Paying for your Parents' Long-term Care: Filial Responsibility Law in North Carolina

Leon Abbas |

Many of us are concerned about paying for long-term care for ourselves, and when that may be required.  But there’s another concern which we should be aware of:  the possibility of having to pay for our parents’ long-term care, whether in an institution or home-care.  On the books in 30 states including North Carolina are “filial responsibility laws” that impose a legal obligation on adult children to take care of their parents’ basic needs and medical care. 

The North Carolina General Statute 14-326.1 states:

“If any person being of full age, and having sufficient income after reasonably providing for his or her own immediate family shall, without reasonable cause, neglect to maintain or support his or her parent or parents, if such parent or parents be sick or not able to work and have not sufficient means or ability to maintain or support themselves, such person shall be deemed guilty of a Class 2 misdemeanor; upon conviction of a second or subsequent offense such person shall be guilty of a Class 1 misdemeanor.  If there be more than one person bound under the provisions of the next preceding paragraph to support the same parent or parents, they shall share equitably in the discharge of such duty.”

This law is currently not being enforced in North Carolina, but there was a recent case in Pennsylvania where a court found an adult child liable for $92,943 of a parent’s medical treatment. 

Filial laws aren’t new.  They have their genesis in the “Poor Laws” written in England in the 16th century.  At one time, 45 states had filial laws on their books; however, as a result of Medicare and Medicaid, many states removed those statutes.  This is because in the context of needs-based government programs (such as Medicaid), under federal law, states are prohibited from considering the financial responsibility of any person other than a spouse in determining whether an applicant is eligible.

But as many local programs aimed at helping the elderly continue to struggle with insolvency, states may reconsider more active enforcement of these antiquated filial responsibility laws.  There have been some rumblings that nursing homes and long-term care facilities are also taking an interest in these statutes as a way to seek reimbursement for unpaid bills.

Should you be concerned?  At this point there is no indication that filial laws are going to be enforced.  In addition, there is the caveat that the children must first be able to reasonably provide for themselves and their families before being forced to pay for their parents’ bills.  The term, “reasonable”, here would be open to interpretation and discussion.

Filial laws are interesting to read about, and perhaps scary to contemplate, but for now they are not something to be overly concerned about.  Instead, consult with your advisor and focus on a sensible long-term financial plan for yourself, as well as your parents. Consider whether long-term care insurance is appropriate in your situation. It may also be helpful to chat with an elder law attorney.

Leon Abbas, CFP®, is an Investment Advisor Representative at Townsend Asset Management Corp., a registered investment advisory firm offering comprehensive wealth management expertise to its clients.  Email: