Filial Responsibility: Should Your Children Be Required to Pay for Your Care?

Nursing home care is expensive; it’s fair to say it is astronomically expensive. Costs can run $7,000 or more per month, depending on location. Hundreds of thousands of people presently need that kind of care, and the numbers are rising. Ten thousand baby boomers a day turn 65, and it is projected that seven of ten of those people will need long-term care. Understanding how to pay for that care -- particularly without imposing filial responsibility laws -- can make a huge difference in a family’s life and in a person’s legacy. Whether adult children should be required to pay for their parents’ care is one of the options many states wrestle with.

Paying For Long Term Care

Without planning, many people simply pay and pay until they run out of money. Once they do run out of money, the Medicaid program is available to step in and pay. However, it is questionable how long that program can continue in its present state. After all, in 2018, Medicaid spending was at $597.4 billion, according to the Centers for Medicare and Medicaid Services. Policy-makers are looking for other alternatives.

Imposing Filial Responsibility by Law

One option is to require adult children to pay for the cost of their parents’ care. This obligation can be imposed through filial responsibility laws. Around thirty states have enacted these laws, some of which even impose criminal fines and imprisonment if an adult child is able, but fails, to pay. (For example, in Pennsylvania in 2012, a son whose mother owed $93,000 to a nursing home was held liable for her bill under that state’s filial responsibility law.) Neither Texas nor Florida has such a filial responsibility law, but understanding these laws is important for those with loved ones in other states and in case the laws ever change in Texas or Florida.

Arguing in Favor for Filial Responsibility

The rationale for such laws is that parents supported children for many years and the children owe a debt of gratitude: they should return the favor when parents grow old and become unable to provide for themselves. Such laws are supposed to motivate children to exert pressure on parents to ensure that long-term care planning is done before the children are called on to pay.

Objections to Filial Responsibility

There are numerous objections to filial responsibility laws. Children may resent being forced to pay, and treatment of the elderly may suffer as a result. The laws differ widely across the states and produce inconsistent results. Courts may not have the power to enforce these laws against children who live in disparate states. And filial-responsibility laws provide no protection for seniors who have no children.

Alternatives to Complete Filial Responsibility

Whether you are in favor or not of filial responsibility, the problem of paying for elder care is multi-faceted and should be tackled on numerous fronts. And as options meet the limits of Medicaid, the options other than filial-responsibility laws seem better-advised to relieve the Medicaid program from the stresses it faces now and into the future.

Take Advantage of In-Home Care Opportunities

In-home care can bring several benefits. Caring for the elderly at home helps delay the need for institutional care for as long as possible. In-home care is estimated to cost one-third the amount of institutional care. Further, personal care can be more suited to the individual if it is given by family and community caregivers. The emotional benefit to the elderly can be incalculable. But it is not merely an issue of having people stay home for care. Planning needs to happen.

For example, the Affordable Care Act greatly expanded options for states to increase funding for home- and community-based services. Additionally, there are HUD funds available for projects like ECHOs (elder cottage housing opportunity units), often referred to as granny cottages or granny pods – small houses for the elderly on a child’s property, to keep family help close by.

Increase Financial Incentives

Rather than implement a law requiring children to pay for parents’ care and using negative consequences for not doing so, positive incentives could help increase the amount of care children provide. Tax deductions and exemptions, like those already allowed in the Medicaid rules, could provide more incentives for at-home improvements like wheelchair ramps and grab-bars. Easing qualifications for long-term care insurance deductions could be encouraged. Family and medical leave from employment could become more available to relieve the caregiving burden that currently rests disproportionately on women and low-income workers.

Taking Charge of Your Long-Term Plan

In the meantime, by advance estate planning and by astute financial planning, a family can reduce or eliminate the impact of the phenomenal costs on a families’ life savings when it comes to paying for long-term nursing care. Elder law attorneys, including McCreary Law Office, can help clients meet the requirements for Medicaid in the future. But planning should be done earlier rather than later. Please contact McCreary Law Office or call the Jacksonville, FL office at 904-425-9046 or the Houston, TX office at 713-568-8600 to learn more.