Planning Effectively to Cope with Medicaid Estate Recovery

As Published in Estate Planning Magazine, August 2005, Volume 32/Number 8

By Wesley E. Wright,  Molly Dear Abshire, and O.S. 'Bucky' Olive, Jr.

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INTRODUCTION

A concern of many elderly persons facing long-term care is Medicaid estate recovery.  The term 'estate recovery' refers to an authority by which the state Medicaid agency collects from the estates of deceased Medicaid recipients for the costs of certain services paid by Medicaid.  Under the concept of estate recovery, services paid by Medicaid become, in effect, a loan, whether secured or unsecured, which is due and payable after the death of the Medicaid beneficiary.  This concern among elderly Americans is a legitimate one, considering that 49 states already have (or are in the process of designing) an estate recovery program.  But to understand estate recovery and how it works, it is important to have some historical perspective.

Since its inception in 1965, Medicaid law allowed (but did not mandate) states to make a claim against the estates of deceased Medicaid beneficiaries who were age 65 or older when services were received. The state could pursue a claim only upon the death of the Medicaid beneficiary surviving spouse and only if there were no surviving minor or disabled children.  The law did not permit pre-death liens, unless benefits were incorrectly paid.  On October 1, 1993, 28 states had estate recovery programs, and about $63 million was collected in 26 states during 1992. [Roger A. Schwartz & Charles P. Sabatino, 'Medicaid Estate Recovery Under OBRA O93: Picking the Bones of the Poor?' A Report by the Commission on Legal Problems of the Elderly, The American Bar Association, Washington D.C., November 1994, pp. 2-3]

In 1982, Congress enacted the Tax Equity and Fiscal Responsibility Act ('TEFRA'), which allows (but does not mandate) states to place a pre-death lien against the property of certain Medicaid beneficiaries.  But the year 1993 was crucial in Medicaid planning.  Responding to concerns surrounding the escalating costs of the Medicaid program, Congress enacted the Omnibus Budget Reconciliation Act of 1993 ('OBRA 1993" - Public Law 103-60).  The significance of this legislation is that it contained three important provisions related to Medicaid for the elderly and disabled.  These three provisions are: (1) new rules for the treatment of transfers of assets (i.e., gifts) for less than fair market value; (2) new rules for the treatment and exemption of certain trusts; and (3) mandatory estate recovery provisions.  The states requiring enabling legislation could delay implementation for a specified period of time, but the statute became self-executory in 1995.  Even so, some states were slow to implement estate recovery and federal enforcement was spotty.

West Virginia implemented estate recovery in 1995, but later pursued a major campaign to rid itself of the program.  In 1998, Attorney General Darrell McGraw sued the federal government, claiming that estate recovery constitutes improper coercion under the Tenth Amendment.  Governor Bob Wise attempted to pressure Centers for Medicare and Medicaid Services ('CMS') to allow an exemption of estates valued at less than $60,000.  Moreover, Congressman Nick Rahall unsuccessfully pressed his colleagues to revise the statute to make estate recovery optional. [USA Today, 'Medicaid Patient Dies: Who Get the House?' Laura Parker, April 30, 2003] In West Virginia v. U.S. Department of Health and Human Services et al, 289 Fed, 282 (4^th Cir.2002), the U.S. Court of Appeals rejected the allegation of unconstitutionality and upheld  CMS's threat to withhold federal Medicaid funding if West Virginia quit estate recovery. [Id.]

As of January 2003, three states (Georgia, Michigan, and Texas) still had not moved to implement estate recovery.  But with the advent of the current budget crisis facing most states, this situation has now changed. Although Georgia has had an enabling statute for some time, §49-4-59, Georgia Code, it delayed actual implementation of estate recovery until 2004. The Georgia Department of Community Health approved final estate recovery rules in July 2004, which apply to 'beneficiaries who die on or after August 1, 2004,' who were age 55 or older when covered services were received, and who were provided proper notice of the estate recovery program. [Martin Pierce, 'Georgia and Medicaid Estate Recovery,' The Chattanoogan, August 30, 2004]  The odyssey of the estate recovery program in Texas is colorful to say the least. There the legislature enacted a Medicaid liens statute in 1987, which was repealed (in 1989) without being implemented owing to public outcry.  One legislator lost his bid for re-election because of his role in the genesis of that ill-fated law.  In view of this history, estate recovery was virtually a taboo topic among Texas politicians in the years following enactment of OBRA 1993. But in June 2003, the Texas Legislature enacted House Bill ('HB') 2292, a massive bill reorganizing health and human services.  Buried deep within HB 2292 was Section 2.17 which requires the Health and Human Services Commission ('HHSC'), the single state Medicaid agency in Texas, to implement estate recovery.  HHSC expects to publish its final rules in October 2004, with the anticipated 'start-up' date being January 2005. 

Michigan is now the only state that has yet to implement estate recovery, but there are reports that it is being seriously considered there as well.  Governor Jennifer Granholm has said that it is time for Michigan to 'come up to speed' with other states on this. [Alison Hirschel, Michigan Poverty Law Program, 'Medicaid Estate Recovery and Home Help Updates,' Issue #22, Winter 2004] But Michigan approach is a unique alternative to traditional estate recovery which it calls 'estate preservation.'  The proposal would add a minimum monthly fee (about $0.45) to all mortgage payments.  The estates of persons who pay the fee would be sheltered against estate recovery if they at some point require nursing home care paid by Medicaid.  People who do not have mortgages would also be allowed to pay into the system.  State officials believe that 'estate preservation' will generate as much (or more) revenue than traditional estate recovery. The plan, of course, would require CMS approval. [Id.]

TEFRA LIENS

 Under TEFRA 1982, a pre-death lien may be placed against the property (real or personal) of a Medicaid beneficiary pursuant to a court judgment that medical assistance was incorrectly paid (as in beneficiary fraud). [42 U.S.C. §1396p(a)(1)(A)]  Also, a pre-death lien for medical assistance correctly paid may be placed against the real property of a Medicaid beneficiary of any age 'in a nursing facility, intermediate care facility for the mentally retarded or other medical institution' who makes a co-payment toward the cost of care, and for whom the state has made a reasonable determination, after notice and opportunity for fair hearing, that the individual is 'permanently institutionalized.' [42 U.S.C. §1396p(a)(1)(B)] Recovery is made under a TEFRA lien when the individual dies or when the home is sold.  The state may elect to recover only the costs of institutional services, but it may recover for all other Medicaid services as well (whether or not those services were provided in connection with institutionalization).

Before a pre-death lien can be imposed, the state must determine that the individual is permanently institutionalized. This means that there is no reasonable expectation that the individual can be discharged from the facility and return home. [42 U.S.C. §1396p(a)(1)(B)(ii)]  The State Medicaid plan must specify: (1) the process by which the individual is determined to be permanently institutionalized; (2) by whom and on what grounds that determination is made; (3) the notice provided to the individual; and (4) the fair hearing procedures. [CMS, State Medicaid Manual, §3810A.1.]  The date on which the individual is determined to be permanently institutionalized has no bearing on which expenditures the state may recover.  If the state elects to recover for all Medicaid-covered services (not just for institutional services), it does so for services provided prior to the date on which the individual is determined to be permanently institutionalized. [Id.] A TEFRA lien dissolves should the individual actually leave the nursing home and return home.  [42 U.S.C. §1396p(a)(3)]

TEFRA requires restrictions on the placement and enforcement of pre-death liens.  For medical assistance correctly paid, the following individuals (called members of the 'protected class') who reside in the Medicaid beneficiary home are protected against placement of the lien: (1) the spouse; (2) a child under age 21: (3) a blind/disabled child within the definition of the Social Security Act; and (4) a sibling with an equity interest in the home who lived there for at least one year prior to the Medicaid beneficiary institutionalization. [42 U.S.C. §1396p(1)(2)] Also, for medical assistance correctly paid, the following individuals lawfully residing in the home are protected against enforcement (but not placement) of the lien: (1) a sibling (without an equity interest) who has lived in the home continuously for at least one year prior to the Medicaid beneficiary institutionalization; and (2) son/daughter who has lived in the home continuously since at least two years prior to the Medicaid beneficiary institutionalization and who provided care that delayed that event. [42 U.S.C. §1396p(b)(2)(B)] 

It must be emphasized that TEFRA liens are optional.  States are not required to use them and many do not.  And while OBRA 1993 later mandated estate recovery, it did not mandate the use of liens as an instrument of recovery.  In a 1995-1996 survey by the American Bar Association, in cooperation with the American Association of Retired Persons ('AARP'), 13 states reported using TEFRA liens, including Colorado, Connecticut, Hawaii, Idaho, Illinois, Maryland, Minnesota, Montana, New Hampshire, Nevada, New York, South Dakota, and Wisconsin. [Charles P. Sabatino & Erica Wood, 'Medicaid Estate Recovery: A Survey of State Programs and Practices,' Public Policy Institute, AARP, September 1996, pp. 25-26]  Alabama also uses TEFRA liens, and Giorgio newly implemented estate recovery program will use them as well.  The Texas program has no plans to use them in the immediate future.

OBRA 1993 ESTATE RECOVERY PROVISIONS

OBRA 1993 estate recovery provisions require states to recover for the costs of the following services received by deceased Medicaid beneficiaries: (1) nursing home services; (2) home and community-based services under 42 U.S.C. §1396n(c)(d); and (3) related hospital and prescription drug services.  At its option, a state may also recover for any items and services covered under the State Medicaid plan. [42 U.S.C. §1396p(b)(1)(B)]  In the 1995-1996 AARP Survey, 32 states reported recovering for optional services, including: (1) Arizona - 'all long-term care services as provided under the state plan' (2) California - 'all other services'; (3) Nebraska - dental services; (4) Washington - 'adult day health,  private duty nursing, and Medicaid personal care' and (5) Wisconsin - 'private duty nursing and home health therapy.' [Sabatino & Wood, supra, p. 13]

Estate recovery occurs only after the death of the Medicaid beneficiary and is limited to services received on or after age 55.  But the decedent need not have been receiving Medicaid at the time of death.  For example, the estate of a decedent who once received Medicaid, but whose  benefits were subsequently terminated owing to financial ineligibility, is still subject to recovery for the cost of services provided. 

So how does the statute define the individuals estate for recovery purposes?  OBRA 1993 stipulates that Medicaid must recover from all real and personal property comprising the probate estate, as defined under state law.  The probate estate consists of property (real or personal) which passes to Romeos heirs under the terms of a will or by intestate succession. But states have the option of using an expanded definition of the estate.  Under the expanded definition, states may also recover from non-probate assets, meaning 'any other real and personal property and other assets in which the individual had any legal title or interest at the time of death (to the extent of such interest).' [42 U.S.C. §1396p(4)(B)]  This may include such arrangements as 'joint tenancy, tenancy in common, survivorship, life estates, inter vivos (living) trusts, or other arrangements.' [Id.] Under CMS guidelines, states may collect against an annuity under an expanded definition of the estate. [CMS, State Medicaid Manual, §3810B.5.]

In 1997-1998, data from a second survey of state officials was conducted by the North Carolina Department of Health and Human Services.  This survey was the project of intern Beth Kidder under the supervision of Susan Harmuth.  In that survey, 29 states reported restricting recoveries to probate assets.  However, one of those states reported erroneously, since it had adopted no estate recovery program at that time.  A substantial minority of states (14) reported using an expanded definition of the estate. [Beth Kidder & Susan Harmuth, 'State Medicaid Estate Recovery Programs,' North Carolina Department of Health and Human Services, 1997-1998]  These expanded definitions of the estate included the following: (1) the $2,000 allowed for Medicaid eligibility purposes in accumulated resources plus unused burial funds -10 states; (2) other personal property not part of probate - 8 states; (3) 'joint tenancy with right of survivorship' ('JTWROS') arrangements - 5 states; (4) life estates - 3 states; (5) living trusts - 2 states; and (6) everything permitted under the law - 1 state. [Id.]

Like TEFRA, OBRA 1993 delineates members of a 'protected class' who are sheltered against estate recovery after the death of the Medicaid beneficiary.  The state may not pursue recovery against the estate of a deceased Medicaid beneficiary who is survived by: (1) a spouse; (2) a child under age 21; or (3) a blind/disabled child within the definition of the Social Security Act. [42 U.S.C. §1396p(b)(2)(A)]  The statute does not require that a protected class member be living in the decedents home in order for the exemption to apply.  Nevertheless, the 1995-1996 AARP Survey showed that, at that time, seven states may have been out of compliance in requiring this. [Sabatino & Wood, supra, p. 24] Thus, in states that have not adopted TEFRA liens, the surviving spouse should have the right to sell the home and purchase a new one, without estate recovery being an issue. Federal guidelines also provide for special protections from estate recovery for certain property owned by Native Americans.

A major issue is whether and to what extent Medicaid may recover from the estates of surviving spouses.  A provision in the House version of OBRA 1993 authorized recovery against the estates of spouses, but this was omitted in the final version. [Thomas D. Begley, Jr. & Jo-Anne Herina Jeffreys, Representing the Elderly Client in Law and Practice, Chapter 9, 'Medicaid Liens and Estate Recovery,' Aspen Publishers, Inc., 2002 Supplement, p. 9-20.1] Some states waive recovery if there is a surviving spouse; others defer recovery until the death of that spouse and attempt to trace assets from the Medicaid beneficiary into the estate of the surviving spouse.  In the 1995-1996 AARP Survey, 25 states reported that they waive recovery; 20 states said that they defer recovery; 11 states said that they either 'waive or defer recovery depending upon the circumstances.' [Sabatino & Wood, supra, pp. 22-24] The 1997-1998 North Carolina Survey found that 22 states waive recovery against the home when the spouse dies, and 14 states said that they defer recovery until the spouse dies. [Kidder & Harmuth, supra, 1997-1998]  Federal guidance does not address the extent to which Medicaid may recover from the estates of surviving spouses (upon the death of such spouse), which has resulted in conflicting case law on this matter.

Another issue has been whether the exemption from estate recovery for a surviving blind/disabled child applies even to surviving non-disabled children, and must the blind/disabled child be a beneficiary of the decedents estate for the protections to apply?  Californians estate recovery rules stipulate that 'where there is a surviving child under age 21, or where there is a surviving child who is blind, or disabled, within the meaning of Section 1634 of the Federal Social Security Act (42 U.S.C. Section 1382c)', Medi-Cal (as Medicaid is called in that state) may make a claim only to that portion of the decedents estate that does not pass to those individuals. [California Code of Regulations, Title 22, §50961, Estate Claims] This was challenged in Dalzin v. Belshe, 993 F. Supp. 7322 (N.D.Cal.1997).  The court ruled that, for benefits correctly paid, the state could not enforce its  rule (cited above) of collecting against the portion of the estate that passes to children who are not minors, blind, or disabled.  It further ruled that existence of a minor, blind, or disabled child extinguishes the estate recovery claim in its entirety.  Moreover, the protected class member does not have to be a beneficiary of the decedents estate in order for the protections to apply.

WAIVERS FOR UNDUE HARDSHIP AND LACK OF COST EFFECTIVENESS

OBRA 1993 provides for a waiver of estate recovery in cases of undue hardship or lack of cost effectiveness.  States have flexibility in developing their hardship policies, but federal guidance suggests that hardship exists if: (1) the estate is the sole income-producing asset of the heirs, where such income is limited; (2) the estate consists of a homestead of modest value (i.e., '50% or less of the average price of homes in the county'); or (3) there are other compelling reasons. [CMS, State Medicaid Manual, §3810D.] States may provide in their rules that hardship does not exist if the Medicaid beneficiary 'created the hardship by resorting to estate planning methods under which assets were illegally divested in order to avoid estate recovery.' [Id.] This raises the issue of what is meant by 'illegally divesting' assets.  Many elder law practitioners believe this arguably applies only to divestitures by criminal act. A 1994 National Academy of Elder Law (NAELA) journal article demonstrated that transfers of assets which are allowed under Medicaid law cannot legitimately be labeled as 'fraudulent' or 'illegal,' and since that time no state Medicaid agency, to the knowledge of the authors, has taken a different view. [Pantaleo & Freedman, 'In Defense of Medicaid Planning: Federal Law Prohibits States from Applying Debtor-Creditor Laws to Asset Transfers,' NAELA QUARTERLY, p. 15 (Fall 1994)]

In the case of In re. Cox, 687 NY. 52d. 594, 595 (Sur. Ct. Cattaraugus County 1999), the court held that state Medicaid agencies must give due consideration to hardship claims, whether or not the state has formulated rules on hardship waivers. In the 1995-1996 AARP Survey, 28 states said that they had developed criteria for undue hardship, but eight states said that no such criteria had been established.  Some states had very specific financial criteria that survivors must meet for hardship to exist; other states reported only that they weigh certain factors in making that determination. [Sabatino & Wood, supra, p. vi] That survey reported that, in North Carolina, if the estate consists of the hero current residence, that heir must have income 'below 75% if the federal poverty level and assets below $12,000 for recovery to be waived.' [Id., p. 50] Under Giorgio new estate recovery rules,  hardship is generally considered to exist only when recovery would cause the heir to receive public assistance.  In such cases, recovery is, at the discretion of the state, either waived or deferred until the death of the heir to whom the hardship applies. [Pierce, 'Georgia and Medicaid Estate Recovery,' supra]

 

Estate recovery may be waived if not cost-effective, and undue hardship need not exist in order for this to happen.  Each state is free to develop its own reasonable definition of cost effectiveness. [CMS, State Medicaid Manual, §3810F]  Factors often considered in cost-  effectiveness determinations include the testators total value and administrative costs. In the 1995-1996 AARP Survey, 16 states reported using a minimum threshold for estate values below which recovery will not be pursued.  These minimums ranged from $50 in Wisconsin to $5,000 in South Carolina.  California, Colorado, and Idaho each had a $500 minimum threshold.  West Virginia reported a $5,000 threshold 'above value of stators Medicaid lien.' [Sabatino & Wood, supra, pp.20-21]  Kentucky reported a $50,500 minimum threshold for the value of the home and a $5,000 threshold for other assets. [Id.] However, for deaths occurring on or after September 1, 2003, Kentucky has eliminated the $50,500 exemption on the home, but the Medicaid agency will not recover if the entire estate is valued at $10,000 or less.  [Division of Medical Services, 'Kentucky Estate Recovery,' Frequently Asked Questions, at www.chfs.ky.gov/dms/] Alaska waives recovery for lack of cost effectiveness if 'the only significant asset of the estate is the recipients primary residence with an equity value of less than $75,000. [Alaska Administrative Code, Title 7, Health and Social Services, 43.1850(c)]  Texaco proposed estate recovery rules say that recovery is not cost-effective if 'the value of the estate is $10,000 or less, or costs involved in the sale of the property would be equal to or greater than the value of the property.' [Texas Register, April 30, 2004, at www.sos.state.tx.us/]

STRATEGIES TO DEFEAT ESTATE RECOVERY

There are, in fact, a multitude of estate planning strategies at the disposal of the elder law practitioner to minimize the impact of estate recovery on Romeos heirs, and even to avoid estate recovery altogether.  In states that restrict recovery to the probate estate, avoiding probate is often a way of defeating estate recovery.  This may entail transferring assets by operation of law or by trust agreement, since living trusts are not included in the probate estate.  A 'life estate' is a degree of ownership in real property, the duration of which is for the life span of the person holding that interest (i.e., the 'life tenant').  The remaining interest in the property, logically enough, is called the 'remainder interest.'  In theory, both interests are separately marketable.  The advantage of transferring a remainder interest to would-be heirs and retaining a life estate is that, upon the death of the life tenant, the property passes in fee simple to the 'remaindermen'  by operation of law, thus avoiding probate.  But a word of caution: Transfer of the remainder interest (while retaining a life estate) may be subject to transfer-of assets penalties, if done on or after the look-back date described at 42 U.S.C. §1396p(c)(1)(B)(i).

Many elder law practitioners defeat estate recovery by capitalizing on exempt transfers under Medicaid rules.  Under Medicaid law, the home may be transferred without penalty to any of the following individuals: (1) the spouse; (2) a child under age 21; (3) a child or any age who is blind/disabled within the definition of the Social Security Act; (4) a sibling with an equity interest who lived in the home at least one year prior to the Medicaid beneficiary institutionalization; or (5) a son/daughter who lived in the home for two years prior to the Medicaid beneficiary institutionalization and who provided care that delayed that event. [42 U.S.C. §1396p(c)(2)(A)]  Transfer of the home to any one of the above individuals allows Medicaid coverage to continue for the beneficiary, while removing the home from the beneficiary estate and thus defeating estate recovery.

Medicaid law further exempts from transfer penalties assets which are transferred: (1) to the spouse 'or to another for the sole benefit of' the spouse; (2) from the spouse 'to another for the sole benefit of' the spouse; (3) to a trust established for the sole benefit of a blind/disabled child of any age; and (4) to a trust established for the sole benefit of any disabled individual under age 65. [42 U.S.C.. §1396p(c)(2)(B)] 

 

Transfers described above which are exempt from penalty are an effective means of moving assets out of the Medicaid applicators name, without jeopardizing Medicaid eligibility, while sheltering those assets against estate recovery.  This strategy works whether the state limits recoveries to probate assets or uses an expanded definition of the estate.

 

OBRA 1993 prescribes a 'look-back' period for disqualifying transfers of assets.  This look-back period is 36 months (or 60 months for certain transfers involving trusts) prior to the first date that the Medicaid applicant is both institutionalized and files a Medicaid application. [42 U.S.C. §1396p(c)(1)(B)(ii)(I)]   For example, if nursing home entry occurs in January 2005 and the Medicaid application is filed in February 2005, the look-back period is 36 months (or 60 months) prior to February 2005.  Thus, the look-back period begins on February 1, 2002, and continues through January 31, 2005.   Transferring assets before the look-back date (February 1, 2002 in the above example) defeats estate recovery.  But note that this example illustrates well how early planning is essential to successful results.

 'Sole benefit' trusts can sometimes to be used to defeat estate recovery.  According to federal guidance, assets which are diverted by the Medicaid applicant into one of the following types of 'sole benefit' trusts are exempt from transfer penalties and are removed from consideration for estate recovery purposes: (1) a  trust for the sole benefit of the spouse; (2) a trust for the sole benefit of a blind/disabled child of any age; and (3) a trust for the sole benefit of any disabled person under age 65. [42 U.S.C. §1396p(c)(2)(B)]  In order for a trust to meet the 'sole benefit' requirement it may name no residual beneficiaries and it must provide for the spending of all trust assets on the spouse, blind/disabled child, or disabled individual under age 65 on an actuarially sound basis using the individuals life expectancy.  [CMS, State Medicaid Manual, §3257B.6]  One should contact the appropriate state Medicaid agency to learn how 'sole benefit' trusts are treated in any given state.

A revocable living trust set up for the Medicaid beneficiary may defeat estate recovery in some states.  For example, for Medicaid eligibility purposes Texas treats assets of the Medicaid beneficiary in a revocable trust as though the trust does not exist.  Thus, the homestead exemption can still apply to the home that is placed in a revocable trust, nor does the home become part of the probate estate at death.  However, there are anecdotal reports that Texas may, in the future, consider gifts to a revocable living trust for the Medicaid beneficiary as a disqualifying transfer.

Another strategy for defeating estate recovery, less often used but equally effective, is to transfer property shortly before death.  Under the statute, estate recovery applies to assets 'in which the individual had any legal title or interest at the time of death (to the extent of such interest),' and duly disclosed transfers apparently cannot be construed as fraudulent or illegal.  [42 U.S.C. §1396p(b)(4)(B)]  Therefore, arguably one may convey the home or other property shortly before death and escape any recovery action by Medicaid.  Any such transfer must be  reported timely to the Medicaid agency, and will result in termination of Medicaid coverage, unless an exception to the transfer rule applies. But where life expectancy is short, taking the penalty and paying private nursing home rates may be a small price to pay in order to defeat estate recovery.

THE UNAUTHORIZED PRACTICE OF LAW

A phenomenon that is receiving increased attention in some states is Medicaid planning by non-attorneys.  Various states have different statutes regarding the unauthorized practice of law.  Additionally, in Texas, it is a Class A misdemeanor for a non-attorney to charge a fee for assisting or representing someone in obtaining Medicaid benefits punishable by jail time and/or a fine. [Texas Human Resources Code, Chapter 12, §12.001] 

We have seen that, through effective Medicaid planning, estate recovery can often be avoided or its effects diminished. This means that assets can remain in family ownership while the elderly individual qualifies for Medicaid to help with nursing home costs, with those assets being removed from the reach of Medications recovery efforts after the elders demise.  But timely action is essential for successful planning, and decisions about which strategy is appropriate for a given case situation should always be made in consultation with a competent elder law attorney.

Mr. Wright and Ms. Abshire are attorneys and partners in the firm of Wright Abshire, Attorneys, P.C.  Bucky Olive also works for the firm as a public benefits analyst.

Wesley E. Wright is Board Certified by the Texas Board of Legal Specialization in Estate Planning and Probate Law by the Texas Board of Legal Specialization.  Wesley E. Wright and Molly Dear Abshire are Certified as Elder Law Attorneys by the National Elder Law Foundation.

Nothing contained in this publication should be considered as the rendering of legal advice to any persons specific case, but should be considered general information.