While helping his father qualify for Medicaid Long Term Care benefits (known as “ALTCS” in Arizona), my client asked whether his father’s application might be denied based on the son’s financial situation. My client has family in Puerto Rico, where the filial responsibility law requiring children who can afford it to contribute to the cost of their indigent parents’ care is actively enforced.
In addition to Puerto Rico, 29 states have filial responsibility laws on their books, although at least 10 of those states have never enforced them. 15 more states previously had laws that they repealed once Medicaid was enacted as the safety net for those who cannot afford the cost of long term care.
Elder law attorneys around the country took note when, in Health Care & Ret. Corp. of America v Pittas, 2012 Super 96 (Pa. Super. Ct. 2012), the Pennsylvania Court of Appeals upheld a decision holding John Pittas responsible for the unpaid cost of his mother’s nursing home care. The facts of this case were consistent with the conditions under which filial responsibility laws generally apply:
- The parent is accepting some sort of financial support, such as Medicaid health insurance, from the state
- Even though the parent is indigent, he or she does not qualify for the state’s Medicaid long term care program
- The parent had not abused or abandoned the child as a minor
- The child has the ability to pay, with the burden of proving that he or she cannot pay on the child
While Arizona does not have such a law, it is important that adult children not create the impression that they will subsidize the cost of their parents’ care. A child should not sign care contracts or admission agreements for care facilities as the “responsible party.” Children signing on the parent’s behalf for the sake of convenience should make it clear that they are doing so as the parent’s agent.