August 2019 Update
To obtain a legal gender change, an individual previously had to obtain an affidavit from a doctor stating that they received “clinically appropriate treatment for the purposes of gender transition.” Now, when petitioning the superior court, an individual must only complete an affidavit stating that, “I, (petitioner’s full name), hereby attest under penalty of perjury that the request for a change in gender to (female, male, or nonbinary) is to conform my legal gender to my gender identity and is not for any fraudulent purpose.” Health & S C §103430(a). See §§1A.8–1A.8A.
In 2018, the California Supreme Court extensively revised and renumbered the California Rules of Professional Conduct. Chapter 2 has been thoroughly revised to explain how the new Rules affect the elder law practitioner.
There was a 2.8 percent cost-of-living adjustment (COLA) for SSI beneficiaries and Social Security beneficiaries for benefit year 2019. In 2019, the standard Medicare Part B monthly premium (without an income-related adjustment) is $135.50. Because there was a 2.8 percent COLA for Social Security benefits in 2019, some Medicare beneficiaries, who were “held harmless” against Part B premium increases in prior years, will see an increase in their 2019 monthly Part B premium. ACWD Letter No. 19–11 (Mar. 28, 2019). See §7.12.
The charts in §§7.44, 7.56, and 7.115 have been updated to reflect 2019 cost-sharing amounts for Medicare Parts A, B, and D, respectively. All other amounts have also been updated throughout the chapter, including those for the Part D low-income subsidy (see §§7.131–7.134) and Medicare savings programs (see §7.167).
It appears that California may not implement the transfer rules of the Omnibus Budget Reconciliation Act of 1993 (OBRA 1993) and the Deficit Reduction Act of 2005 (DRA) until mid-2020 or later. See, e.g., §§9.4, 10.4, 11.3, 11.49, 11.59.
For 2019, the Medi-Cal Minimum Monthly Maintenance Needs Allowance (MMMNA) is $3161. ACWD Letter No. 18–28 (Jan. 14, 2019). See §§9.34, 10.74, 10.83, 11.85, 11.91, 11.107, 11.112, 13.71C–13.71D.
A person with a disability who is under age 65 may now establish his or her own special needs trust without the need to have a relative, guardian, or court establish it. 42 USC §1396p(d)(4)(A). See §9.57.
For 2019, the average private-pay rate (APPR) set by the California Department of Health Care Services (DHCS) for nursing home care is $9337. For 2018, the figure was $8841, and for 2017, it was $8515. ACWD Letter No. 19–07 (Feb. 15, 2019). Calculations that include the APPR have been updated with the 2019 amount. See chaps 10–11.
For 2018, the lifetime exemption amount is $11.4 million. Like the lifetime exemption, the annual gift tax exclusion is adjusted for cost-of-living increases. For 2019, it remains at $15,000. Rev Proc 2018–57, 2018–49 Int Rev Bull 827. See §11.55.
The community spouse resource allowance (CSRA) is $126,420 for 2019. ACWD Letter No. 18–28 (Jan. 14, 2019). See §§9.34, 11.85, 11.107.
The cost of long-term care continues to rise. For example, in 2018, the median annual cost for a semiprivate room in a California skilled nursing facility (SNF) was $100,375 (an increase from $97,367 in 2017); a private room costs $117,804 per year (an increase from $116,435 in 2018). Additional expenses, such as supplies and pharmaceuticals, can add thousands of dollars annually to this base cost. See https://www.genworth.com/aging-and-you/finances/cost-of-care.html. See §13.1.
The Tax Cuts and Jobs Act increased the threshold for the deduction of medical expenses to 10 percent of a taxpayer’s adjusted gross income (AGI) from the previous “floor” of 7.5 percent of AGI for taxable years 2017 and 2018. IRC §213(f). Even if a taxpayer itemizes deductions and has medical expenses exceeding 10 percent of AGI, the Internal Revenue Service limits the amount that can be deducted from income for long-term care insurance (LTCI) on the basis of an individual’s age. The amount is adjusted annually to reflect changes in the cost of living. IRC §213(d)(10). See §§13.31–13.32.
The financial analysis of the fiscal benefits and efficiency of LTCI contained in §§13.17A–13.17F is updated to reflect the current costs of LTCI.
The Department of Housing and Urban Development (HUD) published the Single Family Policy Handbook (HUD Handbook 4000.1), which supersedes previous Mortgagee Letters. However, the handbook’s section on home equity conversion mortgages (HECMs) is reserved for future use and notes that FHA-approved reverse mortgages (HECMs) must continue to comply with all existing handbooks, mortgagee letters, notices, and “outstanding guidance.” HUD Handbook 4000.1 §III(B). The handbook and mortgagee letters are combined in the FHA Single Family Housing Policy Library. See §14.11.
In 2019, the national Federal Housing Administration (FHA) loan limit for a home equity conversion mortgage (HECM) is $726,525 (150 percent of the national conforming limit of $484,350). The loan limit is effective for all HECMs assigned an FHA case number on or after January 1, 2019, through December 31, 2019. See HUD Mortgagee Letter 2018–12 (Dec. 14, 2018). See §§14.11A, 14.12, 14.15.