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/.

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

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/.

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.

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.

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/.

In 2012 all SNPs will have to be approved by the National Committee on Quality Assurance. CMS wants to monitor the strengths and weaknesses of SNPs with these new requirements. By 2013, private Medicare plans that help low income patients who are dually eligible must enter into contracts with state Medicaid agencies.

For patients with Alzheimer’s disease and their families, this news is encouraging and stands to improve the quality of care for this disorder that affects millions of elderly Americans. September is World Alzheimer’s Month and highlights the fact that the condition involves very expensive health care, coordination of government benefits, and an extended network of family and friends to support the individual and his or her caregivers.

A part of the CMS changes also eliminates Medicare prescription drug Part D enrollment penalties for patients who delay enrollment. Also, insurance agents and Medicare Advantage and Part D brokers have more regulations against switching coverage plans and giving out marketing gifts.

The New York special needs law firm Littman Krooks LLP has extensive experience with individuals with Alzheimer’s disease and helping their families take advantage of government benefits as well as proactively protect assets and plan for long-term care needs. Their New York City, White Plains or Fishkill Special Needs attorneys are skilled in assisting people with chronic conditions and disabilities. To learn more about New York special needs planning, visit http://www.littmankrooks.com/special-needs-planning.

People often incorrectly assume they will outlive their pet, or that a friend or family will take care of their pet when they are gone, according to Anne Culver, director of Disaster Services for the Humane Society. Formal provisions can ensure a pet will receive proper care in a loving home after its owner has passed away.

It is important to outline a temporary plan for a pet before even drafting a long-term plan. Estate plans can take time to carry out, especially if they are contested, but pets need daily care and immediate attention. A designated friend, family member or neighbor can ensure a pet’s needs are met while an estate plan is being carried out.

Formal, long-term arrangements for a pet can be created with the help of a lawyer in the form of a special will, trust, or other document. When selecting a caregiver, seniors should consider close family or friends who have met the pet and who have successfully cared for a pet of their own. If an estate plan includes more than one pet, they should be kept together, especially if they have bonded. Seniors should keep in contact with potential caregivers over time to ensure that their circumstances have not changed, and they are still willing to care for the pet.

In the event that a caregiver cannot be found, the executor of a will can be authorized to find a satisfactory new home for a pet. This may take time, so careful instructions and proper funding are paramount. An estate plan can include funding for a pet’s temporary and permanent expenses.

A trust for a pet may also be set up as an alternative to a will. Unlike a will, which only takes effect upon death, a trust goes into effect as soon as a senior becomes incapacitated. This means that a pet can be cared for immediately.

http://www.elderlawnewyork.com/blog/
To learn more about New York elder law, New York estate planning, visit http://www.elderlawnewyork.com or http://www.littmankrooks.com

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In Estate of Olivo v. Commissioner (U.S. Tax Ct., No. 15428-07, July 11, 2011), the Tax Court ruled that the costs of a family member taking care of their parent can not be written off when there is an oral agreement. A family member can deduct the expenses incurred in taking care of their loved one when there is a written agreement between the two parties. Anthony Olivo said he and his mom had an oral agreement that she would repay him from her estate for taking care of her. From 1994 to 2003, he halted his law career and incurred $1.25 million in costs taking care of her. The Internal Revenue Service (IRS) and the Tax Court would have allowed this write off had there been a written agreement regarding this.

The second court case of Estate of Lillian Baral (U.S. Tax Ct., No. 3618-10, July 5, 2011) involves a woman with dementia that needed around-the-clock care per the recommendations of her doctor. Lillian Baral needed full-time supervision because of this cognitive impairment, so her son employed caregivers to help her. After she passed away, her estate appealed the expenses for her caregivers as the IRS initially denied the deductions for long-term care.

The U.S. Tax Court ruled that the care qualified as a deductible expense because her doctor authorized the need for long-term care. The caregivers did not have to be medical personnel. Medical care expenses can be written off when itemized taxes are done. In 2011, long-term care expenses can be deducted when costs exceed 7.5 percent of adjusted gross income. In 2012, this will increase to 10 percent.

Individuals and their loved ones should seek legal counsel early on when long-term care expenses become a reality. Proper estate planning to protect assets, plan for special needs, and utilize government benefits is critical.

A knowledgeable New York City, White Plains or Fishkill Elder Law lawyer will greatly assist you and your loved one to create a comprehensive plan to account for all the matters that come up with long-term care needs.

To learn more about New York elder law and New York estate planning, visit http://www.littmankrooks.com or http://www.elderlawnewyork.com.

“Increasingly, evidence is accumulating that overt symptoms of autism emerge around the end of the first year of life,” the researchers wrote. “…[W]e hypothesize that at least some of the environmental factors impacting susceptibility to autism exert their effect during this critical period of life.”

Autism rates have exploded since the 1980s, when one in 10,000 children developed autism. Now, one in every 110 children is likely to develop autism, according to the CDC. Researchers have been trying to locate a gene in the human body that acts as a “switch” to turn on the disorder, but have been largely unsuccessful. Advocacy groups like the National Autism Organization say that a genetic cause cannot fully explain the massively increased rates of the disorder, and that environmental factors are likely to play a major role.

Some studies have sought to tie the increasing autism rates to vaccinations that most infants receive. These studies have been inconclusive, and fraudulent in one famous case, but may receive revived interest based on the NIH study.

The Combating Autism Act, passed by Congress in 2006, directed the NIH to research any possible environmental causes of autism. But in 2009, only 9 percent of research funding was spent on environmental causation, according to the National Autism Association.

To learn more about New YorkSpecial Needs visit http://www.littmankrooks.com or www.specialneedsnewyork.com

Social Security payments for August 3, 10, 17 and 24^th will be made on time and as scheduled. People that receive paper checks can sign up for Direct Deposit.All current beneficiaries must switch to electronic payments by March 1, 2013.

Seniors who use PACE are assessed by a team consisting of professional and paraprofessional staff. The team creates a care plan tailored to an individual senior’s needs and delivers many services to the senior’s home, including acute care services and nursing facility services. Other social and medical services are completed in an adult day health center. These include adult day care, dentistry and prescription drugs.

To qualify for PACE, seniors must be at least 55 years old, qualify for Medicare or Medicaid, live in an area serviced by PACE, and be eligible to receive nursing home care from an appropriate state agency.

Seniors who use PACE pay a monthly premium, but all Medicare services are covered if the senior is eligible. The premium amount is dependent on the senior’s financial situation. Medicare also covers a small portion of the monthly premium.

The Balanced Budget Act of 1997 founded PACE as a national service and established it as a permanent part of the Medicare program. A similar program operated in California as early as the 1970s. The program is currently available to all eligible seniors near one of its 75 centers in 29 states.

In New York, the law firm of Littman Krooks LLP features Certified Elder Law Attorneys nationally recognized by the National Elder Law Foundation who can help seniors plan for their futures. To learn more, visit http://www.elderlawnewyork.com/blog/ or call 914-684-2100.

To learn more about New York elder law, New York estate planning, visit  http://www.littmankrooks.com or http://www.elderlawnewyork.com

The results were released just days before World Elder Abuse Awareness Day, a worldwide effort to bring attention to elder abuse and neglect that takes place annually on June 15.

The study warned that women between the ages of 80 and 89 who live alone and require some type of outward assistance are the most targeted victims of financial abuse in the United States. Men between the ages of 30 and 59 accounted for 60 percent of crimes against the elderly.

According to the study, 51 percent of all instances of financial abuse of the elderly are crimes committed by strangers. Approximately 34 percent come from family, friends or acquaintances. This figure is a decrease from the estimated 55 percent in 2008. Crimes classified as “scams” committed by strangers accounted for 28 percent of all financial abuses, business-related exploits made up 12 percent, and Medicare and Medicaid fraud accounted for 4 percent of cases.

The study found that the majority of cases involved strangers who exploited seniors with visible vulnerabilities, such as the use of a cane, a handicap tag hanging in a vehicle, or clear signs of confusion. These cases tended to involve physical assaults, purse snatchings or cons.

When family or friends were involved in elderly abuse, the study found that most cases involved forged checks, stolen credit cards, drained bank accounts, and transferred assets.

MetLife conducted the study by analyzing news articles that referenced financial abuse of the elderly and extrapolating data from the findings.

To learn more about New York elder law, New York estate planning, visit http://www.elderlawnewyork.com

Most of them, at some point, will develop a chronic disease or disability. So who will call the  insurance company or ensure that they’re taking their medication?  Most in-home care for the elderly is performed by family members. Hospital stays are getting shorter, driven by cost-saving initiatives, making it even more likely that these seniors will need outside help at some point in their lives.

Their options include friends, paid caregivers and government-sponsored social services. There may be an increased need for long-term care insurance to cover in-home, as well as nursing home, services. And more advance directives are likely to designate friends as health and financial decisionmakers.

Stories are beginning to appear about women building networks of close friends to share household and home care costs, to advocate for one another, and to provide the emotional support that might otherwise come from a spouse or child.  So far, it appears, men have  been less likely to test such situations.

One problem is that such measures are largely unprotected by law.  The Family Medical Leave Act, for instance, provides no benefits to individuals who may wish to care for a grievously ill friend.

There is also little guidance on how to financially structure such mutually supportive arrangements. There’s an emerging movement, though, that seeks to change that.  Some legal scholars are  espousing the establishment of “friendship law,” which would confer certain rights upon “designated friends”  who play a significant caregiver role—including hospital visitation,  tax breaks and claims to an estate if no will has been established. This is, to say the least, controversial.

On the other hand, when the nuclear family can’t provide an answer, what sort of “caretaking community” can step in? There’s  research to support the important role that friends play in the aging process.  Studies indicate that, especially for seniors, having friends can improve both physical and mental health.  It reduces stress, correlates with better immunity and may even be a factor in women’s longevity, given their .greater likelihood of having strong social networks. Ethan Leib, who teaches law at the University of California at Hastings, points to public savings that accrue when friends step in during illness and other emergencies.

Boomers have repeatedly changed our culture. Although childless seniors would seemingly be at greater risk than others, research indicates that –so far—they do not receive less care or enjoy life less than their counterparts.

Do you know someone in this situation? How is that individual planning for the likelihood that, at some point, outside help will be needed?

For more information, visit www.elderlawnewyork.com or www.littmankrooks.com.

As the spring season comes to a head, it is time to start thinking about summer services for students with disabilities.  Designed to assist in the maintenance of skills your child learns during the school year, extended school year services, or “ESY,” is available under the IDEA Regulations (34 CFR § 300.106) and offered pursuant to your child’s IEP.

In addition to regression and recoupment (i.e. is the child likely to lose critical skills or fail to recover these skills within in a reasonable time), whether the IEP team will determine that ESY is appropriate for your child will depend upon a number of factors, including but not limited to your child’s behavioral and physical impairments; his or her rate of progress; and the availability of resources.  The IEP team will also consider your ability, as Parents, to provide the structure your child needs at home.  It is important to keep in mind that ESY cannot be limited to particular disabilities or types of services.

While the school district will cover the cost of ESY, it is important to keep in mind that not all students will qualify for the service.  ESY is not “summer school.”  It is a service offered to students with disabilities who, in the past, have shown regression during vacations or other extended breaks from the school year.  As parents, note when you see a regression in skills, and when your child’s teachers or providers indicate to you that they see regression.  For example, it is necessary for your child to re-learn certain skills after the winter or spring breaks?  It is important to collect and compile information and documentation to support this regression so that the IEP team may consider ESY for your son or daughter.

Lauren I. Mechaly is an associate attorney at Littman Krooks LLP who focuses her practice on special needs planning, special education advocacy and elder law. For more information, please visit www.specialneedsnewyork.com or www.littmankrooks.com

The Importance of Proper Advance Health Care Directives

By Bernard A. Krooks

Recently, discussions in health care legislation have brought up the need for individuals to consider advance health care directives.  It is important that these advance directives be thorough, so that they do not conflict with an individual’s wishes or a designated surrogate health care proxy’s decisions.

Thinking about the medical care and treatment one might want or need in the future is often a difficult task, as it requires individuals to seriously consider unfortunate circumstances.  However, it is important that all individuals over 18 prepare advance health care directives to ensure that their wishes are being fulfilled in the event of an emergency.  In the absence of advance health care directives, emergency medical treatments have left as many as 30,000 individuals in a permanent comatose and vegetative state.  Due to these emergency treatments, as many as two million Americans have been confined to nursing homes, resulting in a major financial burden on loved ones.  By failing to plan for life-changing situations, millions of individuals leave themselves exposed to prolonged, painful treatments.  What is more, their loved ones may become exposed to financial difficulties and emotional conflicts.  Establishing advance health care directives will ensure that these issues do not arise.

There are several different forms of advance directives.  The most common, a Living Will, is also the oldest form of an advance directive.  In a Living Will, an individual may express his or her wishes to avoid certain types of medical treatment, citing quality of life issues or religious conflicts.  Living Wills may also designate an individual’s desire to avoid lifesaving measures, such as tube feeding or resuscitation, in the event of a terminal illness.

Other forms of advance health care directives include establishing a durable power of attorney and health care proxy.  Recently, the State of New York has begun requiring that durable powers of attorney be notarized.  New York also requires that powers of attorney be witnessed by the persons taking on those responsibilities.  It is also important that an individual’s wishes be thoroughly discussed with the designated power of attorney, in case the durable power of attorney is forced to make a decision due to an unforeseen circumstance.

When creating advance directives, it is important that an individual consult a professional.  Without having someone with experience guiding the process, important elements could be left out, causing an individual’s wishes to be ignored or a conflict to be created among family members.

Bernard A. Krooks, JD, CPA, LLM (in taxation), CELA, and a nationally known and widely quoted expert on elder law.

For more information regarding advance directives, visit www.littmankrooks.com, www.elderlawnewyork.com, or www.specialneedsnewyork.com. For more information about National Healthcare Decisions Day, visit www.nationalhealthcaredecisionsday.org.

Testators may account for these occurrences while drafting the will and follow steps to make a will contest less likely to succeed.

Ensuring a will is properly executed can severely limit the ability for a will contest to succeed. An experienced elder law or estate planning attorney can assist with this process and verify that a will is executed according to the law.

A no contest clause, or in terroreum clause, is a provision included in a will that can be used to strip the inheritance from anyone who contests the will if that person loses the lawsuit. A disgruntled family member will often not risk losing his or her inheritance over a perceived injustice in the will and will choose not to contest it.

Proving competency at the time the will is drafted may prevent a will contest over the testator’s mental capacity after he or she has died. Drafting attorneys can check for competency by sending the testator to a doctor or by asking the testator a series of questions. A videotape of the testator signing the will may help to show the court that it was signed freely and with the requisite mental capacity to agree.

Explaining the will to family members or leaving a related letter to be read after the testator’s death often goes far in assuaging family members and preventing will contests. Explanations for how provisions were distributed may help an inheritor to understand why he or she should not feel slighted.

To remove the possibility of allegations of undue influence, the testator should draft the will independently and without family input, especially if the testator is under the care of another family member.

For more information about will contests or to limit the possibility of a will contest, contact an experienced New York estate planning attorney or New York elder law attorney. Visit www.littmankrooks.com or www.elderlawnewyork.com for more information.

Bernard Krooks is a New York Elder Law and New York Estate Planning lawyer with offices in White Plains, Fishkill, and New York, New York.

From Devastation to Acceptance to Advocacy:

The Journey of a Mother & Attorney Through the Maze of Autism

By Sheryl R. Frishman, Esq.

I could take you back further in my life, but I feel as though my true life began in the year 2002 when my son, Aaron, was diagnosed with Autism.

I will digress a bit to my earlier life, as it will set the stage for my journey.  I grew up in a loving family and my childhood was what some would consider entitled.  I was a good student, had friends, went to a good college and found a meaningful career path in law school.  I was married to another attorney in 1996, moved to Westchester shortly thereafter, and had a wonderful career as the senior associate attorney in a prominent law firm where I managed the elder law department (which interestingly enough was a practice devoted partly to representing the rights of families with disabled children and parents).  In March of 2000, my life changed, as I gave birth to beautiful twins, Aaron and Rebekah.  They were relatively healthy babies.  However, Aaron was born with one enlarged kidney which when tested was benign, and was put on an antibiotic prophylaxis which was to prevent any urinary tract infections which could possibly irritate his kidney.  He also suffered from colic, had reflux, and had many ear infections. I do not remember much about this wild time, but I was a career woman and went back to work when the twins were four months old.  Everything was progressing nicely, the twins hit all their milestones in a timely fashion, and I was balancing my family and career well.

Nevertheless, at about 13 months of age (incidentally right after Aaron’s MMR vaccine), I began to notice that Aaron was acting differently than other children.  He was difficult to engage and loved to line toys up in an order that really only made sense to him.  He was not speaking, and was quite happy to be left completely alone in the corner of a room with books.  I was told by his pediatrician, and my family, that he was fine and just progressing slower (boys are supposed to do that).  So I left it alone for a few months hoping they were right but in my gut knowing that there was something wrong.  In the meantime, I became pregnant again and was working and trying to balance my busy life.

When Aaron was about 20 months old, a friend of mine, who is a speech therapist, told me that she thought that Aaron should be evaluated by early intervention because she was noticing strange behavior.  Again, I took Aaron back to the pediatrician, who told me to say “earth to Aaron” to get his attention, and that this type of behavior was not uncommon for boys.  Nonetheless, when Aaron was two years old, I could stand over him and try to make eye contact with him but he would always look away.  Finally, I took him to be evaluated by speech and occupational therapists and a psychologist.  They told me at the end of the arena evaluation that Aaron had Autism.  This was a day I will never forget.  I was numb.  When I spoke to my family and spouse, they all tried to convince me that he may have some Autistic features but would ultimately be fine.

Here started my insanity.  Six months pregnant, I left my job, and became a full time advocate to “cure” my son and became a “stay at home” mom.   I researched Autism and left no stone unturned.  I quickly went to see all sorts of doctor “specialists” – developmental pediatricians, neurologists, psychiatrists, allergy and immunologists, and alternative practitioners.  There was only one consensus amongst them all – that my son was profoundly Autistic, Apraxic, had sensory dysfunction, an auditory processing disorder, ADHD, and was possibly “mentally retarted”, and in order for him to make any progress he was going to need intense therapy (more than 40 hours per week) in all aspects of development, possibly medication, drastic change in diet etc. etc. etc.

Well….. I did everything that I could, some that made sense and some not so much and anything that I could afford.  I got him intense therapy both at home and at school, got specialized behavioral therapy, specialized speech therapy for Apraxia, sensory OT, listening therapy, considered and tried medication, and started a restricted gluten casein free diet.  I researched the causes of this disorder, and found that along with genetics, that there were several environmental factors that could have contributed to Aaron’s Autism including the antibiotics he was on since infancy, toxic mercury in his vaccines, and mercury that I could have ingested while pregnant.  Finally, a remarkable service plan was put into place for Aaron and I spent my days taking him from therapy to therapy, my nights awake researching about Autism (and being with Aaron – because he never slept) and worried about the baby that I was carrying (who I knew was a boy), and my daughter, Rebekah, who was not getting the attention she deserved.  I paid no attention to my husband, who was working endlessly to provide for our family and dealing with a crazed wife and his own feelings about the situation,  I also paid no attention to myself and was on auto drive to make my son as well as he could be.  Everywhere I turned there was a different program or a different treatment for Autism.   I tried any of them that made sense to me and that I could afford, and I craved one place that a parent could go to get all of the answers but there was none  – so I started compiling a list of programs and services for families myself.

When my second son Zachary was born in July, of 2002, Aaron was already deep into his therapy and progressing slowly but nicely.  Thank goodness that Zack was a good baby.  So the dust cleared, and it was time for me to mourn – mourn the loss of anything “typical” in my life, mourn the loss of the intimacy with my husband, mourn the loss of my career, mourn the loss of myself, and mourn for Aaron.  The best thing that I did personally that really saved me was to enter into therapy for myself.  This helped me to accept the diagnosis, cry, express anger, resentment, blame, jealousy and work through these emotions and realize that my son is who he is.  It helped me realize that my mission was not to cure his Autism, but to do what I could to make his life as fulfilling as it could be and give him every opportunity that he should have to find happiness as he is without neglecting myself and my family.  I also realized that only when I became part of Aaron’s therapeutic team would he truly progress.  I also joined a support group of women who had similar issues to me and this helped me cope and be a better parent.  So instead of wishing for something that was unlikely going to come true – a cure – I began to examine the disability world and see what was out there for my son in the present and in the future.

I became active in organizations that I knew could help my child now and in the future.  I helped raise money for NAAR (the National Alliance for Autism Research) – Now Autism Speaks – and have had a large team – “Aaron’s Army”.  I joined the board of directors at Arc of Westchester – where I was able to experience the full lifecycle of a disabled individual.  Through Arc of Westchester, I found that my child, although disabled, could live a happy and productive life, could have a job, a wonderful place to live, terrific activities, and wonderful people to help care for him.  I serve on the board of other organizations that represent the needs of people with disabilities, speak endlessly to organizations, and   also helped to develop programs for disabled children in areas of need in Westchester County and New York State.  Through my involvement with these various activities, I learned so much about the system and really made it my mission to improve it as best as I could so my son and other children like my son could lead happy and productive lives.  I then met a woman, who similar to me, is an attorney and has three children, one of whom is profoundly disabled.  We discussed that there was really not one place for parents of special needs to get all of the legal services that they need to navigate the complicated special education and disability law system.    There are some law firms that do primarily special education advocacy, and some that do the estate planning, and some that do public benefits and guardianships.  But there was no “one stop shop” for families where all the needs of their disabled children could be met in one place.  Thus, the birth of my fourth child – my current law practice which I began in 2005.

Currently I practice at Littman & Krooks, LLP, which specializes in providing expert counseling and quality advocacy for the unique needs of children and adults with special needs from birth through adulthood.   I have found that my skills and experience (both professional and personal) enable me to serve as a resource for families of children and adults with special needs in varied settings.  From assistance in obtaining appropriate special education services, to helping families obtain guardianship over their disabled relatives, to navigating the maze of public benefits, to special estate and financial planning, Littman Krooks is there for all of the legal aspects of having a child or relative with special needs.  The special education system is a difficult one and it is part of the mission of the team I work with at Littman Krooks to empower parents and teach them their rights and how to advocate for their children so they will receive the free and appropriate services that they deserve from their school districts.  Parents of children with special needs also need help transitioning from school to adult life and assistance with what that entails, including guardianship and the school districts responsibility in proper transition – the team at Littman Krooks helps families with this as well.  There is also a whole world of public benefits and resources available for children and adults with special needs but the system is very difficult to navigate for parents and many families are not even aware that they are eligible for these services.  Additionally, the scariest thing for any parent is what is going to happen to our child if something happens to us how and who will take care of them.  The team at Littman Krooks assists families in specialized estate and disability planning and helps them secure a bright future for their child or relative.  I am so happy that I am able to be part of the team at Littman Krooks that does this important work for families, and help them through a legal system that is sometimes unjust to people with disabilities and frankly does not make very much sense.

At this time, my son Aaron is doing beautifully.   He is speaking, and is a happy and engaged little boy.  He has far exceeded my expectations based on what the professionals first told me.  He is a remarkable little boy.  He still has Autism and always will, but has improved dramatically.  I know that whatever he chooses to do in his life he will be happy – maybe it won’t be “typical” but it will be what is right for him.  As for my other children, my youngest son was diagnosed with some developmental delays that are not as profound as his brother, and my daughter is adjusting to the special needs world herself with a support network that I have assisted her in setting up. Are there still days that I get sad and worn out by my family’s situation – of course – but I am so proud of my children and thank God and Aaron everyday for guiding me to be a better mother, showing me that I have a strength I never thought I had, and helping me find a purpose in my life that fulfills me and will help other families like my own.

Sheryl Frishman, Esq., is Of Counsel to the law firm of Littman Krooks LLP. Her practice is devoted entirely to the advocacy and life planning needs of children and adults with disabilities and their families.Sheryl also currently serves as President of the Board of Directors of Westchester Arc, the largest agency serving people with developmental disabilities and their families in Westchester County, New York.

On February 1, 2011, a Manhattan Federal Court Judge rendered a decision in D.A. v. New York City Dept. of Education, 09 Civ. 5097 (S.D.N.Y. Feb 1, 2011) that reaffirmed a family’s right to seek and obtain “direct” tuition funding for a private school education where the family proves that the local school district failed to provide a free and appropriate public school education (FAPE) to the student.

For many years, the courts have generally recognized the right of parents to seek reimbursement of private school tuition under the Individuals with Disabilities Education Act (IDEA).  However, parents who could not financially afford to pay the cost of private school have relied on an Impartial Hearing Officer, State Review Officer or federal court, to order a school district to pay the tuition directly to the private school when a determination has been made that the local school district did not provide a FAPE to the student.

In this case, although the New York State Office of State Review held that there was no legal right to obtain direct tuition payment under the IDEA statute, in his recent decision Judge Gardephe stated:

“A contrary ruling would be entirely inconsistent with IDEA’s statutory purpose, including the goal of ensuring a FAPE to the least privileged of the disabled children in our nation.  Such a ruling would also be irreconcilable with decades of case law…holding that the exercise of rights under IDEA cannot be made to depend on the financial means of a disabled child’s parents.  Limiting the right of unilateral withdrawal…only to those with the financial means to pay the cost of private school tuition…is entirely antithetical to IDEA’s universal guarantee of a ‘free appropriate public education’ to all children with disabilities, regardless of means.”
The type of funding addressed in this recent decision is typically known as “Connors” funding where a school district is ordered to pay the cost of tuition and related costs  directly to a private school.  Tuition reimbursement to a parent who has already paid the cost of private school tuition is typically referred to as “Carter” funding.

Although NYCDOE may very well elect to appeal this case, we believe at the present time, this decision is a very welcome win for parents who continue to advocate for an appropriate education for children with special needs.  It sends a message that all children, regardless of their economic status should be afforded a free and appropriate education.

Continuing care retirement communities (CCRCs) consolidate a range of services, from housing to full nursing care, into one facility. Generally, CCRCs offer a guarantee of lifetime care, which is an attractive option for many seniors. The facilities often require sizable entry fees, however, in addition to monthly rent. Many seniors must sell their homes in order to afford the entry fees, making them dependent on the financial stability of the community for their long-term care. If a community is forced into bankruptcy, residents could lose their deposits to the community’s creditors, leaving them few options for continued care.

While the report acknowledges that few communities have failed, it also notes the strain a challenging real estate market and low occupancy rates have placed on some communities. CCRCs are not federally regulated, and states have varying degrees of financial oversight and consumer protection. The report looked closely at regulations in eight states, including New York.

The report, entitled “Continuing Care Retirement Communities Can Provide Benefits, but Not Without Some Risk,” can be read and downloaded at the GAO website: http://www.gao.gov/products/GAO-10-611.

Long-term care insurance plans usually pay a daily benefit for a pre-determined period of time. When determining how much long-term care insurance to purchase, consider what daily benefit will be necessary to cover one’s care costs and how long the policy will need to pay the benefits. Policies generally cover a minimum period of two years. Longer periods of coverage and plans that cover the policyholder’s full lifetime are also available. Five-year plans are popular, since they can be used to cover costs during the five-year Medicaid look-back period for transfers of assets.

Long-term care insurance policies that pay a high daily benefit or cover an extended period of time can be costly. An estate planning professional can help you tailor a plan to fit your long term care needs and budget.

To learn more about New York
elder law, New York
estate planning, visit http://www.elderlawnewyork.com

This repeal has the potential to affect the estate plans of millions of Americans, as wills and trusts that were once properly prepared may no longer provide protection for spouses or other beneficiaries upon the death of a family member. The lawyers at Littman Krooks LLP have carefully studied the potential impact of the repeal of the Federal Estate Tax and encourage attendance for those who want to ensure that their estate plan is not obsolete.

The seminar will be offered in two sessions on Wednesday May 12, 2010, at the Duchess County Regional Chamber of Commerce in Poughkeepsie, NY. Registration for the morning session begins at 9:30 a.m. in Room 400. The morning session will be held from 10:00 a.m. to 11:00 a.m. Registration for the afternoon session begins at 3:30 in Room 400. The afternoon session will be held from 4:00 p.m. to 5:00 p.m.

For families whose loved ones die in 2010, the repercussions of the Federal Estate Tax repeal could only add to their grief at the passing of their loved one. The seminar will cover the challenges facing estate planning in 2010 and the consequences of this unusual appeal. This appeal has created unprecedented uncertainty in the world of estate planning, and the lawyers at Littman Krooks LLP wish to offer their guidance in these uncertain times.

Attendance to this event is limited, so those interested in attending must reserve a place by phoning Melissa Hayn at 845-896-1106 or emailing mhayn@littmankrooks.com.

For more information on the firm, visit www.littmankrooks.com. Littman Krooks LLP offers legal services in several areas of law, including elder law, estate planning, veterans’ benefits, special needs planning, special education advocacy, and corporate and securities.

Parents’ intentions regarding gifts to children should be made clear in their estate planning documents. A document could state, for example, that you are not making any adjustments based on gifts you have made. Doing so will make it clear that none of the children should receive a reduced share of the estate based on past gifts. On the other hand, you could list past gifts that have been made and carefully explain why one child is receiving a reduced share of the estate.

Loans made to your children should also be addressed in your estate planning documents. Verbal loans can be particularly tricky. You might, in this case, make a provision in your documents that classifies all verbal loans as gifts. If, however, there are verbal loans that you do not wish to have considered as gifts, you should state this in writing. If you wish to consider loans made to your children as advances on their inheritance, then this should also be specified in your estate planning documents.

Carefully considering and planning how you would like to deal with gifts and loans to your children will help avoid conflict among them in the future. You should consult an estate planning attorney to ensure that your legal documents provide guidance regarding your intentions.

Learn more at Littmankrooks.com.

Community Living Centers offer veterans both short-term (less than 90 days) and long-term (more than 91 days) stays. To be eligible for short-term stay in a CLC, a veteran must be enrolled in VA health care. During a short-term stay, veterans receive a variety of services including: respite care, rehabilitation, hospice, skilled nursing, and maintenance care for those waiting for placement in the community. Long-term stays are available to enrolled veterans who need care for the term of their lives or for an extended amount of time due to a service-related disability.

State veterans homes are owned and operated by the states. States must petition the VA to receive a portion of the construction costs and to be recognized as a state home. Once a home has been recognized, the VA pays a portion of the per diem cost as long as the home continues to meet VA standards. States are entitled to establish their own eligibility requirements, as well as to determine which services will be offered for short- and long-term care. Some homes may offer specialized services to veterans.

Veterans can also receive nursing home care from some community nursing homes that have established contracts with the VA. These partnerships allow veterans to receive long-term nursing home care in their own communities so that they can stay near their loved ones.

Placement in any of these programs requires that a potential resident be medically stable, have sufficient functional defects to make inpatient nursing home care necessary, and receive an assessment by a medical provider that states institutional nursing home care is necessary. In addition to this, each potential resident must meet the requirements of the facility to which he or she is applying. An elder law attorney can assist in the process of choosing the appropriate institution.

Adult children often take on the care of a parent without question, and without consideration for the consequences of spending large amounts of money, or even going into debt, to fund the care. However, dipping into savings or retirement accounts to care for parents could leave individuals without adequate assets for their own future care.

An estate planning or elder law attorney can help individuals plan for the possibility of contributing to the care of an aging parent. A good estate plan will allow for the care of loved ones while preserving enough assets for one’s own future needs.

Bernard Krooks is a New York Elder Law and New York Estate Planning lawyer with offices in White Plains, Fishkill, and New York, New York. To learn more, visit http://www.littmankrooks.com.

Wills are living documents, meaning they can be modified or amended at any time to reflect changing circumstances. However, busy schedules may prevent changes from being made in a timely manner. Naming alternate beneficiaries will prevent the need to modify a Will during already difficult times.

Naming alternates in a Will is a good practice in general. Families with young children should name guardians and successor guardians. Alternate executors may also be named should the original executor be unable to perform his or her duties. Careful planning will help ensure wishes are carried out even when unexpected events arise.

Bernard Krooks is a New York Elder Law and New York Estate Planning lawyer with offices in White Plains, Fishkill, and New York, New York. To learn more, visit http://www.littmankrooks.com.

It is still unclear whether the tax will be repealed in 2010. Earlier this month, the House passed a one-year extension of the tax, essentially freezing it at current levels until 2011. The House has also passed smaller extensions, from one to three months, in an attempt to give the Senate time to come up with a more permanent solution.

However, the Senate has, at this point, not passed any legislation dealing with the estate tax. Senate lawmakers recently rejected a one-month extension of the tax. Democratic leadership has promised to take up the issue in the new year and may pass an extension that applies retroactively to January 1, 2010.

This uncertainty could make estate planning somewhat more difficult for individuals with large estates, as the Senate continues to deliberate. Some estate planning professionals are advising a “wait and see” approach. But for those who need to settle affairs quickly, the decision about how to handle a large estate may be more complicated. An estate planning or elder law attorney can advise on the best way to handle this delicate situation.

Bernard Krooks is a New York Elder Law and New York Estate Planning lawyer with offices in White Plains, Fishkill, and New York, New York. To learn more, visit http://www.littmankrooks.com.

Some examples of powers that a trust protector may be given include: removing or replacing a trustee, handling disputes between trustees and/or beneficiaries, amending the trust, adding beneficiaries, changing disbursements according to changes in beneficiaries’ circumstances (such as divorce), and having the final say over investment of the trust’s assets. The trust document can be used both to name a trust protector and to define his or her powers.

Although anyone may serve as a trust protector, it is generally a good idea to hire an independent third party or professional, since s/he may have to make decisions that affect beneficiaries or resolve conflicts between beneficiaries should any arise. An experienced elder law and estate planning attorney can help ensure that a trust protector is given the right balance of power to oversee a long-term trust effectively.

For more information, please visit http://www.littmankrooks.com.

Same sex couples are not eligible for Social Security spousal benefits. When two married individuals retire, the spouse with the lower monthly benefit can choose to take either his or her own benefit or one-half the higher-earning spouse’s benefit, whichever is greater. For example, if one member of a married couple qualifies for a yearly benefit of $15,000 and the other for a yearly benefit of $6000, the lower earning spouse could instead choose to receive $7500 as a spousal benefit. A lower earning member of a same sex couple does not qualify for the higher benefit.

Same sex couples are also not eligible for survivor benefits, in which a surviving spouse may qualify for the higher-earning spouse’s benefit after s/he has passed away. Legally adopted minor children, however, are eligible for survivor benefits. Since New York law permits single, joint and second-parent GLBT adoption, same sex couples can and should take advantage of the law and legally adopt any minor children to whom they are not biologically related.

For more information, visit http://www.littmankrooks.com.

Financial planning for a child with special needs is the first step in providing a solid base of lifetime support. Once the child turns 18, his or her income will be used to determine eligibility for public benefits. Earning too much — for example because of contributions from parents — will cause the loss of public benefits. This can be avoided through a Supplementary Needs Trust. Funds paid into the Trust will not be counted as income and, therefore, will not affect eligibility for benefits. Planning for lifetime care must include instructions as to how the funds in the Trust are to be distributed and who will manage the trust.

Other questions to be considered:

• Do special arrangements need to be made with a college or other educational institution?
• What arrangements need to be made for housing?
• Will the individual need care of a legal guardian even after turning 18?
• Can the individual execute a Power of Attorney or Health Care Proxy?

Growing up and moving into adulthood is difficult for any adolescent, and even more so for a child with special needs. However, appropriate special needs planning can help make the transition go more smoothly for the whole family.

To learn more, visit http://www.littmankrooks.com.

A resident must be considered “chronically ill” in order for assisted care expenses to be deductible. This means a doctor has certified that the individual cannot perform at least two activities of daily living — for example, eating or bathing — and that the individual requires supervision because of a cognitive impairment. The services must also be administered in accordance with a plan of care prescribed by a doctor, nurse or social worker. Generally, only medical expenses my be deducted, but room and board expenses may qualify for deduction if the patient is chronically ill and in the nursing home for the purpose of medical care.

For more information, visit http://www.littmankrooks.com.

Once a minor child has been legally adopted, parents should draft an Authorization for Consent to Medical Treatment of a Minor, detailing who is authorized to make medical decisions for the child, and appoint a guardian and successor guardians. Taking the proper legal precautions will ensure that minor children will be cared for in accordance with the wishes of their parents and primary caregivers.

For more information, visit http://www.littmankrooks.com.

The Section 811 program provides a benefit to individuals with disabilities in the form of housing vouchers. These “Section 8” vouchers help low income individuals afford housing by paying the difference between the rent and what the tenant can afford. Section 8 vouchers, paid to government-approved landlords, increase housing options for people who may otherwise not be able to afford to rent an apartment. The Section 811 program provides such vouchers specifically to individuals with disabilities.

According to a release from Senator Menendez’s office, the legislation would improve and expand HUD’s Section 811 program by:

• Increasing the number of available housing vouchers for people with disabilities and ensuring that vouchers continue to be used to help people with disabilities.

• Encouraging the integration of mixed-used developments into the program and allowing funds from Low Income Housing Tax Credits and the HOME program to be used.

• Extending the length of rental assistance contract terms from 20 years to 30 years for projects using Low Income Housing Tax Credits.

The bill has attracted many endorsements, including support from such organizations as the National Association of County Behavioral Health and Developmental Disability Directors, the National Council for Community Behavioral Healthcare, the National Disability Rights Network and the National Multiple Sclerosis Society.

For more information, visit http://www.littmankrooks.com.

This week, the administration declared in a brief that the act is discriminatory and should be repealed by Congress, although the Justice Department will still offer a reluctant defense of the act. The brief intends only to clarify the official stance of the administration in favor of repeal of the act.

Assistant Attorney General Tony West wrote, in the brief filed with the U.S. District Court for the Central District of California, “This administration does not support DOMA as a matter of policy, believes that it is discriminatory and supports its repeal. Consistent with the rule of law, however, the Department of Justice has long followed the practice of defending federal statutes as long as reasonable arguments can be made in support of their constitutionality.”

For more information, visit http://www.littmankrooks.com

The person named as your attorney-in-fact does not have to be a lawyer. In fact, when choosing a person to act as an agent, the most important characteristics to look for are trustworthiness, organizational and management skills, and good common sense. Depending on the complexity of the estate, it may be a good idea to name someone familiar with financial matters, as well as someone familiar with your wishes and personal habits. Make sure your attorney-in-fact has access to all necessary information, such as accounts, PIN numbers, and passwords that will be necessary should he or she have to begin making financial decisions on your behalf.

Unfortunately, the majority of Social Security disability claims are initially denied. According to the Social Security Administration’s own annual report, in 2006 only 32 percent of disabled workers applying for Social Security disability benefits were determined to be entitled to an award. Those in the position of applying for Social Security should be aware of this issue and prepared to take the next step if an application is denied.

If the Social Security Administration (SSA) determines that an applicant is ineligible for benefits, he or she will receive a letter in the mail with a notification of the denial and a brief list of the medical information that was used to make the determination. This letter is referred to as the initial denial, and the applicant then has 60 days from receipt of the letter to file an appeal in writing. In New York, the SSA assumes that you have received your letter five days after the date on the letter unless other evidence is presented. If no appeal is made within this 60-day window, the SSA closes the case and will take no further action.

After the initial denial, there are three levels of appeal available to applicants in New York: a hearing by an administrative law judge, a review by the Appeals Council, and a Federal court review.

The hearing before an administrative law judge is critical, because in this step, the applicant, witnesses, and a representative may appear before the judge to present evidence. The judge is independent of the SSA and is not bound by the fact that the applicant has been previously denied. The judge’s decision will be based upon the evidence presented at the hearing and a prior review of the case. According to the SSA, it is in the applicant’s advantage to attend this hearing.

If the claim is denied after the administrative hearing, the applicant may still ask for a review by the Social Security Appeals Council. If the Appeals Council decides to review a case, it may decide the case itself or order it returned to an administrative law judge for further review.

In the event that the Appeals Council decides not to review the applicant’s case or reviews the case and still denies the claim, the applicant may file suit before a Federal Court.

The process for appealing a denial of Social Security disability benefits is complicated and can be lengthy. According to the SSA’s own statistics, however, those willing to undergo the process are often successful in having the initial denial reversed. A New York Estate Planning attorney can offer advice and representation throughout the process to help ensure a positive outcome.