In Episode 3 of The ROADS Podcast, Kristen and Jill welcome elder law attorney Susie Chalgian of Chalgian & Tripp for an informative conversation on legal planning for aging adults and their families. Susie shares expert guidance on powers of attorney, wills, trusts, Medicaid planning, and how families can protect both assets and peace of mind while navigating long-term care decisions. This episode is packed with practical legal insight for anyone planning ahead or helping care for a loved one.
The Roads Podcast Episode 3: Elder Law, Medicaid Planning, and Protecting Your Family’s Future
Listen to the episode
Episode Highlights
In Episode 3, Kristen and Jill are joined by elder law attorney Susie Chalgian to answer some of the most common legal and financial questions families face as loved ones age.
- Explanation of essential elder law documents, including medical and financial powers of attorney
- Clear breakdown of the differences between wills, trusts, and Lady Bird deeds
- Guidance on how Medicaid estate recovery works and how families can protect assets legally
- Discussion of common misconceptions about Medicare vs. Medicaid coverage
- Insight into how elder law attorneys help families navigate long-term care planning
- Practical advice on planning ahead before a crisis creates unnecessary stress
Key Takeaways
This episode emphasizes that early legal planning gives families more control, better protection, and greater peace of mind as care needs change.
- Powers of attorney are critical documents for adults of any age, not just seniors
- A will does not avoid probate, while trusts can help simplify asset distribution
- Lady Bird deeds can be powerful tools for protecting homes from Medicaid estate recovery
- Medicare covers short-term medical needs, while Medicaid supports long-term care needs
- Medicaid planning is not about “losing everything” — proper legal guidance can preserve important assets
- Working with an experienced elder law attorney helps families avoid costly mistakes and reduce confusion
## Episode Transcript
Prefer to read instead of listen? The full episode transcript is available below.
Okay. Hey, everybody. Welcome to the Rhodes podcast. And it’s episode number three. I think
you’re really going to be excited about this one. We’ve got a great topic today. We’re
going to give out some great information. My name is Kristen Campbell. I’m the strategy
officer here at Ingham County Medical Care Facility on Dobey Road. And I’ve got my awesome
podcast partner Jill with me today. Hi, Jill. Hi, how are you? Good. Introduce yourself and then
our guest for today, please. I am Jill Closer. I am a social worker in a home care and has this
consultant for advisacare. And I we have invited one of my folks. I just love and worked with for
many years at the law office, Susie Chalgian. And we’re going to answer. We’re going to let her
answer a lot of the questions. Yeah. Over the last couple podcasts. And I think you will enjoy her.
Yeah. Welcome, Susie. Hi. Thank you so much for having me. And tell us a little bit about you.
You’re an attorney, obviously, with Chalgian and Tripp. And how long have you been an attorney?
And how long have you been at Chalian and Tripp? So I have been an attorney and a children trip
over 10 years now. So my dad also works there. It’s a family business to some sense. So I’ve
been at Chalgian & Trip since the beginning in some ways. And I’ve been around what is the specialty
of our firm that whole time. So we do elder law. We do special needs planning. We do probate and
estate planning. And then we do litigation within the pro rate realm. So grew up in it, love it to
death and have really enjoyed being an attorney. Awesome. Well, I’m so happy you’re here. I think
you’re going to offer a lot of resources for our listeners today. So we’re going to go ahead and
just get started here. So the first question I have for you is what do you feel like are the top
three or four documents that everybody should have as they get older? So I would say most people come
in first day planning really preparing for what happens when they pass away. And that is important
and especially to certain individuals, something that they care a lot about. For me, I like to
shift the conversation more towards the state planning documents that are focused on what happens
while you’re alive, but maybe in a vulnerable or incapacitated situation. Okay. A lot of people
don’t think about you can become disabled and the belief in that, right? And we, because we
deal on the other end of it, see that all the time. So the minute you become 18, you don’t have
anyone who could step in and make decisions for you. So power of attorneys are that. It’s you
controlling what happens in that instance. If I’m a 20 year old at college and I have a medical
event that lands me in a coma, my parents are probably going to want to make decisions about what
happens to my body, my treatment, my care, as well as any resources that I had in order to pay for
my care. That would take a medical power of attorney, which is the document that says this is
who’s going to take care of me, make decisions about my body, about my care and treatment.
And then a financial power of attorney would be the person who’s able to access resources
that are in that individual’s name and utilize those for the support of the individual.
So this can come up at any age, but obviously it’s important in those big instances of disability
or as we see people getting older, if they’re slowly declining with cognitive ability,
power of attorneys become huge as far as the support. And a lot of times people are fearful of
power of attorneys because they see it as I’m giving this power to someone else. But the reality
is it’s not giving away any power. In fact, you’re controlling something that you otherwise wouldn’t
control. Like I always think of it like, you know, if you don’t do anything, it’s the court and
they have their priority and that might not be who your priority is, but they don’t know what you
would want. So this is your way of telling people, this is what I would want. And not only are you
naming people, but you’re telling them what to do, the document describes, these are the decisions
I hope that you make. And I don’t have to tell you exactly what the outcome will be, which this
is where I should mention Michigan doesn’t do living wills, which is like a if this than that.
What we do is the medical power of attorney. So we say, I want these decisions to be made by my
medical person and that includes maybe end of life. So while I’m not telling them to pull the plug,
I am giving them the option to decide if that’s a quality of life that I’d want. So there’s a lot
in those documents. It’s very personal, very tailored to individuals and a lot of control and
peace of mind can be put into those documents. So to me, most valuable hands down for you, your
adult children, everything. Yeah, great advice, I think, especially as parents transition from
your kid living at home and, you know, all those kind of things to going off to college,
it just should be part of what you do for college prep really is to get that in place because
you’re right. You never know. And that’s you least that’s you don’t expect that, right? So
And isn’t one of the fears Susie with power attorneys for health care is that I’m giving up my
decision, my right to make decisions. And can you talk about when that that actually springs into
Yes. So it is, it absolutely is. And the way I, people don’t understand is you will always make
your own medical decisions as long as you’re a capable. A medical power attorney triggers when
two doctors have stated that you don’t have the capacity to make it. So that could be physical,
right? And in a coma, I can’t participate in the conversation, but it could also be a mental
evaluation that you don’t understand the choices anymore. So someone stepping in.
Yes, the medical is an or that means if I name jealous my power of attorney, I’m the person
making decisions up until those two evaluations happen. And then she’s going to make the decisions
from that point forward because now I’m not able to anymore. So that is a little bit of giving up
control, but only where you would have already lost it. Great. Yep. The financial power of attorney
could be written in two ways. One is that same trigger capacity that evaluation, okay, you don’t
have the capacity anymore to make those decisions. I prefer to write it as an immediate in most
secret instances because an immediate power of attorney is an and I always have the ability
to make my own financial decisions. Until the court intervenes, I have the ability to access my
resources and spend them how I want, which actually gets people in trouble sometimes, right?
And so if I have an immediate financial power of attorney, I can name Jill as my agent. And she
can act right away, but it doesn’t take away my authority. Okay. And if I’m naming someone,
hopefully I trust them. And if I’m declining mentally, having an individual who can come and
kind of participate in management with me is such an easier slope to go down because then it’s
not, hey, Susie, you don’t have it anymore. You can’t do this anymore. It’s just like, hey,
I’m going to do a little bit more for you because it seems like you need help balancing that
checkbook. I think it’s also an opportunity for conversations with your loved ones.
We’re absolutely. Mom, what are your accounts? What are what bills are concerning you? Because I
think the older generation is very private about their finances. Yes. And I know you’ve had this
experience where something happens and people are going through file cabinets and shoe boxes
and trying to figure out what’s going on. Figure out heads from tails and what we actually do have
and what we’re working with. So yeah, I’m amazed at how many spouses are in that situation,
which I get it like a partnership. It works because you take the different shifts and you do your
part. But yeah, there’s a lot of people out there who just don’t know what’s available for that
individually. They want to support it. Yep. Makes sense. Interesting. Well, along that vein,
can you talk a little bit about the difference between a will and a trust? And if you could for
just a brief little bit get into the lady bird deed. I know you get a lot of questions about that.
Yep. So when you do power of attorneys, that’s your I’m alive stuff, right? When you start to look
at, I’ve passed away what documents would I need to distribute things the way I want? That’s wills
and trusts and lady bird deeds. So a state planning, the traditional sense would be what happens to
my stuff when I die. A big misconception about a will is that it avoids probate. A will is actually
a direction to the probate court and it just says, Hey, here’s what I want to happen, right? And
a trust is a document that says, Here’s what I want to happen. And it’s going to be in my own
terms outside of the court. So a lot of times you hear people prefer a trust. It mainly is because
you’re stepping away from the probate court process and kind of creating your own instruction manual.
It’s a more complicated document. It costs more money to do one because it’s very tailored to you,
but it can make it more convenient, a little bit cheaper, all those things. Trusts also are
really valuable if you have a complicated distribution plan that you want. If you’re not just
giving things equally to your children, you’ve got little bits and pieces here. A great example would
be you got a disabled child and you want to pass money as a special needs trust, right? That
would be a reason to say, Hey, this isn’t so simple. We might want to do a trust to make sure
that things are handled appropriately. Every disabled child needs a trust. Right. Just means that
every time you add another factor, you’re looking at that balance between probate court versus trust
a little bit more. Okay. But there are other ways that people pass assets, right? Joint ownership
is a big one. If you’re married, the first one to die most of the time, you don’t need anything
to happen at all because you own everything jointly and they just took or beneficiary designation
that can pass directly through that. Okay. A lady bird deed is a real real property
passes through deeds, right? Yes. And so if you want to name someone to inherit the property
when you die, a lady bird deed is effectively like a beneficiary designation because it says,
I’m going to own it with all of my rights as an owner throughout my lifetime, but immediately
upon my death, it’s going to transfer to this individual of these people. Interesting. So you you
really, you know, hate to come back to attorneys, but when you’re looking at a state planning,
you’re sitting with your attorney, you’re going through your assets, you’re going through what
you want to happen and you’re making a really organized plan. What’s the best way to distribute
these to those people and what documents do I need to do that? probate court isn’t that bad for
a lot of situations. It gets a bad rap, but it can be an organized distribution. It might take
a little longer. It might have a fee associated with it, but it might make sense for your estate.
And then trust you might say, you know, when I value that because I have something different
that I want. And lady bird deeds, I’d say are very, very popular right now because they’re
a beautiful document for Medicaid purposes. Okay. You can get into that in the long-term
care conversation. Okay. But when you talk about lady bird deeds for a state planning,
they’re limited in what they can do for just a state planning. They’re a little more complicated.
And so I’d air towards really questioning that as part of your state plan conversation if you don’t
expect to need Medicaid. Okay. Interesting. Well, let’s go down that road really quickly. If we’re
talking about Medicaid and, you know, here at Dobie Road, obviously, one of the things that
that we specialize in is long-term care. Do people who who really need to go into a nursing
home do they have to worry about losing their home or, you know, if you could talk a little bit
about Medicaid recovery and how that all impacts the care that you might need someday. Right.
So finally, every most people come in and their first concerns are about Medicaid taking something
away. When the reality is it’s like you’re not even on the program yet, slow down. Let’s figure
out if you should use the program or if you’re eligible for the program. But that’s the fear.
Is that if I use long-term care in any sense, somehow Medicaid is going to get in the,
in the door without me asking, insert to take. And that’s just not the case. Right.
A state recovery is completely on the back end. It says you’ve been on the Medicaid program,
you’ve utilized these resources. And we’re talking specifically about long-term care Medicaid,
not all those other Medicaid programs. Yeah. And there’s a difference. There’s a difference
between community Medicaid and nursing home like long-term care Medicaid. Absolutely.
Because there’s so many programs in Medicaid. Yes. People don’t realize how distinct they can be.
Yes. So long-term care Medicaid, basically the state of Michigan just says,
hey, if we paid out for you over your lifetime, we’re not going to ask anything back right now.
But if you pass away, we’re now a creditor of your estate. Because we’ve got this amount of money
that we paid. And if you have money, we’d like to be paid back. Right. So I get it reasonable
from their point of view. Right. And then there’s also the people want to protect the assets
that mom or dad did have. Right. So we also have the reasonable, what can we do to protect those.
When we look at a state recovery, we take an individual who’s already been on the program. So
they’ve already met eligibility. Their actual assets are very limited. You either have a married
person, which they’ve already transferred all their assets to their spouse. So they’re not subject
to state recovery. Or you have a single individual. And let me guess that they probably have
four assets. Right. They have a prepaid funeral contract. It was irrevocable because that’s
what Medicaid requires. They have a joint bank account. Or maybe they just have a single bank
account. A lot of times they’ll be joined with a kid. But if it’s a single bank account in their name,
that bank account shouldn’t have any more than $10,000 in it because Medicaid rules. You’ve got a
maybe a vehicle, one vehicle, because they allow that without counting it. And they have a house,
maybe, because they allow that. So let’s go through those and talk about recovery, right. While
prepaid funeral contract pays to the funeral, pays up your funeral, there’s no value left over to
receive. You’ve got your bank account. If it’s under $10,000, then the state of Michigan allows you
to transfer that to next up with our deprobated state by a small estate affidavit. It’s just a little
form that you complete. Okay. So the joint owner would take, if there’s no joint owner, no
beneficiaries, then you get to the smallest state affidavit and you pass it to the family. Okay.
Or I guess I should say anyone who inherits under the will is under that one. And then you’ve got
your vehicle. Again, if there’s no probated state, the vehicle can pass by a secretary of state
to the next of kin. You just bring in death certificate and you explain that there’s no estate.
It has to be lower than $80,000, but God help me if you’re on a medicaid with $100,000.
That’s right. You’re being right, right. Not a clever. Yeah.
And then the last one’s your house. And that’s why lady bird deeds are so popular, because essentially
what you’re doing is you’re passing it by beneficiary designation to someone. And because you’ve
passed it by beneficiary, it’s not going into a probated state. And the state of Michigan cannot be
a creditor outside of the probated state. So they’re just sitting there with no assets to collect from.
So good planning is going to avoid the state recovery program. And good planning comes with how
you go on to the medicaid program to begin with. So you should have all your eyes dotted tees
cross before you even get to that point. Okay. Great information. Yeah. Go ahead, Jill.
And I think passing out of that house for a lot of our folks is just something that
it’s very important. The very next generation, you know, they worked at GM the whole life
with the family and all that. Yeah. Christmas. That’s where we had parties. And that is very,
I think, very important to a lot of our, our older folks, because that’s, that’s our legacy of what
they’re thinking on. So it’s more sentimental and value than people realize. Yes.
And you lose a family member. You start to say, you know, I’m not upset about the money they want.
I’m upset that they want to take the house. Exactly. Okay. Wow. Great information. Okay. So let’s talk
about the biggest misunderstanding that you think people have about the difference between
Medicare and Medicaid. I mean, they’re so commonly confused. And I don’t know why the names
are so similar. I know. It’s true. I think the biggest misconception is their coverage because
it does blend together so easily. When we look at it from the long-term care context, I always use
the example of, you know, mom breaks a hit. She falls and breaks a hit, right? She goes to the hospital.
She gets her surgery done. She discharges. She goes to a rehab facility. And what happens next is
going to change whether she has coverage or not because Medicare is a short-term program.
She covers what’s going on for you right now to an extent of recovery, right? So in that scenario,
in that example, she has pretty much between Medicare and her supplemental to that. Hopefully,
she’s got a supplemental. She’s probably got full coverage all the way through that rehab.
Now mom’s ability to walk after that rehab is now going to fluctuate. Okay, because Medicare
is going to say, well, that’s as good as you got. Whatever we gave you, you got your rehab,
that’s where you’re at, right? So we don’t need to do any more coverage. This is you now.
If you can walk, you go home, you go back to your normal life, you don’t need any additional
coverage. If you can’t walk, they say, well, that’s a long-term problem. You’re going to have
that problem rest of your life because we tried to rehab you and you didn’t get better. So this is
you now. And that’s a you problem. And so Medicaid is the program that picks up there. And it says,
oh, you have an ongoing need every day for the rest of your life to be able to live your life,
you need support. That’s a Medicaid problem. And so that’s very different than that hospital
state and discharge to rehab. It is now an ongoing need and that coverage is a lot bigger,
but it’s also much more expensive. And the biggest difference between those few programs is that
there’s a financial needs test, right? Because Medicare, you just got both of them you paid for.
Right. Both of them you’re entitled and have a right to use. I think people sometimes
devalue Medicaid. But one of them you have to prove that you’ve used essentially that your
resources are depleted. So you need that program to cover that care. Interesting. Okay, awesome.
Do you, well, you’ve kind of already covered that question. So we’re going to, I’ll skip that one.
So what do you think makes an attorney a certified specialist in elder law?
I think, um, elder law is just one of those things you learn with your hands into it.
So I mentioned I’ve been around it so long. So I feel very comfortable in it.
That being said, estate planners can do documents, but they drafting the document might not understand
all the complexities that come out of the language that they add in there. So you, you want to look
for somebody who practices and and hopefully is appropriately marketing for specifically elder
law because that’s the person who’s got their hands in it, right? Their power of attorney is
going to tell you this is how you’re going to use it once you’re actually incapacitated. They’re
going to be able to carry those things forward. You want someone who’s familiar with the
Medicaid and Medicare programs so that they can advise you. I always say elder law is very much
holistic. It’s not just law. It is at least 50% social work. Yeah. And and hopefully the attorneys
who are doing it love that about it because that’s the rewarding piece. Yeah. And so you want
somebody who’s willing to sit down and kind of look at the whole scape of things because if I fix
one legal issue, there’s so much that then affects that client. I get you a conservatorship, right?
Somebody needs to manage your resources to pay for care. I should probably have the conversation
with you about where are you going for care? How are you going to use these resources? They’re
only going to last a year there. Have you thought about Medicaid and how you could utilize that?
And should we be planning now because Medicaid sometimes takes time to get activated and all of
that. So there’s a lot there. I so I just would look for an attorney who has experience with it.
Yeah. Who can meet all of those objectives and not just give you one word answers. They probably
don’t have enough experience if they can’t. Yeah. And I think even based on what we’ve talked about
just in our short time together today, hopefully people can understand there’s so many
you know, caveats and nuances that affect elder care. Like you’re saying alive and after you
passed away that it’s important to make sure you’ve got someone who specializes just like you
would get someone who would specialize in pediatric, you know, care or like you said, special needs care.
That’s a completely different thing. And I think there’s so many more components to all the law
than there. There is an entity that families really need someone who’s going to listen to them and
they ask someone who understands all the different levels of care and understands how the public
assets and the private assets, how they can blend together, create, fulfill someone’s wishes of how
they do want to live. We used to talk about that all the time of, you know, it’s so many more
components than, you know, how, what every document she does really affects.
Everything. Yeah. And how much peace of mind will you get and have after having all of this stuff
in place, seeing that you got all your, like you said, your eyes dotted and your teeth crossed and
everything’s in place and what nice peace of mind that is to have. So huge. Right. And it’s also,
I mean, I’ve come to really appreciate what the family feels as far as the overwhelm stress
that comes with just being dropped on top of you, you know, whether it’s a disabled child that
you had no preparation for, how do I even navigate this world? Or it’s an aging parent or loved one.
Whoa, you know, I said I’d care for my mom at home. I always knew that I wanted to do that, but
God help me. Like, I don’t know what it means to manage all of her assets, to access the care
she needs, to talk to all these people. You know, they’re taking their time off of work, FMLA.
And so they like, I can’t find enough time in the day to deal with everything I have to. Right.
So the value of a good, elder, law attorney should be that you walk in there and you say
everything that I possibly can is now been, you know, explain to me. If I want to pay them to help
me with it, then I got that off my load. And I now have a partner that’s able to, I mean,
have so many families who are just like, fix the problem right now, but then we stay in contact
for the rest of that person’s life because they just need a resource. And they don’t want to
call 10 people to get 10 different questions answered. They want to call one place. And so good,
elder, law attorney is offering that kind of understanding of what’s happening.
And seeing with a social worker, you know, if you’re an elder, if you’re an elder, law firm has
social workers, I mean, that’s a big green flag. I agree. I agree. Yeah. No, that’s it is such a
combination of navigating long-term care and navigating that road that it takes a team to
really help families out sometimes. Yep. Thousand percent. Okay, let’s see. We’ll kind of make
this our last question for the podcast today. But what do you think is the biggest myth about
Medicaid that you encounter? So I will say, I really, and this is a little bit like I said before,
I really think people are so worried about the Medicaid program being in control and taking.
And it’s this fear that people act on with Medicaid that keeps them from using it. I was just
talking to someone the other day about immigrant communities who are so focused on keeping someone
at home and they’re scared of the system changing that goal. And I would hope that a good elder
law attorney would really be able to add value to that because you’d be surprised what our system
can do to work for you. And you don’t have to take anything you don’t want. So if you don’t like
what the system is offering, you have the ability to say no, but at least explore your options.
Right. There’s so many families suffer alone trying to provide the care because they don’t want to
welcome in, you know, something they think is going to change those choices. So for example,
like Medicaid has community, community programs that pay for care in home and assisted living.
People always think that they’re going to be forced towards one direction now. Certainly
income cap on those community programs doesn’t help. But the, the return would be is, okay,
so if you’re not eligible, now we know. Right. Now we know that Medicaid is only going to be in a
nursing home. So let’s focus on what we can do to keep private resources paying for care as long
as we can at home. Or, you know, just VA benefits is when I talk to people a lot about how that
can supplement being able to stay at home. Different resources people might have, if they have a
more private resources than $10,000 and they don’t understand that there are so many planning
techniques that attorneys can do to create eligibility. And the goal of that planning isn’t just to
like stockpile money. It’s because a lot of times there’s a spouse who needs more than what
Medicaid would normally allow. So planning is able to say, if we have this pool of money,
let’s keep it for the survivor because one person shouldn’t deplete the whole resource.
Yeah. If you have a single person, sometimes we even do gifting planning just because we want
to keep the house going and what the Medicaid program is providing isn’t enough for them to keep
the house able for them to stay home. I mean, there are so many pieces of it that can really benefit
and it’s not about you being selfish, wanting an inheritance. It’s not about you saying, I want
to cheat the system and take advantage of a government program. It’s not about saying, I’m going to
just put my parent into the institution and be systematized. Like it really just is knowing the
information that could potentially support what you were already going to do and make your life
easier and make the loved one have the quality of life they want. And God, how many of you come in
and you don’t like any of the advice, you just walk out of there and you’re saying, no, I know,
I’m not missing anything. But I think normally people pick up a few different things that are
really valuable. Wow. This has been awesome. This has been really great. You’re such a fountain of
information. I know the listeners are just going to love this podcast. And Susie, tell us really
quickly, how can people get in touch with you if they’re interested in coming into meeting with you?
So child and trip has eight offices across the state. Okay. So if you call any one of the numbers
on our website, it will get you to that office. So that’s why if you’re calling from the Euclensing
Area, it’s five, one, seven, three, two, three, eight, zero, zero. But and you can call that and you
can schedule anywhere. But that would be the main way to call and meet with us. Every one of our
attorneys is we all focus on this. So we’re very, very educated in it. The other way is the websites
out there. There’s information on the website. We do have social workers on staffs. You can always
call and use a social worker as well. But yeah, you can reach out or. Okay. And the website has some
really good articles and resources. It’s W-W-W-M-I-L-O-W.com. It’s their website. But there’s some
really good articles down there that if you’re just looking for some real good information,
that’s a great tool for you to start and just start building your tool box of resources as
you navigate long-term care. Yeah. And I’m open to questions, especially, you know, and there’s
other providers out there who ask questions too. I mean, I always feel like it’s easier to share
information than to let you make a mistake and then come in and pay for it. Yeah.
So this has been so great. Thank you so much for your time. We really appreciate it. If you have
any questions, feel free to write in. And we will get back to you. But we hope to have Susie back
again as we continue our journey on the Rhodes podcast and giving you information about resources
that you can use. So thanks again for listening. And we’ll see you next time.