Does your child need a special needs trust to get Medicaid?

Posted on April 24, 2019 by Pamela

Children with developmental disabilities – cerebral palsy, Down Syndrome, autism, and any other condition that began in childhood – who are not able to work and support themselves are probably going to be able to get social security benefits and Medicaid (called MassHealth in Massachusetts) when they turn 18 years of age. In some cases, they can receive these benefits before 18, but in almost every case they can do so after 18. Social security provides a limited cash payment to persons with a disability who have very low or no income and assets. Even if a child with a disability continues to live at home with parents after they turn 18, if they have little or no income and little or no other resources like savings, they will probably be eligible for supplemental security income (SSI) and Medicaid.

SSI cash benefits are pretty low (currently $770 a month, with some states adding a little bit more), so it’s important to have a way to supplement the limited spending power of that SSI money. While parents are alive, they can buy “extras,” like computers, videos, vacations, even additional therapy or vocational training not covered by insurance. But when the parents die, an inheritance to a child receives SSI and Medicaid will almost always cause them to lose those benefits. People with developmental disabilities who are receiving, or will probably receive in the future, SSI and Medicaid benefits, should never be left an inheritance or be named as a life insurance or pension beneficiary because it will jeopardize their benefits.

That’s where the special needs trust comes in. If a parent or grandparent puts money into this very special type of trust, that money can be used to supplement the government benefits while keeping those benefits in place. A New Jersey special needs trust, a Massachusetts special needs trust, a New Hampshire special needs trust, even a Texas special needs trust, all work the same way to let parents, grandparents, and anyone else who wants to leave money to improve the quality of life of a person with a disability give them money without causing any problem to their government benefits.

So back to the original question: Do you need a special needs trust in order for your adult child to get Medicaid? There are two parts to the answer. First, you may need a special needs trust to get Medicaid at age 18 if the child already has significant assets in their own name. Those assets can be moved to a special needs trust so that the adult child meets the very low asset threshold for eligibility.

The second part of the answer is that even if the adult child initially qualifies for Medicaid without a trust, they will probably need a special needs trust in order to keep those benefits when their parents die. The trust can receive an inheritance, life insurance proceeds, or even pensions, and that money can be used to enhance the quality of life of the adult child without causing them to lose their Medicaid or SSI benefits.

Parker Counsel Legal Services serves families in Central Texas, Western Massachusetts, Northern New Jersey, and the New Hampshire Seacoast with special needs estate planning, special needs trusts, and guardianships. Contact us for a consultation at 833-RED-BOOT (833-733-2668) or legal@parkercounsel.com or schedule a short information call at calendly.

How to ask for help from family and friends

Posted on March 4, 2019 by Pamela

Give people permission to be involved

Finding and nurturing people who will help your adult child have a safe and fulfilling life is an important part of a parent’s planning for when the parent is not around. Involved and interested family and friends can be the difference between a vulnerable life and a great life. But getting people to be involved isn’t always as easy as it seems. It involves more than simply letting people know you have a child with special needs.

If you want the people who know your child to be involved, you need to focus on your communication with them so that they have an understanding of your child’s life and so they understand that they are welcome to be part of it in many different ways.

Here are a few ways to boost your contact and draw people in so that they want to help:

Incorporate More Emotion Into Your Updates

The human brain is more engaged by storytelling than logical facts. There are a few reasons for this, but the bottom line is that emotion plays a big part in decision making. When you tell people what’s going on with your child, talk like a parent. Let people hear when you are proud, scared, frustrated, excited or whatever about your child’s situation, and do your best to convey whatever emotions your child may be having about what is going on in their life. Rather than a big yearly report about where your child is living and what medical events have occurred over the prior year, pick out a few interesting stories to tell throughout the year.

Emotions activate the part of the brain that makes us feel as if we are part of something, even if we are not physically present. The more we feel that we are already part of something, the easier it is for us to actually take an action.

Your family and friends will feel less hesitation to visit or offer suggestions or help for your child when they feel like they are part of the circle.

2. Make Clear Requests for Help

Some family and friends may wind up hearing your stories about your child with no real expectation of doing anything other than kind of generally keeping up with the family. In many cases, even if they have a strong interest in the well being of your child, they may not know that there are things they can easily do to be an active part of your child’s life. Making clear and specific requests for action will encourage them to take a step toward less passive interest.

Requests can be as low key as asking people to send your child birthday cards, all the way up to more time consuming projects like taking your child to a movie or making calls to find a dentist that will work with your child. You don’t want to overwhelm people into feeling personally responsible for your child if they don’t have the time or inclination for that, but you don’t want to skip over smaller things that many people would be happy to do if they only knew they could.

Ultimately, you are trying to convey to people that they are welcome to be part of your child’s life in whatever way they choose. You will have chosen people who will play legally sanctioned roles for your child when you, the parent are gone, but don’t forget to let everyone else know that they can choose to be involved as much or as little as they want.

3. Use Pictures

Picture sharing is so easy now that there is no excuse for failing to share pictures often with your family and friends. Pictures not only contribute to the emotional aspect of your communication, they often stimulate ideas in the minds of your audience – for example, a picture of your child in their room might prompt someone to suggest new drapes that match some preference or interest your child has.

The Power of Community

The more people who are paying attention to what is going on with your child, the better off your child will be. Everyone’s life is better when they have friends around. But also important for a person who may not be able to advocate for themselves, the more people who are watching and paying attention to the care your child receives, the less likely any serious problem will develop. Parents may not be there till the end of their child’s life, but parents can protect their child till the end of the child’s life with smart planning.

Creating an engaged community of people around your adult with special needs

Posted on February 4, 2019 by Pamela

One of the four key planning areas for parents who have a child that will always need assistance with their care is to create a community of caregivers. For many of these, that means a guardian for personal care and a trustee for money management, but those should not be the only people in your child’s life. Think of all the different things you as a parent do for your child – you feed and bathe and shelter them, of course, and you make sure they have health insurance and medical care, but you also do things like the following:

search out activities to do
buy clothes and toys and personal items
decide (or help) on clothing and hair styles
keep an eye out for new resources
notice how caregivers and therapists treat your child and make changes if there are problems
keep track of how your child feels and acts so you’ll know if a doctor’s appointment is needed
keep company with your child and interact or play with them

. . . and this is only a very short list of the things parents do for their children, and that, depending on your own child, you may continue to do into adulthood.

When you think about the community of people you want to build around your child, these are the kinds of things that your community will be doing for your child. Some people may visit and play, some will be more task oriented, and some may never see your child in person but will be on the lookout for resources and ideas for others to use. You don’t need a large group of people who can be the full time caretaker, you need a group of people who all contribute to your child’s life in a variety of ways.

Here are some tips on creating your community:

Ask people if they would like to stay in touch with you and your child. Many people who have worked with your child develop a fondness and would be delighted to keep up with your child in the future. If you welcome them into the group and give them a way to stay in touch, you may be surprised at how fast your child’s community grows.
Update everyone regularly, and include both major events and little day-to-day details. Make sure to share lots of pictures. Staying in touch isn’t about giving a quarterly report, its’ about keeping the group informed about your child’s life, which may include big life or medical events, but also includes things like going to the store to buy clothes, or having a great day watching movies at home, or even being sad that grandma’s visit was over. Little details will keep people informed of how your child lives and what they enjoy or think about. Our family uses a Facebook group for this, which makes it really easy to share pictures, but you can do email groups, or periodic mail, or any other communication technique that you like.
Give people specific permission to be involved in your child’d life and to communicate with the people who are with your child the most. You want everyone to know that not only is it ok for them to contact you, but that you really really want them to contact you if they have an idea or a thought or suggestion. Make sure people know that even if they are not the “official” legal caretaker, their participation is welcome and invited.
Ask for help sometimes. Be sure to ask for help in a range of ways. Give people ideas about what to do to help – even if its’ as simple as asking for birthday cards be mailed to your child. If you’re trying to come up with activities your child might like, ask the group for ideas. If you want someone to come by and visit your child if they’ve been stuck at home for a while due to an illness, ask. If you’re having trouble finding a new therapist that takes Medicaid, ask if anyone would be willing to make some phone calls. In other words, let people know what you or your child would like them to do, and most of the time people will happily jump in to do it.

The more people who know your child and are around in their life, especially as your child grows older and the parents begin to transition out of day to day caretaking, the better off your child will be, and the more at peace you will be that your child will stay safe and happy.

Medicaid waivers and developmental disabilities

Posted on January 31, 2019 by Pamela

If 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 are 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 Medicaid 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 adults. 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

Posted on January 25, 2019 by Pamela

ABLE 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:

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.
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.
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.
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, New Jersey, and New Hampshire.

Special needs trusts and other scary things

Posted on January 23, 2019 by Pamela

Can 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, Northern New Jersey, 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

Posted on January 11, 2019 by Pamela

How 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. Attorneys at Parker Counsel special needs law firm 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.

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

Posted on April 26, 2018 by Parker Counsel

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 (833) RED-BOOT (833-733-2668) , schedule a short information call at calendly , or email legal@parkercounsel.com

Four reasons your special needs child will never be neglected

Posted on February 27, 2018 by Pamela

Special needs parents worry. I say it a lot because it’s true. They worry about the day to day, they worry about money for therapies and equipment, they worry about school resources, they worry about finding good people to help care for their child, they worry about the future, and most of all, in the back of their mind where they shove the worries they don’t want to have to think about, they worry about their child being abandoned, neglected, and abused. They worry about the very thing that happened to 35 poor residents of a Chicago-area residential home this week. You can read the story here. But the upshot is that a worst case scenario happened and the owners of this residence simply locked the doors and left the residents alone. Abandoned, neglected and abused in the purest sense of those words.

The good news is that you have the power to eliminate that risk for your child if you plan properly. Even though your child will probably outlive you, you can still take care of your child long after you have left this earth. If you do what you need to do, there is every reason to believe that your child will never be one of the forgotten.

Imagine yourself having just completed all the the Four Keys to Special Needs Planning. Here are the four reasons your special needs child will never be neglected:

People are involved with your child. You have created a community of caregivers who have a way to stay updated on your child, have been asked to participate in your child’s life in whatever way they like, have been given specific permission to communicate with the “official” guardian and trustee for your child, and, most importantly, have been made to feel like they are a part of the group who is responsible for caring for your child.
Money is available for your child. You have made sure that your child will remain eligible for government benefits and that all other financial resources that may be available for your child are found, maximized, and properly managed.
You have left instructions and details. You have left all the information anyone might need to be able to both care for you child and also to make important decisions about their life and care in a way that is important to you and that takes into account all your child’s strengths and preferences. You have made sure that this information is accessible and available at short notice whenever needed.
The force of law is on your side. You have been to a lawyer and have gotten all the paperwork, court orders, and legal mumbo jumbo you need to ensure that your plans are carried out the way you intended.

It’s a big project. It will take you some time and it will take some money to complete this project, but it is within your reach. If you haven’t gotten our Special Needs Planning Blueprint yet, click here to request your free copy – Blueprint.

You are not the only person who can care for your child

Posted on November 27, 2017 by Parker Counsel

My heart is breaking again. Several times a year, every year, I see stories such as this one – an aging or ill parent caring for a disabled child, has become isolated and hopeless that anyone will ever be able to properly take over the care of their child, and ultimately sees only one way out: to leave this world together with their child.

The latest story ended in even more tragedy than most of these stories. A mother facing cancer tried to end her life and her daughter’s life, but the mother did not die. The mother was found before death and saved, only to face criminal charges in the death of her daughter. Convicted and facing prison two years later, she was able to try again and this time succeeded in ending her life, as well.

You can read the story in the Chicago Tribune here.

Although it is easy for parents to tell themselves that they would never do such a thing, far too many parents face their child’s adulthood without adequate support and planning and cause untold stress for themselves during their own lifetime, as well as needless stress and chaos for their family after they die. And yes, a few become so overwhelmed that they make what they have convinced themselves is the best choice for their child.

Please don’t wait to learn about what you can do to prepare for the time when you are no longer able to personally care for you child. There are choices. There are safe choices. There are happy choices. But the longer you wait, the fewer choices you have.

Start here –Four Keys to Special Needs Planning – or simply call us for an appointment to sit and talk about your situation and how to put together a plan that will make sure your child is safe and secure until the natural end of their life.

Parker Counsel special needs law firm is available by phone: 833-RED-BOOT (833-733-2668), by email: legal@parkercounsel.com, or schedule a short informational call with Calendly.