Pooled Special Needs Trust Can Provide Peace of Mind for Donors and Beneficiaries

When creating and administering a special needs trust, it can be hard to find a suitable trustee that is skilled in investments and the ongoing administration of the trust. A pooled special needs trust, also known as a (d)(4)(C) SNT, is established and operated by a nonprofit association that typically has record for how it administers assets for individuals with disabilities.

The pooled special needs trust maintains a separate account for each beneficiary of the trust. A beneficiary’s parent, grandparent, guardian, or individual with the disability must first set up the account. An initial enrollment fee and annual maintenance fee vary depending on the trust provider. The pooled trust achieves the same objectives as an individual special needs trust – to maintain the beneficiary’s government benefits such as Supplemental Security Income or Medicaid while using the trust monies to supplement government benefits.

A pooled SNT also allows the trust to be created with any amount of money, whereas professional trustees will only accept an individual special needs trust when the account begins with $500,000, for example. A pooled SNT account can be funded through a will, life insurance policy, and third party as well.

When the beneficiary passes away, the remainder of the account balance can be subject to retention guidelines. This can mean the remainder goes to the charity, to the state Medicaid agency, or some combination of the two. When donors want the remainder to go to family members, they must establish a companion SNT beforehand to leave the trust balance to family members and avoid the requirements.

As SNTs are complex and the best option for each individual with disabilities varies, it is advised to consult an experienced asset protection and special needs planning attorney. Littman Krooks LLP counsels individuals and families on SNT issues, government benefits and services, and asset protection. To learn more about New York asset protection or New York special needs planning, visit http://www.littmankrooks.com.

Considerations for Determining if a Student Needs a One-to-One Aide

Decisions to recommend a one-to-one aide must weigh the factors of both:

-          The student’s individual needs;

-          The available supports in the setting where the student’s IEP will be implemented.

There are certain important considerations that must be made by the CPSE/CSE in regard to the factors above. These include, but are not limited to, consideration of each of the following:

-          The student’s individual needs that require adult assistance.

-          The skills and goals the student is planned to achieve that will reduce or eliminate the need for the one-to-one aide.

-          The specific role (i.e. instructional, assistance with personal hygiene) that the aide will provide for the student

-          Other natural supports, accommodations and/or services that could support the student to meet these needs (i.e. behavioral intervention plan; environmental accommodations or modifications; changes in scheduling; instructional materials in alternate formats; assistive technology devices; peer-to-peer supports).

-          The extent (i.e. portions of the school day) or circumstances (i.e. for transitions from class to class) the student would need the assistance of a one-to-one aide.

-          The special class side the CPSE or CSE has recommended for the student. Special class size recommendations are made in consideration of the students’ management needs. For a student in a special class, an additional aide should only be recommended for specialized circumstances based on a student’s individual needs and when it has been discussed and determined by the CPSE/CSE that the recommended special class size in the setting where the student will attend school, other natural supports, a behavioral intervention plan, etc., cannot meet these needs. Whenever a student is recommended for placement in a board of cooperative educational services (BOCES) or approved private school, the CSE should consult with the program regarding their staffing ratios prior to recommending a one-to-one aide in the student’s IEP. The staffing configurations in these programs are designed to fully support students with similar needs.

-          The potential benefits from assignment of the one-to-one aide and how these will be measured to determine continuation of the recommendation.

-          The potential negative impact of assignment of a one-to-one aide for the student (i.e. self-image, isolation and/or development of independence).

Questions regarding this memorandum may be directed to the Special Education Policy Unit at (518)473-2878 or your Special Education Quality Assurance Regional Associate at one of the following Regional Offices:

Central Region                        (315) 476-5081
Eastern Region                       (518) 486-6366
Hudson Valley Region           (518) 473-1185
Long Island Region                 (631) 884-8530
New York City                         (718) 722-4544
Western Region                      (585) 344-2002
Non-district Unit                      (518) 473-1185

To read more about the considerations for determining if a student needs a one-to-one aide, visit our blog and click here.

Medicaid Offers Home Attendant Services For Eligible Individuals

New Yorkers who have Medicaid and need home attendant services can have this type of care covered. Approval is granted when financial and medical criteria are met, and an individual submits an M11q form that his or her doctor has thoroughly completed. These services can offer substantial savings for an individual and their family, and helps to provide for daily care.

Personal care services, which are also called home attendant services, can greatly assist individuals affected by physical or mental impairments. Individuals who have excess resources or income can get the skilled advice of a New York Medicaid planning lawyer to access benefits and preserve assets. Once home care is authorized, an attendant can assist from 12 hours a week to around-the-clock care.

It is also important for people who have been denied benefits to have their case reviewed. An experienced Medicaid planning attorney can uphold an individual’s rights and ensure that the medical and financial information is complete when a hearing is needed to seek benefits the second time around. Hearings can also be expedited in certain circumstances.

Littman Krooks LLP counsels individuals and families on how to access Medicaid benefits and plan for comprehensive care and estate matters. Our New York City, White Plains and Fishkill Medicaid planning attorneys are well versed in state regulations, benefits, and asset protection. To learn more, visit http://www.littmankrooks.com/elder-law-medicaid-planning/.

National Family Caregivers Month Time To Applaud Caregivers and Help Them Connect With Support Services

November is a time to applaud all those who contribute to caregiving and the National Family Caregivers Month. Caregivers play a crucial role in helping family members and friends get the care they need to overcome the daily challenges of a chronic or disabling condition. Many people are caregivers who graciously sacrifice their time and resources to provide for an ailing parent, sibling, or friend. Caregivers should know that there are state and federal resources out there to help them.

The Older Americans Act, which is part of the U.S. Administration on Aging, is a valuable resource that caregivers can connect to that offers caregiver support, home-delivery nutrition services, and specialized programs for Alzheimer’s disease, lifespan respite care, and community living assistance, for example.

Caregivers deserve a lot of praise and should know that there are resources in the health care, legal, and financial field that can help them adequately plan for their loved one’s long-term care. Various programs throughout New York help a caregiver address their loved one’s needs and also take the steps to help them plan for themselves.

New York law firm Littman Krooks LLP assists caregivers and their loved ones to plan for medical needs, estate planning and asset protection, and preservation of government benefits. Our New York City, White Plains or Fishkill elder law and estate planning attorneys are a trusted resource for many New York families.To learn more, visit http://www.littmankrooks.com/elder-law/, http://www.littmankrooks.com/estate-planning/ or http://www.elderlawnewyork.com

New York Medicaid Changes Affect Estate Plans

Changes to the Medicaid program in New York can have a big effect on estate assets and planning. New regulations that were put into place in early September allow for the state to recover costs spent on an individual’s Medicaid services. Estate recovery of these costs can come from any assets that pass via a will, intestacy, or real and personal property.

Previously, only probate assets were subject to an estate recovery of Medicaid costs. But now that joint accounts, annuities, life estate interests in deeds, and other assets are now subject to estate recovery, individuals and their loved ones need to get legal guidance to review their estate plans and protect their assets even more. The changes in New York are due to budget laws that were passed earlier in the year.

Since these regulations are so new, individuals should seek a qualified elder law attorney and estate planning attorney. If you already have a trust or deed with a life estate, a skilled estate planning lawyer can review your existing plans and assets too.

Littman Krooks LLP counsels individuals and families on how to access government benefits such as Medicaid while protecting assets. Our New York City, White Plains and Fishkill estate planning attorneys and elder law attorneys are accomplished in comprehensive estate planning including these new regulations, probate matters, and asset protection. To learn more about New York estate planning, visit http://www.littmankrooks.com/estate-planning/.

Women Can Review Assets and Health Care Needs with the Guidance of an Estate Planning Attorney

Women are so busy raising kids, taking care of their elderly parents, and maintaining a household and career that they often do not focus on what will happen to them in retirement and beyond. A new white paper by the Volunteers of America called “Boomer Bust 2011: Still Unprepared and Unaware” highlights how unprepared seniors and their caregivers are as they age.

Being unprepared can particularly affect women more as they are often called on to be the caregiver and deal with health and financial problems of their own later on in life. When women can get education and legal guidance to prepare for their retirement and long-term care needs, they can lessen the risk of their golden years being a difficult time.

Having a skilled estate planning attorney review assets, health care needs, and end of life wishes can help women feel confident about the years ahead. Getting legal guidance early on will establish a roadmap to show a woman how to save for a comfortable retirement, prepare documents with the input of family members, and help a senior live more independently.

Littman Krooks LLP counsels individuals and families to create appropriate estate plans, plan for long-term needs and government benefits, and protect assets. Our New York City, White Plains and Fishkill estate planning attorneys and elder law attorneys are accomplished in asset preservation, trusts, and estate planning. To learn more about New York estate planning, visit http://www.littmankrooks.com/estate-planning/.

Follow up: The Importance of Self-Esteem with Children and Bullying

By Susan Hendler,

Owner of Sociable Kidz (Mamaroneck, NY)

As the owner of Sociable Kidz, a social skills group for kids, it is clear that children with low self-esteem are easy targets for bullying. Bullies like to take control and hurt others. They like to make others feel powerless. Bullies feel better about themselves when they put others down.

In my work I try to encourage children to “stand tall, be proud and confident” in themselves. Many children lack these abilities on their own due to being teased or bullied at one time or another. We do a lot of role-playing with the children. Someone will act out being the “bully” and the other children practice standing up for themselves. One way, is by using an I-statement (our favorite I-statements include, “I don’t like what you are doing! I want you to stop!”). It is not easy using an I-statement. We practice and practice until the children feel confident doing it themselves.

We write jokes together for the children to use as another strategy against bullies. I encourage my students to have one or two jokes at the tip of their tongue to use against someone who is being mean to them. Telling a joke in the middle of a confrontation really confuses the bully.

I teach my students to turn around an insult and give it right back to the bully. For example, as an adult, if someone tells me he/she doesn’t like my dress, it could bother me all day if I let it. I have learned to turn these types of statements around. I say, “I like my dress and I don’t care what you think about it!” I turn around and walk away. I have empowered myself by telling the “bully” how I feel. This is very powerful for young children to master.Children need to feel good about themselves and have the inner confidence and self-esteem in order to stand up to a bully.

Listen to Susan’s full podcast on “Peace of Mind with Bernie the Attorney” by clicking here. For more information about Sociable Kidz, contact Susan Hendler at 914-502-3295 or visit www.sociablekidz.com.

Opportunities Within Reach For Individuals With Down Syndrome

The National Association for Down Syndrome dedicates October as Down Syndrome month, and encourages awareness in online and offline events throughout the month to show how this condition affects many children and adults. Advocacy for individuals with Down Syndrome has increased over the years, but there is always more that can be done to focus on their special needs and the many educators and caretakers that dedicate their lives to the cause.

Even though there might be certain health and education challenges that individuals with Down Syndrome must overcome every day, great strides have been made to help them lead healthy, fulfilling lives in the greater society. Access to government benefits, a free and appropriate public education, therapeutic recreation, and other mobility services are available to people with Down Syndrome and their loved ones who are looking to provide the best living environment.

A recent success story shows how much individuals with Down Syndrome can achieve. A 31-year-old Minnesotan man with Down Syndrome was able to move out of a group home he lived in for 10 years to his very own townhome. In the townhome setting, he is able to decrease the need for around-the-clock care by 25 percent. He is able to do this by having the home wired by Sengistix, a health and safety technology company. Sensors on the front door, bathroom door, stove, under the mattress, and on a cedar box that is his medicine cabinet are all connected to alert his parents, remote caregivers, and townhome maintenance staff should he fall, open the front door after 11 p.m., or forget to take his medicine. By being on his own for an increased amount of time, he is gaining more confidence and life skills.

Littman Krooks LLP counsels individuals with Down Syndrome and their families to get the federal and state support services their loved one needs. Our New York City, White Plains and Fishkill special needs planning attorneys assist in education planning, health benefits, and innovative resources for individuals with Down Syndrome. We believe in helping clients build a strong foundation for their child’s well-being and optimal independence. To learn more about New York special needs planning, visit http://www.littmankrooks.com/special-needs-planning/ or http://www.specialneedsnewyork.com.

Home Health Agencies Must Provide Adequate Care According to Doctor’s Orders

Unless a doctor has cleared the patient and has informed all parties in a sufficient manner, a CHHA cannot cut services without warning. If a CHHA is illegally doing this, they can receive violations for not adhering to state regulations and policies. Individuals and their loved ones can seek to have a fair hearing about the issue. Until a decision is made at the hearing, home health care must continue.

Some CHHAs are blaming the changes due to Medicaid payment cuts or state budget constraints. But state law specifically says that, “Agencies may not discriminate against a patient based on source of payment, and may not diminish nor discontinue services solely because of a change in the patient’s source of payment.” Around-the-clock care is still available for patients who receive a doctor’s orders for this type of care.

When patients are able to complete daily tasks on their own again and a doctor has approved this, a CHHA must follow defined procedures to discharge the patient from the home health care plan. This is also a critical component of the Medicaid home care procedures.

People who have had services unjustly cut or diminished need to contact a New York elder law attorney or New York special needs attorney. New York law firm Littman Krooks LLP excels in helping the elderly and people with special needs get their present and future needs upheld.

Our New York City, White Plains or Fishkill Elder Law and Special Needs attorneys have substantial experience in standing up for your rights. To learn more, visit www.elderlawnewyork.com.

Get Legal Advice Before Selling the Family Home and Starting Nursing Home Care

Entering a nursing home can provide highly sought-after services and around-the-clock care. Family members and loved ones can have the expertise of skilled staff that provides peace of mind for your elderly parent. But if proper planning for the monies involved in nursing home care and estate planning are not done in advance, it can put your loved one at risk financially.

Especially for seniors on Medicaid, there are important considerations to take before moving into a nursing home. Many seniors own a home, and depending on what is done with a home before moving into the nursing home can greatly affect their assets. Before deciding on selling the family home or transferring it to a family member, it is critical to speak to a qualified estate planning attorney.

Transferring a home can incur penalties unless the home is transferred to a spouse, disabled child, specific trusts, a sibling with an equity interest in the home, or a caretaker child. There are strict rules of how long siblings and caretaker children must have lived in the home prior to an individual going into a nursing home. If a transfer or sale of home is done incorrectly, it can hurt a person’s Medicaid eligibility and make them have to pay nursing home costs on their own. Some transfers also have a Medicaid penalty period that is equal to the value of the transferred asset divided by the state’s average pay rate for nursing home care.

After a loved one passes away and if the home is not properly accounted for, the state can come after an estate or put a lien on the home for benefits given for the senior’s care. Skilled Medicaid planning attorneys know how to protect assets, the family home, and keep loved ones from incurring unjust hardships.

New York law firm Littman Krooks LLP assists seniors and their families to plan for nursing home needs, estate planning and asset protection, and preservation of Medicaid and government benefits. Our New York City, White Plains or Fishkill Medicaid planning attorneys are a trusted resource for many New York families. To learn more, visit http://www.elderlawnewyork.com or http://www.littmankrooks.com/estate-planning/.