Elder Law of Louisville's Blog
Tuesday, January 18, 2011
Our clients can attest, we do not recommend naming two or more people to act as a Power of Attorney, Health Care Surrogate, Executor, Trustee, etc. It is a breeding ground for conflict. If two people have to act together, what happens when they disagree? Nothing gets accomplished. What happens if one of them gets mad and just walks away? Nothing gets accomplished.
Attorney Craig Reeves, former President of NAELA and practicing elder law attorney in Kansas City, MO, agrees. Here is an answer he provided for the NY TImes' Ask an Elder Law Attorney section of their New Old Age Blog:
Q: What is done when a power of attorney is left to both siblings jointly but one decides to become uncommunicative and “checks out,” not participating in decision-making, handling estate matters or caring for a parent with dementia? Does the sibling left with shouldering the burden really have to go to court to get the other sibling’s name taken off the power of attorney? — Kcz
A: I think you may have to go to court, but there are two avenues you should pursue first.
First, take a close look at that power-of-attorney document. Re-read the section where you and your sibling are named (it usually will refer to you as “attorney-in-fact” or “agent”). Make sure the document really requires both of you to act together and doesn’t say “either may act alone” or something similar. In the statutes I’ve checked, if you don’t see language like that, you will have to act together.
Also carefully review the document to see if there’s any provision that allows one agent to remove the other or otherwise describes a process for handling this type of situation. It’s not common, but it may be buried in there somewhere. Perhaps the attorney who drew up the document foresaw the possibility of conflict.
If nothing in the document helps, the next alternative is to look at the state statutes. Every state has laws that authorize durable powers of attorney, and there may be a statute or case law in your state that addresses this situation. You can usually find these statutes online.
If neither of these approaches helps, the only way to change an existing legal document is to file a petition asking the court to modify it. Typically, this would be the court that deals with wills and trusts; they tend not to have long dockets, so you should get a hearing fairly quickly. You’ll need an elder law attorney at this point.
Your question indicates why naming multiple agents in a durable power of attorney and giving them equal authority can create chaos. If everyone gets along, if everybody’s always available, the partnership may work. If there’s conflict, or someone can’t be present when needed, problems arise.
I always recommend that a durable power of attorney name agents one at a time, in order of priority. The first person can serve alone, but if that person dies or is incapacitated or not available, then the next person can act alone, and so on down the list.
Tuesday, January 18, 2011
The Department of the Treasury has announced that it will phase out paper checks for Federal government benefits by March 1, 2013. This new rule will extend the safety and convenience of electronic payments to millions of Americans.
People who do not have electronic payments for their federal benefits by that time will receive their funds via a pre-paid debit card. Called the Direct Express® Debit MasterCard® card, it is issued by Comerica Bank as the financial agent of the U.S. Treasury. And persons applying for federal benefits for the first time from six agencies on or after May 1, 2011, will receive their payments only through direct deposit to their bank or credit union account or to a Direct Express® Debit MasterCard® card.
The programs affected include the Social Security Administration, Supplemental Security Income, Veterans Affairs, Railroad Retirement Board, Office of Personnel Management, and Department of Labor (Black Lung).
Source: AoA January 2011 E-News (January 2011)
Full story: http://aoa.gov/AoARoot/Press_Room/Enews/CurrentNewsLetter.pdf
More info: http://www.godirect.org/media/about/fact-sheet-direct-deposit-federal-benefits/
Monday, January 17, 2011
Few things are more stressful than finding a nursing home for a loved one. Everyone has heard nursing home horror stories and no one wants that to happen to a loved one. While there is no way to guarantee that nothing will go wrong, some careful research and planning can help reassure you. You should consider the following criteria when looking for a nursing home.
No single factor is more important to quality of care and quality of life of a nursing home resident than visits by family members. Visits can be the high point of the day or week for the nursing home resident. So, make it as easy as possible for family members and friends to visit.
Make sure the facility can meet any special needs the resident may have, including a ventilator, psychiatric care, or extra supervision. If the resident has dementia, the facility will need to be one that handles dementia patients. Make sure the staff is properly trained for dementia patients. There should be enough staff, especially at night, and staff members should be assigned to a particular resident.
Can the facility meet personal needs, such as religious or ethnic needs? Also, if the resident speaks a language other than English, are there staff members who speak the same language?
Ask the facility to provide the names of family members of residents so you can ask them about the care provided in the facility and the staff's responsiveness when the resident or relatives raise concerns.
www.Medicare.gov allows you to get three years worth of inspection reports on the nursing homes you are considering. Find out who owns the facility and if they own any other nursing homes, and see if you can get reports for those nursing homes as well. In addition, talk to the long-term care ombudsman in your state to find out if there have been complaints against the nursing homes you are considering. http://www.ltcombudsman.org/ombudsman/kentucky
Interview the Administration and Staff
Talk to the nursing home administrator or nursing staff about how care plans are developed for residents and how they respond to concerns expressed by family members. Make sure you are comfortable with the response. It is better that you meet with and ask questions of the people responsible for care and not just the person marketing the facility.
Tour the Nursing Home
Try not to be impressed by a fancy lobby or depressed by an older, more rundown facility. What matters most is the quality of care and the interactions between staff and residents. Observe how the staff interacts with the patients, how well residents are attended to and whether they are treated with respect. Also, investigate the quality of the food service. Eating is both a necessity and a pleasure that continues even when we're unable to enjoy much else.
Contact a Professional
Our best advice is to contact a professional who can help you place your family member in the right facility. If you do use a professional, you should understand how that person is compensated and why they are recommending a particular facility. Please contact our office for our recommended list of professionals.
Monday, January 17, 2011
1. If I Don't Transfer Assets Sixty Months Before Entering a Nursing Home, I Can't Make Any Transfers.
Not true. The five-year rule is a look back rule. It has nothing to do with when a person enters a nursing home. It has to do with when a person applies for Medicaid. There is a question on the Medicaid application that reads, "Have you transferred any assets to an individual in the last five years?" If a transfer has taken place during that period of time, there may be a period of time the Medicaid applicant is not eligible for Medicaid. The penalty period can be longer or shorter than five years.
2. I Can't Transfer Assets after I Am Already in a Nursing Home.
Again, the same rule applies. Neither the look back nor the penalty period has anything to do with when a person enters a nursing home. Under the look back rule, all transfers and financial information must be disclosed to the Medicaid agency five years prior to the date of the Medicaid application. The penalty period is a completely different rule. The penalty period is calculated by dividing the amount of the transfer by the State Divisor Rate. For 2011, the State Divisor Rate in Kentucky is $4,584. There are complicated rules on when the penalty period begins.
3. To Protect My House I Should Give it to My Children Right Away.
This is almost always untrue. Before you give your house to your children, you should consider the tax and Medicaid ramifications of such a gift. A common mistake is for a person to give a house to a child after the house has significantly appreciated in value. When the child sells the house, the child must pay the capital gains tax on the gain. If the house is sold by the parent, capital gains tax is usually avoided. Often the solution is to transfer the house into a trust. Each case must be analyzed individually.
4. I Was Told my Only Choice Was to Spend Down.
In the case of a married couple, it is almost always unnecessary to spend down. If spending down is the only advice you are receiving, then you are talking to the wrong person.
5. You May Not Apply for Medicaid Within Five Years of Making a Gift.
As indicated above, the five year look back has nothing to do with the penalty period. A penalty is calculated by dividing the value of the assets gifted by the State Medicaid Divisor. This calculation results in a number of months for which a person making a transfer is ineligible for Medicaid. The penalty period does not apply to transfers between spouses.
6. There Is No Hurry to Begin Medicaid Transfers.
One thing that is extremely time sensitive in Medicaid planning is making a transfer early. The transfer penalty does not begin until the transfer is complete. The transfer rules are more complex after February 8, 2006. You should consult a qualified elder law attorney before making any transfers.
7. I Don't Need to Disclose Assets to Medicaid If I Am Not Reporting Income from Those Assets on My Income Tax Return.
Failure to disclose assets to Medicaid such as annuities or EE bonds that do not produce current income is a crime subject to a term of imprisonment. ALWAYS DISCLOSE everything to Medicaid.
8. If One Spouse Goes to a Nursing Home All of His or Her Income Goes to the Nursing Home.
The spouse in a nursing home is allowed to keep $60 per month in Kentucky as a personal needs allowance. In addition, the person may keep an amount necessary to pay for their private medical insurance. The law also guarantees that the well spouse receives a minimum amount of income. For 2011, the well spouse is guaranteed at least $1,821.25 of income per month.
9. All Nursing Homes and Assisted Living Facilities Accept Medicaid.
Not true. Some facilities do accept Medicaid, some do not. A person intending to apply for Medicaid must determine at the time of admission if the facility accepts Medicaid. A facility accepting Medicaid will ask you if the individual is going to private-pay, or if he/she will be applying for Medicaid (or is already on Medicaid).
10. If a Facility Takes Medicaid, I Will Not Have to Private Pay If I Am Eligible for Medicaid.
In Kentucky, when a person enters a nursing home, the faciliyt will ask if the person is private-pay or on Medicaid or applying for Medicaid. If you indicate the person is applying for Medicaid and wants a Medicaid bed and the facility accepts the person, then the facility cannot charge the person privately. The facility will not get paid until the Medicaid application is approved and benefits are paid. That being said, it is often times much easier to get into a nursing facility if you intially private pay.
Thursday, January 13, 2011
When our loved one is at home and it becomes obvious that professional care in a nursing home is the best long term option, we don't have the advantage of a hospital social worker or discharge planner to set things in motion. There are many available articles and checklists about how to choose a nursing home, including right here on on this site. There is very little information available about the actual process of having a loved one assessed and admitted to a nursing home after the selection has been made.
For a senior with medical needs that require 24-hour nursing care the process of applying for admission to a nursing home is relatively straightforward. In general, the process is as follows:
The patient will need to have seen his or her physician no more than 30 days before applying for admission to a nursing home. The physician must agree that nursing home placement is appropriate, and will usually have to provide the nursing home with the documents listed below. The nursing home you choose will tell you exactly what they want from the doctor.
Sometimes the nursing home will also want to send a nurse to assess your elder at home before they make an admission decision. This is hit and miss, depending on the facility.
1. A "History and Physical". This is a written summary, signed by the physician, that provides a general description of the patient (height, weight, age, etc.), a description of his primary medical problems, and a list of any "secondary" diagnoses;
2. A copy of the most recent laboratory reports (bloodwork, scans, eeg, ekg, etc.);
3. A list of all the medications the patient is taking and how they are to be administered. This list must be signed by the physician;
4. A copy of any nursing notes, therapy reports, or other information that would be helpful to the nursing home;
5. A written "order" signed by the physician for admission to a nursing home for long-term care.
The admission director or administrator of the nursing home will often assist with the coordination of this process.
For those seniors with limited assets, locating a nursing home which will accept a person as a "Medicaid pending" patient may be difficult. "Medicaid pending" is the situation where the patient cannot apply for Medicaid until he is in a nursing home, and he does not have the funds to pay the nursing home while awaiting Medicaid. Many nursing homes will not accept Medicaid pending patients because this essentially means they will be providing either free or very low-cost care for several months until Medicaid is approved. If, for some reason, the patient does not qualify for Medicaid after moving into the nursing home, then the nursing home has a non-paying patient they cannot easily evict. Many nursing homes try to avoid this scenario at all costs.
If there is a spouse who will be remaining at home, it is very important to protect assets and income. It is a wise investment to have a consultation with an elder law attorney who can give advice on managing income, assets and property to the best advantage of the stay-at-home-spouse. Do this before your loved one moves to a nursing home, or as soon as possible after the move.
From The Elder Care Team (www.eldercareteam.com).
Monday, January 10, 2011
Long-term care costs can add up quickly. For veterans and the surviving spouses of veterans who need in-home care or are in a nursing home, help may be available. The Veterans Administration (VA) has an underused pension benefit called Aid and Attendance that provides money to those who need assistance performing everyday tasks. Even veterans whose income is above the legal limit for a VA pension may qualify for the Aid and Attendance benefit if they have large medical expenses for which they do not receive reimbursement.
Aid and Attendance is a pension benefit, which means it is available to veterans who served at least 90 days, with at least one day during war time. The veteran does not have to have service-related disabilities to qualify. Veterans or surviving spouses are eligible if they require the aid of another person to perform an everyday action, such as bathing, feeding, dressing, or going to the bathroom. This includes individuals who are bedridden, blind, or residing in a nursing home.
To qualify the veteran or spouse must have less than $80,000 in assets, excluding the home and vehicle. In addition, the veteran's income must be less than the Maximum Annual Pension Rate (MAPR). Following are the MAPRs for 2007:
Single veteran $18,234
Veteran with one dependent $21,615
Single surviving spouse $11,715
Surviving spouse with one dependent $13,976
Income does not include welfare benefits or Supplemental Security Income. It also does not include unreimbursed medical expenses actually paid by the veteran or a member of his or her family. This can include Medicare, Medigap, and long-term care insurance premiums; over-the-counter medications taken at a doctor's recommendation; long-term care costs, such as nursing home fees; the cost of an in-home attendant that provides some medical or nursing services; and the cost of an assisted living facility. These expenses must be unreimbursed (in other words, insurance must not pay the expenses). The expenses should also be recurring, meaning that they should recur every month.
How it works. The amount a person receives depends on his or her income. The VA pays the difference between the veteran's income and the MAPR. Here is an example:
John, a single veteran, has income from Social Security of $16,500 a year and a pension of $12,000 a year, so his total income is $28,500 a year. He pays $20,000 a year for home health care, $1,122 a year for Medicare, and $1,788 a year for supplemental insurance, so his total medical expenses are $22,910. Subtracting his medical expenses from his income ($28,500 - $22,910), John's countable income is $5,590. John could qualify for $12,644 ($18,234 - $5,590) in Aid and Attendance benefits.
If you, your spouse, a parent or grandparent is:
1. A veteran or the surviving spouse of a veteran;
2. Blind; or
3. Living in a nursing home or assisted living facility; or
4. Requires the daily assistance of a third-party for certain activities of daily living (dressing, bathroom, taking medications)
VA Aid & Attendance may be an option. Give Walsh & Wilson a call. We are VA Accredited and can assist you in applying for this benefit.
Friday, January 7, 2011
Republican governors are pressing the Obama administration to make it easier for states to cut Medicaid enrollment, setting up a fight over one of states' costliest programs. On Friday, January 7, 2011, 33 Republican governors and governors-elect plan to send a letter to the White House and congressional leaders asking them to remove a part of the health-care overhaul law. Under the rule, states that drop enrollees from the program would lose the federal money that accounts for the bulk of Medicaid funding, an unthinkable scenario for states staring down unprecedented budget shortfalls in 2011.
"The effect of the federal requirements is unconscionable," the governors wrote. "The federal requirements force governors to cut other critical state programs, such as education, in order to fund a 'one-size-fits-all' approach to Medicaid." The signatories include all 29 of the GOP governors who will hold office this year, plus four who are leaving office soon. Supporters of the current rule said states shouldn't be allowed to chop millions of poor people from the rolls when the weak economy makes Medicaid coverage critical. They also fear that loosening the rule could undercut the health overhaul, which is designed to expand Medicaid to an additional 16 million Americans starting in 2014. But states say that swell in enrollment could make the program unmanageable.
Another problem for states: An extra $26 billion they got from the federal government last year to prop up Medicaid expires in June. Medicaid, which provides health insurance and covers nursing-home costs for the poor, has become most states' top spending conundrum. Although the federal government pays 57% on average of states' Medicaid costs, states are straining to cover the other 43% because Medicaid enrollment continues to rise. Medicaid enrollment rose to 47.8 million people in 2009 from 42.6 million in 2008, according to the Census Bureau. The percentage of Americans on Medicaid is the highest since 1987.
Prevented from paring enrollment, states have cut services, including Arizona's limiting of Medicaid coverage for organ transplants. In New York, Democratic Gov. Andrew Cuomo is considering a cut of about $2.1 billion in the state's projected spending on Medicaid in the upcoming fiscal year. He has asked union leaders and hospital executives for cost-cutting ideas. At least a half-dozen states have publicly discussed withdrawing from the Medicaid program altogether because of its expense.
"For most governors, this is the biggest budget problem, and federal mandates are a huge part of that," Mississippi Gov. Haley Barbour said in an interview. Mr. Barbour, a potential Republican presidential contender in 2012, said lifting the requirement would allow his state to move enrollees to more efficient health programs, and wouldn't necessarily increase the ranks of the state's uninsured.
The Obama administration said it was trying to help states tame rising Medicaid costs. "We understand that states are facing extraordinarily tight budgets, and that's why we supported measures like enhanced Medicaid funding", said Reid Cherlin, a spokesman for the White House. "We're exploring options to continue to assist states."
Congress would need to pass legislation to approve the change. So far there's no sign that congressional Democrats would give it the support it needs. The health overhaul does contain a provision that allows states with budget deficits to seek permission from the federal government to limit Medicaid eligibility, but only for relatively higher-income adults who are not pregnant or disabled. Under the current requirement, a state effectively can't change its Medicaid eligibility rules until it has one of the new health-insurance exchanges created by the overhaul law. That's expected to happen in 2014.
States are pressing forward with deep cuts to the few parts of Medicaid they can change without risking losing their federal matching funds. Those including trimming nonessential benefits for adults—such as prescription, vision and dental coverage—and shaving the rates Medicaid pays health-care providers. Texas estimates that it will cost an additional $9.1 billion to retain its current Medicaid service levels through 2013. If it tried to plug that gap by cutting health-care provider rates, it would have to reduce them by 48%— and that might drive care providers to stop accepting Medicaid patients, according to the governors' letter. Texas Gov. Rick Perry, a Republican, has threatened to pull out of Medicaid.
Coursey of The Wall Street Journal.
Thursday, January 6, 2011
The executor (or if a woman, the "executrix") of an estate is the person who has accepted the responsibility of closing out the estate of someone who has passed away. Some estates are small, and the executor has only a few things to do. Large estates may need as long as a year or even longer to reach the point where inheritances can be distributed to the heirs. Something to keep in mind that confuses lots of people: If you were the Power of Attorney for someone who is now deceased, this does not automatically make you the Executor of their estate. The Power of Attorney is designed to allow you to help a living person with the chores of daily financial and medical life. At the moment the person who appointed you passed away, your authority under the power of attorney ceases to exist. The Executor of that person's Will is either named in the Will, or appointed by the Court if no one has been named.
Unlike what you see in movies or on TV, it is unusual in our practice to have a reading of the Will. The Will is filed with the Probate Court and recording with the County Clerk's Office. This makes the Will a public record for anyone to read.
The actual distribution of assets to beneficiaries does not happen right away. This is difficult for many beneficiaries to understand, but there is an initial 6 month period, generally referred to as the "creditor period" when the Executor is not allowed to distribute assets.
In general, an eEecutor is responsible for:
1. Identifying and securing the assets of the estate. This can be as simple as putting a new lock on the door(s) to keep the contents secure, to searching for property, investments, insurance policies and other financial information. This can take many months if you are looking for property you are not certain about or if you must wait for statements to arrive so you can identify accounts.
2. Establishing the value of all these assets. This means that except for very small estates or for things that have already been valued, such as bank accounts, the Executor will probably have to have the assets professionally appraised.
3. Paying legitimate debts of the person who has passed away from the assets of the estate. In the case of medical bills, it may be many months before all the bills have been accounted for. If there is not enough money in the estate to pay these bills, the executor is not personaly responsible to pay them. However, if there is not enough cash, but there are other assets with value, then the Executor will usually have to liquidate assets to pay the bills. In Kentucky, creditors have 6 months from the time the Will is filed in Probate Court (the 6 month creditor period discussed above) to come forward with their claims.
4. Completing all tax filings and pay required state, local and federal taxes from the estate. The Executor should also review or have reviewed the decedent's returns from the previous one or two years to be sure that taxes were paid properly. The IRS will certainly come back to the estate for any unpaid income taxes.
5. While all these details are unfolding the Executor continues to remain responsible for preserving the value of the estate. Property, boats and automobiles must be maintained. Investments must be managed. If assets must be sold, the executor manages the sale and decides how the proceeds are to be managed.
6. When all the legitimate debts and all the taxes have been paid, the Executor then distributes the remaining estate to the beneficiaries in exactly the way the decedent specified in his or her Will. The Executor does not have the authority to make changes to how the estate is distributed, even if the instructions of the Will do not seem to be fair.
If you are the Executor of someone's Will, the best first step is to contact an attorney who practices "estate" or "probate" law for a short consultation. In Kentucky, there is no requirement that an Executor hire an attorney to assist with the estate. There are many ways to retain an attorneys services, if desired, to accommodate the estate's budget, from a one-time consultation, to an ongoing consultation (you do the work, the attorney just tells you the steps), to full representation (where the attorney essentially handles everything). Be sure that the attorney you consult is licensed to practice in the state where your relative passed away. Attorneys should be paid from the assets of the estate, not your own personal money. Be sure to reach an understanding about the exact level of service you want and the attorney's fees and billing process (flat fee, percentage fee, hourly fee) before you proceed.
Wednesday, January 5, 2011
If medical personnel have access to your medical history during an emergency, it could mean the difference between life and death. But if you are injured or in shock, you may not be able to provide that information. To solve this problem, a number of systems have been developed to help make important contact and medical history information available to emergency medical personnel.
Medical ID Card. There are multiple forms of medical ID cards available now. This starts at the basic ID bracelet. Then there is a paper ID card (it folds to the size of a credit card) that contains your allergies, prescriptions and blood type (www.med-id-card.com). There is a laminated ID card that contains more information, such as contact information for your physicians. (www.imgcard.com). Then there is the ID card that is a computer disc. You can load all your medical history onto the card and emergency personnel can plug the card into any computer to pull up the information. (www.911medicalid.com).
ICE Contact. A campaign is encouraging people to put their emergency contact information in their cell phones under the heading ICE (In Case of Emergency). This would allow paramedics or other medical personnel to immediately know who to contact in the event of an emergency. The campaign was started by a paramedic in the United Kingdom and has spread to the United States. It is fast, easy and free.
The National Next of Kin Registry (NOKR). The NOKR is a free Web site that allows you to register yourself and your next of kin. The information is not available to the public, but it is available to emergency service personnel. If you are in an accident, the emergency services agency would be able to search the website to find your next of kin and notify him or her about your condition. To register, visit: www.nokr.org.
Vial of Life Project. The Vial of Life Project provides a form and decals for free. You can fill in your medical history on the form, put it in a bag, put other important information you may have in the bag, affix a decal to the front of the bag, and tape it in a prominent place. If medical personnel respond to an emergency at your house, they will be able to easily access your medical history, names of your doctors, and your emergency contact information. To fill out the Vial of Life form, visit: www.vialoflife.com.
To get the most out of an emergency contact, you should make sure the person you choose as your emergency contact has agreed to act in this capacity, knows about any allergies or other factors that could affect your treatment, and knows who to contact on your behalf.
Wednesday, January 5, 2011
"Jane" has been helping her father, "John," for many, many years. Until recently Jane rested comfortably with the thought that she would be able to handle anything that came along.
Then John developed an illness that left him unable to understand his health care needs. As his involved daughter, Jane was astounded when John's doctors would not accept her authorization for treatment. You see, Jane has several siblings. John never legally appointed anyone to make medical decisions for him. Because the doctors were aware that there was some conflict in the family about the best course of action, John's physicians were reluctant to go forward with the potentially life-altering surgery Jane wanted for her father without the consent of her brothers and sisters.
Also known as a Medical Power of Attorney or Health Care Proxy, the Power of Attorney For Health Care gives a person named by you the authority to make medical decisions for you if you can't do so for yourself. If you're a caregiver, this document gives you authorization not only to talk to medical personnel, but to consent to care for your loved one.
Contrary to what many people believe, a Power of Attorney for Health Care is not the same as a "Living Will." The Living Will only comes into play if a person is terminally ill with little or no hope of recovery. The Power of Attorney for Health Care can be used even if the patient isn't terminally ill. If you are ill or injured and need someone to be your authorized representative with doctors or hospitals when you can't, the Power of Attorney for Health Care will give the person you name that authority.
If you were in an accident, or if emergency personnel were to come to your aid while you were home alone, how would the medical personnel who treat you in an emergency know that you have named someone your "Agent in Fact" (your Power of Attorney for Health Care)? Here's how to be sure they will know, even if you can't tell them yourself.
Courtesy of ww.eldercareteam.com.
Tuesday, January 4, 2011
Kentucky's Transfer Resource Factor (TRF) for 2011 is $5,820. This is the number used to calculate the penalty for transfers of assets for less than fair market value, otherwise known as gifts. If a parent gifts a child a $100,000 house and then applies for Medicaid, there will be a 17 month period of ineligibility for Medicaid due to that gift (100,000 / 5,820 = 17.18213).
The attorneys of Elder Law of Louisville (formerly Walsh & Wilson, PLLC) assist clients in Louisville, Kentucky and surrounding counties of Jefferson, Oldham, Shelby, Spencer, and Bullitt. Our Office also serves Southern Indiana and the towns of New Albany, Jeffersonville, and Clarksville.