2015 Annual Convention
How to Market, Run, and Maintain an
Elder and Special Needs Law Practice
Elder and Special Needs Law Committee
1.5 General CLE Hours
Speaker Biographies
Dennison Keller
Attorney at Law Cincinnati, Ohio
Mr. Keller received his undergraduate degree from Miami University in Oxford, Ohio, and he received his JD from Northern Kentucky Salmon P. Chase College of Law. His professional memberships include the Cincinnati Bar Association (Elder Law Committee), Ohio State Bar Association, National Academy of Elder Law Attorneys, Ohio Forum of Estate Planning Attorneys (Medicaid Committee), and WealthCounsel. Mr. Keller is a partner of his firm and practices in the areas of elder law, Medicaid planning, veterans benefits, and estate planning. He was awarded with the Outstanding Project in the Field of Aging Award by the Association for Professionals in Aging for successful efforts in leading other elder law attorneys across Ohio to prevent the State Legislature from eliminating the use of pooled trusts for elderly Medicaid applicants. Mr. Keller’s article, Older, Wiser and More Dispensable: ADEA Options Available Under Smith v. Jackson: Desperate Times Call for Disparate Impact was published by the Northern Kentucky Law Review in 2008. He is a frequent lecturer on the topics of elder law, Medicaid planning, veterans benefits, and estate planning at long-term care facilities and hospitals across the tri-state area. For additional information, please visit www.elderlawcincinnati.com/OurAttorneys.htm.
Brittany D. O’Diam
O’Diam & Stecker Law Group Dayton, Ohio
Ms. O’Diam received her BS in Journalism from Ohio University and her JD from The University of Akron School of Law. Her professional memberships include the Ohio State Bar Association, Florida Bar Association, Dayton, Bar Association, Greene County Bar Association, WealthCounsel, ElderCounsel, and the National Academy of Elder Law Attorneys – Ohio Chapter (Secretary). Ms. O’Diam is a partner of her firm and practices in the areas of estate planning and administration, Medicaid, nursing home planning, asset protection, and elder law. She recently wrote a paper on Medicaid Estate Recovery that was published in The National Academy of Elder Law Attorneys Student Journal (Vol. 5). Ms. O’Diam serves as volunteer legal counsel for the Greene County Community Foundation. She also serves The Disability Foundation (Chair) and is on the Greene County Business Advisory Council. For additional information, please visit www.oslawgroup.com.
Janet E. Pecquet
Beckman Weil Shepardson LLC Cincinnati, Ohio
Ms. Pecquet received her BA from California State University, Long Beach and her JD from Southwestern University School of Law. Her professional memberships include the National Academy of Elder Law Attorneys and the Ohio State Bar Association (Chair, Elder and Special Needs Law Committee). Ms. Pecquet is a partner of her firm and practices in the area of elder law – primarily planning for Medicaid eligibility for individuals who are institutionalized in a nursing facility or assisted living facility or living at home and seeking home – and community-based care. This includes developing Medicaid eligibility plans, filing applications, meeting with the Medicaid Department and appealing decisions, if necessary, and developing a plan for the family. Ms. Pecquet has represented hundreds of consumers before the Medicaid Agency. She also advises individuals and parents of children with special needs on estate planning and special needs trusts. Long-term care insurance and private disability insurance denials are also a focus of her practice. Ms. Pecquet is a frequent speaker on elder law matters and participates in various community organizations involved in providing services to consumers who are aged and have special needs. For additional information, please visit www.beckman-weil.com.
How to Market, Run, and Maintain an Elder Law Practice • i
Chapter 1:
How to Market, Run, and
Maintain an Elder Law Practice
Brittany D. O’Diam
O’Diam & Stecker Law Group, Inc. Dayton, Ohio
Table of Contents
I. Getting Started ... 1
A. Practice structure. ... 1
B. Education. ... 2
1. Most beneficial ohio cle programs (not just for starting out . . . these are great to attend annually to stay sharp, too). ... 2
2. Helpful national resources. ... 2
C. Mentoring/professional networking. ... 2
II. Marketing ... 2
A. Resources. ... 2
B. Education-based model. ... 3
1. Educational materials. ... 3
2. Educational seminars. ... 3
III. Running Your Practice ... 4
How to Market, Run, and Maintain an Elder Law Practice • 1.1
Chapter 1:
How to Market, Run, and
Maintain an Elder Law Practice
Brittany D. O’Diam
O’Diam & Stecker Law Group, Inc. Dayton, Ohio
I. Getting Started
I decided early on in law school that I wanted to pursue a career in elder law. I’ve always had an affinity for senior citizens and as I learned more about the unique issues that impact this
demographic, I knew that I wanted to help. I already had a job at an estate planning firm, but they did not handle any elder law issues at the time. It seemed to me that an estate plan wasn’t truly complete without addressing elder law issues, because long term care can easily derail the entire plan. My firm enthusiastically welcomed the idea of adding elder law as a practice area. But it was up to me (fresh out of law school) to learn it, develop it and make it happen. So, I did. I wrote a paper on Ohio Medicaid Estate Recovery in my third year of law school, which was published in the NAELA Student Journal, and that was an excellent way to learn the black letter rules of Medicaid. One month after I took the Ohio Bar, I joined MPS (now called Lawyers With Purpose) and attended their “boot camp” program to learn the actual planning process and techniques. From there, I hit the ground running (before I was even sworn in as an attorney) – developing contacts, refining office systems and spreading the word throughout the Dayton community. Within one year of practice, elder law cases accounted for the majority of my workload . . . and it has completely taken off from there.
A. Practice structure.
What type of firm is a good fit for this practice area?
1. In the elder law arena, there is a lot of law to keep up with and it’s a quickly changing landscape, so be prepared to devote a large amount of time to staying on top of the changes. Trying to stay sharp in elder law and dozens of other practice areas will likely spread you too thin, so elder law may not fit well into a broad general practice (for a solo practitioner). It is a logical fit into an estate planning practice, since elder law issues greatly impact estate planning options.
1.2 • How to Market, Run, and Maintain an Elder Law Practice
B. Education.
How to become proficient in the applicable law and processes (i.e., Medicaid eligibility, application/appeals, pre-planning versus crisis planning techniques, etc.)
1. Most beneficial ohio cle programs (not just for starting out . . . these are great to attend annually to stay sharp, too).
a. Taps’ Medicaid Manual Seminar. b. OSBA Elder Law Institute.
2. Helpful national resources.
a. ElderCounsel.
Our firm is a member and we have also been in WealthCounsel since it started. These groups have wonderful educational programs, excellent drafting software, practice management tools and other very helpful resources.
b. Lawyers with Purpose (formerly MPS).
This is where I started, before I left to join ElderCounsel. It was helpful to use as a spring board.
c. National Academy of Elder Law Attorneys – excellent educational programs
C. Mentoring/professional networking.
1. You can know the black letter law forwards and backwards, but that’s a small portion of being a good elder law attorney (since, in practice, the agencies change their interpretation of the rules regularly. It is extremely helpful to develop close relationships with seasoned
attorneys who can walk you through the “practical” side of elder law, so you can benefit from their experience
2. The elder law community is very close-knit and collegial, so there are many opportunities to develop relationships with other practitioners who can help you brainstorm strategies to navigate difficult client scenarios. Elder law attorneys are motivated to help each other achieve positive results, in order to set the right precedent statewide and protect planning
opportunities for our future clients.
a. NAELA Ohio Chapter (the annual “UnProgram” every August is a great way to learn from the pros!).
b. OSBA Elder Law and Special Needs Committee.
II. Marketing
A. Resources.
ElderCounsel/Lawyers with Purpose – all of these groups have sample materials and marketing strategies to give you ideas. To be honest, I haven’t looked at them a whole lot so I cannot necessarily say how good they are, but for someone who is at a loss for ideas, I’m sure it would be a good place to start.
How to Market, Run, and Maintain an Elder Law Practice • 1.3
B. Education-based model.
The cornerstone of our marketing efforts is education. No one is going to go forward with something if they don’t feel comfortable with it, and the best way to help them feel comfortable is to make sure they actually understand it.
1. Educational materials.
We have in-house materials that we have written to help explain the process/issues to clients. a. “Medicaid Made Simple.”
This is a short booklet with just the most basic information about Medicaid (mainly what not to do) that I developed to hand out to local senior centers. Now, many financial advisors, insurance advisors, home care companies and other referral sources keep a regular stock of these booklets to give to their clients (so they can avoid trying to explain Medicaid on their own).
b. Overview of our planning process.
I believe that setting expectations up front is crucial, because clients will feel more
comfortable moving forward and I won’t have to continually steer them back to my process. Before the first meeting, I send them an overview of how elder law works in our office (Medicaid planning and application, asset protection planning, guardianships and basic estate planning). It gives the basics of how the legal process itself works, but also how we structure the meetings, fees, timing, etc.
c. Key:
Write it in a way that they can actually understand it. This is a very complex, confusing area of the law, but the clients need to receive the information in a manner that makes sense (or they’ll just bury their heads deeper in the sand). We have a rule that none of our
educational materials can be written above a Ninth grade reading level. 2. Educational seminars.
a. Public Seminars.
I really don’t do many public seminars on my own, because I have a steady stream of advisors, senior care communities, support groups, etc. that ask me to speak at their seminars on a regular basis. I develop all of my programs and power points in-house and tailor them as needed.
i. Topics include Medicaid eligibility rules, Medicaid planning opportunities
(pre-planning vs. crisis (pre-planning), estate (pre-planning and how/when it relates to elder (pre-planning, guardianships, etc.
ii. For opportunities, introduce yourself to senior centers, your local Alzheimer’s Association, senior care communities, Councils on Aging, other advisors, etc. b. CE Seminars for Advisors.
These have been very successful for us. We try to put on a few of our own every year (free to the advisors), but there are several groups that also ask us to come speak to their employees, members, etc. for CE credit.
1.4 • How to Market, Run, and Maintain an Elder Law Practice
i. Social workers and nurses – this has been huge, both for referrals and just for making sure that social workers are up to date with the latest information. They are on the front lines dealing with families facing these issues and they are often uninformed,
misinformed or at a loss for where to send people for help.
ii. Financial planners, insurance advisors, CPAs, other attorneys (*other attorneys are a great referral source!)
III. Running Your Practice
A. Developing (and sticking to!) efficient systems and processes is absolutely key. There is a lot of detailed information required for these plans, so making sure it doesn’t fall through the cracks is imperative.
1. ElderCounsel has good resources for structuring this
2. We refined the processes we had in place for Estate Planning to work for Elder Planning as well, since the two areas overlap constantly (and often the client doesn’t really know which one they need).
B. Our process:
1. We mail an initial packet to prospective client when they call in, before first meeting. It contains overview of our process, Medicaid Made Simple and a Profile for them to fill out about their family, financial info, etc. (and we have them send the Profile back to us at least 3 days before first appointment).
2. First appointment (1 hr; $125 fee) – we review the Profile with theclient, explain how Medicaid eligibility process works using their numbers (as provided in the Profile), broadly explain planning opportunities and issues. At the end of this appointment, they decide whether they want our help (or defer decision until they can discuss it with their family).
a. We charge for the meeting because we give a lot of info at this meeting, and the client tends to take it more seriously if they are paying for it.
b. All of our planning is done on a flat fee basis, paid up front (kept in IOLTA until earned; our fee agreement states when the fee is earned).
3. From there, if they hire us for Medicaid planning we walk them through info gathering, we do the look back, we develop a spend down plan, we help them execute the spend down plan, we file the application, we attend the interviews with the caseworker, we handle the follow up, etc.
If they hire us for pre-planning/asset protection, we do a design meeting, signing meeting, and then help get everything appropriately funded.
C. Consistency is key – don’t reinvent the wheel for each client. If a client doesn’t like your system, they probably shouldn’t be your client.
IV. Maintaining
A. Stay in contact with referral sources – don’t let it drop off just because you get busy.
Establish yourself as a resource for referral sources (so they can call to bounce questions off of you, even if the client isn’t coming your way).
How to Market, Run, and Maintain an Elder Law Practice • 1.5
B. Surround yourself with quality support staff!
1. Good paralegals and assistants are worth their weight in gold because there is a lot of information to gather & organize, lots of follow up with clients, etc.
2. If you try to do it all on your own, you will not have the capacity to handle nearly as much as you could with the right help.
C. Stay on top of the ever-changing rules – you can’t learn it once and think you know it, because if you wait 5 minutes it will change.
D. Keep the right mindset – it’s not all about protecting an inheritance for the next generation, it’s about maximizing the benefit that the client gets from their hard-earned life savings (to enhance their quality of life as much as possible). We aren’t there to cheat the system, we’re there to protect the client. Those who actively try to “cheat” tend to create bad precedent for the rest of us (so you end up cheating all of our future clients).
Life Care Planning • i
Chapter 2:
Life Care Planning
Dennison Keller Attorney at Law Cincinnati, Ohio
Table of Contents
Life Care Planning • 2.1
Life Care Planning – PowerPoint Presentation
How to Market, Run, and Maintain an Elder and Special Needs Law Practice • i
Chapter 3:
How to Market, Run, and
Maintain an Elder and Special
Needs Law Practice
Janet E. Pecquet
Beckman Weil Shepardson LLC Cincinnati, Ohio
Table of Contents
Getting Started ... 1
Know Your Market ... 1
Develop a Business Plan ... 2
Involve Yourself in Your Bar Association ... 3
Become the Expert ... 3
Your Local Legal Services Organization ... 3
Our Motto ... 3
Other Marketing Activities ... 3
How to Market, Run, and Maintain an Elder and Special Needs Law Practice • 3.1
Chapter 3:
How to Market, Run, and
Maintain an Elder and Special
Needs Law Practice
Janet E. Pecquet
Beckman Weil Shepardson LLC Cincinnati, Ohio
Getting Started
Decide what you want to do. Do you want to focus exclusively on elder/SN law, or do you want to add other areas of law as well, such as estate planning and probate administration,
guardianships, litigation surrounding these areas? Who else do you know who practices in this area? Try to talk with them. Join your local bar association – maybe there is even a committee on elder law. This is a great place to meet other elder law attorneys. Participate in the OSBA Elder and Special Needs Law Committee, another great place to meet other elder law attorneys. Join the National Academy of Elder Law Attorneys, and the Ohio Chapter. These organizations are great resources.
Do you want to work in a firm, and if so, what size – large, medium, small? Do you have a firm in mind? Talk to other lawyers and find out about the firms in your areas. Maybe the firm you are interested in does not know what elder law is, and you could bring them a lucrative area of practice.
How much do you need/want to earn? What do you have to do (hours, investment) to get there?
The firm I joined in 1998, Beckman Weil Shepardson LLC, had never heard of elder law. 15 years later, we had grown to supporting three elder attorneys and a geriatric licensed social worker (we now have 2 elder law attorneys). I started by mailing a letter to all of the nursing homes in the surrounding five counties, and enclosed an outline they could distribute to their residents and families. I gave consumer seminars and seminars to professionals. Word of mouth helped to spread the business.
Know Your Market
Who are your clients? If you want to practice in the area of Elder Law and Benefits
Preservation, your clients are older adults, children of aging parents, parents with children who have special needs, and disabled adults who receive benefits – Medicaid, Medicare, Food
3.2 • How to Market, Run, and Maintain an Elder and Special Needs Law Practice
Stamps, SSI, Social Security Disability Insurance Benefits, and housing assistance. Personal Injury attorneys are another source of clients. Attorneys, financial planners, CPAs, physicians, geriatric care managers, nursing facility staff, hospital discharge planners - these are all referral sources. Families who have children with disabilities are thrilled to find a lawyer who understands the system. We are on the Children’s Hospital referral list for estate planning for parents with special needs children. We are also on referral lists at the Hamilton County Developmental Disabilities, NAMI, Alzheimer’s Association, several individual nursing facilities, The Drake Center (trauma care), some hospital discharge offices, and the Medicaid caseworkers.
Develop a Business Plan
Once you have decided what to do and who your market is, develop a business plan. Elder Law is a high volume practice which can be stressful at times. Most families feel they have to see you right away. We are often running triage.
You have to figure out a way to get the volume in the door. Ways to do this are:
Give CLEs to lawyers and other professionals.
Send a letter to your target audience – in my case, I sent a letter to all the area nursing facilities letting them know I was with this firm and ready to see clients.
Give community seminars. For example, our local chapter of the Alzheimer’s
Association presents a Caregiver Series four times a year, and brings in professionals to speak on various topics. We usually speak at one of the sessions. A local funeral home association also has a community educational series and we present on topics of interest to their clients.
Volunteer with target organizations – get on Boards and volunteer to work at
various events. The Association for Professionals in Aging is a local not-for-profit organization of professionals in all areas of geriatric care – nursing home, home care, geriatric care management, lawyers, financial planners, etc., and this organization provides great exposure to professionals in the field. If no such organization exists in your area, create one.
Sponsor events.
Look for support groups and offer to speak at meetings.
Become the expert in your area.
Be an advocate for your clients – take on projects that benefit your clients in the broad spectrum.
Form a discussion group of attorneys who practice in your area to keep up with the
latest changes.
Send a newsletter or other informational material to your clients and to the
How to Market, Run, and Maintain an Elder and Special Needs Law Practice • 3.3
Involve Yourself in Your Bar Association
Bar association involvement lets you meet local attorneys who practice in your area and who can be a source of referrals. Form your own practice group, and if there is no committee in your practice area, create one. We probably get 30% of our clients as a result of referrals from other attorneys.
Become the Expert
Become the person others look to for the correct answer. Give of your time, within reason, to answer questions on the phone. Be generous and willing to help others develop their practice, and be a mentor if requested. I generally will talk to someone for 15 minutes before I tell them they need to schedule an appointment, and attorneys and financial planners often call about their clients with questions.
Your Local Legal Services Organization
Generously take volunteer cases, if needed. Co-counsel with your local legal services organization and involve them in your advocacy efforts.
Our Motto
Personal Attention is the Hallmark of Our Firm. Our goal is to call people back within 24 hours, and we believe we are attentive to our clients’ needs. We have also found that if you involve the client in one or two other attorneys from your firm, the client tends to come back with other work. We have special events for clients, and try to take care of them the way we would want to be taken care of.
Other Marketing Activities
We send sympathy cards when clients pass away and make donations on behalf of clients for whom we have done significant work. We have a special coding system so we can send clients alerts of changes in the law that might impact them. We send Christmas/Holiday cards to clients and referral sources, and hand-written thank you notes to referral sources. Sometimes we host events. We sometimes send gift baskets to referral sources. We give a student scholarship to support a career in geriatrics/aging issues.
Expand Your Practice Area:
In my prior life as a legal services/Title III attorney, many of the cases I handled were state hearings in which Medicaid had already been denied. Now, we handle applications, and very rarely an appeal. County caseworkers are a referral source and relationships that we respect. We handle annual reapplications for eligibility.
Also, as spin off cases, we have been involved in other cases: probate – estate administration, uncontested and contested guardianships, and elections against the will in probate court, breach of fiduciary duty cases (to set aside gifts or to defend gifts by an attorney-in-fact), long term care insurance breach of contract cases (one class action), life insurance breach of contract actions, private disability benefit insurance appeals, trust reformations, estate planning, special needs planning and trusts, class action litigation involving federal law violations by The Ohio Department of Medicaid, and others. There is room to expand, particularly in the special needs area (and individual education plans for children).