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Excellent information.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

August 2010 - Vol 4, Issue 12

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member, Amy C.

O'Hara. Amy is an attorney with Littman Krooks LLP with offices in New York

City, White Plains, NY and Fishkill, NY. Most of her work involves helping

people with special needs planning (trusts, guardianships and government

entitlements), estate planning and administration (wills and trusts), elder law

issues (Medicaid and Medicare, Veterans' Benefits, guardianships).

Your Special Needs Trust Explained

A Special Needs Trust (SNT) is a discretionary trust

created for a person with a disability, referred to as the " beneficiary, " as a

way to supplement his public benefits and enhance his lifestyle. Public benefits

often include Supplemental Security Income (SSI), Medicaid, and Section 8

Housing. One of the many appealing aspects of a SNT is that the beneficiary does

not have direct access to the trust assets, which are, therefore, not countable

when establishing financial eligibility for public benefits.

SNT assets can be used to purchase a home for the

beneficiary, services that Medicaid does not cover (including special therapies,

wheelchairs, handicap accessible vans and mechanical beds), recreational and

cultural experiences and, for the most part, any services or items that would

enrich the beneficiary's life.

Several requirements must be met when establishing a

SNT. First, the trustee must be given absolute control over the distribution of

the trust assets. Neither the beneficiary nor anyone acting on his behalf can

demand distributions be made from the trust. Second, the beneficiary cannot have

authority to revoke or amend the trust; otherwise the trust assets would be

deemed an available resource to the beneficiary, and he would lose his public

benefits. Third, the trustee should not give cash outright to a beneficiary

receiving SSI, as this would cause an immediate dollar-for-dollar reduction or

loss of public benefits.

Generally speaking, there are three types of SNTs: (a) a

first party special needs trust; (B) a pooled special needs trust; and © a

third party supplemental needs trust.

First Party Special Needs Trusts

A first party SNT is funded with assets owned by the

trust beneficiary. A first party SNT--also commonly referred to as a " self

settled " or " (d)(4)(A) " Trust--may be established to protect current or future

means-tested government benefits if an individual is about to receive a

settlement, inheritance or other monies that will bring his countable assets to

more than $2,000.

First party SNTs are most commonly required when an

individual with disabilities has received a settlement from a personal injury

action or an inheritance from a well-meaning person who did not understand that

such a gift could disqualify the beneficiary from important government aid.

Another common use for a first party SNT is for divorce alimony or property

division, or for child support payments when dealing with a child who has a

disability. Unless such funds are sheltered in a first party SNT or used to

purchase exempt resources, the beneficiary would lose his benefits and be

required to pay medical bills and many other expenses from the assets until

those assets have been spent down to $2,000.

When establishing a first party SNT, there are key

requirements that must be provided for in the trust agreement; otherwise, the

SNT may not protect the beneficiary's continued eligibility for public benefits.

Also, the beneficiary must be under 65 years of age at the time the SNT is

funded and must be disabled as defined in the Social Security Act.

Additionally, the law requires that the SNT must be for

the benefit of the individual with disabilities and that it be established by a

parent, grandparent, legal guardian of the individual's property, or the court.

The trust agreement must provide a Medicaid payback provision requiring the

state Medicaid agency to be reimbursed upon the death of the beneficiary.

Finally, the SNT must be irrevocable.

Pooled Trusts

A pooled SNT is also funded with assets that are owned

by the trust beneficiary. At times the settlement or inheritance the person

receives is small, and a first party SNT may not be the best solution,

especially if there is no parent, grandparent or legal guardian available to

establish the trust. If spending the funds for the individual's care or needs or

exempt resources is not a viable option, it may be more practical to place the

litigation proceeds or inheritance in a pooled special needs trust.

Pooled trusts are established and managed by nonprofit

organizations. The assets in the trust are pooled together for investment

purposes, but the nonprofit organization manages a sub account for the

beneficiary. A major difference between a first party SNT and a pooled trust is

that an individual with disabilities can establish the pooled trust sub account

himself. This is an attractive option for many beneficiaries who have no living

parents, grandparents, or a legal guardian of their property.

Third Party Supplemental Needs Trusts

A third party SNT is funded with assets that are owned

by parents, relatives or friends, but not assets owned by the trust beneficiary.

Third party SNTs are an ideal estate planning vehicle for parents and other

friends and relatives who want to leave an inheritance to an individual with

disabilities. Parents frequently say that their greatest worry is how their

child with disabilities will fare once they have passed away. Not only will a

third party SNT shelter an intended inheritance, it can be used during the

parents' lifetimes for ongoing expenses that are not covered by government

entitlements.

A significant attraction of the third party SNT is that,

unlike a first party SNT, when the beneficiary dies, there is no Medicaid

payback requirement. The person who created the third party SNT (often a parent)

chooses and has complete control over selection of the trust remainder

beneficiaries.

A third party SNT can either be testamentary (created

under a will) or inter vivos (created during lifetime). Additionally, an inter

vivos third party SNT can often be made revocable or provide an easy mechanism

for changes of trustee lineup or remainder beneficiaries if the parents want

flexibility to change the trust agreement in the future.

Thoughtful consideration should also be given to the

designation of the trustee of any SNT. For example, in situations where the

beneficiary's parents have large estates, sometimes it is recommended that the

parents not serve as trustees of an irrevocable SNT due to potential adverse tax

consequences.

In choosing a trustee, consider the potential trustee's

ability to (a) be sensitive to the beneficiary's disabilities, (B) actively

monitor any services provided, © aggressively advocate for all entitlements,

and (d) prudently invest SNT funds. Because of the trustee's many roles,

consider appointing a professional corporate trustee, either to serve alone or

to serve jointly with a family member trustee.

Have you had your special needs trust reviewed lately?

Whether you are a trustee or a parent, it is a good idea

to have the SNT reviewed periodically (ideally, annually) with your special

needs planning attorney. Some of the questions that should be reviewed include:

1. Have there been any changes in the laws that affect

the SNT?

2. Do you need to make any changes to the trustees or

trust advisors? Perhaps a successor trustee is ill or recently passed away and

you need to designate a new successor trustee. Or perhaps you want to consider a

corporate trustee if you have not previously designated one.

3. Do you understand the tax ramifications? It is

important for you to understand how the income earned in the SNT is reported and

on what type of income tax return. Questions you want to review with your

attorney are whether your trust is a " grantor trust " for income tax purposes or

whether it is considered a " qualified disability trust. " Also, what are the gift

tax reporting implications, if any, when a third party makes a gift to the

trust?

4. Is the trustee making any distributions that would

cause the beneficiary to lose benefits? Constant monitoring and oversight must

be made regarding SNT distributions. For example, if the trust is paying housing

costs for the beneficiary, the beneficiary may suffer a reduction in his SSI

benefit.

5. Are the assets designated to pour into the SNT as

intended? Your last will and testament will not control the disposition of

certain assets, such as annuities, insurance policies, and retirement plans, if

you designate beneficiaries other than the SNT. Your attorney can help you check

and update your beneficiary designations on these assets to make certain that

they pass to the SNT at your death, if intended.

This overview and list of questions to be reviewed with

a special needs planning attorney demonstrates that SNTs are very complex and

require careful consideration and planning to ensure that the appropriate SNT

has been set up for the beneficiary. By understanding the terms and requirements

of the SNT chosen for the beneficiary, you will be in a better position to help

protect the beneficiary's benefits and quality of life.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

August 2010 - Vol 4, Issue 13

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Amos Goodall of the State College,

Pennsylvania law firm Goodall & Yurchak, P.C. His practice emphasizes estate

planning and implementation for elders, persons with special needs and their

families. A member of the Special Needs Alliance and of the National Academy of

Elder Law Attorneys, Amos is also a Fellow of the American College of Trust and

Estate Counsel.

Crummey Doesn't Mean Lousy

How can families transfer and hold funds to be used to

help a child with special needs while avoiding gift taxes or a reduction in

their protection from estate taxes? How can parents provide a way for other

family members to do so as well?

Parents should consider creating " standalone " special

needs trusts for their children with disabilities. This is an excellent idea for

many reasons, including supplying an account for other relatives to contribute

to for the child's benefit. Without this, a well-meaning relative may simply

name the child with disabilities as a beneficiary on a life insurance policy or

in a will -- either jeopardizing the child's benefits or requiring the creation

of a much more restrictive kind of trust. Also, grandparents often want to

provide for all their grandchildren, and while a Section 529 education account

may be appropriate for a child going to college, a special needs trust may be

more appropriate for a child with disabilities

Gift and estate tax laws can complicate matters for

wealthy persons when funding a standalone trust. A contribution to a trust is a

gift subject to gift tax, like most other gifts. Most families are aware of the

annual exclusion from federal gift tax, which permits gifts of up to $13,000

(adjusted annually for inflation) per year from each person making a gift to

each recipient, without the gift counting against the $1 million limit on gifts

that can be made without payment of federal gift tax. Since married partners can

allocate their annual exclusion to their partners, grandparents can give $26,000

to each grandchild in a particular year without any gift tax consequences. Gifts

that exceed the annual exclusion will either be subject to a gift tax or will

reduce the donor's protection from state and federal estate taxes.

Unfortunately, this annual exclusion does not normally

apply to gifts to a trust. This is because the annual exclusion is available

only if the recipient has a " present interest " in the gifted property -- the

immediate right to use the property. Gifts in trust usually limit the use of the

property to a trustee's discretion or to distribution at a later time.

A number of years ago, attorneys devised a method of

making gifts to trusts qualify for the annual exclusion by including a special

withdrawal power in the trust, and this technique was recognized in a case

called Crummey v. Commissioner. As a result, trusts incorporating this

withdrawal power are known as " Crummey trusts " and the withdrawal powers are

called " Crummey powers. " These Crummey powers are often found in trusts that own

life insurance, sometimes called " life insurance trusts. "

How do Crummey trusts work? The donor (such as a parent)

creates a trust which contains a provision that allows the donee or beneficiary

to withdraw funds deposited into the trust for a period of time, typically 30

days from the date of notice to the beneficiary. At the end of the 30 day notice

period, if the beneficiary has not withdrawn the funds, the beneficiary loses

the right to do so. The IRS generally classifies gifts to Crummey trusts as

present interest transfers, therefore eligible for the annual exclusion. It may

not be surprising to learn that Crummey beneficiaries very rarely exercise their

power to withdraw the donated funds!

This technique by itself is not necessarily useful to

parents of children with disabilities, since most agencies hold that a

" withdrawable " transfer is an available resource. In the year of gift, the

amount will be " available " ; afterwards, the child may be considered to have made

a gift by not exercising the withdrawal power. Thus, the Crummey case alone may

not solve the problem.

Fortunately, attorneys have devised a second technique

that can be useful for beneficiaries with special needs -- a trust which gives

the right of withdrawal to someone other than the beneficiary with disabilities

(even though the person with disabilities is the person the trust is really

designed to benefit). This technique was approved by the Tax Court in a case

known as Estate of Cristofani.

In Cristofani the donor created an irrevocable trust

naming her children as primary trust beneficiaries and minor grandchildren as

contingent beneficiaries. In an effort to multiply the allowable gift tax

exclusions, the trust gave both the children and the grandchildren Crummey

withdrawal rights. If children and grandchildren did not withdraw the funds, the

funds remained in the trust for the benefit of the children, only going to the

grandchildren if their parents did not survive the donor for 120 days. The

grandchildren's possibility of getting the trust property if their parents

didn't survive is called a " contingent remainder. " The IRS took the position

that the annual exclusion did not apply to the gifts which the grandchildren had

the right to withdraw, because all the grandchildren had was a " contingent

remainder, " but the Tax Court disagreed. The Tax Court held that the

grandchildren's withdrawal rights made the gifts qualify for the annual

exclusion, even though the trust really benefited their parents.

Thus, the court's decision in Cristofani suggests that a

trust could include a Crummey withdrawal right for a person other than the

beneficiary with a disability, which would cause the gift to qualify for the

annual exclusion without the gift being an available resource to the disabled

donee.

This planning strategy has some limits. The IRS believes

that trusts like the one in the Cristofani case give rise to a suspicion that

there is collusion between the parties, a secret agreement that the withdrawal

right will not be exercised. The IRS has indicated that it will consider

challenging arrangements where the withdrawal power resides in someone other

than a current beneficiary. In one opinion, the IRS said: " the Service will deny

exclusions for powers by individuals who either have no property in the trust

except for Crummey powers or hold only contingent remainder interests. " Even

though one more Tax Court case like Cristofani has been decided in favor of a

beneficiary, it would still be very aggressive planning to rely on that case and

Cristofani when the IRS has said it will continue to challenge such trusts.

Therefore, if avoiding the gift or estate taxes is

important, the Crummey withdrawal power should be limited to someone who will be

receiving at least some of the assets in the trust after the child with

disabilities passes on, and even then, the family will need to be prepared to

prove to the IRS that there are circumstances indicating that there was no

collusion between the donor and the holder of the Crummey withdrawal power. A

carefully planned trust with named remainder beneficiaries can theoretically

give withdrawal powers to these beneficiaries, so that grandparents and others

could make annual exclusion gifts into this trust-assuming that they will

ultimately be used for the benefit of the child with disabilities, without being

deemed an available resource and without interfering with a child's present

benefits. Alternatively, the trust could give a set amount -- preferably more

than 5% -- to other children, and those children would have the Crummey

withdrawal powers.

This is a specialized planning technique, and it should

only be attempted with the advice of an attorney who is well versed in both

special needs and tax law. However, it can allow parents and others to benefit a

child with special needs while reducing tax consequences.

Most people will not have to worry about federal gift or

estate taxes, so the complexities of a trust with Crummey powers can be avoided.

However, if these taxes are a part of your planning, a properly constructed

trust with Crummey powers can be advantageous. A knowledgeable special needs

attorney can help you make this decision.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

September 2010 - Vol 4, Issue 14

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance members

V. Wilcenski and Tara Anne Pleat.

EDWARD V. WILCENSKI, Esq., is a founding partner of the

law firm of Wilcenski & Pleat PLLC in Clifton Park, New York. He practices

in the areas of special needs planning, elder law and trust and estate planning

and administration. A member and past president of the Special Needs Alliance,

Ed writes and lectures frequently on issues affecting individuals with

disabilities and their families.

TARA ANNE PLEAT, Esq. is a founding partner of the law

firm of Wilcenski & Pleat PLLC in Clifton Park, New York. She focuses her

practice in the areas of special needs planning, trust & estate planning and

administration, long term care planning and elder law. Tara is a member of the

Special Needs Alliance, frequently speaking on estate planning and

administration, special needs planning and related disability issues for state

and local bar associations and community organizations.

Retirement Accounts and Government Benefits

For many individuals retirement plans are an important

part of their financial security. While retirement plans can be great wealth

building tools, they can also present some significant challenges if an

individual with disabilities needs to qualify for some government benefits.

Retirement plans can be an issue in several different

contexts. Parents often want to leave retirement accounts to their children with

disabilities as part of their estate plan. People with disabilities may have

their own retirement plan that was funded before the onset of their disability.

In some cases a person with disabilities may have employment through a PASS Plan

or a supported job opportunity that includes either employer funding of a

retirement plan or the employee's option to self-fund a retirement plan through

wage deferral or withholding. In each of these cases it is important to know how

retirement plans can affect eligibility for government benefits and what options

are available to minimize or avoid the loss or reduction in benefits.

In this issue of The Voice, we discuss how retirement

plans may affect eligibility for means-tested government benefits. The next

issue of The Voice will address options to shelter retirement plan benefits in

order to preserve needed government benefits.

What is a Retirement Plan?

While there are many different types of retirement

plans, the following are the most common plans:

a.. Individual Retirement Accounts (IRAs). IRAs are

retirement accounts that are owned and funded by individuals with income they

have earned through employment.

b.. 401(k) Plans. 401(k) plans are employer sponsored

retirement plans that are funded by an employee's salary deferral and in some

cases also by employer contributions. 401(k) plans are typically offered by

private and corporate employers.

c.. 403(B) Plans. 403(B) plans function essentially

the same way as 401(k) plans. They are retirement plans that are administered

for the employees of educational institutions, hospitals and municipalities.

Generally speaking, each of these plans defers income

taxes. This means that money you put into the plan is not taxable in the year of

contribution, and it grows tax free within the plan. But when you withdraw funds

from one of these plans, the amount withdrawn is considered taxable income, just

like wages. Thus the tax is deferred but not avoided altogether.

There are rules which govern the manner and timing of

withdrawals from these plans. These rules are designed to encourage people to

save for their retirement, and then use the money once they do retire. The two

most important rules for our purposes are as follows:

a.. Rule 1. Prior to reaching age 59 ½, a retirement

plan owner who withdraws funds from his or her retirement plan will be subject

to an excise tax (like a penalty) equivalent to 10% of the total distribution.

This is in addition to the ordinary income tax that applies to the distribution.

This rule is designed to encourage people to keep money in the plan until they

retire. There are some exceptions to this rule, however, the most important of

which allows a person with a recognized disability to withdraw funds from a

retirement plan before age 59 ½ without incurring the 10% excise tax penalty.

b.. Rule 2. Once an individual reaches the age of 70

½, the individual must begin taking required minimum distributions from the

retirement plan. The IRS has a special life expectancy table that is used to

calculate one's required minimum distributions. If the individual fails to take

a minimum distribution after reaching age 70 ½, then there will be a 50% excise

tax on the total amount of the required distribution. That excise tax is in

addition to the ordinary income tax payable on the distribution. This rule is

designed to encourage people to use the money when they retire.

Retirement Plans and Government Benefit Eligibility

People with disabilities often need help from government

benefit programs that provide monthly income, medical care, attendant care,

housing and food. Many of these programs, including Medicaid, Supplemental

Security Income (SSI) and food stamps, are means-tested. These programs count

the amount of an applicant's monthly income and also the applicant's resources

(bank accounts, stocks, retirement plans, and other assets) in determining

eligibility for benefits.

For those individuals with disabilities who have worked

and accumulated money in a retirement plan, how will those plans be treated when

it comes time to apply for benefits? If a parent wants to name a child with

disabilities as a beneficiary of the parent's retirement plan, how will that

affect the child's eligibility for benefits? If a child is offered a retirement

plan as part of her employment benefit package in a supported work opportunity,

how will that affect her current or future eligibility for benefits?

In almost all cases a retirement plan inherited outright

by a person with disabilities will be treated as an available asset or as

monthly income that will reduce or eliminate means-tested government benefits,

including SSI, Medicaid and food stamps. The fact that the retirement plan is

taxable as funds are withdrawn does not mean it will not affect eligibility for

needs-based benefits.

For example: If Sam inherits a $100,000 IRA from his

mother at her death, that IRA account exceeds the $2,000 Medicaid and SSI asset

limit and will disqualify him from those benefits. In the next issue of the

Voice we will discuss planning opportunities available to Sam's mother to avoid

this result but still protect the retirement plan for Sam's benefit.

If the retirement plan is owned by the individual with

disabilities, the effect of the plan on government benefits is more complicated.

The government benefit program will need to determine if the retirement plan, or

any portion of the plan, can be accessed by the individual. In other words, are

the plan's assets available to the individual? This issue of availability will

vary from plan to plan, and some state Medicaid rules may vary on how

availability is determined.

In most cases, if the plan owner is no longer working,

the retirement plan will be available and counted as a resource. If the plan

owner is still working, the retirement plan may prohibit the owner from

withdrawing funds from the plan while employed. In that case the plan should not

be counted as an available asset. If the retirement plan allows a hardship

waiver of the prohibition on withdrawing from the plan or the option of

borrowing against the account, then the plan may be counted as an available

asset depending upon how the plan defines " hardship " or under what circumstances

employees can borrow again their account.

In some cases the retirement plan may be treated as

monthly income rather than an asset if the plan has been converted from a lump

sum to irrevocable periodic payments from the plan over the life expectancy of

the plan owner. Income usually reduces or offsets means-tested government

benefits, so having a retirement plan treated as income rather than an asset

probably will not help. Again, if Sam inherits a $500 per month IRA annuity from

his mother at her death, the $500 will offset and reduce his SSI income dollar

for dollar (other than $20 that will be disregarded). Instead of receiving his

SSI income of $674 plus $500, Sam will receive $500 from the inherited IRA and

$194 from the SSI program for total monthly income of $694.

The rules governing the treatment of retirement plans

vary depending upon the source of the retirement plan and may vary from state to

state. Individuals with retirement plan assets should seek legal advice before

applying for means-tested government benefits.

In the next article of The Voice, Alliance member Ken

Shulman will address planning options to shelter retirement plan benefits and

preserve eligibility for needs-based benefits.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Good and important information.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

September 2010 - Vol 4, Issue 15

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Ken

Shulman, a partner in the Boston, Massachusetts office of Day Pitney LLP. His

practice includes estate planning and related issues for families who have

children with disabilities, and elder law. He presently serves on the board of

the Asperger's Association of New England and on the Combined Jewish

Philanthropies Committee on Disabilities. He previously served on the board of

the Massachusetts Chapter of the National Academy of Elder Law Attorneys. He is

a co-author of Special Needs Trust Administration Manual, A Guide for Trustees,

available through DisABILITIESBOOKS.

Planning Options With Retirement Benefits

In the most recent issue of The Voice, Tara Pleat and

Ed Wilcenski described the various types of retirement plans and discussed how

these plans affect eligibility for means tested public benefits, primarily

Supplemental Security Income (SSI) and Medicaid. In this issue, we will discuss

the planning options available to retirement account owners, primarily parents,

to shelter these assets for their children who receive means tested benefits.

Retirement assets increasingly make up a significant

portion of many individuals' wealth. With fewer employers offering a defined

pension benefit (payments of a specific monthly sum to the retired worker), most

retirement nest eggs now consist of 401(k) or 403(B) plans and IRAs. When

passing these assets on to their children through their estate plans, parents

and their lawyers must contend with the convergence of several competing

interests, including public benefits issues, taxes and charitable intent. A

recent article (by fellow Alliance member Ed Wilcenski) on Forbes.com describes

some of the complexity.

It is important to remember that retirement benefits are

not controlled by your will. Rather, their disposition is controlled by the

beneficiary form you filled out in association with the retirement plan. For

example, if your will states that you leave all your assets to Neal, but your

IRA beneficiary form names as beneficiary, will receive your

retirement assets.

We often see situations where parents have created wills

and a special needs trust for their child with a disability but have neglected

to revise their beneficiary designations so that the child's share goes to a

special needs trust. It is not uncommon to see a situation where a parent has

designated his spouse as primary beneficiary of his retirement plan and his

three children as contingent beneficiaries. If one of those children is

receiving public benefits, the parent has created a significant and unnecessary

problem that can easily be avoided.

The Basics

SSI and Medicaid have asset and income limitations.

Leaving retirement funds directly to a person receiving these benefits will

almost always disqualify the beneficiary from receiving SSI and Medicaid.

Most retirement funds consist of tax deferred assets.

Generally, the employee receives a deduction for contributions made to the

retirement fund. However, when distributions are made from the funds, they are

taxed at ordinary income tax rates.

Roth IRAs consist of previously taxed assets, and

distributions come out tax-free.

The Internal Revenue Code requires mandatory

distributions from retirement funds when the owner reaches 70½ years of age. A

person can choose to begin receiving distributions without penalty at age 59½.

When the owner of a retirement plan dies, special rules

mandate at what rate an inherited retirement account must be paid out to the

beneficiary. These complicated rules about inherited retirement plans make

planning with them particularly challenging when the beneficiary receives means

tested public benefits. These include:

a.. Retirement funds left directly to an individual

may be stretched out over the beneficiary's life expectancy to preserve some of

the income tax benefits offered by the retirement account. This is attractive

from an income tax perspective, but this is not an option for a beneficiary

receiving means tested benefits because direct receipt of the funds will usually

disqualify the person from receiving benefits.

b.. If retirement funds are left to a trust for the

benefit of a beneficiary, the favorable tax treatment can be preserved if the

trust provides that all of the retirement account's annual required minimum

distribution is to be paid out to the beneficiary each year. Such a trust is

sometimes referred to as a " conduit trust. " Unfortunately, a conduit trust will

not preserve eligibility for means tested benefits because of the mandatory

distributions to the beneficiary.

c.. Because a special needs trust is a discretionary

trust, not a conduit trust, another subset of rules applies, the most important

of which is that the age of the oldest beneficiary, either the special needs

beneficiary or any contingent beneficiary, will be the measuring life for

determining the rate at which retirement funds must be distributed to the trust

and, therefore, taxed.

For instance, assume that Jack is the primary

beneficiary of a special needs trust that is the beneficiary of an IRA from his

deceased father. Also assume that Jack receives SSI and is 35 years old. The

special needs trust provides that at Jack's death any remaining funds in the

trust will go to his sister, , who is 52. The result is that 's age

will be the measuring age for determining at what rate the payments from the

retirement account must be distributed to the special needs trust. Since

is older than Jack, the IRA must be distributed over a shorter period of time

than if Jack's age was used to determine the distribution rate.

Another important rule is that all beneficiaries of a

trust that receives an inherited retirement account must be individuals in order

for the trust to be entitled to receive funds from the retirement account on a

stretched out basis. If any beneficiary is not an individual, then the

retirement funds must be paid out within five years.

Importantly, a charity is not an individual for

retirement plan purposes. If Jack's special needs trust provided that at Jack's

death any remaining funds would be distributed to United Cerebral Palsy instead

of to his sister, the distributions from the retirement fund to the special

needs trust would have to be made over a five year period rather than over

Jack's life expectancy. Since parents often want the organization or

organizations that cared for their child with a disability to receive the

remaining funds in the special needs trust, this can be problematic.

Solutions

When applying these basic rules about retirement

benefits to planning in the special needs area, there are several conclusions

that we can draw:

First and foremost, and worthy of repetition: Do not

name your special needs child directly as a beneficiary of a retirement plan if

your child receives or may later need SSI, Medicaid, or other benefits such as

Section 8 assistance or food stamps. The distributions from the retirement

account will either reduce the entitlements or eliminate them entirely. Instead,

if you want your child to receive your retirement benefits, the named

beneficiary on the account can be the special needs trust for your child.

Even so, this trust should contain special provisions

not typically found in special needs trusts to insure the most favorable

stretch-out and tax treatment discussed above. Consultation with a qualified

expert is critical.

Second: Pay attention to the remainder beneficiaries in

the special needs trust. In the example where Jack is 35 and his sister is 52,

the funds will be distributed over the sister's life expectancy using the

applicable IRS tables. This means that the funds will have to be taken out over

a shorter period of time, thereby reducing the time during which the assets

could continue to grow tax free.

It also means that more income taxes may have to be paid

by the special needs trust than if receipt of the retirement fund could be

stretched out over a longer period. The result is even less favorable if a

charity is named as the contingent beneficiary, which would require the funds to

be distributed to the special needs trust within five years, resulting in large

tax payments by the trust and reduced opportunities for growth.

Third: Given these complexities, parents should consider

the possibility of leaving their retirement benefits to children without

disabilities and leave other assets-cash, stocks, real estate, insurance,

etc.--- to the special needs trust. Leaving non-retirement assets to the special

needs trust avoids the unsatisfactory consequences associated with the shorter

pay-out required when the special needs trust names an older contingent

beneficiary or where the parents would like to name a charity as a beneficiary

of the trust. The retirement funds left to the children without disabilities can

be stretched out to the extent permitted by law, and more of the favorable tax

treatment and opportunities for tax deferred growth can be maintained.

While Roth IRAs do have mandatory annual distributions,

they are not taxable to the beneficiary. Accordingly, the Roth IRA may be a good

choice for funding a special needs trust, especially if the IRA names other

individuals relatively near in age to the child with disabilities as the

successor or contingent beneficiaries.

In any case, consulting a special needs lawyer who

understands special needs entitlements, estate and income taxes and the rules

regarding distributions from retirement plans is crucial when planning for the

proper disposition of retirement assets for children with disabilities.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

October 2010 - Vol 4, Issue 16

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

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The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by SNA member Hyman G. Darling, a partner

in the Springfield, Massachusetts, firm of Bacon , P.C. Mr. Darling

concentrates his practice in estate planning, elder law, probate, special needs

and guardianships/conservatorships. Before joining Bacon , he was a trust

officer for several years. A frequent speaker for civic and charitable

organizations, he serves on the American Cancer Society National Professional

Advisory Committee and the boards of several western Massachusetts nonprofit

organizations for persons with disabilities. He is a member of the National

Academy of Elder Law Attorneys Board of Directors.

Life Insurance on a Child with Special Needs: Benefits

and Challenges

Parents with a special needs child often insure

themselves to provide for their child when they have died. A more complicated

issue is whether the parents should consider purchasing life insurance on the

life of their child to address the possibility that they will outlive their

child. Purchasing a life insurance policy on the life of a child with

disabilities can provide several benefits for family caregivers. The purpose of

this article is to explain these benefits, provide an overview of the

application process and describe the types of policies that may be available,

while highlighting some of the special considerations that family caregivers

should understand. The information here expands on suggestions offered on Life

Insurance and Children with a Disability in an earlier article in The Voice.

Benefits of Life Insurance

For caregivers who have foregone career development to

provide care to a child with special needs, retirement savings, pension amounts

and even Social Security benefits may be adversely affected. A life insurance

policy on the life of the child may help to replace the caregiver's lost wages

and retirement accounts at the child's death. In most cases, when the insured

person dies, insurance proceeds will be paid to the designated beneficiaries

free of any income tax.

Although it is not pleasant to think about, having a

life insurance policy may help cover funeral expenses and make up for lost

income opportunities. Before you purchase life insurance on the child with

disabilities, you should know something about the process of purchasing a policy

and the available options.

Process of Purchasing a Life Insurance Policy

First, you should contact a reputable advisor. The

insurance industry can be driven by commissions, so find an advisor who will put

your family needs ahead of personal gain and who understands the guidelines for

writing policies on a person with disabilities. Some advisors may suggest that a

child with special needs may not be insurable due to pre-existing conditions or

disabilities. Do not accept this response as a final denial of coverage. Despite

such conditions, there may still be options to obtain insurance, such as

requesting a rating, a graded life benefit, or a policy based on the functional

level of your child (explained in more detail below).

One of the important considerations when applying for

insurance is to present the medical and psychological issues in a light most

favorable for issuance of the policy. The details about any medical or

psychological issues must be completed accurately and honestly, but there is

usually no requirement to volunteer additional information. If the company

wishes to request further explanation about test results or details surrounding

the capacity of a person to perform certain tasks, it may do so at a later date.

Another important consideration is to determine the

amount of coverage to request, which depends on your reasons for purchasing a

policy. If the proceeds are intended to cover only funeral and related expenses,

there is probably no need for a substantial death benefit. If the proceeds will

be used to support dependents or to replace a caregiver's lost wages, a larger

death benefit may be appropriate.

When the application is complete, the advisor will send

it, along with required medical information, to the underwriter. After

underwriter review of the application and the requested death benefit, the

company then determines whether to decline the application or to approve it with

a standard benefit, a rated benefit, or with lower coverage than requested.

Since the child is often a minor or is receiving

Medicaid or other means-tested government benefits, the child should not own the

policy. The cash value of the policy is a countable asset of the owner for

purposes of Medicaid and SSI, programs which have very low asset limits. Loss of

these critical benefits could be catastrophic for the child. You may be the

owner, as long as you do not have long-term care or estate tax issues, which

could cause complications for you. An alternative could be to have another child

own the policy, or, for a larger policy, to have an appropriate type of trust as

the owner and the beneficiary.

After the details of the policy have been arranged, it

is time to start making payments. The premiums, of course, will also be a factor

for determining how much insurance to request. It is interesting to note that

sometimes, a person who is younger will have a higher cost of insurance than

that of an older person. For instance, a person who is only 10 years old may

have a premium greater than that of a 20 year old since a 20 year old has

already lived to the age of 20 whereas the 10 year old has 10 more years to

obtain that age.

On the other hand, some companies do charge more if the

insured person is older. For instance, the sample analysis by one company for a

male age 10 with a death benefit of $25,000 will cost $179 per year whereas a

20-year-old male would pay $202 per year for the same coverage.

The cost of premiums will also vary depending upon

whether the policy is " term " insurance or " whole life " insurance. Term insurance

is guaranteed for a set number of years such as 20 years. When the term ends,

the insurance company may or may not agree to renew the policy for an additional

term. There is no accumulated cash value to a term insurance policy.

Whole life insurance, on the other hand, is typically

for the lifetime of the insured with a guaranteed death benefit regardless of

the age at death so long as the proposed premium schedule is maintained. The

insurance company cannot refuse to renew the policy as long as premiums are

paid. Whole life insurance typically accumulates a value over time referred to

as the cash surrender value. Term life insurance is cheaper than whole life

insurance as it does not provide any cash value.

Note that there are also " hybrid " policies that combine

aspects of term and whole life insurance. These policies are a little more

difficult to understand, and an explanation here would unnecessarily bog us down

-- ask your insurance advisor for an explanation and comparison of the different

types of policies.

The above steps and considerations highlight the process

of purchasing an insurance policy on the life of a person with special needs.

The following summarizes in more detail the types of policies that may be

available.

Insurance Policies for People with Special Needs

Even though premiums may be higher, a whole life policy

that guarantees coverage for the lifetime of your child will ensure continued

coverage if health conditions deteriorate over time. If your child's health is

stable and not likely to deteriorate over time, then term insurance may be less

risky.

Due to the inherent risk of insuring a person with

special health care needs, many companies establish guidelines for writing

policies on individuals with disabilities and have separate allocations,

referred to as the " tables, " regarding the cost of insurance. The company may

rate certain conditions or possibly assign an insured person what is known as a

" graded life benefit. "

A rating or a graded life benefit is not a denial of

coverage, but rather is an adjustment the insurance company makes about how or

when benefits will be paid. Instead of paying a fixed amount upon the death of

the insured party, a graded life benefit may schedule various benefit amounts

based on the number of years of survival after the application. For instance, if

the insured dies in the first year, the premium will merely be returned without

interest. If the insured dies in the second year, the death benefit may be 50%

of the face amount of the policy, death in the third year being 75% of the face

amount, and in the fourth year and thereafter, the death benefit will be the

full amount. However, if the insured dies as a result of an accident and not

from natural causes, then the full face amount may be paid.

Other policies may be issued as well as charged based on

the level of functioning of the insured. Thus the amount of insurance for which

a high functioning person can qualify may exceed the amount issued to a person

with more severe impairments. For illustration purposes, the following

summarizes how at least one insurance company describes certain levels of

functioning:

a.. High functioning autism is comparable to an IQ of

70. The insured should have no or only minimal impairment in sensory motor

ability and should have well developed language skills.

b.. Mild functioning autism is comparable to an IQ

range between 50 and 70. To qualify under this description, an insured should

have minimal impairment in sensory motor ability and be able to acquire grade

school academic skills. The insured should be able to achieve vocational skills

for self-support, even with assistance or guidance, but may also be able to live

independently or with limited supervision.

c.. Moderate functioning autism is comparable to an IQ

range between 35 and 49. To qualify under this description, an insured should be

able to acquire some communication and personal care skills through training.

The insured may have academic skills limited to the early grade school level,

and social skills are significantly impaired, but the insured may be able to

perform unskilled or semi-skilled labor under supervision.

d.. Severe functioning autism is comparable to an IQ

range between 20 and 34. Insured parties in this description show poor motor

development, minimal speech, and little to no communication skills.

e.. Profound functioning autism is comparable to an IQ

of about 20 or less. Insured parties in this description have minimal speech

development and self-care ability, may need to live in a closely supervised

setting, and may be able to perform only a few simple tasks with training.

In each of the above descriptions, the underwriting

decision of a company will depend on various issues such as the diagnosis, the

presence of co-morbid disorder such as depression, anxiety and obsessive

compulsive disorders, any history of seizures and epilepsy, level of

intellectual functioning, IQ, and the ability to work and live independently.

The mere fact that a person has a disability of any type

may affect the premiums or terms of the life insurance policy, but is not

necessarily a cause for denial. In addition, since there is no cost to applying

for a policy, there is really nothing to lose in an attempt to obtain coverage.

It may be that if a person has not been fully diagnosed when the application is

denied, an application may be resubmitted a few years later when a person may

have been sufficiently trained in self-sufficiency tasks to allow a policy to be

issued.

Whether you would benefit from purchasing insurance on

your child is complicated and, sadly, is premised on the possibility that you

could outlive your child. The cost of any policy must be weighed against the

potential benefits to you. Having a knowledgeable insurance advisor review

options can help you make an informed decision.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

November, 2010 - Vol 4, Issue 17

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member

Wilcenski, a founding partner of the law firm of , Wilcenski & Pleat, PLLC

in Clifton Park, New York. He practices in the areas of Special Needs Planning,

Elder Law, and Trust and Estate Planning and Administration. Ed is a past

President of the Special Needs Alliance, and writes and lectures frequently on

issues affecting individuals with disabilities and their families

Dear Grandma and Grandpa...

Each year as we approach the holiday season, we

receive questions from our clients as to how grandparents and other relatives

can make gifts to children with special needs without creating problems for

government benefits. These conversations don't involve gifts of toys and other

items of personal property, since these items are typically excluded as " exempt "

resources and have no impact on public benefits. Instead, the questions usually

involve how grandparents and other family members might make gifts of cash or

other financial assets.

Most of our clients are informed enough to know that a

direct gift of cash is almost always a bad idea. In fact, the challenge often

lies not in the discussion of the type of gift, but rather in determining how

best to raise the topic in the first place. Indeed, discussions of money can

often be awkward and uncomfortable for both sides.

In this issue of The Voice, we thought it might be

helpful if we wrote a letter to Grandma and Grandpa on behalf of the grandchild

with special needs, in hope that it may facilitate a more detailed discussion

with those who are inclined to be generous.

Dear Grandma and Grandpa:

Thank you so much for thinking about me again at this

time of year. I know how lucky I am to have such generous family and friends. I

am writing this letter to you because sometimes things that are done with the

best intentions can result in unintended problems. Sometimes those problems

occur immediately, but in many cases they don't happen until many years later.

I understand that you are concerned that I may not be

able to work and support myself when I get older and that you would like to

provide some financial assistance to help make it easier for me when that day

comes. I want to explain some of the things that can happen when these acts of

generosity are carried out for the right reasons, but in the wrong way.

Counting Your Nickels

You probably know that I get special help because of my

disability. Sometimes that help comes in the form of a check each month, and

sometimes that help comes in the form of government funded insurance to pay for

social workers, therapists, and other aides that are not available through the

school district or through mom and dad's health insurance. These programs have

very strict limits on what I can own and what I can earn. When someone gives me

money or opens an account in my name, I have to tell the government that I have

assets in my name (even if I'm too young or incapable of spending it). When that

happens, it puts my benefits at risk.

Delaying (not avoiding) the Problem

You might be thinking that a safe way to make gifts is

to open an account which is not available to me until I reach 18 or 21. This is

partially true, because some government programs will disregard these accounts

until I reach the age when the account will be put into my name. More often than

not, however, these accounts create significant complications in the future,

often involving additional time, effort and expense at precisely the time when

you thought the money would be available to help.

For example, a Uniform Transfers to Minors Act (UTMA)

account becomes my property when I reach the age of 18 or 21. This occurs

automatically, regardless of whether I am participating in one of those means

tested government programs, and even if I am not capable (because of my

disability) of managing that money. When this happens, I am really stuck. On the

one hand, by law the money is considered mine when the account terminates on my

18th or 21st birthday. This means I will likely lose my Supplemental Security

Income (SSI), Medicaid and other government benefit programs as of that date.

Yet, at the same time, my disability may prevent me from making my own decisions

with the money, so I may not be capable of taking any steps in order to protect

my eligibility for benefits.

In many cases I will need to hire a lawyer in order to

get court permission to put the money in a different type of account, usually a

type of " first party supplemental (special) needs trust " account. Depending on

the amount in the account, I could end up with quite a bit less than you

originally intended once the costs and expenses of the proceeding have been

paid. In addition, any funds remaining in that trust at my death would have to

first reimburse the government for any services it has paid on my account

through the Medicaid program before it could pass to anyone else (your other

grandchildren, for example). I know you wouldn't want that.

Words Matter

I know that you have been buying savings bonds for me

from the day I was born. Sometimes you put my name on the bond, sometimes you

put both my parent's and my names on the bond, and sometimes you put my parent's

name on the bond, " payable on death " to me. These bonds can create the same

types of problems that a Uniform Transfers to Minors Act account can create. At

some point they will be countable in determining my continuing eligibility for

one of these really important programs, and I may not be capable of taking any

steps to protect the bonds without the assistance of a lawyer and the permission

of a judge.

The Unlucky Beneficiary

Maybe you were thinking that you can avoid some of these

problems by waiting until the end of your life before the property is given to

me, perhaps by naming me as a beneficiary on a life insurance policy, an

annuity, or even a small retirement account. But remember that those proceeds

are available (and countable) to me when you die if I am the named beneficiary.

Just as with the Uniform Transfers to Minors Act account, the government benefit

programs will count any assets that come to me by beneficiary designation.

Hoping for the Best, but...

While it may be difficult for you (and for me) to admit,

it could turn out that I will not be ready to manage money when I turn 18

regardless of possible concerns with government benefits. We both know how

difficult it is to predict how any young child may act when he or she reaches

adulthood. I may be able to read and write, have conversations, go to school

and hold down a job, but I may simply be unable (or unwilling) to make good

decisions with my money. I may spend it irresponsibly, I may give it away, or

(worse yet) I may not be able to tell when someone is taking advantage of me.

Government benefits aside, it just may not be a great idea for me to have direct

access to a lot of money when I get older.

What Can You Do?

There are ways that you can help me. Depending on the

size of the gift, it may be easiest to simply give the gift to my parents and

ask them to hold it for me. So long as the bank account is in their name and

uses one of their social security numbers, it won't create a problem with my

government benefits. For smaller gifts, this can be the best solution.

If you think that I may one day go on to higher

education, you could open a " 529 Account " for my benefit. These accounts earn

money on a tax free basis, and have other tax advantages too. But the most

important thing is that the accounts are considered owned by the person holding

the money (i.e., the " owner " of the account), and not the person who might be

using the money to pay for education expenses at some point in the future.

Some grandparents open these accounts in the name of

their children (i.e., the parent of the child with special needs). If it turns

out that I'm not able to go to school, the money could be used for one of your

other grandchildren who will have that opportunity. Your financial advisor can

help you set up one of these accounts (although you might want to check with my

parents' special needs trust lawyer to be sure the account is titled correctly,

and that the government benefit program rules which deal with these types of

accounts haven't changed).

It may be that my parents have done their estate

planning and have already created a " supplemental (special) needs trust " for me

as part of that plan. These trusts are specifically designed to hold money for

people with special needs, and can provide the best of both worlds: a trustee is

appointed to manage the money (sometimes a parent will serve as the trustee),

and the trust is " exempt " in determining eligibility for most government benefit

programs (i.e., the government won't treat the money as if I own it).

You could also name the trust as the beneficiary of a

life insurance policy or retirement account. Just remember that if you are

thinking about a significant sum of money, it's important for you to talk to a

lawyer who has experience working with these types of trusts.

And, of course, you could always buy me some toys...

But In The End, What I'm Really Thankful For ...

...is knowing that you are thinking about me this

holiday season.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Happy Veterans Day and thanks to those who have served our country.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

November, 2010 - Vol 4, Issue 18

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member

Menashe, of Lynnwood, Washington. is a member of the National Academy of

Elder Law Attorneys and is a past Chair of the Elder Law Section of the

Washington State Bar Association. 's practice emphasizes estate and

long-term care planning, special needs trusts, probate, guardianship and Social

Security/SSI disability appeals.

Veteran's Benefits

As our nation commemorates Veterans Day, honoring and

remembering those who have served and sacrificed, it is an appropriate time to

consider the financial, medical, and other assistance available to veterans,

their families and survivors.

Veterans Benefits are administered at the federal level

by the Department of Veterans Affairs (VA), which is the second largest

cabinet-level department and has a budget of $114 billion this year.

While the full range of VA benefits extends to housing

and home loan guarantees, job training, small business loans, burials, and

memorials, this article will examine the four major benefit programs the VA

oversees:

a.. Disability Compensation;

b.. Pension;

c.. Free or Low Cost Medical Care; and

d.. Education Programs

To be eligible for most VA benefits, a person must have

been discharged from service under other than dishonorable conditions.

Disability Compensation

Disability compensation is paid to veterans who were

injured or contracted a disease while on active duty or who had an injury or

disease that was made worse while on active duty.

Payments range from $123 to $2,673 a month, depending on

the veteran's level of disability. In addition, the monthly payments can be

increased further if the veteran's disabilities are very severe or resulted in

loss of a limb or if the veteran has a spouse or dependent children or parents.

Disability compensation is tax-free.

The key to receiving disability compensation is having a

service-connected disability with a disability rated from 10% to 100%. Some

conditions are presumed to be service-connected. For instance, a veteran who

served in Vietnam and has one of several conditions, including Hodgkin's

disease, Type 2 diabetes, and prostate cancer, is presumed to have a

service-connected disability due to the effects of Agent Orange.

The VA also pays a benefit, called Dependency and

Indemnity Compensation (DIC), to certain survivors of: (1) a service member who

died while serving; (2) a veteran whose death resulted from a service-related

injury or disease; or, (3) in some cases, a veteran with a service-connected

disability that was rated as totally disabling.

The survivors eligible for DIC include a surviving

spouse, a minor child and, in some cases, a disabled adult child that the VA has

determined to be " helpless. " A disabled adult child is a child who before age

18 became permanently incapable of self-support. A spouse's basic DIC benefit is

$1,154, while the maximum benefit available to a child, including a disabled

adult child, is $488 a month.

Pension

Unlike VA compensation, the VA pension does not require

that a veteran have a service-connected disability. Instead, a pension is paid

to wartime veterans with limited income who are permanently and totally disabled

or age 65 and older.

The wartime service requirement does not mean that the

veteran had to serve in actual military conflict but rather that the veteran

must have served for at least one day during a time period that the VA defines

as a wartime period. Service from August 2, 1990 to the present is considered to

be a period of war (technically as the Gulf War period), as are several other

periods, including World War II, Korea, and Vietnam.

The VA pension supplements the veteran's other countable

income to bring total income up to the pension benefit amount. At first blush,

the income limit seems unusually strict, as a veteran with no dependents is only

allowed an income of $11,830 a year. However, unreimbursed medical expenses

reduce countable income. While there is no set limit on a veteran's assets, the

VA will deny a pension application when it considers net worth to be excessive

for a person's particular situation, with that benchmark commonly set at a

house, car, personal possessions and $80,000 or less in other assets.

There is an increasingly well known component of the VA

pension, called Aid and Attendance, which can increase the benefit paid by as

much as $1,632 a month for a single veteran. Significantly, this benefit can

cover a portion of long-term care costs for a veteran who requires assistance

with basic activities of living.

The VA pension also benefits dependents and survivors.

For instance, a surviving spouse of a veteran is eligible for an Aid and

Attendance benefit of up to $1,055 a month. In addition, like with compensation,

minor children and adult children who became disabled before age 18 can be

eligible for pension benefits.

Medical Care

The VA offers veterans a range of health care services

called a Medical Benefit Package, including preventive medicine, inpatient care,

outpatient care, medications and supplies. In addition, in certain

circumstances, the VA can pay for specialized services such as bereavement

counseling, long-term care, and medical equipment and aids.

While all veterans are potentially eligible for

benefits, the VA is required to stay within the limits of funds allocated by

Congress, and thus the VA has instituted a priority system, ranging from 1, as

the highest priority, and 8 as the lowest, with more covered services and no or

reduced co-pays at the higher priority levels.

The highest priority group, Priority Group 1, is for

veterans with a service-connected disability rated 50% or higher or who are

determined to be unemployable due to a service-connected condition. Beyond that,

there are many factors which contribute to the priority group a veteran is

assigned. For instance, a former prisoner of war or Purple Heart recipient is in

Priority Group 3, and a veteran exposed to Agent Orange during the Vietnam War

will be in Priority Group 6.

Priority Groups 7 and 8 are affected by household

income. Until 2009, the VA had not been enrolling new Priority Group 8

Veterans. The VA is now enrolling Priority Group 8 Veterans whose income exceeds

by not more than 10% the set income threshold of $29,402 a year for a veteran

with no dependents.

The VA also has a program called CHAMPVA, which shares

the cost of health care services and supplies with eligible beneficiaries.

Spouses and minor children, and in some cases disabled adult children, are

eligible for this benefit if, generally speaking, the related veteran died on

active duty or is, or at death was, permanently and totally disabled due to a

service-connected disability.

Education Programs

The new " Post 9/11 GI Bill " offers current service

members and veterans substantial assistance with education and training at

accredited colleges and universities. Assistance includes up to 100% of tuition

and fee coverage (based on the highest public institution rate in a state), a

monthly housing allowance, and up to $1,000 a year for books and supplies. An

additional benefit, called Yellow Ribbon payments, pays for 50% of expenses

above the normal highest rate when an institution matches the other 50%.

To be eligible for full benefits, a veteran must have 90

days of service after September 10, 2001, and must have served 36 months of

total service or have been discharged for a service-connected disability.

Benefits are reduced, from 90% to 40%, for those with less than 36 months of

service.

More Information

The VA has just launched an advertising campaign,

entitled " My VA, " aimed at increasing veterans' awareness of the benefits to

which they may be entitled. The VA has estimated that of 23 million eligible

veterans, only about 8 million use VA services. The VA has invited veterans and

their families to visit the VA website as the first stop for information on

benefits that are available through the VA. In addition, veterans' services

organizations, such as the Veterans of Foreign Wars and the American Legion, can

be a very valuable source of support, information, and advocacy.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

December 2010 - Vol 4, Issue 19

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

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The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Albuquerque, New Mexico Special Needs

Alliance member Nell Graham Sale. Nell's practice concentrates on taxation,

estate planning, estate administration, business succession, disability planning

and elder law. She is a Certified Elder Law Attorney as designated by the

National Elder Law Foundation. The recipient of much recognition from her peers,

Nell is a fellow in the American College of Trust and Estate Counsel and since

2007 has consistently been selected for inclusion in Super Lawyers. Not least

importantly, Nell is a regular contributor to the blog at her firm, Pregenzer,

Baysinger, Wideman and Sale.

What Health Reform Means for Persons with Disabilities

The Patient Protection and Affordable Care Act of 2010

(ACA) embodies many reforms of the health insurance industry in the United

States. The principal objective of the ACA is to ensure access to health

insurance for everyone. As of 2014, almost everyone in the United States will be

required to have health insurance. In addition, no one may be denied coverage by

health insurance companies, regardless of age, preexisting conditions, or the

amount of coverage that may be subsequently needed. The rationale for these

reforms is that if all Americans are members of the insured pool, the risks for

insurance companies will be spread across a larger group of persons so that the

cost of private insurance will be less.

The ACA is in some respects similar to Medicare, a

health insurance system run by the federal government, funded by a 2.9% tax

imposed on everyone who earns wages, with 1.45% each paid by the worker and the

employer. Medicare provides health insurance coverage for all individuals who

are over age 65 and eligible for Social Security or Railroad Retirement benefits

and for those who have received Social Security Disability Insurance benefits

for two years or more. There are no exclusions for preexisting conditions,

degree of health need, or age after 65. The pool of the insured under Medicare

includes those who are healthy and those who are not.

The ACA provides that, by 2014, the pool for private

health insurance coverage will be expanded to include nearly everyone. The pool

will include younger, healthier citizens than the current Medicare pool. The

Congressional Budget Office worked over the numbers daily during the legislative

deliberations on the ACA, and the conclusion was that this should work.

Beginning in 2014, health insurance exchanges will be

created through the ACA to provide a mechanism for access to health insurance

with sufficient coverage -- that is, hospitalization, prescription drug

coverage, rehabilitation, mental health services, substance abuse treatment,

preventive and wellness health coverage, chronic disease management, pediatric

coverage (including dental and vision for children) and maternity coverage.

The health insurance exchanges will provide a

marketplace in which to compare plans. The four types of plans that will be

available will be labeled Bronze, Silver, Gold and Platinum. Health insurance

companies that intend to participate in the exchanges must offer at least one

Silver and one Gold plan. The Bronze plan will pay 60% of the insured's costs,

the Silver 70%, the Gold 80% and the Platinum 90%. Bronze plans will have a

$5,950 annual limit for out of pocket expenses.

Small businesses will be able to access health insurance

for their employees through the exchanges. As noted earlier, health insurance

companies will not be able to exclude anyone from coverage for a preexisting

condition or set a cap for the amount of coverage.

Beginning in 2014, all individuals in the United States

who do not have health insurance coverage will pay a penalty. There is a sliding

scale of assistance and premium credits to make health insurance affordable. The

term " affordable " means that the premiums may not exceed 8% of the family's

annual income.

If an individual refuses to obtain health insurance, a

penalty of the greater of $95 or 1% of his or her annual taxable income will be

charged in 2014. In 2015, the penalty is $325 or 2% of taxable income, and in

2016, $695 or 2.5% up to a maximum of $2,085. If a person's income is too low,

there is an exemption from the penalty. In 2014, employers with more than 50

employees will be required to provide health insurance coverage for employees or

the employer will be penalized.

There will be a uniform enrollment form for health

coverage through the exchanges. The exchanges can be a clearinghouse to

determine eligibility for Medicaid, the Children's Health Insurance Program, or

premium credits using this uniform enrollment form. Moreover, the exchanges can

screen for families that may be exempt from tax penalties.

Until the ACA, the only health care coverage available

to persons with disabilities has been either Medicare or Medicaid. Medicare is

only available to workers (and certain dependents of workers) who have a

sufficient work history to be eligible for Social Security benefits. For persons

with disabilities who have a limited work history, unless they became disabled

before age 22 and later qualified for Medicare upon the worker parent's

retirement, disability or death, Medicaid has been the only available source of

health care coverage.

Because Medicaid provides health coverage only to the

poor, disabled individuals often require special needs trusts in order to

shelter so-called excess resources. For special needs planners, assuring access

to Medicaid has been a primary focus of planning.

Because the ACA eliminates the option for health

insurance companies to deny coverage for a preexisting condition, new health

insurance options will open up for some folks with disabilities. As of September

23, 2010, health insurers are no longer permitted to deny coverage to children

under the age of 19 who have a preexisting condition.

Depending on the disability, a disabled child who has

recovered a personal injury settlement does not necessarily have to plan

exclusively for continuing eligibility for Medicaid by transferring the recovery

to a special needs trust. Parents who have health insurance through

employer-sponsored group health plans can now add a disabled child to their

coverage, and can enroll a child up to age 26 as a dependent on the parent's

health plan if the child is without alternative coverage. Thus, there is

significant relief here.

Although the ACA will provide near universal access to

health insurance in 2014, it does not expand the services available for the long

term care needs of people with disabilities or long term chronic diseases. It is

still the case that these types of services are available only through private

resources or Medicaid.

Look for future Voice articles that will cover some of

the ACA's provisions in greater detail. For example, we plan to discuss one

provision in the ACA called the CLASS Act, which may provide some relief for

long term care needs, and the extension of Medicaid eligibility to adults who

have less income than 133% of the federal poverty guidelines ($14,412 for a

single person in 2010).

We will also describe coverage available to persons with

preexisting conditions that would otherwise make them uninsurable. These

provisions also will open up health coverage for some disabled individuals.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Very good and timely article...

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

December 2010 - Vol 4, Issue 20

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Walnut Creek, California Special Needs

Alliance member W. Dale of The Dale Law Firm, PC. Mr. Dale is a

disability rights advocate and attorney dedicated to providing quality estate

planning. He is a frequent speaker on a variety of disability related topics

across the country. Mr. Dale regularly teaches courses to the public, financial

professionals, and other attorneys on special needs trusts and trust

administration. Additionally, Mr. Dale serves as the trustee for the Golden

State Pooled Trust. Mr. Dale offers numerous videos and handouts to the public

and his colleagues, many online through his Achieving Independence initiative.

The Past, Present and Future of Community Living for

Persons with Disabilities - A Christmas Carol

Defining the Issue - Tiny Tim's Story

The holidays are a time of hope and renewal providing an

opportunity to look at past accomplishments, while planning for the future. Many

families are trying to figure out how to plan for the future under the

limitations of today's economy. This is a difficult undertaking under normal

circumstances. Planning for the future needs of persons with disabilities can be

a particularly daunting task, especially when special needs trusts may be

needed. Even if we may believe that we can control our future through our

present actions, it is very important that a special needs trust be as flexible

as possible.

Take, for instance, a fictional example of Tiny Tim, a

17 year-old young man who has autism. Doctors have advised that he will need

assistance for the rest of his life and that his likely lifespan is 87 years.

With this information, it becomes clear to Tiny Tim's parents that they will

need to prepare to provide for Tiny Tim for approximately 70 more years. This

will include health care, living arrangements, education, therapy, recreation,

and protection.

How can Tiny Tim's parents face the challenge of taking

care of Tiny Tim for seven decades, especially with the inevitability of their

own deaths or potential incapacity? Traditionally, advisors would recommend that

the parents create a special needs trust. Be warned, however, that a special

needs trust focused only on protecting Tiny Tim's eligibility for government

assistance may not sufficiently meet the challenge. What if government benefit

programs, such as SSI and Medicaid, no longer exist in 70 years?

The government may do away with such programs or could

introduce alternate programs that operate very differently. This highlights one

reason why, in planning for someone like Tiny Tim, it is essential that a

comprehensive plan have the flexibility to adjust as the programs and systems

that provide for Tiny Tim continue to evolve.

A plan for the next 70 years of Tiny Tim's life that

focuses only on public benefits is not likely to take care of him or enable him

to enjoy the quality of life that a parent would wish for him. The solution (and

therefore, the challenge) is to create a private social service system that will

provide advocacy, comfort and security for the next 70 years, no matter what the

future might bring.

To Look Forward We Need to Look Back - The Ghost of

Deinstitutionalization Past

America's history of caring for people with disabilities

has been, at times, haunting. From almshouses and asylums to mental institutions

and state hospitals, the nation has explored numerous methods of " dealing " with

people who are unable to care safely for themselves.

Beginning in the 1960's, persons with disabilities and

their families initiated a dramatic movement to limit the practice of

institutionalization in favor of community-based services. In 1963, President

Kennedy called for Congress to develop comprehensive community programs to

integrate persons with disabilities into the community. In replacing

institutions, community-based programs would provide outpatient care, day

treatment, rehabilitation, foster care services, and public education with

mental health and related services.

A 1961 report by the Joint Congressional Commission had

provided policy recommendations calling for communities to become responsible

for the treatment of persons with disabilities in locally-based programs. The

ultimate goal was that the system of state hospitals would be completely

replaced by a comprehensive community-based service system.

Unfortunately, Congress did not fully follow the Joint

Commission's recommendations. Today, many community programs for persons with

disabilities are poorly funded and staffed. Most state hospitals have been

closed, yet the full scope of services was never moved into the community.

Without additional planning, Tiny Tim is almost certain to experience the pinch

of inadequately funded state programs and the frustration of understaffing.

Disability Today - The Ghost of Deinstitutionalization

Present

The deinstitutionalization movement has made

considerable progress, but budget deficiencies, politics and a variety of other

causes have forced cuts and stagnation in community and residential programs

across the country. Many states have a moratorium on building new residential

programs at the very time that this need has increased. Many communities have

reduced attendant care programs that are often essential in providing persons

with disabilities essential activities of daily living. Mental health programs

have been underfunded for decades, and many experts believe that the lack of

services has resulted in the unnecessary " criminalization " of persons with

mental illness.

It appears that many of our legislative leaders have

lost the vision of community living for persons with disabilities and treat the

funding of community programs as " humbug. " Were it not for the dedication of

families and the disability organizations which advocate for quality programs,

the future would certainly look bleak.

How does that affect Tiny Tim? Using the example set

forth in the novel that gave us this character, " A Christmas Carol " by

Dickens, the lesson becomes clear: When the community participates in

recognizing and supporting the needs of their disabled citizens, everyone is

blessed.

The Immediate Challenge in the Next Decade - The Ghost

of Deinstitutionalization Future

The United States is struggling out of a recession, but

growth is sluggish. As the United States continues to fight on-going wars

overseas, the first wave of Baby Boomers is currently reaching retirement age.

There has been a rise in applications for Social Security Disability benefits in

the last two years. A shrinking work force and increased need for funding

multiple government objectives is putting the Social Security system under great

stress.

Many services that have been developed over the past 30

years, such as respite care and day programs, will close due to lack of funding.

Even programs that will continue are likely to face extreme cutbacks. Public

agencies and caseworkers who traditionally monitor the welfare of persons with

disabilities are having their budgets cut and caseloads increased. We can

anticipate that the lack of oversight by the traditional government entities

will increase the possibility that Tiny Tim will live in substandard conditions.

Although services will become more difficult to obtain,

people with disabilities will still rely heavily on these public benefits for at

least the next decade. Currently, many services can only be acquired by

qualification for Medicaid. In certain states, such as California, private and

nonprofit organizations are beginning to fill the gap of services vacated by the

government. Private case management may become increasingly important as an

alternative to overburdened government caseworkers. But private case management

is unlikely to be free, forcing people like Tiny Tim or his advocates to make

difficult choices between certain services.

Are These the Shadows of the Things That Will Be, Or Are

They Shadows of Things That May Be, Only?

The old saying rings especially true for special needs,

" Those who cannot learn from history are doomed to repeat it. " Clearly, learning

from the past is key to planning for the future.

Our main lessons are:

1.. Families have always been the strongest advocates

for our disabled citizens.

2.. Benefits and services have changed dramatically in

the past 50 years. There is no reason to assume that this situation will not

continue.

3.. Much of the progress that has been made is due to

the commitment of service organizations such as the ARC, United Cerebral Palsy,

the National Alliance for the Mentally Ill and many other advocacy organizations

working with persons with disabilities and their families. Supporting these

organizations is key to continued advocacy for our most vulnerable citizens.

4.. Families will continue to need attorney advocates

who will help navigate the system, and who will work to sustain - and in some

cases create - whatever system may be needed not only to prevent abuse and

neglect, but also to promote independence, autonomy and quality of life.

Preparing a special needs trust for Tiny Tim will entail

much more than having an attorney fill out a form. The plan must be

comprehensive and adjustable to enable long term support. A law practice

dedicated to planning for people like Tiny Tim will often take steps that

traditional estate planning practices would not need. For example, certain

practitioners employ social service staff as part of their practice or maintain

a good working relationship with care managers and advisors who can assess the

needs of both Tiny Tim and his caregivers.

Practitioners may also develop techniques such as

allowing for oversight by an advisory committee or trust protector under the

counsel of a knowledgeable attorney to address future changes in the continuum

of care. The option of having a trust and a team that re-evaluates itself

periodically as needed during the beneficiary's lifetime can be quite useful.

Hope, Not Fear

The purpose of this article is not to inspire fear, but

to encourage hope. As attitudes, technology and treatments improve and

advocates, service providers, attorneys, trustees and care managers come

together, the future may be brighter than we can currently imagine. The key

factors for constructing this future will be respect for each other, conviction

in our efforts, and the support of community programs.

With families, advocacy organizations and professionals

working together to advocate for the good of persons with disabilities, we will

all be able to say, just like Tiny Tim, " God bless us, every one. "

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

January, 2011 - Vol 6, Issue 1

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by , a partner with Oast &

Hook, P.C. in Suffolk and Virginia Beach, Virginia. She is the editor of the

firm's weekly newsletter, the " Oast & Hook News, " which is available on the

firm's website. She is certified as an elder law attorney by the National Elder

Law Foundation. Ms. is the co-author of the " Special Needs Trusts " chapter

for the Elder Law in Virginia handbook published by Virginia CLE. She is a

member of the Board of Directors and the immediate past president of

Commonwealth Community Trust, a pooled trust in Richmond, Virginia. She retired

from the United States Air Force as a Lieutenant Colonel with over 20 years

active duty service, and earned her Juris Doctorate degree from the College of

and School of Law.

Special Benefits for Military Families -- Elect With

Care

Many families of children with disabilities are also

military families. One benefit that may be available for these children is the

military Survivor Benefit Plan (SBP). The SBP will pay up to 55% of the military

member's retirement pay to a spouse or a dependent child when the retiree dies.

The benefit is adjusted annually for inflation. The military member also has the

option to select a lower benefit at a lower cost and has the option to choose

coverage for only the spouse, spouse and children, or only children.

If a member wants to decline SBP coverage entirely, he

or she can only do that with the written consent of the spouse. If a member

selects spouse and children coverage, the children do not receive SBP until

after the death of the military retiree and his or her spouse. The member's

military retirement pay is reduced by approximately 6.5% for spousal coverage,

and he or she pays approximately $20 per month for dependent children coverage.

SBP can be an excellent benefit for children with

disabilities, but families need to be aware of all the options for their

children before deciding to elect child coverage. Receipt of the SBP benefit may

result in the child losing other important disability benefits.

Children with disabilities are usually eligible for

Supplemental Security Income (SSI) at age 18 if they meet the income and asset

requirements for these benefits. SSI provides funds for food and shelter.

Children with disabilities that occurred prior to age 22 may also be eligible

for Social Security on the record of a disabled, retired or deceased parent. SBP

can provide an additional source of income for the child with disabilities. If a

child with disabilities is receiving SSI, the SSI payment is reduced dollar-for

dollar by unearned income; therefore if the child also receives SBP, SSI could

be reduced or eliminated.

Because the child is the SBP beneficiary, the SBP funds

cannot be paid directly into a special needs trust in order to avoid receipt of

the monthly income by the child. Congress would have to amend the U.S. Code in

order for the SBP payments to be paid directly into a trust without the payment

being considered as received by the child.

Children with disabilities who are receiving SSI are

also able to receive Medicaid, including Medicaid waiver services. Medicaid can

provide for supervision, job training and assistance in addition to health

benefits. In military families, a child with disabilities who is over 18 years

of age can be designated an Incapacitated Dependent with the filing of a DD Form

137-5. This designation can also permit the child to be eligible for health care

benefits under TRICARE.

TRICARE and Medicaid complement each other, and together

can provide a wide array of services and benefits for the child with

disabilities. Some states have an absolute income cap for Medicaid benefits

while other states allow a recipient to spend down excess income on medical

services in order to qualify for benefits. If a child's SBP income is too high,

he or she may not be able to receive Medicaid or Medicaid waiver services.

Military families should consider all benefits that will

be available to their children with disabilities, and decide before the military

member retires whether or not SBP is a good fit for their child. This is

particularly true if the family wants the child to receive Medicaid waiver

services in the community. Unfortunately, once the SBP beneficiary payments

start, there is no way to stop them.

If the military member has already made an SBP election

involving the child with disabilities, he or she can apply to the Board for

Correction of Military Records for their respective service in order to modify

the SBP election. This application must be made while the military member is

still alive, using the DD Form 149. The member will have to justify the change

in the election. For example, he or she might explain that they did not

understand that electing coverage for the child with disabilities could

adversely impact the child's eligibility for other important benefits.

A completed DD Form 149 should be sent to the service

address listed on the form. The Board for the military member's service meets

periodically to review and act on such requests.

Military families who are eligible to receive SBP and

have a child with a disability should work with a qualified attorney to ensure

that they are fully educated on all benefits for which their children are

eligible. It is critical that parents do their homework and make the appropriate

decisions before the military member retires.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

March, 2011 - Vol 5, Issue 4

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Massachusetts Special Needs Alliance

member S. Starr, an attorney with Starr Vander Linden LLC with offices in

Worcester & Fitchburg, Massachusetts. Her practice focuses on estate planning,

elder law, and government benefits issues for families which include individuals

with special needs. is a Fellow of the National Academy of Elder Law

Attorneys, the 2007 recipient of The Theresa Award, a national honor recognizing

extraordinary contributions of attorneys to the community of individuals with

disabilities, and a recipient of the 2008 Scholar Mentor Award from

Massachusetts Continuing Legal Education, Inc.

The Impact of Special Needs Trusts on Eligibility for

Subsidized Housing

The federal and state governments subsidize housing

for elderly persons and individuals with disabilities. The subsidies come in the

form of below-market rent units in public and private housing developments and

Section 8 vouchers for use in the private market. Tenants in subsidized housing

typically pay rent of 30% to 40% of monthly adjusted income.

Some disabled individuals are beneficiaries of special

needs trusts. These trusts are of two types: third party trusts, created either

by third parties (the beneficiary's parents, siblings or others) and funded with

the third parties' contributions, and first party trusts, created by the

disabled persons themselves (or others on their behalf) and funded with their

own assets. Generally the goal of these trusts is to allow the beneficiary to

qualify for income from the Supplemental Security Income (SSI) program and for

Medicaid. Beneficiaries of such trusts who live in subsidized housing often ask

" How does a special needs trust affect my eligibility for subsidized housing and

the amount of my rent? "

Subsidized Housing Eligibility Rules

To understand the effect of a trust on eligibility, it

is essential to understand the housing eligibility rules. Unlike many public

benefits programs, the federal housing programs, most notably the Section 8

program, determine financial eligibility based only on income. There is no asset

limit to qualify for the rent subsidy. Rent is based on a percentage of the

tenant's income. As the tenant's income increases, the thirty percent of income

allocated to rent will increase proportionally. At some point the increased rent

could equal or exceed the fair market rental value for the unit, making the

subsidy meaningless.

a.. " Income " includes regular income from employment

and public benefits such as Supplemental Security Income (SSI) and Social

Security Disability Income (SSDI) as well as " income " derived from net family

assets.

b.. Net family assets include the net cash value of

assets after deducting reasonable liquidation costs but exclude necessary items

of personal property such as " furniture " and " automobiles " .

To determine the income derived from net family assets

the rules require the housing agency to consider the greater of (1) actual

income derived from all net family assets or (2) a percentage of the value based

on the current passbook savings rate. Many subsidized housing programs have used

an imputed passbook savings rate of 2% for many years even though that rate is

high in today's financial market.

For example, if a tenant has $50,000 in the bank earning

3% interest, the tenant will be considered to be receiving $1,500 annually ($125

mo). Thirty percent of that additional income plus other monthly income would be

the tenant's monthly rent. If the tenant owns vacant land with a value of

$50,000, income will be imputed based on the passbook savings rate even though

the asset generates no actual monthly rental income for the tenant. If the

housing program is using an imputed interest rate of 2%, then $1,000 annually

($83.33 month) will be imputed as income to the tenant for purposes of

calculating the rent.

How Funding a Trust Can Affect Rent

When a subsidized housing tenant receives a lump sum,

concerns often arise about how that will affect eligibility for the subsidized

housing benefit. The tenant may be receiving other government benefits in

addition to subsidized housing that will also be affected by the lump sum.

The consequences of giving away assets for federally

subsidized housing are different from the consequences of giving away assets for

the Medicaid and SSI programs. Because assets do not count in the determination

of eligibility, the subsidized housing rules do not impose eligibility penalties

on individuals who have given away assets. However, net family assets include

the value of assets disposed of for less than fair market value during the

preceding two years unless the total fair market value of the gifts is $1,000 or

less. This includes assets placed in an irrevocable trust except when the assets

were received through a lawsuit settlement or judgment.

If a tenant receives a bequest of $50,000 and transfers

it to special needs trust, for example, and if the bequest is earning interest

at a rate of 2%, a transfer of the $50,000 bequest to the special needs trust

will result in the beneficiary being deemed to receive income of $1,000 per year

(or $83.33 per month) for two years following the transfer. If the tenant

receives a lawsuit settlement of $50,000 and puts the funds into a special needs

trust, no income should be imputed from the transfer.

Trusts

The existence of a trust, just as the existence of any

asset, has no direct impact on eligibility for subsidized housing. A trust can,

however, impact eligibility in one of two ways depending upon the terms of the

trust.

a.. If the trust is revocable, or if the tenant has

access to principal, then its value is included in the calculation of net family

assets when calculating the tenant's actual or imputed income.

b.. If the principal is not accessible to the tenant,

which is generally the case with special needs trusts, income may be imputed

from trust distributions.

Regular recurring payments from a trust for the benefit

of the tenant may be treated as income to the tenant even though no cash is paid

directly to the tenant. For example, if the trustee pays a $200 utility bill

every month, that payment may be treated as regular recurring income to the

tenant. The tenant's countable monthly income will thus be $200 higher and will

result in an increased rental payment of approximately $66. There is an

exception for the value of groceries provided by a non-household member, which

presumably would include a trustee.

Because distributions from a trust are considered

income, and because income affects eligibility and the rental calculation, the

trust beneficiary is often at a disadvantage compared to a tenant who owns

assets of equal value in the tenant's own name. If a tenant owns the assets,

then the only impact on eligibility and the rental calculation is the income

generated by or imputed from the assets. If the tenant pays a $200 utility bill

every month out of the tenant's savings account, that is not treated as income

for purposes of calculating the rent. If the assets are instead in a special

needs trust for the tenant, and the trustee pays the same $200 utility bill

every month from the trust, the tenant is considered to have $200 of additional

income every month, thereby increasing the monthly rent. If eligibility for SSI,

Medicaid or other need based benefits is not a concern, then consideration

should be given as to whether a special needs trust is the best option for the

tenant.

Not All Income Is " Income "

Federal regulations exclude temporary, nonrecurring or

sporadic income (including gifts) from the definition of income. Thus, to

maintain a beneficiary's lower rent the trustee of a special needs trust should

be advised to make irregular distributions on behalf of the trust beneficiary

rather than recurring payments. For example, in one month the trustee might pay

$400 toward that $200 current utility bill and a credit toward the next month's

bill. Then several months later the trustee might pay for six months of cable TV

or take the beneficiary shopping for clothing.

With creative budgeting, it is possible to administer a

special needs trust without causing an increase in the beneficiary's rent. If

possible, the trustee should make large onetime expenditures and leave regular

recurring expenses for the tenant to pay. This strategy provides more total

benefit to the tenant/beneficiary by maintaining eligibility for the lowest

monthly rent, thus enabling the individual's funds to stretch further.

For some people with disabilities, a subsidized housing

benefit may be as important or more important than income or medical benefits

they receive. A special needs attorney can help evaluate the impact of a lawsuit

settlement or inheritance on this benefit, whether a special needs trust is

advisable, and how to administer the trust to minimize the impact on the

tenant's rent.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Ellen

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[voice] The Voice - Special Needs Alliance newsletter

March, 2011 - Vol 5, Issue 5

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Losavio, an attorney with

Losavio & De LLC in Baton Rouge, Louisiana. Holding both a law degree and

LLM in tax, Pete is certified as an elder law attorney by the National Elder Law

Foundation and as a Tax Specialist and Estate Planning and Administration

Specialist by the Louisiana Board. Pete is a charter member of the Life Care

Planning Law Firms Association and a member of the Society of Louisiana CPAs. He

limits his practice to asset protection, life care planning and estate and tax

planning.

The Pitfalls of Caregiver Employment: Paying,

Withholding, and Reporting Requirements

A person hiring a caregiver must exercise care in the

hiring and paying of the caregiver. This applies to any prospective employer of

the caregiver, whether the employer is a family member or a trustee who will pay

the caregiver from a special needs trust. Besides the practical considerations

such as the caregiver's competency and background, there are many legal pitfalls

in caregiver employment.

The first matter to address is the classification of the

caregiver as an employee or an independent contractor for income tax purposes.

Before the employer can know how to treat payments made to the caregiver, the

employer must make a critical determination as to whether the caregiver is an

independent contractor or an employee.

For federal tax purposes, there is an important

distinction between an independent contractor and an employee. The

classification as an independent contractor or employee affects how the federal

income tax, Social Security, and Medicare taxes are paid, and how caregivers

file their income tax returns. In addition, the classification affects the

worker's eligibility for employer Social Security contributions and Medicare

benefits.

If the caregiver is classified as an employee, then the

employer must withhold income taxes, withhold and pay Social Security and

Medicare taxes, and pay state and federal unemployment taxes on the wages paid

to the caregiver.

To determine whether the employer must register and pay

state unemployment tax for a caregiver, the employer can contact the appropriate

state taxing authority. Internal Revenue Service Publication 926 contains

contact information for the states. (http://www.irs.gov/pub/irs-pdf/p926.pdf.)

Furthermore, if the caregiver is an employee and not an

independent contractor, state law may require that the caregiver be covered

under workers' compensation. In some states, the failure to provide workers'

compensation coverage is a criminal offense. If the caregiver sustains a

work-related injury, then there may be liability on the part of the employer,

homeowner, and person with the disability. In general, a homeowner's insurance

policy does not cover a caregiver for an employment related personal injury. For

example, consider the situation where a caregiver ruptures a disc while lifting

a person with a disability. The situation may not be covered by the homeowner's

insurance policy, and the employer, homeowner, and person with a disability may

find that they are personally liable to the caregiver for the personal injury.

This type of liability can be substantial.

The law considers many facts in deciding whether a

worker is an independent contractor or an employee. The relevant facts are

behavioral control, financial control, and the relationship of the parties.

Facts concerning behavioral control show whether the employer has a right to

direct or control how the worker does the work. A worker is an employee of a

business if the business has the right to direct and control the worker. It

doesn't matter how much control the business actually exercises, just that it

has the right to do so.

Facts concerning financial control determine whether

there is a right to direct or control the business part of the work. Since

caregivers do not have a significant investment in their work, this factor

favors them being classified as employees. Also, caregivers do not have the

opportunity to make a profit, indicating that they are employees.

Facts concerning the relationship of the parties

illustrate how the employer and the worker perceive the relationship. If the

caregiver receives benefits such as insurance, paid leave, sick leave or

vacation, this would indicate that the person is an employee. If the caregiver

does not receive benefits, he or she could either be an employee or independent

contractor because this factor is not determinative and should not be relied on

to establish independent contractor status.

As explained above, a caregiver is usually an employee

when the employer has the right to direct and control the caregiver. The

employer need not in fact exercise significant control, but need only have the

right to do so. The caregiver is usually under the control of the employer as to

when, where and how the work is to be performed. If the caregiver works

exclusively for the employer, this would indicate that the caregiver is an

employee. If the caregiver is not an employee of an agency, the caregiver will

usually be treated as an employee.

IRS has published several rulings in which it held that

caretakers were employees. Therefore, it would be very difficult to argue that a

caretaker is an independent contractor. If unusual circumstances exist, a

written contract would be necessary to document independent contractor status.

Although not determinative, a written contract may show what the employer and

the caregiver intended concerning the responsibility regarding the withholding

and payment of taxes.

If the caregiver is an employee, the employer has a

responsibility to withhold, remit, and pay certain taxes if the wages of the

caregiver exceed a certain annual amount, currently $1700.00. The employer must

withhold income tax and the caregiver's portion of Social Security and Medicare

taxes. Also, the employer is responsible for paying Social Security, Medicare,

and unemployment (FUTA and SUTA) taxes on the caregiver's wages. The employer is

responsible for payment of the employee's portion of taxes if the employer

neglects to properly withhold it from the employee's wages. If wages total

$1,000.00 or more to all household employees in any calendar quarter, Schedule H

must be filed by the end of the month following the close of the quarter. If the

employee earns $1700.00 or more per year, the employer must give the caregiver a

Form W-2, which is a wage and tax statement showing the amount of wages earned

and taxes withheld from the employee's pay. In addition, the employer is

required to file copies of the W-2 with the Social Security Administration and

the State Department of Revenue, if applicable.

There is a special reporting rule for hiring domestic

help. The employer does not have to report payments to domestic help unless they

exceed $1,700.00 per year. Income tax withholding is not required for a

household employee, but the employer must withhold Social Security and Medicare

taxes from the employee's cash wages and also pay an equal amount, unless the

wages are below $1,700.00. Once payments to a non-exempt employee equal or

exceed $1,700.00, the entire amount, including the first $1,700.00, is subject

to Social Security and Medicare taxes.

The employer can be liable for failing to file Forms W-2

and 1099. A trustee of a special needs trust may not be liable to file a Form

1099 because the trustee is not engaged in a trade or business. However, out of

an abundance of caution, a trustee may want to file the Form 1099. Under the

Small Business Job Act of 2010, the employer can pay penalties of up to $100 for

failure to timely file a correct information return with an annual maximum

penalty of $1.5 million. In addition, there is another penalty of $100 for

failing to timely provide a correct payee statement, with the annual maximum

penalty of $1.5 million. The employer could be liable for $250 per payee if the

employer fails to timely file and timely provide each payee with a 1099 or W-2.

If the caregiver is an independent contractor and is

paid $600.00 or more in one calendar year, then the employer would be required

to give the caregiver a form 1099-MISC, which is a miscellaneous income

reporting of what has been paid to the caregiver. The caregiver would be

responsible for paying his or her own income tax and self-employment tax. The

employer would not have to withhold taxes on the caregiver. However, the

employer is required to file copies of the 1099-MISC with the Internal Revenue

Service.

If the employer is not sure whether the caregiver is an

employee or an independent contractor, the employer can obtain a Form SS-8 which

determines a worker's status for the purposes of federal employment taxes and

income tax withholdings.

It is unlawful to employ a non-citizen who cannot

legally work in the United States. If the employer hires a person to work on a

regular basis, the employer and the employee must each complete part of the U.S.

Citizenship and Immigration Services Form I-9, Employment Eligibility

Verification. The employer must verify that the employee is either a U.S.

Citizen or an alien who can legally work in the United States. The employer must

keep the Form I-9 for his records.

In summary, if the caregiver is an employee, the

employer has the responsibility to withhold income taxes, pay Social Security

and Medicare taxes, pay federal and state unemployment taxes, and file various

payroll forms including Form W-2. Also, the employer may be responsible for

workers' compensation coverage. The employer must also verify if the caregiver

is a U.S. citizen or person who can legally work in the United States. If the

caregiver is an independent contractor, the employer must file a Form 1099-MISC

and be concerned with potential liability for a work-related injury. Any trustee

of a special needs trust who is employing caregivers for the trust beneficiary

should seek help from a tax specialist if there are any questions about

compliance with these responsibilities.

Of course, this entire issue can be avoided if the

caregiver is employed by an agency. For most people, any additional cost is far

outweighed by the relief from the burdensome tax and reporting requirements of

hiring the caregiver directly.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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[voice] The Voice - Special Needs Alliance newsletter

April, 2011 - Vol 5, Issue 6

The Voice, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

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The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Sarasota, Florida attorney Alice

, a member of the Special Needs Alliance and active participant on its

Public Policy Committee. She is a partner at Boyer & , P.A., where her

practice includes special needs and long term care planning, estate planning,

probate and end-of-life issues. Alice is also an active member of the

National Academy of Elder Law Attorneys, a past Chair of the Florida Bar Elder

Law Section, and an adjunct professor in the Stetson University College of Law

Elder LL.M. program.

The Pre-Existing Condition Insurance Plans (PCIP)

Under 2010's Health Care Reform Law

The 2010 health care reform law, now referred to as

the " ACA " (Affordable Care Act), is much like a jigsaw puzzle. To create

comprehensive reform, a number of pieces must be in place. One of the most

important pieces prohibits private insurance companies from denying coverage to

individuals based upon the fact that they have a pre-existing condition. Until

the ACA, most persons covered under a group health insurance plan could be

covered even when a pre-existing condition was present. However, individuals

with pre-existing conditions but lacking group coverage found health insurance

to be either unavailable or prohibitively expensive. Therefore, a critical

component of the ACA is that, beginning in 2014, insurers will no longer be able

to deny coverage to any individual on the basis that he or she has a

pre-existing condition.

While this is an encouraging development, proponents of

health care reform understood that tens of thousands of Americans with

pre-existing conditions would remain uncovered until 2014. Individuals who are

already ill would continue to go without coverage and without treatment, become

more seriously ill and as a result would need care in a more expensive

environment such as a hospital or emergency room. Some would die without

necessary medical attention. To avoid the human tragedy and economic loss that

results from non-coverage, the ACA included a provision known as " Pre-Existing

Coverage Insurance Plans, " or " PCIPs. "

In November, 2010, the Centers for Disease Control

reported that more adults between the ages of 18 and 64 went without health care

between 2008 and 2010 than ever before. (See

http://www.cdc.gov/vitalsigns/healthcareAccess/LatestFindings.html for this and

most of the following data.) Between January and March, 2010, as many as 30

million Americans had been uninsured for more than 12 months. Of the more than

46 million adults in the 18-64 age group, 30% have a disability. The 30% with a

disability had gone for more than 12 months without health care. Persons with

disabilities were shown to be about twice as likely to skip or delay medical

care.

The elimination of pre-existing condition exclusions was

a key element of the ACA and provides new planning opportunities for persons

with disabilities. The federal government set aside five billion dollars in

funding for the program until the 2014 plans come into existence. The programs

are completely federally funded and states are not required to participate

financially. Twenty-three states and the District of Columbia have chosen to

have the federal government administer the program; the remaining states are

self-administering the PCIPs under their own rules within the parameters of the

ACA.

A PCIP is an insurance plan that does not exclude

persons with pre-existing conditions and that has affordable premiums in

comparison to the individual plans currently on the market. The ACA defines a

pre-existing condition as a condition, disability or illness (physical or

mental) which you have before enrolling in a health plan. To qualify to

participate in a PCIP, an applicant must (1) be a U.S. Citizen or in the country

legally; (2) have a pre-existing condition; and (3) have been without insurance

coverage of any kind (including but not limited to Medicaid or COBRA coverage)

for at least the preceding six months. Documentation regarding the lack of

insurance is required in most states, and may include either a denial by an

insurance company, a letter from your doctor, or both. There is no age

limitation for applicants to the PCIP coverage.

A PCIP is not a free pool or plan. Premiums vary by

state, and, within the states, by age and plan chosen. A visit to

www.healthcare.gov or www.pcip.gov will lead you to a map of states and updated

information about rates and plans. As an example, the Texas PCIP is federally

administered and has premiums varying from $261 to $749 per month. In addition,

there are deductibles ranging from $1,000 to $3,000 depending upon the plan

chosen. Co-payments also apply; however, the total amount paid out by an

individual cannot be higher than $5,950 annually. This is a requirement of the

ACA.

The Special Needs Alliance works with individuals who

have been determined to be disabled either by the Social Security Administration

or through a state's disability determination process. We are keenly aware that

many people do not want to make a disability application, have not recognized

that a disability is present, or have a condition which, while not currently

disabling, is likely to become so. It is very important to recognize that

approval to be insured under a PCIP does not require that the pre-existing

condition be disabling. This fact can be very important in situations where

caregivers for persons with disabilities have pre-existing conditions and are

without medical insurance but have chronic illnesses which might be related to

or affect their ability to provide care.

The PCIP program initially began with a single option

plan; however, experience rapidly showed that this single option was

insufficient. The Secretary of HHS has now announced that beginning in 2011,

three plan options will be available in federally administered programs. The

first is the " standard " plan, with two separate deductibles - a $2,000

deductible for medical expenses and a $500 deductible for prescription drugs.

Premiums are lower than they were in 2010.

The second program is the " extended " plan and has a

$1,000 medical deductible and a $250 drug deductible. The premiums for this plan

will be slightly higher than the 2010 single plan premiums. Finally, there is a

" health savings account " option that has a $2,500 deductible but with premiums

that are 16% less than the 2010 plan. Persons choosing this option will have the

tax advantages that apply to any individual who is accessing an HSA.

For persons with disabilities who cannot otherwise

qualify for Medicaid assistance, the PCIPs offer relief until the total

prohibition against exclusion of pre-existing conditions in health insurance

coverage comes into effect in 2014. At that time, the PCIPs will cease to exist

and all citizens will be able to choose from individual, group and state health

exchange policies without concern for their existing health status.

Success of the PCIP program has been difficult to

assess. In the first months that the program was available, enrollment was

scarce. However, between late 2010 and March of 2011, enrollment has doubled

from 12,000 to 24,000 people. Those observing the program's growth cite an

initial lack of education about the availability of PCIP coverage as the reason

for the gradual acceptance of the program's benefits. However, many also

recognize that, while PCIP coverage can be a literal lifesaver for many people,

it remains economically unfeasible for others. Premiums and deductibles remain

out of reach for many people, especially in today's economy. Currently insured

individuals (including but not limited to those with Medicaid or COBRA coverage)

who might consider shifting to a PCIP plan will often find it too financially

risky to go without any insurance for the six months required before they can

qualify for PCIP coverage.

Nonetheless, for the disability community, we know that

coverage is now available to persons of all ages who have been uninsured for at

least six months, and that coverage is comprehensive, providing preventive care,

acute care and prescription medication benefits. In most states, applications

can be made online. Further information is available at www.pcip.gov or

1-866-717-5826.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2010 Special Needs Alliance. .

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Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

May, 2011 - Vol 5, Issue 8

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

Join Our Mailing List >

The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member

Mason, a partner in the Savannah elder law firm of MasonCerbone and the North

Carolina firm of Mason Law, PC. Bob is certified as an elder law attorney by the

National Elder Law Foundation, is past Chairman of the Elder Law Section of the

North Carolina Bar, and secretary of the Elder Law Section of the Georgia State

Bar. You can e-mail Bob at ram@..., or visit his website at

www.masonlawpc.com.

Avoid This Common Banking Error

Many people make mistakes in titling bank and investment

accounts. Often advisors and bankers counsel customers to " put your child's name

on the account " or to set the account up as a " pay on death " (POD) account.

However well-intentioned the advice, the results of either approach to titling

an account can be surprising and unpleasant. Good intentions do not good advice

make.

The Allure of Joint and POD Accounts

Often the attraction is probate avoidance. Either a

joint account with survivorship features or a POD account will pass as a

nonprobate asset and avoid a state-mandated probate process, which can in

exceptional cases take several months to a year or longer.

For joint accounts, the attraction is often convenience.

Unlike a POD account, during the parent's lifetime a joint account holder has

immediate co-ownership rights, and, thus, immediate access to the account. An

older person may feel better knowing that a trusted son or daughter has

immediate access to an account " in case something happens. "

The Dangers of Joint and POD Accounts

If the POD or joint account payee is a child with

disabilities, the result could be terrible for the child upon the parent's death

because the receipt of the account could jeopardize continuing qualification for

public benefits such as Medicaid or SSI.

There are other compelling reasons why a joint account

may not be the proper approach:

a.. The co-owner child now owns the account as much as

the parent. What if the child is sued? What if the child goes through a messy

divorce? Or what if the IRS takes a keen interest in the child's affairs? Those

events happen to the best of children; nevertheless, in those cases the joint

account will be presumed to be owned by the child.

b.. Another problem is that the co-owner/child's

sibling may be out of luck. This happens all the time. For example, Mom wanted

the kids to share equally, but after Mom is gone Sis suddenly recalls that Mom

wanted her to have the accounts since she " was the one who always helped Mom. "

Because Sis was a co-owner of Mom's accounts and likely had survivorship rights,

she owns the accounts now. Usually there is nothing the rest of the family can

do about it, even with legal assistance.

A Better Way

If the goal is asset management in the event the owner

becomes incapacitated, one effective approach is a properly drafted power of

attorney.

A power of attorney has nothing to do with appointing

lawyers. The word " attorney " has its roots in an old French Norman word for

" legal substitute. " A power of attorney is simply a document signed by someone

called the " principal " appointing an " attorney-in-fact " or " agent " to manage

some or all of the principal's financial and business affairs.

The terms of the power of attorney document control what

the agent may, or may not, do. If the document covers a broad spectrum of

duties, then it is a " general " power of attorney. An agent can be given very

broad powers, but if that makes the principal nervous, the instrument can

require the agent to secure some other person's permission before use. (Note:

Many banks and financial institutions prefer to use their own POA forms, but a

growing number of states have laws requiring the institutions to accept other,

often attorney-drafted, power of attorney documents.)

If the goal is to avoid probate upon death of the

account owner, the better approach may be a revocable or living trust. The

assets in the trust will avoid probate. In fact, a revocable trust can also

assist in post-incapacity management of the person's assets because a successor

trustee named in the trust agreement can step in to handle continuing management

of all assets held in the trust. Moreover, in contrast to the unlimited access

of a joint account co-owner who may have issues with his own creditors, the

assets in the trust are protected from the trustee's creditors.

Finally, all of the above considerations especially

apply if the parent has a child with disabilities. There will rarely, if ever,

be an appropriate time to name a child with disabilities as the co-owner of a

joint account or the beneficiary of a POD account. Carefully consider using a

special needs trust, either under a will, as part of a revocable trust, or

created as a separate trust document, to hold that child's intended inheritance.

Properly drafted, the special needs trust assets will not jeopardize the child's

continuing eligibility for various public benefits.

Here's the point: Do not put your children on the

accounts as a joint owner. Instead, execute a power of attorney that grants

appropriate sorts of powers to an agent whom you completely trust to assume the

day to day responsibility for managing your financial and business affairs when

and if needed. Alternatively, consider a revocable trust. In the meantime, keep

the accounts in your name.

The downside to the advice given here: Some fees to a

lawyer. The upside: You may avoid a train wreck.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

© 2011 Special Needs Alliance. .

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Here is a topic that recently came up on IPADDU...

This is particularly well written. It makes a very complicated issue, a little

more understandable.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

June, 2011 - Vol 5, Issue 10

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

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The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Bryn Anne Poland and Pi-Yi Mayo, of

the Law Office of Pi-Yi Mayo, in Baytown, Texas (www.pi-yimayo.com). Their

practice focuses on elder law and special needs planning, including special

needs trusts, Medicare set-asides, and Qualified Settlement Funds. Both are

members of the National Academy of Elder Law Attorneys and the Texas chapter (TX

NAELA). Pi-Yi is a Certified Elder Law Attorney, Special Needs Alliance

Executive Committee member, and currently serves on the Board of the TX NAELA

chapter. Bryn graduated from Washburn University School of Law in 2007 and

currently serves as Co-Chair of the Elder Law Committee of the Houston Bar

Association. Together they have authored many papers covering topics from long

term care insurance to Pickle people (http://www.pi-yimayo.com/Papers.htm).

Planning for Adult Children with Disabilities

As parents of children with disabilities age, there are

many issues that they must address. First, parents must plan for their own

retirement, possible disability and eventual death. To add stress and

complication to that planning, parents must also consider the impact their

retirement, disability or death will have on their children. Often, parents seek

counsel and devise a plan to ensure that their child will be able to obtain or

maintain access to Supplemental Security Income (SSI) and the Medicaid program

while their children are still young. As both parents and children age, parents

should revisit those plans and inquire into any other programs or benefits that

might be available. One important social security insurance benefit is the

Childhood Disability Benefit (CDB), which is sometimes referred to as the

Disabled Adult Child (DAC) benefit. For purposes of this article we refer to the

benefit as Childhood Disability Benefit or CDB.

Childhood Disability Benefits Defined

CDB is a monthly cash payment to a child based on the

social security earnings record of a parent of that adult child. The amount of

the payment is based on the parent's primary insurance amount (PIA). A disabled

adult child is entitled to one-half of the parents' PIA if the parent is living,

and three-fourths of the PIA if the parent is deceased. If both parents are

disabled, retired or deceased, the child is entitled to CDB benefits on the

higher account of the two. A disabled adult child is entitled to CDB based on

the social security record of a parent only if all of the following conditions

are met:

1.. An application for CDB is filed;

2.. The child meets the definition of " disabled "

applicable to all social security disability insurance (SSDI) applicants;

3.. The child is not married, or is married to a

social security beneficiary;

4.. The child is age 18 or older and under a

disability which must have begun before age 22; and

5.. The parent is entitled to social security

disability insurance or retirement insurance benefits, or is deceased.

In some cases a child may be eligible for CDB benefits

on the account of a grandparent or stepparent.

If the disabled adult child is eligible, the child will

receive a notice from the Social Security Administration that he or she is

entitled to benefits based on a parent's social security earnings record. In

many cases the child may have received SSI prior to the start of CDB. If the CDB

benefit is higher than the SSI maximum federal benefit ($674 in 2011), the SSI

benefits will be terminated. In addition, the child will also be eligible for

Medicare after a 24 month waiting period from the date of the first month the

child became eligible to receive CDB.

If an adult disabled child loses eligibility for SSI

when CDB begins, he or she can often continue eligibility for Medicaid. In many

cases, Medicaid funds the vital supports and services the child is receiving.

Many states have rules and regulations in place that provide for continuing

Medicaid eligibility even after the child's eligibility for SSI is terminated.

When a child qualifies for and receives CDB, the additional income is excluded

from countable income for Medicaid eligibility if the child's SSI was terminated

because of the increased income but the child is otherwise eligible for SSI:

determined disabled and having countable resources of $2,000 or less. In some

states the transition from SSI-linked Medicaid to CDB Medicaid is automatic and

in others, the state Medicaid agency may require a new application. Regardless

of the mechanism, it is important for families to be aware of the benefit and

the transition, so that the transition can be managed as necessary to prevent an

interruption in benefits.

How Does Work Affect CDB?

There are two timeframes where work can affect

eligibility for CDB. First, in order to be eligible for CDB, a child cannot have

participated in Substantial Gainful Activity (SGA) after the onset of disability

but prior to initially qualifying for CDB. In 2011, an individual earning more

than $1,000.00 per month is presumed to be engaged in SGA and therefore not

disabled. If the individual is blind, the SGA amount is slightly higher. If the

CDB benefit has not started, the individual should seek advice as to how much he

or she is able to earn while still maintaining eligibility for CDB upon the

retirement, disability or death of a parent.

While working at the SGA level of earnings before

initially qualifying for CBD can have a harsh affect on eligibility, working is

not as problematic if the individual works or attempts to work after initially

qualifying for CDB. If a disabled adult child is receiving CDB and would like to

engage in an employment opportunity, the individual can participate in a trial

work period. During a trial work period, the individual can continue to receive

full CDB benefits for a period of 9 months while working and earning above the

current SGA amount. After that allowed time period, if the individual continues

to have earnings that are " substantial, " the CDB benefits will end; however, for

any month when the individual does not meet the definition of Substantial

Gainful Employment, he or she will be eligible for monthly benefits. If the

individual's income dips below the current SGA amount, or if the income stops

completely within 36 months of having received CDB benefits, then no new

application or disability determination is needed.

Here are two illustrations of how work can affect

eligibility for CDB: Tim was disabled before the age of 22 but from age 25 to 27

he was able to work full time and had SGA. Tim had to stop working for health

reasons and re-apply for SSDI on his own account after working for two years.

Tim's father then retires when Tim is 32. Tim cannot qualify for CDB on his

father's account because Tim had SGA before his father retired. Tim meets all of

the requirements for CDB except that he had SGA before he could apply for

benefits when his father retired. In the second example, Tim has no SGA before

his father retires when Tim was 32. When his father retires, Tim will be

eligible for CDB to supplement his SSDI benefits. At age 35 Tim is able to work

and earn $2,000 per month for two years. Tim will lose his CDB benefit after a 9

month trial work period. After working for two years Tim must quit his job

because of his disabilities. He can again qualify for CDB even though he had SGA

for two years because his employment occurred after he qualified for CDB.

How Does Marriage Affect CDB?

If a disabled adult child receiving CDB marries, that

child may or may not lose her eligibility for CDB. As noted above, a disabled

adult child who is receiving CDB is doing so based upon having a disability that

began before reaching age 22 and the retirement, death or disability of a parent

who had a social security work record. The marriage of a CDB beneficiary to

another social security beneficiary will not cause the CDB beneficiary to lose

eligibility for those benefits. If the disabled adult child marries a person who

is not a social security beneficiary, then the disabled adult child will lose

the CDB eligibility that derived from the parent's status as a wage earner.

Conclusion

CDB, DAC, SSI, SSDI and SGA may sound like a new variety

of clustered alphabet soup. In fact, parents, caretakers and adult children with

a disability need to know the meaning and function of each of these

abbreviations and the relevant rules that apply to the programs in this alphabet

soup. Keeping the CDB eligibility rules in mind while reevaluating a care plan

for aging parents and disabled children can help relieve stress and provide

groundwork for maintaining Medicaid benefits. The potentially increased CDB cash

payment can help a disabled adult child significantly, but ensuring Medicaid

eligibility after the payment increase is of crucial importance for many such

adults. Knowing these rules will allow caretakers to take action immediately if

the disabled child receives notice that Medicaid will be terminated because the

child is no longer eligible for SSI. In addition, understanding when a disabled

adult child can seek Substantial Gainful Activity and just how much the child

can earn each month will allow families to better evaluate each decision as it

relates to these often vital benefits.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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to receive these articles directly, usually twice a month, go to

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Rubin<mailto:BRIAN@...> *

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The Law Offices of

Rubin & Associates

Law practice limited to serving the future & legal planning

needs of Rubin's fellow Illinois families of children & adults

with intellectual disabilities, developmental disabilities, & /or mental

illness...

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www.SNFP.net<http://www.snfp.net/>

(O) 847-279-7999 - (F) 847-279-0090 - (TF) 866.TO.RUBIN

Mail: 1110 West Lake Cook Road, Buffalo Grove, Illinois 60089-1997

* President, The Arc of Illinois 2011-2013

* Member by invitation of SNA, the Special Needs Alliance (web

site<http://www.specialneedsalliance.org/>). The SNA is the national non-profit

association of experienced " Special Needs Planning " Attorneys. Rubin is a

member of SNA's Board of Directors.

* Member of the Special Needs Law Steering Committee of

NAELA,<http://www.naela.org/>the National Academy of Elder Law Attorneys.

<http://www.naela.org/>

* Was a Charter Member of the Academy of Special Needs Planners

* Has been awarded the dale Hubbell Peer Review<http://martindale.com/>

Rating of AV Preeminent, the highest rating given<http://martindale.com/>.

* For more information about Rubin, please visit our web

site<http://www.snfp.net/>.

Notices:

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From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of ELLEN BRONFELD

Sent: Friday, June 17, 2011 3:20 PM

IPADDUnite ; teri steinberg; Betty Korey; Eissman;

Whitefield; Robynn Medansky; Barb Cabin; Geri Brown; Debbie Rudin

Subject: Fw: [voice] The Voice - Special Needs Alliance newsletter

Here is a topic that recently came up on IPADDU...

This is particularly well written. It makes a very complicated issue, a little

more understandable.

Ellen

Ellen Garber Bronfeld

egskb@...<mailto:egskb%40sbcglobal.net>

[voice] The Voice - Special Needs Alliance newsletter

June, 2011 - Vol 5, Issue 10

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs Alliance. This

installment was written by Bryn Anne Poland and Pi-Yi Mayo, of the Law Office of

Pi-Yi Mayo, in Baytown, Texas (www.pi-yimayo.com<http://www.pi-yimayo.com>).

Their practice focuses on elder law and special needs planning, including

special needs trusts, Medicare set-asides, and Qualified Settlement Funds. Both

are members of the National Academy of Elder Law Attorneys and the Texas chapter

(TX NAELA). Pi-Yi is a Certified Elder Law Attorney, Special Needs Alliance

Executive Committee member, and currently serves on the Board of the TX NAELA

chapter. Bryn graduated from Washburn University School of Law in 2007 and

currently serves as Co-Chair of the Elder Law Committee of the Houston Bar

Association. Together they have authored many papers covering topics from long

term care insurance to Pickle people (http://www.pi-yimayo.com/Papers.htm).

Planning for Adult Children with Disabilities

As parents of children with disabilities age, there are many issues that they

must address. First, parents must plan for their own retirement, possible

disability and eventual death. To add stress and complication to that planning,

parents must also consider the impact their retirement, disability or death will

have on their children. Often, parents seek counsel and devise a plan to ensure

that their child will be able to obtain or maintain access to Supplemental

Security Income (SSI) and the Medicaid program while their children are still

young. As both parents and children age, parents should revisit those plans and

inquire into any other programs or benefits that might be available. One

important social security insurance benefit is the Childhood Disability Benefit

(CDB), which is sometimes referred to as the Disabled Adult Child (DAC) benefit.

For purposes of this article we refer to the benefit as Childhood Disability

Benefit or CDB.

Childhood Disability Benefits Defined

CDB is a monthly cash payment to a child based on the social security earnings

record of a parent of that adult child. The amount of the payment is based on

the parent's primary insurance amount (PIA). A disabled adult child is entitled

to one-half of the parents' PIA if the parent is living, and three-fourths of

the PIA if the parent is deceased. If both parents are disabled, retired or

deceased, the child is entitled to CDB benefits on the higher account of the

two. A disabled adult child is entitled to CDB based on the social security

record of a parent only if all of the following conditions are met:

1.. An application for CDB is filed;

2.. The child meets the definition of " disabled " applicable to all social

security disability insurance (SSDI) applicants;

3.. The child is not married, or is married to a social security beneficiary;

4.. The child is age 18 or older and under a disability which must have begun

before age 22; and

5.. The parent is entitled to social security disability insurance or retirement

insurance benefits, or is deceased.

In some cases a child may be eligible for CDB benefits on the account of a

grandparent or stepparent.

If the disabled adult child is eligible, the child will receive a notice from

the Social Security Administration that he or she is entitled to benefits based

on a parent's social security earnings record. In many cases the child may have

received SSI prior to the start of CDB. If the CDB benefit is higher than the

SSI maximum federal benefit ($674 in 2011), the SSI benefits will be terminated.

In addition, the child will also be eligible for Medicare after a 24 month

waiting period from the date of the first month the child became eligible to

receive CDB.

If an adult disabled child loses eligibility for SSI when CDB begins, he or she

can often continue eligibility for Medicaid. In many cases, Medicaid funds the

vital supports and services the child is receiving. Many states have rules and

regulations in place that provide for continuing Medicaid eligibility even after

the child's eligibility for SSI is terminated. When a child qualifies for and

receives CDB, the additional income is excluded from countable income for

Medicaid eligibility if the child's SSI was terminated because of the increased

income but the child is otherwise eligible for SSI: determined disabled and

having countable resources of $2,000 or less. In some states the transition from

SSI-linked Medicaid to CDB Medicaid is automatic and in others, the state

Medicaid agency may require a new application. Regardless of the mechanism, it

is important for families to be aware of the benefit and the transition, so that

the transition can be managed as necessary to prevent an interruption in

benefits.

How Does Work Affect CDB?

There are two timeframes where work can affect eligibility for CDB. First, in

order to be eligible for CDB, a child cannot have participated in Substantial

Gainful Activity (SGA) after the onset of disability but prior to initially

qualifying for CDB. In 2011, an individual earning more than $1,000.00 per month

is presumed to be engaged in SGA and therefore not disabled. If the individual

is blind, the SGA amount is slightly higher. If the CDB benefit has not started,

the individual should seek advice as to how much he or she is able to earn while

still maintaining eligibility for CDB upon the retirement, disability or death

of a parent.

While working at the SGA level of earnings before initially qualifying for CBD

can have a harsh affect on eligibility, working is not as problematic if the

individual works or attempts to work after initially qualifying for CDB. If a

disabled adult child is receiving CDB and would like to engage in an employment

opportunity, the individual can participate in a trial work period. During a

trial work period, the individual can continue to receive full CDB benefits for

a period of 9 months while working and earning above the current SGA amount.

After that allowed time period, if the individual continues to have earnings

that are " substantial, " the CDB benefits will end; however, for any month when

the individual does not meet the definition of Substantial Gainful Employment,

he or she will be eligible for monthly benefits. If the individual's income dips

below the current SGA amount, or if the income stops completely within 36 months

of having received CDB benefits, then no new application or disability

determination is needed.

Here are two illustrations of how work can affect eligibility for CDB: Tim was

disabled before the age of 22 but from age 25 to 27 he was able to work full

time and had SGA. Tim had to stop working for health reasons and re-apply for

SSDI on his own account after working for two years. Tim's father then retires

when Tim is 32. Tim cannot qualify for CDB on his father's account because Tim

had SGA before his father retired. Tim meets all of the requirements for CDB

except that he had SGA before he could apply for benefits when his father

retired. In the second example, Tim has no SGA before his father retires when

Tim was 32. When his father retires, Tim will be eligible for CDB to supplement

his SSDI benefits. At age 35 Tim is able to work and earn $2,000 per month for

two years. Tim will lose his CDB benefit after a 9 month trial work period.

After working for two years Tim must quit his job because of his disabilities.

He can again qualify for CDB even though he had SGA for two years because his

employment occurred after he qualified for CDB.

How Does Marriage Affect CDB?

If a disabled adult child receiving CDB marries, that child may or may not lose

her eligibility for CDB. As noted above, a disabled adult child who is receiving

CDB is doing so based upon having a disability that began before reaching age 22

and the retirement, death or disability of a parent who had a social security

work record. The marriage of a CDB beneficiary to another social security

beneficiary will not cause the CDB beneficiary to lose eligibility for those

benefits. If the disabled adult child marries a person who is not a social

security beneficiary, then the disabled adult child will lose the CDB

eligibility that derived from the parent's status as a wage earner.

Conclusion

CDB, DAC, SSI, SSDI and SGA may sound like a new variety of clustered alphabet

soup. In fact, parents, caretakers and adult children with a disability need to

know the meaning and function of each of these abbreviations and the relevant

rules that apply to the programs in this alphabet soup. Keeping the CDB

eligibility rules in mind while reevaluating a care plan for aging parents and

disabled children can help relieve stress and provide groundwork for maintaining

Medicaid benefits. The potentially increased CDB cash payment can help a

disabled adult child significantly, but ensuring Medicaid eligibility after the

payment increase is of crucial importance for many such adults. Knowing these

rules will allow caretakers to take action immediately if the disabled child

receives notice that Medicaid will be terminated because the child is no longer

eligible for SSI. In addition, understanding when a disabled adult child can

seek Substantial Gainful Activity and just how much the child can earn each

month will allow families to better evaluate each decision as it relates to

these often vital benefits.

About this Newsletter: We hope you find this newsletter useful and informative,

but it is not the same as legal counsel. A free newsletter is ultimately worth

everything it costs you; you rely on it at your own risk. Good legal advice

includes a review of all of the facts of your situation, including many that may

at first blush seem to you not to matter. The plan it generates is sensitive to

your goals and wishes while taking into account a whole panoply of laws, rules

and practices, many not published. That is what The Special Needs Alliance is

all about. Contact information for a member in your state may be obtained by

calling toll-free (877) 572-8472, or by visiting the Special Needs Alliance

online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above article may be reprinted

only if it appears unmodified, including both the author description above the

title and the " About this Newsletter " paragraph immediately following the

article, accompanied by the following statement: " Reprinted with permission of

the Special Needs Alliance -

www.specialneedsalliance.org<http://www.specialneedsalliance.org>. "

© 2011 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

June, 2011 - Vol 5, Issue 11

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Craig C.

Reaves of Reaves Law Firm, PC. in Kansas City, Missouri. Holding the CELA

(Certified Elder Law Attorney) designation from the National Elder Law

Foundation, he is a Past President and Fellow of the National Academy of Elder

Law Attorneys, a Fellow of the American College of Trust & Estate Counsel

(ACTEC), and has been selected for inclusion on the Kansas and Missouri Super

Lawyers list for every year since 2005. Mr. Reaves is an adjunct professor of

elder law at the law schools of the University of Kansas and the University of

Missouri-Kansas City. He practices law in Kansas and Missouri with major

emphasis in the areas of estate planning, elder law, special needs trusts and

planning for persons who have a disability.

The Mission Project

One of the more difficult things to do for a parent of a

young adult who has a disability is find appropriate housing--a place that

provides a safe environment and yet promotes growth and independence.

Sometimes this is relatively easy because the disability

is slight and the child is capable of holding a job and living totally

independently. Or, on the other extreme, the child needs full time care and

supervision. But what about those in between: those who are high functioning,

but not quite to the point of really being able to live completely on their own,

yet they are beyond living in a group home and are stifled living with their

parents? Where can they live?

What if there was a community where:

a.. individuals who have a disability could live in

their own apartment, but have a group of similarly situated friends nearby;

b.. there were within walking distance restaurants,

grocery stores, places to shop, swimming pools, a gym and other recreational

facilities where they were welcomed;

c.. the police and shop owners recognized and watched

out for them;

d.. their parents were involved in, but not

controlling, their lives;

e.. they could get together as a group and openly

discuss any problems they are having with a counselor who can help guide them;

f.. they could take dance lessons, acting lessons,

computer lessons and exercise classes if they want, but were not forced to

participate;

g.. they could have a job, reliable and free

transportation to and from the job, and even a job coach if one is needed;

h.. there were opportunities to plan a group trip,

pick the place to go, save money towards the expense and travel with their

friends to places like Chicago, St. Louis, Cozumel and the Rocky Mountains;

i.. there was a telephone hotline answered 24 hours a

day by someone they know, who cares about them and will answer their questions

about anything they want to know at that moment.

Wouldn't that be a nice place to live? So you think this

is a utopian dream? Well think again. Such a place exists in a suburb of Kansas

City.

It all started in 2003 with the vision of three couples,

all parents of a child with a developmental disability who was in his or her

early twenties, living at home and, although comfortable, was becoming bored and

on the verge of no longer advancing. After encouraging their respective children

during their early years to push themselves and become more independent, the

parents now found themselves enabling their children to regress and plateau in

their own homes.

So the parents began researching available options

locally and across the country. Nothing seemed to fit. After hours of

discussions that sharpened their focus, they developed core values to guide them

through a design process for a new community. They wanted, first of all, a place

that was safe for their children. Next came employment, then continuing

education, physical fitness, social activities, parental input (not control),

increasing independence and continuity.

These parents looked all over Kansas City for a

community that satisfied their core values and settled on the older, close-in

suburb of Mission, Kansas. They then named their dream " The Mission Project. "

Buying an apartment building for housing was considered,

but rejected. Not only would it require a large outlay of money and debt, but it

would make it more expensive and complicated when other families joined. Also,

they did not want to become landlords, and they wanted the flexibility to move

elsewhere if the community changed. They found an apartment complex, met with

the manager and shared their vision - each child living in a separate apartment,

paying his or her own rent through SSI, Section 8 vouchers and jobs, having

parents and case managers who would be around but not living there. The manager

agreed and The Mission Project found a home.

Next the parents met with the mayor, city council,

police and local businesses for the purpose of sharing with them the parents'

vision and the purpose of the project. They also assured these community leaders

and business owners that The Mission Project would not become too large and

overwhelm the community with young adults who had disabilities. The parents

wanted to make sure that their children would not be discriminated against,

ridiculed or feared if they were walking around the community alone or in a

group.

In order to help support the local businesses that were

interacting with their children, the parents instituted " Mission First, " a

commitment to first try to purchase anything they wanted in Mission. So now the

parents drive from other communities in the Kansas City area to Mission to buy

their groceries, hardware and anything else they can purchase from the local

merchants.

The first participants moved in during the summer of

2004. Today it has grown into a community of fifteen individuals who have all of

the amenities described above, plus more.

Each participant has a family member who is a voting

member of the non-profit corporation that is The Mission Project. All of these

members have a job, ranging from serving on a committee (such as the steering

committee, fundraising, government relations, membership, education, social,

etc.) to answering calls that come into the helpline, overseeing the newsletter

the participants produce or chaperoning outings such as movies, bowling, dancing

or group trips out of town.

A goal of The Mission Project is to foster and promote

independence and self-governance in the group and in individual lives. A

supports scale was developed and success is measured in terms of growth of the

participants towards independence, individuality and as part of the larger

Mission Project community. Results are very positive.

The vision of the founding parents is coming true.

Because there is not space in this article to fully describe this program, you

are encouraged to check out their website at www.TheMissionProject.org. If you

want even more information, feel free to contact them directly. You will find a

group of people who are not only excited about what they are experiencing, but

are very willing to help and share with others.

--------------------------------------------------------

Related Innovative Housing Models Research Note to

Families from Special Needs Alliance Publications Committee:

Nationwide, families of adults with disabilities are

searching for ways to develop independent, supportive housing for their kin. The

Mission Project is a wonderful example of an innovative and cost-effective plan

that was developed, funded and managed by parents themselves. A group in Western

North Carolina is working to support family efforts to develop housing where

adults with a wide variety of disabilities can live independently. Now we need

your help.

To save research time for individual families getting

started on this difficult journey, we are compiling a list of innovative housing

models from around the country to be posted on a website currently being built

(myownkey.org). Please send information about plans for supportive housing that

you are part of - or know of - to djohnston@.... Please put HOUSING

PLAN in the subject line. Don't be shy! Simple plans that have worked for your

family will be useful to others. Information about plans that have not worked,

and why, could be just as useful.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

July, 2011 - Vol 5, Issue 12

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

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Capitol Connection

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The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member M.

McCarten, at the Nashville, Tennessee law firm of White & Reasor, PLC, where he

focuses on estate planning, general tax matters and counseling families on

special needs planning. Mr. McCarten has been listed in The Best Lawyers in

America since 2003 in several categories, is a Fellow in the American College of

Trust and Estate Counsel, has served as the Chair of the Tennessee Bar

Association's Tax Section, and serves on the Boards of The ARC of son

County, Tennessee and the Autism Society of Middle Tennessee. You can learn more

about Jim, his firm and his practice at www.whitereasor.com.

The New Medicare Surtax:

Will You or Your Special Needs Trust Be Affected in

2013?

When Congress passed the President's health care reform

initiative in March of 2010, the legislation came in two separate bills. First

came the Patient Protection and Affordable Care Act (PPACA), followed by the

Health Care and Education Reconciliation Act (HCERA) several days later. One

focus of the HCERA was to implement the tax provisions designed to pay for

healthcare reform. Several cases are pending in various federal courts

challenging the constitutionality of the PPACA, but even if the courts

eventually were to declare the PPACA to be unconstitutional, the non-insurance

tax provisions in the HCERA will apply to taxpayers, including the disabled

beneficiaries of special needs trusts (SNTs) and/or SNTs themselves. Like most

taxes, the financial impact of the new tax in the HCERA can be minimized with

proper planning. What follows is a very brief overview of the new tax, some

general planning opportunities, and a brief discussion on how the tax will apply

to SNTs.

Who Will Be Subject to the New Surtax?

One of the largest tax increases arising out of the

President's health care reform initiatives is a new tax on the qualified

unearned or passive income of individuals, trusts and estates. That tax begins

January 1, 2013, will be imposed at a 3.8% rate and is designated as a Medicare

contribution tax (the Medicare surtax). Initially advertised as applying only to

high income individuals, the Medicare surtax also applies to estates and trusts

once the taxable income reaches the top marginal tax rate. Estates and trusts

reach the threshold for taxation at the top marginal rate with far less income

than individual taxpayers. In 2011, a trust hits the top marginal income tax

rate as soon as its taxable income exceeds $11,350. While this threshold is

indexed for inflation, that amount is not likely to change significantly by

2013. As a result, even though no one would describe most SNT beneficiaries as

wealthy, some SNTs will end up with income subject to this new tax.

In contrast, individuals will be subject to the new tax

only if they receive passive income during a year in which their modified

adjusted gross income (MAGI) exceeds a certain threshold. For single

individuals, the MAGI threshold is $200,000. For married individuals, the MAGI

threshold is $250,000. ($125,000 for married individuals filing separately).

When an individual's MAGI exceeds the applicable threshold, and he/she received

passive income during the year, the Medicare surtax will be assessed against the

lesser of the taxpayer's net investment income or the amount by which the

taxpayer's MAGI exceeds the applicable threshold above.

Scheduled Tax Rate Changes in 2013

So what do all these new rules, terms and alphabet soup

actually mean for taxpayers? The so-called Bush era income (and estate) tax cuts

are scheduled to expire after December 31, 2012, reverting to the rates that

existed prior to 2001. If the income tax cuts do expire, the top marginal tax

rates will affect relatively few individuals but many irrevocable trusts. At the

end of this article is a chart showing the top 2012 and 2013 tax rates, with and

without surtax, on various types of income: earned, taxable interest, dividends

and capital gains. Investment income is precisely the type of income

traditionally earned by a trust, and as the chart demonstrates, the tax rates

applicable to most types of investment income will increase to nearly 40%. Add

in the new 3.8% Medicare surtax, and the top marginal rates applicable to most

forms of passive types of income jump to nearly 45%.

Passive Income Subject to or Exempt from the Surtax

What types of income are unearned or passive income for

this new Medicare surtax? Generally, these are what one normally would consider

investment income. The definition specifically includes interest, dividends,

royalties, annuities, rents and capital gains. It also includes gross income

from businesses in which the taxpayer is not actively involved. A good rule of

thumb is that if the income is subject to self-employment tax or FICA tax, it is

not passive income. Almost everything else is treated as passive income. For

planning purposes, distributions from regular IRAs or qualified plans as well as

distributions from Roth IRAs will not, themselves, be subject to the tax.

However, taxpayers must recognize that distributions from regular IRAs and

qualified plans will increase the taxpayer's MAGI, so such distributions must be

reviewed when planning to avoid this new tax.

Deductions, Keeping Schedules and Estimated Taxes

The deductions available for reducing the Medicare

surtax base are not yet fully clear. Most advisors believe that a taxpayer's

gross passive income should be reduced by all deductions properly allocable to

that income, including capital losses, passive losses and investment interest

expenses, to name a few. The IRS will likely issue written guidance on these

deductions as we get closer to 2013. Still, taxpayers should be aware that the

preparation of tax returns is about to become even more complex. For example,

passive losses may be limited or suspended for regular tax purposes but should

be fully deductible for the Medicare surtax. Thus, taxpayers will need to keep

schedules based upon the type of taxes to which the taxpayer is subject (regular

income tax, Medicare surtax and the alternative minimum tax).

When planning for this new tax, advisors and trustees

must understand that it applies to all passive income earned beginning as of

January 1, 2013. Just like the regular income tax, the new Medicare surtax will

be subject to the estimated tax requirements and its penalty provisions. Thus,

if, when returns are filed on April 15, 2014, the tax ends up being due for the

2013 tax year and the taxpayer's estimated tax payments did not anticipate that

extra tax amount, penalties will be assessed.

Planning Ahead

Much like the regular income tax, certain types of

investment income are tax-favored for purposes of the Medicare surtax.

Specifically, municipal bond interest, tax-deferred growth in individual

retirement accounts and other retirement plans, as well as cash value buildup in

life insurance are exempt from this tax. Nevertheless, trustees should first

consult with their certified financial planners, CPAs and/or other tax advisors

before moving significant portions of an investment portfolio into such

investments.

Tax planning with regard to the Medicare surtax will

focus on two primary concepts: (1) managing the timing of income which increases

the taxpayer's MAGI, and (2) managing when the taxpayer recognizes passive

income. In other words, how much income is recognized in any one year and thus

might be subject to the tax. Trustees and financial planners must explore

traditional tax planning strategies for the deferral of income, whether applied

to the taxpayer's passive income or other types of income, in order to reduce

the taxpayer's MAGI. Tax deferred annuities will likely help manage the amounts

of taxpayer's income, both regular income and passive income, recognized in any

single year.

Special Needs Trust Tax Planning

For trustees of special needs trusts, the primary

planning issue is who will report the income. If the trust is a first-party SNT

(created to hold the beneficiary's own funds, such as the proceeds from a

lawsuit or an unrestricted gift or inheritance), the trust is taxable as a

grantor trust. This means that the income is actually reported on the

beneficiary's tax return, at which point it is the beneficiary's MAGI which

serves as the threshold for application of the tax. If the trust is a

third-party SNT (created as part of the parents' or grandparents' estate plan

and funded with their assets), the trustee must determine whether the trust

income is being accumulated or distributed.

If the income is being accumulated, it will be taxable

to the trust at the higher marginal estate and trust tax rates. If some or all

of the trust income is being used for the benefit of the special needs

beneficiary, that income will be reported on the tax return of the beneficiary

and the tax analysis will be similar to that of a first-party SNT. Planning

opportunities are available in both circumstances, but the planning is so vastly

different that trustees should consult and work closely with their tax advisors.

While the President and Congress meant this new tax to

apply only to the wealthy, the Medicare surtax unfortunately may adversely

impact the beneficiaries of third-party SNTs with accumulated passive income in

excess of $11,350 annually. While most SNTs will not fall into this category, it

is unfortunate that these beneficiaries with disabilities, who are among those

meant to benefit from healthcare reform, will be among those who will bear the

burden of paying for these much needed benefits.

How High Will Rates Go?

Type of Income 2012

(Pre-Expiration of the Bush-era tax cuts) 2013

(Post-Expiration of the Bush-era tax cuts) 2013

(Adding the new Medicare Surtax)

Earned Income 35% 39.6% 40.5%*

Taxable Interest 35% 39.6% 43.4%

Dividends 15% 39.6% 43.4%

Capital Gains 15% 20.0% 23.8%

* This figure does not include the already existing

Medicare surtax on wages (1.45% paid by employee) or self-employment income

(2.9%).

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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Guest guest

Powerful information.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

July, 2011 - Vol 5, Issue 13

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the email newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Jim

Caffry, a sole practitioner in Waterbury, Vermont. Jim's practice is

concentrated in special needs planning and advocacy. One of Jim's three

children, his eleven year old son, has autism and other special needs. Jim is a

current member of the Vermont Developmental Disabilities Council, and a past

member of the Vermont Autism Task Force and the Vermont Act 135 Autism Planning

Committee. You can learn more about Jim, his firm and his practice at

www.caffrylaw.com.

Better Advocacy Through Acronyms

Parents, caregivers and advocates of children and adults

with special needs are inundated with acronyms as they navigate their state's

disability systems.

Among the acronyms they likely encounter: EPSDT-Early

Periodic Screening, Diagnosis and Treatment; FIT-Family Infant & Toddler

programs; IEP-Individualized Educational Program; FAPE-Free Appropriate Public

Education; SSI-Supplemental Security Income; CDB-Childhood Disability Benefits;

and HCBS-Home and Community Based Services.

There are two other acronyms, however, that should

become familiar in the never-ending effort to advocate for children with special

needs-FOIA and APA. Armed with an understanding of FOIA and the APA, families

and other advocates can access vast amounts of information that impacts the

quality of life of people with special needs. Understanding FOIA and the APA

will empower families and advocates to play a constructive and productive role

in shaping the laws, regulations, and public policy impacting their state's

special needs community.

What are these " acronyms of better advocacy " ? FOIA

stands for Freedom of Information Act. APA stands for Administrative Procedures

Act. Although these laws may go by another name in some states, all 50 states

have adopted some version of both FOIA and the APA.

The website of the National Freedom of Information

Coalition provides information about every state's FOIA law

(http://www.nfoic.org/state-foi-laws). Florida State University Law School lists

every state's APA citation (http://www.law.fsu.edu/library/admin/admin3.html).

An internet search will almost certainly provide mountains of helpful

information in plain English about how to put each state's FOIA and APA laws to

work. It is always a good idea to review the actual language of a state's laws

and not to rely solely on other sources.

At this point you may be thinking " Why should I really

care about FOIA or my state's APA? " Well, you should if this scenario sounds

even a little familiar to you...

Parent of special needs child-Question to a state

human services agency employee: " Why does the agency in our state only provide

Services X and Y? I recently read an article that our neighboring state has

Alternative Service Z for children with the same diagnosis as my child. Why

can't we do Alternative Service Z here in our state?

Agency staff-Answer: " Because our disability system

provides Services X and Y, and that's the way we have always done it in this

state. "

SN parent-Question: " OK, I understand that, but it

does not answer the question of why our state cannot offer Alternative Service Z

too. "

Agency staff-Answer: " Like I said, it is the

long-standing policy of this state that we provide Services X and Y for the type

of disability your child has. "

SN parent-Questions: " Hmmm. Has anyone at the agency

ever looked into whether or Alternative Service Z could be implemented in our

state for the same or less cost that the current Services X and Y? Is the policy

limiting services in our state to " only services X and Y " in writing? Is it an

agency policy, or a formally adopted rule? Or is it in an actual law adopted by

the state legislature and signed by the governor? "

Agency Staff-Answer: " The agency considered

alternatives way back when we started providing Services X and Y. and it says

right in the agency program manual that service options are X and Y. "

Although you may be thinking that it would feel pretty

good to give this agency staffer a candid assessment of his or her customer

service skills, it is best to stay calm and thank the person for his or her

time.

Remember, FOIA Is Your Friend

" Show me the documents. "

When you hang up the phone, take a few moments to write

down as many details of the conversation as you can recall. Next, take a careful

look at your state's FOIA law. Then write a " Freedom of Information Act Request "

or " public records request " letter to the agency providing a detailed

description of the public information you want the agency to produce. Not sure

how to write the FOIA request? There are many samples out there-an internet

search for " sample FOIA request " produced more than 110,000 hits. The scope of

your FOIA request can be very broad, very narrow, or both. For example:

" I am requesting that any and all documents in the

possession of the agency regarding Disability Services X and Y in this state be

made available for inspection and copying. This request for public information

includes all manuals, reports, studies, internal communications between any

agency staff members, and external communications between any agency staff

members and any other person, including, but not limited to, any state

legislators and any service providers of Services X and Y.

In addition, I am also requesting any and all

documents in the possession of the agency regarding this state's consideration

of and decision not to provide Alternative Disability Service Z. Alternative

Service Z is currently available in the neighboring State of A. This FOIA

request seeks all documents that the agency has identifying Alternative Service

Z, including any documents identifying the legal, economic and/or public policy

bases for the agency's decision not to make Alternative Service Z available in

this state. "

Generally speaking, all FOIA laws will impose time

limits within which public agencies must provide a response to a citizen's FOIA

request. If a public agency refuses to comply fully with the FOIA request and

the dispute ends up in court, the public agency may even have to pay for the

attorneys' fees of the person requesting the public records.

" Redact it! "

FOIA laws all have exemptions specifying the information

that public agencies do not have to make available in response to a FOIA

request, including confidential information about people receiving services. Do

not let a public agency get away with telling you that you cannot have the

information you asked for in your FOIA request because it contains confidential

information.

First, your state's FOIA law will probably include a

requirement that any public agency that refuses to make documents available must

identify every document withheld and provide the reason the agency withheld the

document from you. Second, if a public record contains both information

responsive to your FOIA request and confidential information, the public agency

is generally required to redact the confidential information and to provide the

document to the person requesting it. " Redact " is just a fancy way of saying

" take a big black marker, cross out the confidential stuff, and give me the

document with rest of the information. "

An example of this could be if you wanted to know how

many people in your county had been diagnosed with autism and were receiving

Medicaid-funded home and community based services. You might want to know the

range of services these people were receiving and the range of their waiver

budgets. You could file a FOIA request with the public agency and ask for

" copies of all current service agreements for all individuals with autism in

Washington County receiving home and community based services. " The agency might

give you an answer like " Sorry, that information is confidential. " Your response

should be: " Redact the names, addresses and social security numbers of the

people receiving the services, but the ages, service program details and the

service budgets details are all public information that the agency is required

to provide. "

You might be able to skip a step by stating upfront in

your FOIA request letter that the agency should redact confidential information

on any documents containing both confidential information and responsive public

information.

Know Your State's APA

When it comes to programs and services for people with

disabilities in every state, the legal " chain of command " generally runs this

way: (A) federal laws; (B) federal regulations; © state laws; (D) state

regulations; and finally, (E) state agency policies, practices, guidance

documents, procedures or program manuals. The federal laws and regulations that

authorize states to develop Medicaid programs providing services to different

populations of people with disabilities are very broadly written. In other

words, states have a lot of flexibility in designing and implementing disability

service programs within their Medicaid programs. As many parents already know,

much of how a disability program actually works is based on state agency

" policies " and " practices. "

Unlike laws and formally adopted regulations, many state

agency policies and practices have not gone through a public review process

known as " notice and comment. " Instead, many state policies and practices are

developed, consciously or by inertia, internally, within the state agency. That

is how we end up with a public agency's

" because-that-is-the-way-we-have-always-done-it " policy.

APA to the rescue

This is where your state's administrative procedures act

can help. The general purpose of a state's administrative procedures act is that

public agencies should maximize the involvement of the public in the development

of rules that implement laws.

If a decision about what services your child is or is

not receiving is based on a public agency's unwritten policy or practice, your

state's APA may give you the right to force the agency to put the policy or

practice in writing in a single document. Remember to give the agency a written

FOIA request for all documents relating to the policy, including internal agency

emails. The state's APA may even require that certain policies or practices be

adopted as regulations, complete with publication, " notice and comment, " and a

vote by an official body.

Strength in numbers

Even if your state agency has put its policy in writing,

or even if it has adopted a rule for the current service program using the full

formal process, this does not mean that parents are stuck with that program.

Check your state's APA for the steps required to

petition a public agency to adopt, amend or repeal a rule. Your state law may

allow a single individual to file a petition for rule-making, but some states

may require a minimum number of people to sign the petition for rule-making.

Even if the APA in your state allows an individual to file the rule-making

petition, it is a good idea to gather the signatures of as many like-minded

parents as you can. It is a truism to say that the agency is going to take a

petition with 100 signatures more seriously than it will take a petition from a

single person.

If your petition is to get your state agency to allow

" Alternative Service Z " in your state, then it would be a good idea for your

petition to include information about whether any other states already allow

Alternative Service Z. If the other states already offering Alternative Service

Z are doing so at the same or less cost than your state is implementing Services

X and Y, your petition should highlight that fact. Be aware that an agency

hostile to your proposal may produce facts and figures claiming that Alternative

Service Z is much more expensive, so it is a good idea to present your own data

at the start, if possible.

If, after all of that effort, your public agency denies

your petition, remember that all of the agency's internal communications and

documentation generated or acquired during the agency's consideration of the

rule-making petition are public records. Send the agency a new FOIA request for

all public records related to the agency's consideration of your rule-making

petition. After that, your next stop will likely have to be the legislature.

Conclusion

The Freedom of Information Act and Administrative

Procedures Act exist in some form in every state to give all citizens access to

public information and a voice in how public agencies implement the federal and

state laws. FOIA and the APA are powerful tools for parents in their

never-ending advocacy for their children with special needs. You may not win

every battle, but you do not have to settle for the agency's

" because-that-is-the-way-we-have-always-done-it " answer. They are public

agencies, spending public money. You have a right to know how and why public

agencies do what they do. Do not let anybody tell you otherwise.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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By the way, my fellow Special Needs Alliance member, the author of this article,

was my co-presenter at the National Convention of the Autism Society of America,

earlier this month, and is the father of an eleven year old son with Autism.

His practice is in Vermont.

Rubin<mailto:BRIAN@...> *

[cid:image003.jpg@...]<http://www.snfp.net/>

The Law Offices of

Rubin & Associates

Law practice limited to serving the future & legal planning

needs of Rubin's fellow Illinois families of children & adults

with intellectual disabilities, developmental disabilities, & /or mental

illness...

(E) brian@...<mailto:brian@...> - (W)

www.SNFP.net<http://www.snfp.net/>

(O) 847-279-7999 - (F) 847-279-0090 - (TF) 866.TO.RUBIN

Mail: 1110 West Lake Cook Road, Buffalo Grove, Illinois 60089-1997

* President, The Arc of Illinois 2011-2013

* Member by invitation of SNA, the Special Needs Alliance (web

site<http://www.specialneedsalliance.org/>). The SNA is the national non-profit

association of experienced " Special Needs Planning " Attorneys. Rubin is a

member of SNA's Board of Directors.

* Member of the Special Needs Law Steering Committee of

NAELA,<http://www.naela.org/>the National Academy of Elder Law Attorneys.

<http://www.naela.org/>

* Was a Charter Member of the Academy of Special Needs Planners

* Has been awarded the dale Hubbell Peer Review<http://martindale.com/>

Rating of AV Preeminent, the highest rating given<http://martindale.com/>.

* For more information about Rubin, please visit our web

site<http://www.snfp.net/>.

Notices:

1. This message does not create an attorney-client relationship, and is not

legal advice absent such a relationship with the recipient. This message may

contain confidential information protected by the attorney-client and/or work

product privilege. The information is only for the use of the intended

recipient. If you are not such recipient, disclosure, copying, distribution or

reliance upon this e-mail is strictly prohibited. If you have received this

transmission in error, please notify The Law Offices of Rubin & Associates

by e-mail and destroy the original message and all copies.

2. IRS CIRCULAR 230 NOTICE: TO THE EXTENT THAT THIS MESSAGE OR ANY ATTACHMENT

CONCERNS TAX MATTERS, IT IS NOT INTENDED TO BE USED AND CANNOT BE USED BY A

TAXPAYER FOR THE PURPOSE OF AVOIDING PENALTIES THAT MAY BE IMPOSED BY LAW.

3. Disclaimer Regarding Electronic Signature. If this communication concerns

negotiation of a contract or agreement, electronic signature rules do not apply

to this communication: contract formation in this matter shall occur only with

manually-affixed original signatures on original documents. The Signature given

hereon is not an electronic signature and is provided only for the purposes of

providing information as to the identity of the sender and for no other

purpose(s) whatsoever.

From: IPADDUnite [mailto:IPADDUnite ] On Behalf

Of ELLEN BRONFELD

Sent: Wednesday, July 27, 2011 3:28 PM

IPADDUnite ; Cardoso Krasne; Randi Heichman;

Needleman; Roseth; Janice Weinstein; Janice Kavanaugh; Carol Rapaport;

Ester Stein; Geri Brown; Debbie Rudin; Barb Cabin; Eissman;

Whitefield; Betty Korey; Shari Coe; Robynn Medansky; nn Schaider; Laurie

; Emde; Carleen Emde; teri steinberg; Gail Gordon

Subject: Fw: [voice] The Voice - Special Needs Alliance newsletter

Powerful information.

Ellen

Ellen Garber Bronfeld

egskb@...<mailto:egskb%40sbcglobal.net>

[voice] The Voice - Special Needs Alliance newsletter

July, 2011 - Vol 5, Issue 13

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the email newsletter of The Special Needs Alliance. This

installment was written by Special Needs Alliance member Jim Caffry, a sole

practitioner in Waterbury, Vermont. Jim's practice is concentrated in special

needs planning and advocacy. One of Jim's three children, his eleven year old

son, has autism and other special needs. Jim is a current member of the Vermont

Developmental Disabilities Council, and a past member of the Vermont Autism Task

Force and the Vermont Act 135 Autism Planning Committee. You can learn more

about Jim, his firm and his practice at

www.caffrylaw.com<http://www.caffrylaw.com>.

Better Advocacy Through Acronyms

Parents, caregivers and advocates of children and adults with special needs are

inundated with acronyms as they navigate their state's disability systems.

Among the acronyms they likely encounter: EPSDT-Early Periodic Screening,

Diagnosis and Treatment; FIT-Family Infant & Toddler programs;

IEP-Individualized Educational Program; FAPE-Free Appropriate Public Education;

SSI-Supplemental Security Income; CDB-Childhood Disability Benefits; and

HCBS-Home and Community Based Services.

There are two other acronyms, however, that should become familiar in the

never-ending effort to advocate for children with special needs-FOIA and APA.

Armed with an understanding of FOIA and the APA, families and other advocates

can access vast amounts of information that impacts the quality of life of

people with special needs. Understanding FOIA and the APA will empower families

and advocates to play a constructive and productive role in shaping the laws,

regulations, and public policy impacting their state's special needs community.

What are these " acronyms of better advocacy " ? FOIA stands for Freedom of

Information Act. APA stands for Administrative Procedures Act. Although these

laws may go by another name in some states, all 50 states have adopted some

version of both FOIA and the APA.

The website of the National Freedom of Information Coalition provides

information about every state's FOIA law (http://www.nfoic.org/state-foi-laws).

Florida State University Law School lists every state's APA citation

(http://www.law.fsu.edu/library/admin/admin3.html). An internet search will

almost certainly provide mountains of helpful information in plain English about

how to put each state's FOIA and APA laws to work. It is always a good idea to

review the actual language of a state's laws and not to rely solely on other

sources.

At this point you may be thinking " Why should I really care about FOIA or my

state's APA? " Well, you should if this scenario sounds even a little familiar to

you...

Parent of special needs child-Question to a state human services agency

employee: " Why does the agency in our state only provide Services X and Y? I

recently read an article that our neighboring state has Alternative Service Z

for children with the same diagnosis as my child. Why can't we do Alternative

Service Z here in our state?

Agency staff-Answer: " Because our disability system provides Services X and Y,

and that's the way we have always done it in this state. "

SN parent-Question: " OK, I understand that, but it does not answer the question

of why our state cannot offer Alternative Service Z too. "

Agency staff-Answer: " Like I said, it is the long-standing policy of this state

that we provide Services X and Y for the type of disability your child has. "

SN parent-Questions: " Hmmm. Has anyone at the agency ever looked into whether or

Alternative Service Z could be implemented in our state for the same or less

cost that the current Services X and Y? Is the policy limiting services in our

state to " only services X and Y " in writing? Is it an agency policy, or a

formally adopted rule? Or is it in an actual law adopted by the state

legislature and signed by the governor? "

Agency Staff-Answer: " The agency considered alternatives way back when we

started providing Services X and Y. and it says right in the agency program

manual that service options are X and Y. "

Although you may be thinking that it would feel pretty good to give this agency

staffer a candid assessment of his or her customer service skills, it is best to

stay calm and thank the person for his or her time.

Remember, FOIA Is Your Friend

" Show me the documents. "

When you hang up the phone, take a few moments to write down as many details of

the conversation as you can recall. Next, take a careful look at your state's

FOIA law. Then write a " Freedom of Information Act Request " or " public records

request " letter to the agency providing a detailed description of the public

information you want the agency to produce. Not sure how to write the FOIA

request? There are many samples out there-an internet search for " sample FOIA

request " produced more than 110,000 hits. The scope of your FOIA request can be

very broad, very narrow, or both. For example:

" I am requesting that any and all documents in the possession of the agency

regarding Disability Services X and Y in this state be made available for

inspection and copying. This request for public information includes all

manuals, reports, studies, internal communications between any agency staff

members, and external communications between any agency staff members and any

other person, including, but not limited to, any state legislators and any

service providers of Services X and Y.

In addition, I am also requesting any and all documents in the possession of the

agency regarding this state's consideration of and decision not to provide

Alternative Disability Service Z. Alternative Service Z is currently available

in the neighboring State of A. This FOIA request seeks all documents that the

agency has identifying Alternative Service Z, including any documents

identifying the legal, economic and/or public policy bases for the agency's

decision not to make Alternative Service Z available in this state. "

Generally speaking, all FOIA laws will impose time limits within which public

agencies must provide a response to a citizen's FOIA request. If a public agency

refuses to comply fully with the FOIA request and the dispute ends up in court,

the public agency may even have to pay for the attorneys' fees of the person

requesting the public records.

" Redact it! "

FOIA laws all have exemptions specifying the information that public agencies do

not have to make available in response to a FOIA request, including confidential

information about people receiving services. Do not let a public agency get away

with telling you that you cannot have the information you asked for in your FOIA

request because it contains confidential information.

First, your state's FOIA law will probably include a requirement that any public

agency that refuses to make documents available must identify every document

withheld and provide the reason the agency withheld the document from you.

Second, if a public record contains both information responsive to your FOIA

request and confidential information, the public agency is generally required to

redact the confidential information and to provide the document to the person

requesting it. " Redact " is just a fancy way of saying " take a big black marker,

cross out the confidential stuff, and give me the document with rest of the

information. "

An example of this could be if you wanted to know how many people in your county

had been diagnosed with autism and were receiving Medicaid-funded home and

community based services. You might want to know the range of services these

people were receiving and the range of their waiver budgets. You could file a

FOIA request with the public agency and ask for " copies of all current service

agreements for all individuals with autism in Washington County receiving home

and community based services. " The agency might give you an answer like " Sorry,

that information is confidential. " Your response should be: " Redact the names,

addresses and social security numbers of the people receiving the services, but

the ages, service program details and the service budgets details are all public

information that the agency is required to provide. "

You might be able to skip a step by stating upfront in your FOIA request letter

that the agency should redact confidential information on any documents

containing both confidential information and responsive public information.

Know Your State's APA

When it comes to programs and services for people with disabilities in every

state, the legal " chain of command " generally runs this way: (A) federal laws;

(B) federal regulations; © state laws; (D) state regulations; and finally, (E)

state agency policies, practices, guidance documents, procedures or program

manuals. The federal laws and regulations that authorize states to develop

Medicaid programs providing services to different populations of people with

disabilities are very broadly written. In other words, states have a lot of

flexibility in designing and implementing disability service programs within

their Medicaid programs. As many parents already know, much of how a disability

program actually works is based on state agency " policies " and " practices. "

Unlike laws and formally adopted regulations, many state agency policies and

practices have not gone through a public review process known as " notice and

comment. " Instead, many state policies and practices are developed, consciously

or by inertia, internally, within the state agency. That is how we end up with a

public agency's " because-that-is-the-way-we-have-always-done-it " policy.

APA to the rescue

This is where your state's administrative procedures act can help. The general

purpose of a state's administrative procedures act is that public agencies

should maximize the involvement of the public in the development of rules that

implement laws.

If a decision about what services your child is or is not receiving is based on

a public agency's unwritten policy or practice, your state's APA may give you

the right to force the agency to put the policy or practice in writing in a

single document. Remember to give the agency a written FOIA request for all

documents relating to the policy, including internal agency emails. The state's

APA may even require that certain policies or practices be adopted as

regulations, complete with publication, " notice and comment, " and a vote by an

official body.

Strength in numbers

Even if your state agency has put its policy in writing, or even if it has

adopted a rule for the current service program using the full formal process,

this does not mean that parents are stuck with that program.

Check your state's APA for the steps required to petition a public agency to

adopt, amend or repeal a rule. Your state law may allow a single individual to

file a petition for rule-making, but some states may require a minimum number of

people to sign the petition for rule-making. Even if the APA in your state

allows an individual to file the rule-making petition, it is a good idea to

gather the signatures of as many like-minded parents as you can. It is a truism

to say that the agency is going to take a petition with 100 signatures more

seriously than it will take a petition from a single person.

If your petition is to get your state agency to allow " Alternative Service Z " in

your state, then it would be a good idea for your petition to include

information about whether any other states already allow Alternative Service Z.

If the other states already offering Alternative Service Z are doing so at the

same or less cost than your state is implementing Services X and Y, your

petition should highlight that fact. Be aware that an agency hostile to your

proposal may produce facts and figures claiming that Alternative Service Z is

much more expensive, so it is a good idea to present your own data at the start,

if possible.

If, after all of that effort, your public agency denies your petition, remember

that all of the agency's internal communications and documentation generated or

acquired during the agency's consideration of the rule-making petition are

public records. Send the agency a new FOIA request for all public records

related to the agency's consideration of your rule-making petition. After that,

your next stop will likely have to be the legislature.

Conclusion

The Freedom of Information Act and Administrative Procedures Act exist in some

form in every state to give all citizens access to public information and a

voice in how public agencies implement the federal and state laws. FOIA and the

APA are powerful tools for parents in their never-ending advocacy for their

children with special needs. You may not win every battle, but you do not have

to settle for the agency's " because-that-is-the-way-we-have-always-done-it "

answer. They are public agencies, spending public money. You have a right to

know how and why public agencies do what they do. Do not let anybody tell you

otherwise.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter useful and informative,

but it is not the same as legal counsel. A free newsletter is ultimately worth

everything it costs you; you rely on it at your own risk. Good legal advice

includes a review of all of the facts of your situation, including many that may

at first blush seem to you not to matter. The plan it generates is sensitive to

your goals and wishes while taking into account a whole panoply of laws, rules

and practices, many not published. That is what The Special Needs Alliance is

all about. Contact information for a member in your state may be obtained by

calling toll-free (877) 572-8472, or by visiting the Special Needs Alliance

online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above article may be reprinted

only if it appears unmodified, including both the author description above the

title and the " About this Newsletter " paragraph immediately following the

article, accompanied by the following statement: " Reprinted with permission of

the Special Needs Alliance -

www.specialneedsalliance.org<http://www.specialneedsalliance.org>. "

© 2011 Special Needs Alliance. .

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FYI:

Reprinted with permission of the Special Needs Alliance

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

August, 2011 - Vol 5, Issue 14

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

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Capitol Connection

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The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Carol S.

Battaglia of San Diego, California. She is one of the authors of Special Needs

Trusts: Planning, Drafting and Administration, published by the State Bar of

California. Carol also serves as counsel to the Special Needs Trust Foundation

of San Diego, a charitable pooled special needs trust. Her practice is limited

to the creation of estate plans using special needs trusts and assisting trial

lawyers in implementing special needs trusts and other strategies to receive an

injured party's settlement funds while maintaining eligibility for government

assistance.

Utilizing the Spend Down Option to Maintain SSI and/or

Medicaid Eligibility

People with special health care needs and limited funds

of their own often rely on public benefits for their well-being. Some of the

most common public benefits include Supplemental Security Income (SSI),

administered by the Social Security Administration, and Medicaid, administered

separately in each state. To be eligible for SSI and/or Medicaid, an individual

usually is limited to $2,000 in resources (or $3,000 for a couple). For SSI,

there also is a very low income ceiling.

Because the resource limits for SSI and Medicaid are so

low, the receipt of a lump sum, including an inheritance or a settlement, can

easily disqualify the individual. Upon the receipt of sums in excess of the

resource limits, the individual can opt to discontinue benefits, shelter the

excess amounts in certain types of special needs trusts, or attempt to

re-qualify for benefits through a process known as a " spend down. "

What is a Spend Down?

The term " spend down " describes the process of literally

spending the excess money received by a benefits recipient down to the maximum

allowable resource limits. By spending the excess funds in the month in which

they are received, the individual can remain eligible for benefits. Note that

although a spend down can preserve eligibility for SSI/Medicaid, it is likely

that the individual may need to repay part or all of the SSI benefit for the

month in which the lump sum is received. The reason for this is that SSI

considers a lump sum to be income in the month received. Any income not spent in

the month of receipt will be countable as a resource in the following month.

Some state Medicaid agencies also treat a lump sum as income in the month of

receipt; other states only count the lump sum as a resource in the month after

the month of receipt.

When Might a Spend Down be Appropriate?

There are legal strategies that can help an individual

maintain public benefit eligibility after receiving a lump sum. Transferring

excess funds to a properly drafted and administered special needs trust is a

common strategy. In several instances, however, a spend down might be a better

choice. If the amount of the excess resources is relatively small, it might make

more sense to spend the money rather than to incur the set-up and ongoing

administration costs associated with a special needs trust. A spend down could

also be a strong option is in the situation where the beneficiary has current

need for high-ticket items such as a home, a handicap-modified vehicle, or even

to pay off debt. Spending for these items would not be possible if the

beneficiary were to rely solely on public benefits.

Timing a Spend Down

It is wise to have a spending plan in place prior to

receipt of the lump sum. In order to minimize the loss of SSI and Medicaid,

goods and services must be purchased in the same calendar month in which the

lump sum is received. Note that the individual does not have a period of a month

or 30 days to complete the spend down. If a lump sum is received on the 20th of

August for example, the spend down must be completed in 11 days to bring

resources below the applicable limit before September 1.

Prioritizing Items and Services to Purchase

To be clear, spend down does not imply or encourage the

frivolous wasting of money. It is important that the funds be spent only on

exempt resources and that the items purchased are solely for the benefit of the

disabled recipient. There are certain resources that the SSI and Medicaid

programs do not count in determining eligibility, including one's residence, a

vehicle, household furnishings and certain burial arrangements. These are

referred to as " exempt resources. " Purchasing exempt assets will ensure that the

items will not be counted toward the asset limitation in determining

eligibility. Purchasing items for other people is usually considered a gift of

assets, and making a gift will usually cause a period of ineligibility for

benefits. The following is a nonexhaustive list of exempt expenditures that the

lump sum recipient could make and still qualify for SSI:

a.. Purchasing a home; paying off a mortgage on a

home; paying rent for that calendar month only; modifying a home to accommodate

an individual's disabilities; home repairs, remodeling, or deferred maintenance

expenses (including landscaping)

b.. Purchasing home furnishings or appliances

c.. Medical expenses/bills not covered by Medicaid or

Medicare (e.g., better quality wheelchair than what is authorized by

Medicaid/Medicare)

d.. Dental expenses, eye glasses, physical therapy,

support services not covered by any benefit program

e.. Education expenses (including computer, software,

books, etc.)

f.. Entertainment/recreation expenses (books,

magazines, movie/concert tickets, sporting events, audio/video equipment)

g.. Vacation travel (airline tickets, train/bus

passes, food & shelter while temporarily away from home on vacation, etc.)

h.. Pay an attorney to do estate planning and/or

Medicaid planning

i.. Pay off debts (existing credit card debt, loans

with supporting paperwork)

j.. Pre-pay burial arrangements

k.. Personal hygiene (haircuts, manicures)

l.. Purchase an automobile, pay for registration and

insurance

m.. Purchase clothing

n.. Set aside up to $2,000 for a single person, or up

to $3,000 for a married couple, in non-exempt resources, e.g., in savings,

checking, etc.

Reporting the Spend Down

The spend down must be reported to Social Security by

the 10th day of the month following the month in which the lump sum was

received. State Medicaid agencies have similar or even earlier reporting

requirements. Here are some guidelines to follow in order to properly prepare

for the reporting:

a.. Keep sufficient funds in a bank account to repay

SSI benefits for the month in which the excess funds were received-but remember

that this amount needs to be included as part of the individual's countable

resources.

b.. Keep receipts for all items or services purchased,

including payments for home remodeling.

c.. The beneficiary must be on the title to any real

property or vehicle purchased with the lump sum.

d.. The beneficiary must be the loss payee for any

auto or homeowners insurance purchased with the lump sum.

e.. Make copies of current bank statements from all

accounts, as well as a printout on the last day of the month showing the balance

as of that day.

f.. Checks to purchase items and services should clear

the beneficiary's bank account by the last day of the spend-down month. If there

is any question that a check may not clear the account in the month, payment

should be made by certified check or a cashier's check.

g.. Have the bank provide documentation of the bank

balance on the first day of the next month to verify the spend down was

successfully completed.

An individual may have spent down the lump sum in the

month of receipt, but an SSI check or other monthly income is deposited into the

account at the beginning of the next month, pushing the bank balance above the

non-exempt resource limit. That will not be a problem because the SSI check or

other monthly income is not counted as part of the resource limit in the month

the income is paid to the individual.

In conclusion, spending down a lump sum can be a great

option in certain circumstances, either alone or in conjunction with other

options. Keep in mind, however, that a downside to a spend down is that the

money will not be available in the future to pay for special needs. Careful

thought and planning must go into the preparation for a spend down to minimize

the ineligibility period and to avoid wasting critical funds. Although funds

will no longer be available, if the spend down is done properly, the

beneficiary's quality of life can be improved for years to come through use of

the items and services purchased.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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FYI

Reprinted with the permission of the Special Needs Alliance.

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

August, 2011 - Vol 5, Issue 15

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

Accessing Past Issues of The Voice

Readers of The Voice have access to all of the archived

issues going back to October, 2007 when we began regular publication as the

e-mailed newsletter of The Special Needs Alliance. Today's issue provides in

reverse chronological order the article titles, each linked to the corresponding

article in our archives. As you can see, the articles address a myriad of

topics. We suggest that you save this e-mail for ready access to articles you

may wish to read in the future. We encourage readers to forward this email to

other professionals, advocates and family members who may find these articles

helpful.

We always welcome your questions and ideas for future

articles of The Voice. Readers' questions often have spurred members of The

Special Needs Alliance to write an article in response. If you have a burning

question or a topic request, please address it to Hales,

bryan@..., who will relay it to our Publications Committee.

Do you know someone who may be interested in receiving

future editions of The Voice in their email? Forward them this email or send

them to http://www.specialneedsalliance.com/subscribe.html.

2011

Utilizing the Spend Down Option to Maintain SSI and/or

Medicaid Eligibility

August 2011 - Vol. 5, Issue 14

Better Advocacy Through Acronyms

July 2011 - Vol. 5, Issue 13

The New Medicare Surtax: Will You or Your Special Needs

Trust Be Affected in 2013?

July 2011 - Vol. 5, Issue 12

The Mission Project

June 2011 - Vol. 5, Issue 11

Planning for Adult Children with Disabilities

June 2011 - Vol. 5, Issue 10

Buying a House for a Special Needs Beneficiary: Proceed

with Care!

May 2011 - Vol. 5, Issue 9

Avoid This Common Banking Error

May 2011 - Vol. 5, Issue 8

Decisions Arising with the Death of a Child

April 2011 - Vol. 5, Issue 7

The Pre-Existing Condition Insurance Plans (PCIP) Under

2010's Health Care Reform Law

April 2011 - Vol. 5, Issue 6

The Pitfalls of Caregiver Employment: Paying,

Withholding, and Reporting Requirements

March 2011 - Vol. 5, Issue 5

The Impact of Special Needs Trusts on Eligibility for

Subsidized Housing

March 2011 - Vol. 5, Issue 4

The Other Special Need: Planning for Those with Severe

Mental Illness

February 2011 - Vol. 5, Issue 3

Comparing Social Security Disability Insurance (SSDI)

and Supplemental Security Income (SSI)

January 2011 - Vol. 5, Issue 2

Special Benefits for Military Families -- Elect With

Care

January 2011 - Vol. 5, Issue 1

2010

The Past, Present and Future of Community Living for

Persons with Disabilities - A Christmas Carol

December 2010 - Vol. 4, Issue 20

What Health Reform Means for Persons with Disabilities

December 2010 - Vol. 4, Issue 19

Veteran's Benefits

November 2010 - Vol. 4, Issue 18

Dear Grandma and Grandpa...

November 2010 - Vol. 4, Issue 17

Life Insurance on a Child with Special Needs: Benefits

and Challenges

October 2010 - Vol. 4, Issue 16

Planning Options With Retirement Benefits

September 2010 - Vol. 4, Issue 15

Retirement Accounts and Government Benefits

September 2010 - Vol. 4, Issue 14

Crummey Doesn't Mean Lousy

August 2010 - Vol. 4, Issue 13

Your Special Needs Trust Explained

August 2010 - Vol. 4, Issue 12

Your Retirement Age Can Affect Your Child's Disability

Benefits

July 2010 - Vol. 4, Issue 11

Being Prepared For a Disaster

July 2010 - Vol. 4, Issue 10

What happens when persons living with disabilities

marry?

June 2010 - Vol. 4, Issue 9

Housecleaning? Please Don't Pitch These Records!

June 2010 - Vol. 4, Issue 8

Signing the Social Security Application

May 2010 - Vol. 4, Issue 7

Life Insurance and Children With a Disability

April 2010 - Vol. 4, Issue 6

18, 19, 21 Candles on that Cake

March 2010 - Vol. 4, Issue 4

Pooled Trusts for Individuals with Special Needs

March 2010 - Vol. 4, Issue 5

Taxes and Special Needs Trusts

February 2010 - Vol. 4, Issue 3

Estate Planning for People with Disabilities

January 2010 - Vol. 4, Issue 2

Medicare Premium Rules Will Affect Some Large Trusts

January 2010 - Vol. 4, Issue 1

2009

Advocacy for Parents of Children with Disabilities

December 2009 - Vol. 3, Issue 11

The Secret of When Less Is More

December 2009 - Vol. 3, Issue 10

Top Ten Tips When Planning For Special Needs

November 2009 - Vol. 3, Issue 9

What Property May a Person Receiving SSI Own?

November 2009 - Vol. 3, Issue 8

" I'm Glad She Did That "

August 2009 - Vol. 3, Issue 7

Letter of Intent

June 2009 - Vol. 3, Issue 6

The Military's Survivor Benefit Plan and the Disabled

Child

June 2009 - Vol. 3, Issue 5

Special Needs Trusts and " Qualified Disability Trusts "

April 2009 - Vol. 3, Issue 4

Generational Planning: When the Caregiver Needs Help

March 2009 - Vol. 3, Issue 2

Planning for Multiple Generations

January 2009 - Vol. 3, Issue 1

2008

Peering Into the Crystal Ball: Planning for Potential

Disability

December 2008 - Vol. 2, Issue 20

Choosing an Attorney to Help With Special Needs Planning

December 2008 - Vol. 2, Issue 19

Is My Money Safe?

November 2008 - Vol. 2, Issue 18

Alliance Praises Passage of ADA Amendments Act

September 2008 - Vol. 2, Issue 17

Realistically Assessing an Exceptional Child s Future

September 2008 - Vol. 2, Issue 16

August 2008 - Vol. 2, Issue 15

Insurance and Other Concerns for Parent/Caregiver

August 2008 - Vol. 2, Issue 14

Remembering Harriet McBryde

June 2008 - Vol. 2, Issue 13

What to Pay Before Funding a Special Needs Trust

June 2008 - Vol. 2, Issue 12

Economic Stimulus Payments and TV Converter Box Coupons

June 2008 - Vol. 2, Issue 11

Our Readers' (That Is, Your) Questions

May 2008 - Vol. 2, Issue 10

An Introduction to " In-kind Support and Maintenance "

April 2008 - Vol. 2, Issue 9

Income Tax Benefits for Families With Special Needs

Children

April 2008 - Vol. 2, Issue 8

Moving a Special Needs Trust to a New State

March 2008 - Vol. 2, Issue 7

What Can a Special Needs Trust Pay For?

March 2008 - Vol. 2, Issue 6

Structuring a Personal Injury Settlement

February 2008 - Vol. 2, Issue 5

Beware of UTMA Accounts

February 2008 - Vol. 2, Issue 4

Fixing a Flawed Special Needs Estate Plan

January 2008 - Vol. 2, Issue 3

Questions About Setting Up a Special Needs Trust

January 2008 - Vol. 2, Issue 1

Third Party Special Needs Trusts

January 2008 - Vol. 2, Issue 2

2007

Managing Care: A Looming Perfect Storm

December 2007 - Vol. 1, Issue 9

International Attention Focused on Disabilities

December 2007 - Vol. 1, Issue 8

A Reader's Question About Pooled Trusts

December 2007 - Vol. 1, Issue 7

Subsidized Housing and Special Needs Trusts

November 2007 - Vol. 1, Issue 6

Special Needs Trusts and Individual Retirement Accounts

November 2007 - Vol. 1, Issue 5

Veterans and Special Needs Trusts

November 2007 - Vol. 1, Issue 4

Non-Profit Organizations as Trustees of Special Needs

Trusts

November 2007 - Vol. 1, Issue 3

Alternatives to Litigation Special Needs Trusts

October 2007 - Vol. 1, Issue 2

Estate Planning for Families With Special Needs Children

October 2007 - Vol. 1, Issue 1

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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Guest guest

FYI:

Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

September, 2011 - Vol 5, Issue 16

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment's author is V. Wilcenski, Esq., a founding

partner of the law firm of Wilcenski & Pleat PLLC in Clifton Park, New York. He

practices in the areas of special needs planning, elder law and trust and estate

planning and administration. A member and past president of the Special Needs

Alliance, Ed writes and lectures frequently on issues affecting individuals with

disabilities and their families.

Special Needs Information on the Internet: Proceed with

Caution

The Good News About the Internet

Like almost everyone else nowadays, lawyers who practice

in the area of special needs often turn first to the Internet with their

questions. When they learn of an unfamiliar disability or diagnosis, off to the

Internet they go. They look for explanations of the disability, how it might

impact a client's life, and what programs and services are available to help

support the individual. The result is often both better legal advice and better

planning documents.

Similarly, new clients often arrive at a special needs

planning lawyer's office with a basic understanding of special needs trusts,

guardianships, and government benefits, most of it also garnered from the

Internet. With both client and counsel having done their preliminary research on

the Internet, they can get right to a discussion of the client's needs and

goals. As one commercial says, " An educated consumer is the best customer. " The

same concept applies to special needs planning.

There's another major use of the Internet for special

needs planning lawyers. They use the Internet for legal research, to remain

abreast of changes in the law, and to share questions and planning approaches

with colleagues who practice in the same area.

Finally, clients who are parents of children with

special needs use the Internet to meet and get support from other parents, to

find programs and services in their communities, and to follow developments in

medication, treatment, and therapies. All in all, the Internet is a great

resource for client and counsel alike.

That is the good news. However, there is a down side as

well. Much Internet information is superficial, biased, or only a part of the

whole story. It can even be flat-out wrong. Without context and perspective, it

can be difficult to determine the reliable from the unreliable, the useful from

the useless. This article highlights a few ways that Internet information can

become a hindrance rather than a help.

Not All Special Needs Trusts Are Created Equal

Readers of The Voice may be familiar with the concept of

a " special needs trust. " To briefly review, this is a type of trust specifically

designed to hold money or other assets for individuals with disabilities who

receive government benefits when eligibility for those benefits depends on the

individual having few assets and/or low income. Special needs trusts (SNTs) are

then used to provide goods and services that supplement what is available

through those programs without damaging the recipient's eligibility for

benefits. Clients who want more information about SNTs are likely to turn first

to the Internet - but should exercise caution as they review material there.

One of the most common points of confusion for clients

(and even many professionals) is the distinction between a " first party " SNT and

a " third party " SNT. A first party SNT is funded with assets belonging to the

person with the disability, while a third party SNT is funded with assets that

belonged to someone else. If a visitor to an Internet website discussing special

needs trusts does not know the difference between the two (or if the website

does not draw a sufficient distinction in its explanation), the visitor is

likely to draw conclusions that are not relevant to his or her situation.

For example, a first party SNT must include a " payback "

provision effective upon the death of the beneficiary that requires the SNT to

pay back the state for all Medicaid benefits this beneficiary ever received.

Third party SNTs do not need to include such a payback provision, and indeed

should not have one. The funds remaining in a third party SNT can go wherever

the creator of the trust chooses after the death of the beneficiary with a

disability. Nevertheless, clients and professionals alike can often be heard to

say that SNTs generally require a Medicaid payback at the end of a beneficiary's

life, without distinguishing between the two types of SNTs.

This error can have disastrous consequences. For

example, if a mother wants to update her estate plan and incorrectly believes

that any money she leaves for her child with a disability will be subject to

Medicaid repayment after the child's death, she may choose to leave that child

out of her estate plan altogether. Even worse, special needs planning attorneys

sometimes see a payback provision in an otherwise well-drafted third party SNT.

After the death of the " settlor " or creator of the SNT, it is usually too late

to do anything about it. The SNT will end up making a big and unnecessary gift

to the state after the death of the beneficiary with a disability solely because

the trust included the inappropriate payback provision.

Tip O'Neill Would Certainly Agree

The second problem with Internet information is that it

is often either national in scope, or specific to some other state. This can be

very misleading because the rules governing special needs planning in general,

and SNTs in particular, vary greatly from state to state, and in some cases even

from region to region within an individual state. Former Speaker of the House of

Representatives Tip O'Neill famously said, " All politics is local. " The same is

true of special needs law and planning.

Relying solely on general national rules can lead to

major planning errors and missed opportunities. Consider an adult with mental

illness who resides independently and receives services through a

community-based, Medicaid-funded program. Assume that his only source of income

is Social Security Disability Insurance (SSDI), and that he does not receive any

Supplemental Security Income (SSI). Assume further that his brother is trustee

of a discretionary SNT established by his parents before they died some years

ago. Can the trustee use money from the SNT to make rent payments so his brother

can move into a nicer apartment without disqualifying him from his Medicaid

benefits?

In New York, the answer is yes, because the New York

Medicaid program does not (with a few limited exceptions) count payments to

landlords as income for Medicaid eligibility purposes. The answer would be quite

different in other states where the Medicaid program rules treat payments for

housing as income that reduces benefits, and where SNTs are therefore drafted to

discourage the trustee from making distributions for such purposes. So the

answer to the trustee's question will depend not only on the types of benefits

the beneficiary receives (e.g., Medicaid, SSI, or Section 8), but also on the

state where the SNT beneficiary lives (and sometimes where he or she lives in

that state).

Here's another issue that Internet websites often gloss

over. How much money can the beneficiary of an SNT have in his name without

prejudicing his or her benefits? Many websites use $2,000 as the resource limit

for SNT beneficiaries. In many cases, such as when the beneficiary is a

recipient of SSI, this figure is correct. In others, as in the case of the New

York beneficiary with mental illness described above, the Medicaid program's

resource limit will control instead of the $2,000 SSI limit. In New York in

2011, that limit is $13,800. In other states, the figure is different.

Other deviations from the general rules typically found

on the Internet abound. For example if an individual is married and receiving

services through a community-based, Medicaid-funded program, can the nondisabled

spouse work without prejudicing the benefits of the spouse with a disability?

That additional household income would help take some of the pressure off the

SNT being held for the disabled spouse. The answer depends on the particular

type of Medicaid-funded program. Some programs count the income of the

nondisabled spouse in determining Medicaid eligibility for the disabled spouse,

and some don't.

It should be clear from these examples that no website

can provide detailed and current information to cover every possible situation.

Instead, it is important for website readers to understand that the information

on the Internet is just the beginning of a search for the right answers. The

right answers will come only with a subsequent close analysis of the

individual's circumstances: his or her existing and potential benefits, needs,

desires, and residence.

You Can't Judge a Book . . .

Finally, there is the issue of website advertising. As

most readers know, attorneys, financial planners, accountants, private care

managers and others announce relevant experience and competence in this area.

Everyone knows that he or she shouldn't draw conclusions - positive or negative

- about a professional based solely on a website or yellow page advertisement.

Most also know that no one monitors what a professional says on a website about

her experience in a particular practice area or discipline. Nevertheless, most

people do rely on these sources to help them filter out the seemingly endless

number of options for professional services. In addition, it's hard not to be

persuaded by a good presentation.

Over the years, increased attention has been given to

special needs planning and related disability issues. For example, many

financial institutions are expanding their trust and other financial management

services to meet the needs of a growing number of families having to deal with

disability issues. Lawyers and accountants are dedicating time and resources to

learning more about this area of practice. Case managers and other service

providers who had previously concentrated solely on the elderly population are

expanding their reach and offering privately paid advocacy and services to

younger individuals with disabilities. In general, these are good developments

because they increase the number of options available to consumers of these

services. The Internet is a great way to locate such professionals in our

communities.

That said, anyone can claim to be an " expert " on the

Internet. A general estate planning lawyer can magically become a " special needs

planning expert " just by naming himself as one on his website. A financial

planner who has always focused on tax planning can become " an experienced

special needs estate planning professional " just by saying so on her website.

There is little to limit such grandiose self-descriptions on the Internet.

Obviously readers of websites need to go past the

self-serving declarations of professionals seeking work. Readers should be

particularly suspicious of professionals who claim a broad area of competence or

offer charges that seem too good to be true. A lawyer who says he does

everything probably does not have much experience in anything particular.

In addition, careful consumers of legal services should

look for biographies and publications to show that a lawyer has experience and

training in special needs issues. Is the professional actively involved with the

disability community, or does he or she have a family member with a disability?

How long has he or she focused on this area of law? Are there any published

articles that are available for review? Is the lawyer a member of, or have a

position of responsibility with, relevant professional organizations and

nonprofit advocacy groups?

Finally, careful consumers should look for reliable

references. They can talk to other, similarly situated families, check with

service coordinators and staff from local disability organizations, and ask for

help from other professionals who serve the disability community, such as

doctors and other health care professionals.

All this is clearly more work than simply accepting the

promises of the flashiest website, but it will undoubtedly be worth the effort.

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

October, 2011 - Vol 5, Issue 17

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Barbara

Isenhour, of the firm of Isenhour Bleck, PLLC in Seattle, Washington. The firm

focuses on government benefits for individuals with disabilities and estate

planning for families with special needs children. A board member of NAMI

Eastside in Redmond, Washington, and Full Life Care in Seattle, Barbara

frequently lectures around the state of Washington on issues involving special

needs trusts and government benefits for the elderly and disabled.

Title II Disability Work Rules Part I:

Will I Lose My Disability Benefits if I Try to Work?

Sometimes a person receiving disability benefits has an

opportunity to work. The individual still has a medical disability but would

like to have a job and earn a wage. A job may mean more monthly income than the

disability benefit, and the job can provide a sense of purpose and personal

growth. Even with these potential benefits, there is often anxiety about trying

to work: " What if my work attempt is unsuccessful? " " Will I end up with less net

income than the SSDI cash benefit if I try to work? " And for many individuals

attempting work, the biggest worry is what will happen to their health benefits

from Medicare or Medicaid.

Title II Disability Benefits

This article discusses how work can affect a person's

eligibility for Title II disability benefits, commonly referred to as " Social

Security Disability. " The next Voice article will discuss preserving Medicare

and Medicaid benefits when a Title II disability recipient begins to work.

Title II of the Social Security Act provides three types

of insurance benefits for individuals with disabilities. Some people receive

Title II disability benefits on their own work history (Social Security

Disability Income or SSDI). Others receive Title II disability insurance on the

account of a deceased spouse or former spouse (Disabled Widow(er)s Benefits or

DWB). Some adult children receive Title II disability benefits on the account of

a disabled, retired or deceased parent (Childhood Disability Benefits or CDB).

In order for a worker, spouse, or child to qualify for Title II disability

benefits, the worker on whose account benefits are paid must have paid Social

Security taxes on earnings and must have earned the requisite number of work

credits. (An upcoming Voice article will cover the work history requirements in

order to qualify for Title II disability benefits.) Title II disability benefits

are a type of insurance and are not affected by a person's assets or unearned

income.

For simplicity this article refers to SSDI benefits for

the disabled worker, but the rules discussed below also apply to CDB and DWB

beneficiaries. This article does not cover the work rules for recipients of

Supplemental Security Income or SSI, a needs-based benefit available to

qualifying elderly, blind or disabled individuals. SSI work rules are different

from Title II work rules, and they will be covered in an upcoming Voice article.

There are a couple of preliminary concepts to keep in

mind whenever discussing how work affects SSDI benefits. First, wages do not

reduce or offset SSDI benefits. Either a person is eligible for SSDI in spite of

the wages, or the wages will show the person isn't disabled and thus not

qualified to receive SSDI. It is an " all or nothing " system for SSDI. Second,

wages are counted in the month the work is performed, not the month in which the

wages are paid.

There are several separate components of the SSDI work

rules that must be pieced together to understand how a job and wages can affect

a person's cash benefits. These components include trial work period,

substantial gainful activity, extended period of eligibility and expedited

reinstatement of benefits. For this discussion, assume that the disabling

medical condition still exists but that the SSDI recipient is going to try to

work in spite of the medical condition. Also, remember that the financial

figures referenced below are likely to change annually - check the Social

Security website for the latest figures.

Trial Work Period

Keep in mind that in order to qualify for SSDI, in most

cases a person must show an inability to engage in substantial gainful activity

(SGA) described in more detail below. Social Security will monitor the SSDI

recipient's earnings as a way to find out if the individual is again able to

engage in SGA and therefore is no longer disabled.

After SSDI benefits begin, Social Security will first

count every month when the individual's gross wages equal or exceed $720 toward

a " trial work period " (TWP). (Work deductions discussed below are not counted.)

For self-employed individuals, months where net income equals or exceeds $720 or

where the hours worked exceed 80 hours per month will be counted as a trial work

period month. Months when earnings equal or exceed $720 are referred to as

service months. An individual is entitled to have 9 service months treated as

the TWP. The months do not have to be consecutive months but must be within a

five-year period. An individual is only entitled to one TWP.

While individuals are in a TWP it does not matter how

much they earn in wages. The Substantial Gainful Activity limit does not apply

during the TWP. During the TWP, SSDI recipients will receive their wages, no

matter how high, as well as their SSDI benefit.

Example: is 28 years old and was severely

injured in an auto accident when she was 24. worked prior to her

accident and was eligible for an SSDI benefit of $800 per month based upon her

earnings before she was injured. A year after 's accident, she was

offered a part time job with Kmart as a stocking clerk. In June through November

of 2008 earned $800 per month (6 months). In March, August and

September of 2009 earned $1,500 per month (3 months). Since

earned more than $720 in each of these months, as of the end of September 2009

had completed a TWP of nine months. Until the end of her TWP, it did

not matter how much earned in wages. She could have earned $3,000 per

month and she still would have received her SSDI benefit of $800 per month in

addition to her wages for those nine TWP months. On the other hand, if her

earnings had been only $710 per month during her first six months, she would not

have used up her nine-month TWP, but only three months of it, and would still

have received her SSDI benefit even if earning $1,500 per month for the

remaining six months of the TWP after September 2009.

Substantial Gainful Activity

After the TWP is over, Social Security will determine if

a person's wages are considered by Social Security to amount to " substantial

gainful activity " (SGA). If the gross monthly wages, minus reductions for work

related expenses or work subsidies, are $1,000 per month or more, Social

Security may determine that there is SGA. (The SGA amount for a person who meets

the Social Security definition of blindness is $1,640 per month.) The SGA amount

is calculated based upon when the work was performed, not when the wages were

paid.

Obviously it is helpful if the SSDI recipient can keep

countable earned income below the SGA limit in order to receive the SSDI benefit

amount and the earned income. There are two work deductions that can apply:

impairment related work expenses (IRWE) and work subsidies.

IRWE include goods or services the individual must

purchase in order to work. These expenses cannot be reimbursed and must be paid

out of pocket by the SSDI recipient after starting work. Examples of IRWE

include purchasing durable medical equipment, transportation to and from work

(but not public transportation) or medications required to work. A large

out-of-pocket purchase can be amortized over a 12 month period. IRWE are

reported as item #7 on the Social Security Administration Work Activity Report

(SSA-821 BK).

The second deduction from gross wages to reduce

countable wages for SGA purposes is supported or subsidized working conditions.

In some cases a person requires special work conditions or support in order to

work. If so, the value of this support can reduce the gross wages when computing

her countable wages. Unlike IRWE, work subsidies are not paid out of pocket by

the SSDI recipient.

Example:

Suppose that while works for Kmart she requires

25% more supervision than her co-workers in order to perform her duties. If her

gross wages are $1,200 per month, Social Security should reduce the value of her

wages by 25% in calculating whether her countable wages show SGA, even though

does not pay for this support out of her pocket. With this work

subsidy, can continue to receive her SSDI check of $800 per month and

her wages of $1,200 because her countable earnings will come below the SGA

limit.

If is paid the same as other stock clerks but

she is 20% less productive because of her impairments, she could also request

that her countable wages be determined by reducing her gross wages by 20%.

Another example of a work subsidy is if 's group home arranges to get

her to and from her job. The home estimates the market value of this

transportation is $200 per month. In that case Social Security should reduce the

value of her wages by $200 even though she does not pay for the transportation

herself. Work supports and subsidies are claimed as item #5 on the Work Activity

Report SSA-821 BK.

The idea behind reducing the dollar value of 's

wages is that the SGA limits supposedly measure 's true earning capacity

- ability to earn - not what she actually earns. If she is getting extra help,

requires special equipment to perform her job, or is allowed to be less

productive, her true earning capacity is less than what she takes home.

Extended Period of Eligibility

So how does SGA affect a person's eligibility to

continue receiving his or her SSDI check? After the individual has accumulated 9

months of a TWP, he or she then has a 36- month period referred to as an

" extended period of eligibility " (EPE). During the EPE, Social Security looks at

whether earnings in any given month exceed the applicable SGA amount, after

taking into account any gross wage reductions for IRWE or work subsidies. If

adjusted net earnings exceed the applicable SGA amount, Social Security will

make a determination of cessation of disability. The SSDI benefit amount will be

terminated after the third month from the cessation of disability month. If

wages drop below the SGA amount in any given month during the 36-month EPE, the

SSDI benefit amount will be reinstated.

Example: Again, let's look at . She completed

her TWP in September of 2009. Beginning in October of 2009 through September of

2012 has a 36 month EPE. In October of 2009 's adjusted earned

income, after taking into account work subsidies and IRWE, comes to $1,100 per

month. These wages are above the SGA amount so Social Security will give

a cessation of disability notice effective for October of 2009.

will still get her SSDI check for a three-month grace period (October,

November and December), but her SSDI check of $800 per month will end after

December of 2009. In June through August of 2011 's adjusted earned

income dropped to $900 per month. Because her countable earnings are below the

SGA amount for those months, will receive her $800 SSDI check for June,

July and August of 2011 because she is still in the EPE. If 's countable

earnings exceed $1,000 in September, 2011 and subsequent months, she will not

get another 3 month grace period and her SSDI check of $800 will be terminated

beginning in September. If 's countable earnings again drop below $1,000

in subsequent months while she is in the EPE her SSDI benefit amount will be

reinstated.

The importance of the EPE is that an individual can

again receive the SSDI benefit amount in any month during the 36-month period

when countable earnings fall below the SGA amount.

Expedited Reinstatement of Benefits

At the end of the EPE there is an additional five year

period called " expedited reinstatement of benefits. " If the original impairment

flairs up within five years of the end of the 36-month EPE, preventing the

individual from earning SGA, Social Security can reinstate the SSDI benefits

provisionally while a medical review is completed. If the medical review

confirms the disability condition or blindness, then the provisional SSDI

benefits will be made permanent. If the medical review concludes that there is

not a medical disability, SSDI benefits will be immediately terminated but with

no overpayment for benefits paid provisionally.

Conclusion

Between the TWP, the EPE and the five-year expedited

reinstatement of benefits, there are safeguards to protect Title II

beneficiaries who want to try to work. It is important for advocates to be sure

that appropriate earnings reductions are requested if needed to bring wages

below the SGA limit in order to preserve the SSDI benefit.

The next Voice article will discuss three additional

work incentives for Title II beneficiaries: Ticket to Work Program, extended

Medicare benefits and extended Medicaid benefits.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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FYI

Ellen

Ellen Garber Bronfeld

egskb@...

[voice] The Voice - Special Needs Alliance newsletter

October, 2011 - Vol 5, Issue 18

The Voice®, the Official Newsletter of SNA

Quick Links

> How we help families

> How we help professionals

> Related topics

> More about us

> Unsubscribe

> Subscribe to the

Capitol Connection

Join Our Mailing List >

The Voice is the e-mail newsletter of The Special Needs

Alliance. This installment was written by Special Needs Alliance member Barbara

Isenhour, of the firm of Isenhour Bleck, PLLC in Seattle, Washington. The firm

focuses on government benefits for individuals with disabilities and estate

planning for families with special needs children. A board member of NAMI

Eastside in Redmond, Washington, and Full Life Care in Seattle, Barbara

frequently lectures around the state of Washington on issues involving special

needs trusts and government benefits for the elderly and disabled.

How Work Can Affect Title II Disability Benefits Part

II: Ticket to Work and Extension of Medicare and Medicaid Benefits

This article is a continuation of a previous Voice

article, addressing the effect of employment on a person's eligibility for Title

II disability benefits (Social Security Disability Income, Child Disability

Benefits and Disabled Widow(er)s Benefits). The article addresses three work

incentives when a recipient of Title II disability benefits attempts to work:

Ticket to Work, extension of Medicare benefits, and extension of Medicaid

benefits. This article also addresses the reporting requirements when a Title II

disability recipient starts earning a wage.

Ticket to Work

Social Security has a work incentive program called

" Ticket to Work, " designed to help individuals with a disability transition into

a job and employment. The Ticket to Work program actually applies both to

disabled Title II beneficiaries and to disabled (Supplemental Security Income or

SSI) recipients, but this article only addresses its impact on Title II

beneficiaries.

The purpose of the Ticket to Work program is to help

disabled individuals achieve their employment goals by working with an

authorized vocational program. The program may include vocational training, job

referrals and other employment support. Social Security has a list of vocational

providers in every state. The providers include private employment networks and

government vocational agencies. Authorized programs also include public or

private school programs for students between the ages of 18 and 21 who have a

vocational program as part of their Individual Education Program (IEP).

Every person between the ages of 18 and 64 who is

receiving cash disability benefits and has not medically improved has a

" ticket. " These individuals can assign their ticket to an authorized vocational

provider to provide job training, job referrals and related employment support.

What are the benefits of enrolling in the Ticket to Work

program, aside from the vocational assistance in finding and keeping a job?

First, Social Security will not conduct any continuing disability reviews during

the term of the enrollment in Ticket to Work. Otherwise, when Social Security

first determines that a person meets the agency's definition of disabled or

blindness, the individual is given a medical review date to determine whether

the disabling medical condition has improved. The review date can be anywhere

between six months and seven years depending upon the medical condition and

expected improvement over time. The medical review can be a source of anxiety to

a recipient of disability benefits.

Another benefit from participation in the Ticket to Work

program is continuation of cash disability benefits even if the medically

disabling condition ends, provided the person is currently enrolled in a Ticket

to Work program. Social Security will still pay the cash disability benefits

until the vocational program has ended or as long as Social Security determines

that the vocational program will help the individual to stay off of the

disability rolls in the future.

Extending Medicare Benefits

Recipients of Title II disability benefits will qualify

for Medicare health insurance in the 25th month after their cash benefit begins.

If a recipient begins receiving Medicare, then completes a Trial Work Period

(discussed in the prior article in this series), and then has disability cash

benefits terminated because of substantial gainful activity (SGA) , Medicare

benefits will be extended for up to 93 months following the last month of the

Trial Work Period. After the 93 months, these former Title II recipients can

purchase Part A and Part B Medicare coverage if they wish. This can be a

significant benefit for individuals with disabling medical conditions because of

the relatively low cost of Medicare premiums and the ability to avoid

pre-existing condition exclusions that may be imposed by a privately-purchased

health insurance policy. In some states, benefits known as Medicare savings

plans may even pay these premiums if the individual meets the applicable income

and asset limits for the plan.

The extension of Medicare for 93 months and the option

to purchase Medicare after 93 months only applies to Title II recipients whose

cash benefit ended because they had SGA. If the cash benefits were terminated

because the individual's medical condition improved, the Medicare extension

provisions would not apply.

Extending Medicaid Benefits

Some recipients of Title II disability benefits receive

both Medicare and Medicaid health coverage. These individuals are often referred

to as concurrent beneficiaries or dual eligibles. Forty-two states have Medicaid

programs for disabled individuals who are working, even if they have lost all

their Title II cash benefits due to SGA. Most of these Medicaid programs have no

asset limits in order to qualify; where asset limits apply, they may be more

generous than the limits for ordinary Medicaid benefits. Most programs will

require that income is below a specified limit adopted by the state, but this

limit may be generous to take into account work-related expenses. Most states

have a premium for the Medicaid coverage based on a small percentage of

countable income, and so these programs are sometimes called Medicaid buy-in

programs. Benefits covered by the Medicaid program vary with each state program.

Some states' Medicaid programs cover attendant care for severely disabled

individuals, so that they can get to and from their job site or reside in a

community setting. This type of care would not be covered by Medicare.

Reporting Earnings

Social Security requires that individuals who are

working and also receiving cash disability benefits must report their earnings

by the 10th day of the following month. Because the Title II disability programs

count wages in the month the wages were earned, not the month of payment, it is

important that reported earnings make it clear when the wages were earned. This

can make a difference when determining whether wages exceed SGA in any given

month.

As discussed in the last Voice article, beneficiaries

need to know if they are still in a Trial Work Period (TWP) and when the TWP

ends. When their TWP ends, they need to know whether their countable wages

exceed SGA, and what work-related expenses can be used to reduce their countable

wages. For many individuals trying to work, wages may fluctuate on a monthly

basis. Earnings may be above SGA in some months and below SGA in other months

because of changes in health, changes in impairment-related work expenses or

subsidies that reduce countable earnings for SGA, or changes in availability of

hours of work from the employer.

Even when individuals report their earnings promptly,

there may be overpayments assessed for months when countable earnings exceed

SGA. Workers with disabilities and their families or other advocates need to

track wages carefully and to understand how SGA affects the ability to qualify

for the Title II disability benefit in any given month. To help track a working

individual's continued eligibility for Title II benefits, the Social Security

Administration provides a useful form, the " Benefits Planning Query " (SSA-2459).

This document will show the individual's Social Security benefit amount and the

specific program(s) paying the benefits (SSI, SSDI, CDB, DWB). The form shows

the disability onset date, whether or not any overpayments have been assessed,

whether or not the individual is receiving Medicare and/or Medicaid, and whether

or not the individual has completed a TWP. The form will also show prior

reported earnings and whether the earnings are verified or only estimated. This

form also indicates when the next medical review is scheduled with Social

Security.

Reporting earnings is a requirement, not an option-but

there is an additional benefit when individuals with disabilities report their

wages to Social Security. Most workers pay into the Social Security system with

each paycheck through withheld payroll taxes; self-employed individuals who

report earnings pay into the Social Security system through self-employment tax.

These individuals are gradually building up their own work history of Social

Security contributions, which will be used to calculate the amount of their

disability benefits and their eventual retirement benefits.

Conclusion

The Social Security disability programs are not designed

to punish individuals who want to try to work despite their medical conditions.

There are incentives to help transition individuals from disability benefits to

full employment with Ticket to Work and Medicare and Medicaid extended benefits.

There are also ways for many individuals to keep both their full Title II

disability benefits and their wages, depending upon the amount of their

countable earnings. The work rules for Title II disability benefits are

complicated, but with good advocacy and a good understanding of trial work

periods, substantial gainful activity, impairment-related work expenses and

subsidies, the Ticket to Work program, and continuing coverage from the Medicare

and Medicaid programs, individuals with disabilities can gain employment that

will enhance, not jeopardize, their financial security.

--------------------------------------------------------

About this Newsletter: We hope you find this newsletter

useful and informative, but it is not the same as legal counsel. A free

newsletter is ultimately worth everything it costs you; you rely on it at your

own risk. Good legal advice includes a review of all of the facts of your

situation, including many that may at first blush seem to you not to matter. The

plan it generates is sensitive to your goals and wishes while taking into

account a whole panoply of laws, rules and practices, many not published. That

is what The Special Needs Alliance is all about. Contact information for a

member in your state may be obtained by calling toll-free (877) 572-8472, or by

visiting the Special Needs Alliance online.

--------------------------------------------------------

Requirements for Reprinting this Article: The above

article may be reprinted only if it appears unmodified, including both the

author description above the title and the " About this Newsletter " paragraph

immediately following the article, accompanied by the following statement:

" Reprinted with permission of the Special Needs Alliance -

www.specialneedsalliance.org. "

© 2011 Special Needs Alliance. .

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