A primer on the Long-Term Care Trust Act
June 8, 2019
By: Mark Harvey
Email: harvemb@dshs.wa.gov
(I’m all atwitter! I have a new acronym to play with! Ready?)
LTCTA!
(…hmm…That’s near as much fun, when you try to actually pronounce it…)
I know you’re on the edge of your seats, so let’s not dawdle: “What-the-heck is ‘LTCTA’?”
It stands for “Long-Term Care Trust Act,” which you may (depending upon your level of consciousness) have seen or heard blow by in recent news reports about the Washington State legislature’s recently completed session. Here’s what I know.
The Long-Term Care Trust Act (which I’m now going to refer to as “LTCTA,” because I don’t want to type that much AND I’m enjoying your futile attempts to pronounce it) will provide a $36,500 lifetime benefit (indexed to inflation) to eligible beneficiaries for long-term care services’ now, let’s think about what that actually means.
“Long-term care” means exactly what it sounds like it means: Somebody needs care (“Help,” if you will – And a fair amount of it) for a very long time – Perhaps, permanently.
An “eligible beneficiary” is (or will be) someone who has paid the .058 percent mandatory premium as an employee through payroll deductions (No, there is NO “employer contribution), beginning in 2022; then, beginning in 2025, if he/she has worked a minimum number of hours for ten years, with at least five if interrupted or three of the last six years (I know, but that’s what it says) AND is at least 18 years of age AND is a Washington resident AND is assessed to need assistance with at least three “activities of daily living,” he/she morphs magically into an “eligible beneficiary.”
Hang in there.
What, pray tell, are “activities of daily living?” Things that we all have to do every day in order to live, e.g. dressing, eating, bathing, ambulating, medication management, etc.; so, in 2025, if you’re 18 or better, you live here, you’ve paid into the trust fund long enough through your employment and you need assistance with at least three of those “activities,” you’re ELIGIBLE!
For what, you reasonably ask? No, the State of Washington is NOT going to send you a check for $36,500, but here’s what you could use that benefit for: home modifications (e.g. ramp), emergency response systems (think, “panic button gizmo”), adaptive equipment and technology, transportation, home-delivered meals, professional health services, in-home personal care, respite, adult family home care, nursing home care, and more.
You’re right: $36,500 isn’t going to last forever if a person needs a substantial amount of help on a very long-term or permanent basis, but let’s consider what happens now, to a person in similar circumstances.
People just struggle on, doing without and/or doing the best they can by paying for help privately and relying on friends and family to help out; often, a lot. If it goes on long enough, money runs out, family/friends burn-out (literally) and the only option left is Medicaid.
Now, if that’s what it comes, that’s what it comes to you, and Medicaid (NOT “Medicare!”) saves lives and often keeps people at home, but it requires relatively low income, limited assets and can include things like “estate recovery,” etc. so it has its issues. The LTCTA will have none of the latter.
Also sometimes, for some people, all they need is the home modification (or whatever) on a one-time basis, and they do pretty darned well for a very long time; OR, maybe someone just needs some assistance for a while, then they recover and get back to their previous lives, so VOILA!
Yes, I think this could be a good thing for a lot of people, but before you pepper me with questions, allow me to observe that this is a brand new thing, and there are a lot of rules, regulations and bureaucratic structures that don’t yet exist, so the answer to a lot of your questions is going to be, “I have no idea.”
- “What if I never use this benefit, but paid into it? Will I get a refund or rebate or whatever?” I have no idea, but I sincerely doubt it. I suspect it will work like Social Security or Medicare, meaning we’ve paid into those all of our working lives, too, but if we never “collect,” that’s how that cookie crumbles.
- “Could I use some of this benefit at one time, and then more of it some other time, etc.?” I presume so.
- “Could I use it to pay my wife to take care of me?” I sincerely doubt it, but I have no idea.
- “If I only used some of this benefit, but then kicked-off, could the unused portion go to my heir(s), as designated in a will?” I sincerely doubt it. I suspect it will work a lot like Social Security: It goes when you go.
- “Do you really think this will be a good thing, or are you just parroting the bureaucratic BS?” Fair question, although you could have been a little less… Yes, I do. There are some obvious drawbacks, and I don’t know anyone who will celebrate the advent of another payroll deduction, but I think it will (eventually) do a lot of people a lot of good, while mitigating the personal impacts of Medicaid, AND might save a lot of caregivers from a more dire fate.
That’s it, at least for now – MUCH more will be revealed in the next two years – But that’s what the ballpark looks like. There’s only one last question that occurs to me:
“But, I need help NOW?!”
Then, call any of the numbers at the end of this column and decent people will help you understand your options, and they’ll do it for free.
But I’ll warn you: They won’t be able to pronounce “LTCTA,” either.
Mark Harvey is the director of Information and Assistance for Olympic Area Agency on Aging. He can be reached at harvemb@dshs.wa.gov or 532-0520 in Aberdeen, (360) 942-2177 in Raymond or (360) 642-3634. FACEBOOK: Olympic Area Agency on Aging-Information & Assistance.