Medicaid waivers and developmental disabilities

wheelchair and caregiverIf you have a child with a developmental disability or other special needs disability, you need to know about Medicaid waivers.  Very broadly speaking, a waiver is a program available to persons with a disability and other specific qualifications (depending on the type of waiver) that provides supports and services intended to help the person continue living in a community setting rather than a nursing home or institutional setting.

Waivers may be available to people who don’t otherwise qualify for regular medicaid because their income or assets are above the limit.  They may also be available as additional support for people who are already receiving Medicaid.

Medicaid is a federal program, but each state administers the program, makes some of the rules, and kicks in some of the money to pay for it.  This means each state handles waivers differently.

Our firm has clients in three different states.  Here’s what you need to know for each state.

Massachusetts: The Massachusetts waiver program is administered by the Department of Disability Services.  The majority of waivers south-hadley-107565_1280are for persons age 18 or over, but there are some waiver services for children. You must submit an application to DDS for services.  This application is in addition to your Medicaid (MassHealth) application.  Placement in waiver programs occurs during the open enrollment period each year.

Information on applications and available Medicaid waivers in Masschusetts is here: https://www.mass.gov/orgs/department-of-developmental-services

 

 

New Hampshire: New Hampshire has several waivers covering both children and adults.  The application process is integrated into the downtown PortsmouthMedicaid application at the New Hampshire Department of Health and Human Services, here: https://www.dhhs.nh.gov/dfa/apply.htm  There is sometimes a waiting list for waivers, but it is typically less than a year and may be far shorter.

 

 

 

 

Texas: Texas has a number of different waiver programs that serve both children and bluebonnetadults.  Children who do not otherwise qualify for Medicaid due to family resources may qualify for one or more of the waivers.  Texas has very long waiting lists for most of its waiver programs, however, several as long as ten years.  It is recommended that all persons with a developmental disability have their name placed on the “interest list” which allows them to apply for the waiver as spots come open.  This means you can place your child on the interest list without knowing whether they will actually qualify for it or not at the time they come to the top of the waiting list.  If they no longer need the waiver when a spot is open, you can simply decline to apply.  Two different state agencies handle waivers and each has their own interest list, so you must get on all that may apply to your child.  You can find the information you need to get on these lists here: https://www.navigatelifetexas.org/en/insurance-financial-help/texas-medicaid-waiver-programs-for-children-with-disabilities

 

Medicaid and the waiver programs are critical benefits for persons with serious disabilities that prevent them from supporting and caring for themselves.  Parents should seek out and obtain any relevant government benefits such as these as part of their complete plan for their child’s lifetime.  These benefit programs generally provide the foundation of care that can then be supplemented by the resources of the parents.  For more information on leaving money or assets to care for your child with a disability without endangering their eligibility for Medicaid and waiver programs, give us a call at 833-RED-BOOT (833-733-2668) or email at legal@gmail.com.

 

4 Things to Know About ABLE Accounts

accountant-1794122_1280ABLE accounts are a relatively new tool that people with disabilities and their families have to use in planning for adulthood.  ABLE is an acronym for Achieving a Better Life Experience and the basic idea is that it allows the accumulation and spending of money in the name of the disabled person without causing the loss or reduction of SSI (social security) and medicaid benefits.  Before the ABLE accounts, this was not possible.

ABLE accounts do NOT replace the need for special needs trusts and other planning tools, but they do some very useful things for some circumstances.  Here are a few basic things you should know about ABLE Accounts:

  1. ABLE accounts are the ONLY way an individual can accumulate money in their own name and still receive all the SSI and Medicaid benefits they would otherwise be eligible for. However, there are limits to the amounts of money – currently up to $15,000 per year and $100,000 total can be accumulated without causing a benefits disruption.  The yearly amount may fluctuate from year to year.
  2. ABLE accounts are only available to individuals whose disability occurred prior to their 26th birthday.  This means all individuals with a developmental disability such as cerebral palsy, autism, or Down Syndrome are eligible, as well as individuals whose disability was the result of an accident or medical malpractice or illness, as long as it occurred prior to age 26.
  3. Funds in an ABLE account may be able to pay for some things without causing an SSI reduction that would occur if funds from a special needs trust or another source were used.  This means that even people who are not capable of handling an account themselves, may benefit from having one.  This is a benefit that should be discussed with your attorney to see if using an ABLE account in conjunction with other tools may be useful.  This also may be a benefit that future legislative changes could eliminate, so if you are using an ABLE account for this purpose you will need to keep a close eye on legal and regulatory changes.
  4. Any funds being held in an ABLE account that remain at the time of the individual’s death are subject to claim by Medicaid. It may still be a good idea to accumulate money, but in many cases it may be better to avoid using the ABLE account merely as a savings account because of the possibility of it eventually going to Medicaid rather than designated beneficiaries.

Not all states currently have ABLE accounts, but you do not have to open an account in the state in which you live.  You can find great information on the specifics of currently available accounts on the ABLE National Resource Center website.

For more information generally on planning for the future of a child with special needs, you can read our articles here and here, or call our office for a short, free consult.  You can reach us toll free at 833-RED-BOOT (833-733-2668).  We serve families in Texas, Massachusetts and New Hampshire.

Special needs trusts and other scary things

planning journalCan you guess what the hardest part of doing special needs planning is?

Getting started. Hands down, the number one thing that keeps people from doing their plan is never getting started.

Is the thought of calling an attorney intimidating/scary/expensive/overwhelming?

Here’s how we can help you get over that and start your plan – talk to us on the phone for 15 minutes and you’ll see just how nice and helpful we can be. Tell us a little about your family and we’ll walk through what we can do for you. We guarantee that you will learn something new when you talk to us.

Schedule your free, no strings attached phone introduction now – you can even drink coffee while we talk!
https://calendly.com/parkercounsel

We have attorneys in Central Texas, the Pioneer Valley of Massachusetts, and Portsmouth, New Hampshire that can work with you to design a plan that will provide all the supports needed to care for your child with a disability once you are no longer able to do so.  We will help you figure out the seemingly impossible task of caring for a child for many years after you are no longer around.

So click the calendar link above and take advantage of this free, personal introduction to our firm and what we can do for you.  We guarantee you’ll learn something you didn’t know before.

The worst family emergency may be the one that happens to you

surgery-1822458_1280How well would your family function if a medical emergency happened to you? As special needs parents, we tend to focus on preparing for emergencies that might happen to our kids, and it’s fair to say that’s a good thing to do.  But in reality, there is probably a far greater probability of serious consequences happening if the primary caretaker in the family has an emergency and no preparation has been done.

 

 

 

  • Who knows your child’s routine?
  • Who knows how to contact medical providers – and has the authority to talk to them?
  • Who has access to your appointment calendar?
  • Who can access your bills and bank accounts to make sure the mortgage and the health insurance premium is paid?
  • Who can authorize medical care for you – and who can authorize visitors to the hospital?
  • Who can speak to your child’s teachers and therapists?
  • Who knows how to spend your child’s benefits and to keep track of expenses for reporting purposes?
  • Who knows how to find your child’s special needs trust?
  • Is it clear who will become your child’s guardian if you can’t continue – or will family members be fighting over it?
  • Will your child’s social security and medicaid benefits continue without interruption if your medical emergency becomes a death?

Americans are chronically underprepared for incapacity and death – less than half of adults have a will.  Lack of planning creates unnecessary expense and chaos – but when you are also the caretaker of a special needs child or adult, that lack of planning can create immediate and serious problems for that child who is dependent on you for care.

Estate and incapacity planning for families with special needs members requires very specific tools, and requires thinking through more scenarios than other families.  Parker Counsel attorneys know how to put together a plan that will meet your family’s specialized needs and we will work with you prepare for the worst of times with the least disruption to your child with disabilities.  We work with families throughout Texas, Massachusetts, and New Hampshire on estate planning, special needs trusts, guardianship, and other planning needs.

Give us a call or email for a short consultation – we guarantee you will learn something you didn’t already know about planning for your family.

1-833-RED-BOOT (833-733-2668)

legal@parkercounsel.com

Seek out others like you and learn from them

support- scrabbleIf you’ve been a parent of a child with special needs for very long, you know how many things you run into that the ordinary parenting books, and ordinary parents, can’t answer for you.  The very best thing I ever did for myself as a parent of children with special needs is to hook up with other parents.  There are many ways to do so – your school may sponsor special ed parent meetings, local disability organizations may sponsor parent meetings.  Online you can find parent groups connected by email, and many parent support groups are on Facebook.

Join a group and listen.  Make a point to participate by answering questions and asking your own.  Share the good, the bad, and the ugly about your days.  You’ll learn a lot.  You’ll learn about resources for your kids. You’ll learn about treatments and techniques that others use.  You’ll learn about programs for your kids.  You’ll learn about ways others have found to deal with insurance, and doctors, and therapists, and bureaucracy.  You’ll learn what the future may hold for your child.

And most importantly of all, you’ll learn that you are not alone.  You’ll learn that there are people who understand your life and that you can talk to without judgement.

You may know I have two personal needs children of my own, and I belong to several parent groups.  And frankly, I have learned and still learn frequently from the clients sitting in my office as we drift away from discussing executors and trustees and start talking about our lives.  No matter where you live and how much you know, there is always more information out there, and parents are often the best source.

Some online parent groups you may want to check out:

North Shore – Seacoast Special Needs Parents

Pioneer Valley Special Needs Parents

Austin Special Needs Facebook Group

Parent Support – Veterans of the Fight

Adults with Cerebral Palsy Advising Parents of Kids with CP

Parents of Severely Disabled Kids

If you belong to a great parent group, please post it in the comments for others to check out.

New offices, more attorneys, new name, Oh My!

sun-3313646_1280Summer is always an exciting time.  The routine of the year is shaken up when summer comes – kids are out of school, families take vacations, work is more relaxed, outdoor festivals erupt every weekend.  You may vow to read that book you’ve had sitting on your bedside table since Christmas, or you may just be excited to have longer days to be able to enjoy the sunshine.  Whether you’re excited about summer activities or dreading having the kids home all day, summer is definitely a time where the usual routines get thrown out the window.

More special needs families can work with us

This summer shook our firm up quite a bit, too.  The Law Office of Pamela Parker has been serving special needs families for about a decade now, but Pam knew the need for good information and good legal services for families with special needs children is so great, than more service was needed.  So we’ve expanded.  A lot.

A new name for the same great firm

The Law Office of Pamela Parker is now Parker Counsel Legal Services, although Pam is still heading up the operation.  We’ve also opened four new offices in three states, and now have five attorneys in addition to Pam helping families design and prepare plans to take care of their special needs children long into the future.

Five locations in three states now serve special needs families

Our original North Austin office is still there serving Austin and Williamson County, but we’ve added a South Austin office to serve Hays County and southern Travis County, including Westlake, Dripping Springs, Circle C, Kyle and Buda.    Meet the attorneys here. 

We’ve also opened two offices in Massachusetts serving Western Mass and the North Shore.  Families can visit us in person in Amherst and Newburyport.  Meet the attorneys here. 

And last but not least,  New Hampshire seacoast families can visit our Portsmouth office to do all their special needs planning.  Meet the attorney here. 

Our attorneys are the best team you could want

But the thing we are most excited about is the legal team we’ve assembled to work with our families.  Our six attorneys are all moms or aunts, with children ranging from nearly newborn to fully grown.  Some of us have special needs kids of our own, some of us have blended families, some of us have twins (!), some are adoptive moms,  some are active in the schools, some do volunteer work in the community, some are married, some are single, some have children at home and some have children in residential group homes, some love to read and some love to watch movies . . . in other words, we are all just like you and we know what your life is like.  That means we really understand the needs you have and can help you come up with solutions to any planning problem you may have.

You don’t need to know what to do, you only need to decide its time to create your plan.  Our team is here to help you figure out what to do, and with our new offices and our new legal team, we can do that for more of you than ever before.

You can give us a call at 1-833-RED-BOOT (833-733-2668) for a short consultation on your needs, or sign up here to have written information mailed to you – Send me information on planning for my special needs child.

Eighteen and armed . . . with all the best documents!

I love having 18 year olds in my office.  They signal they are listening intently to me by making their eyes wide and keeping them trained on me while I talk, but the slight glaze over the eyeball is obvious as they nod and agree and pretend like they understand everything we’recollege students talking about.

Now, don’t get me wrong, they DO understand, but they don’t UNDERSTAND.  They know that the power of attorney means someone else can access their bank account and get money to pay the landlord if for some reason they can’t do it, but they don’t really get why that matters.   They understand that the HIPAA form means everyone they list on it will be able to call the hospital and get information on their condition if they wind up in a car crash far from home, but they don’t really know why we think that might happen.  They understand that the FERPA release will let their parents arrange for a leave of absence from their college if a medical emergency lays them low for a few months, but they really kinda think we’re being ridiculously anxious about things that will never happen.

They don’t yet understand that life is unpredictable.  They don’t yet understand that the unpredictability can cause problems that last for years if they are ignored.  They don’t yet understand that it’s easier to prevent a major problem with a little planning than it is to try and clean up a problem that has grown to an intrusive problem.  They don’t understand that one eviction for nonpayment of rent, one default on tuition payments, one medical emergency where an insurance company gets away with denying services that should have been covered can all have far reaching consequences that affect their life and options for years to come.

But parents understand.  So every 18 year old client that I have, sitting in front of me while I explain the personal legal documents that every adult should have, has a parent or two sitting in the waiting room, who understand.

It’s easy to book an hour and a half appointment for your young adult to complete all the personal legal documents every adult – even young ones – should have.  Give us a call at 833- RED-BOOT (833-733-2668) or email legal@parkercounsel..com  Whether you’re in Austin, TX, Western Massachusetts (Amherst, Northampton, Springfield, the Berkshires) or Portsmouth NH, we’re ready to help you. 

Swedish Death Cleaning

Have you heard about this?  As I understand it, there is a tradition in Sweden, verified by the existence of a single word in the Swedish cleaning toolslanguage that means the cleaning and decluttering done by a person who believes that their life is close to the end, of culling your worldly possessions to a manageable amount of meaningful or immediately useful items before you die. Or something like that.  I’m not sure if this is an actual Swedish tradition or merely something we’ve all suddenly started talking about here in the U.S.  Either way, it’s an interesting idea.   You can read more about it here and here.

I’m certainly not opposed to the idea behind Death Cleaning.  However, it seems to me to be the same as the idea behind Spring Cleaning, or behind the “Decluttering” advice, which you can read about here and here.  The only difference I can see is that Swedish Death Cleaning is for people who never got around to Spring Cleaning or Decluttering.   Same thing, just pushed to the last minute.  Maybe, at its heart, Swedish Death Cleaning is the ultimate proof of hardcore procrastination versus your ordinary, garden variety procrastination.

And finally, remember that unless your death cleaning results in throwing every single one of your possessions, you’ll still need a will.  (Had to get that plug in, because taking care of adult business always includes paperwork!)

 

People and Money – How to Prepare for Lifelong Care for Your Special Needs Child

people and money product shot (1)It’s overwhelming to think about, we know.  But we have a system and can walk you through the four key areas of planning that will create a system to care for your child no matter what the future may bring.   We will help you, step by step, put together a community of caregivers, maximize financial supports, create transition tools, and nail it all down with the proper legal documents.

Start with a free phone conversation.  Find out what you need to know.  Find out how we can help.  Find out how to put your plan together.  Step by step.  It’s easier than it seems.   Call us (413) 203-9358  or email legal@parkercounsel.comstart-1063441_1280

3 Things to know about attorney-client privilege

secret-3037639_1280The term attorney-client privilege is in the news today.  If you have an attorney, or if you are about to hire an attorney, or if you are thinking about an attorney, some of this news may be alarming to read.  So before you go any further, I want to give you three important things to know about attorney-client privilege.

  1. Attorney-client privilege protects confidential information learned by an attorney in the course of consulting with, advising, or representing a person.    Attorney’s can’t give good legal advice if they don’t have good information.  Sometimes the information the attorney needs is something the client doesn’t want other people to know about – like how much money they have, or whether they gave a child up for adoption, or that their mother would make a terrible guardian for their child.  The attorney client privilege is intended to make sure that people feel comfortable telling their attorney all relevant information so that the attorney can give the right legal advice to them.
  2. Attorney-client privilege does NOT protect communications made in order to plan, continue, or cover-up a crime.  If a client confesses a crime to an attorney, that information is covered by attorney-client privilege.  But if the client and attorney discuss how to commit a crime, or if the attorney gives advice on covering up a crime that has already been committed, those communications are not covered by privilege.   An attorney cannot help a person commit a crime, and any communications surrounding such advice or assistance are not protected by privilege.
  3. Attorney-client privilege does NOT apply if the communications aren’t made in a confidential manner.   The attorney-client privilege extends only to communications and information that is intended to be confidential.  If the client discusses information in front of people who are not connected to the representation, it may not be considered confidential.  Talking to or in front of the attorney’s staff is generally the same as talking to the attorney, but if a person discusses information in a public area where others can overhear, that may void the confidentiality.  Clients sometimes want family members to sit in on meetings with their attorney, but doing so might mean that anything discussed in front of the family member loses its attorney-client privilege.

What does this mean for you today?  It means that despite what you may hear in the news, attorney-client privilege is alive and well and will protect your confidential communications with your attorney. This also means that it is safe to answer any questions your attorney needs to ask in order to properly represent you.  If you are hesitant to tell your attorney a sensitive piece of information, ask about confidentiality first and have your attorney explain to you how the privilege works in your specific situation.