,000 Upper Capital Limit �21,500 Wales : Lower Capital Limit �19,000 Upper Capital �22,000. Personal Expenses Allowance (PEA) of �21.15 The PEA applies to all care home residents [Effective April 2008]

12. Clients Objectives How might funding care impact upon: Inheritance tax planning Business and succession planning Married couples assets The family home

13. The Family Home CRAG Guidelines for Disregard. HSCA 2001 : 12 week disregard Deferred Loan Scheme Valuation Problems : Resident spouse wants to move. Surviving Spouse decides to move in with children [Palfrey [ Carer wishes to continue to occupy. Council �Right to Buy� Deferred Payments Schemes Equity Release

14. Gifting Assets CRAG Guidelines : Notional Capital Rules Deliberate Deprivation Gifts of Property : Implications for future liability to pay for long-term care [Guidelines for solicitors prepared by Mental Health and Disability Committee]Revised April 2000 Lifetime Gifting and Use of Trusts Gifting by Will

15. Legal Support Services Provides access to legal and financial technical support and guidance on all aspects of advising the Older Client. www.legalsupportservices.co.uk