As an elder law attorney, you know that an irrevocable Medicaid Asset Protection Trust (MAPT) can be an effective estate planning tool for many of your clients. A MAPT offers an alternative to long-term care insurance, allowing individuals or married couples to transfer some assets into a trust and to hold and manage those assets throughout their lifetime. The remaining assets can then be transferred to the heirs of the trust at the time of the client’s death.
Of course, it’s important that you as the attorney understand the pitfalls of a MAPT — such as the potential impact on Medicaid eligibility — in order to ultimately decide if establishment of this type of trust is right for each individual client.
If properly executed, the planning for this type of trust and the resulting Medicaid Asset Protection Letter (MAPL) can be used as a springboard to further planning with a client, and therefore, further profits. Like every aspect of elder law, MAPT planning will yield the biggest benefit for your practice and your clients if you have a process in place. ElderCounsel member Will Dennis, an elder law attorney practicing in both California and Oregon, recently shared his own 8-step process for providing initial long-term care evaluations to his clients.

Long-Term Care Evaluations in 8 Steps
Step 1: The client telephone call
Of course, step one occurs when you get a call from a potential client that is interested in discussing long-term care options. This is when the appointed person within your firm should schedule an appointment for an initial consultation. In order to make this first meeting as fruitful as possible for both you and the client, you’ll need to have well-crafted client intake form. The person scheduling this initial meeting must communicate to the client the importance of filling out the form completely and bringing it with them (or better yet, sending it it in ahead of time) to their appointment.
Step 2: The initial consultation
Despite the inclination to use this meeting to discuss laws around Medicaid and asset protection trusts, the initial consultation isn’t the time to prove to your client everything that you know. Instead, Dennis suggests using this meeting to listen to the client. Find out what concerns they have, and then let them know that you have to perform a long-term care (LTC) evaluation and explain to them what that entails. When answering questions in the initial consultation, Dennis advises attorneys to always refer back to “that is what the evaluation is for.” This will prevent you from using too much of your time or providing free advice to a prospect that isn’t yet a paying client. If the client agrees, then you can move onto step 3 — the LTC evaluation.
Step 3: Moving forward with the LTC evaluation process
If the prospect decides they want to go forward with the LTC evaluation, sign them up. First and foremost, make sure they sign your fee agreement and collect payment. You can explain that payment is up front because of the front end load on you. Then present them with your firm’s LTC questionnaire, agree on a date by which they’ll complete it and schedule two meetings.
Step 4: Review their information and spool-up MAPL
The first meeting you schedule will be to review their worksheet in order to make sure you have all of the pertinent information you need to move forward. Follow up with client to get any additional information your firm needs to ensure you’re as prepared as possible for the LTC evaluation meeting.
Step 5: Prepare the information you will present to the client at the LTC evaluation meeting
The value of offering a visual representation of your preparation cannot be underestimated, according to Dennis. Whether you whiteboard it, use a PowerPoint, or devise some other more creative method, your client will take note of your preparation and appreciate that you have laid it all out for them. Be as concise as you can in your presentation and show them that you’ve analyzed the potential solutions they should consider.
Step 6: Conduct the LTC evaluation meeting
Once you’ve done your planning and due diligence you’ll be ready for the LTC evaluation meeting. This is your opportunity to educate the client and help them to make an informed decision about taking the next step in planning, so you should slate two hours for this engagement. Dennis suggests allocating no more than one hour of those two hours to reviewing the facts of the client’s case/situation, and then making sure you leave at least one hour to address planning and strategies. At the close of this meeting, remind the client they will be receiving the MAPL in 48 hours and of their next appointment.
Step 7: Finish the MAPL and Get it Out (ideally within 48 hours)
After your LTC evaluation, you’ll be armed with all of the information you need to finish the MAPL. You should complete the MAPL as soon as possible after the meeting, while all of the details and facts are fresh in your mind. You can include specifics from your discussion with the client in the planning/strategies/summary part of the MAPL in order to tailor it more specifically to them. Dennis cautions against waiting to finish the MAPL. “You will be thoroughly pleased with the quality of your MAPL the sooner you address it following the meeting,” he says. In fact, Dennis promises clients a 48-hour turnaround. By completing this step quickly, you’ll also build client confidence and reiterate that you are professional and efficient, and will deliver as you’ve said you will.
Step 8: Conduct a follow-up appointment
The follow-up appointment presents an opportunity for you to answer questions regarding the LTC evaluation and the MAPL. More importantly, this is your opportunity to review the planning and strategies you’ve laid out and to offer your services to help the client with the next steps. This is also your opportunity to discuss pricing on the subsequent services you’re recommending to them.
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