We recently spoke with Stan Klein, PhD, clinical psychologist and Director of DisabilitiesBOOKS, Inc., and Barbara D. Jackins, an attorney, parent of a young adult with developmental disabilities and one of the authors of Managing a Special Needs Trust: a Guide for Trustees. The book serves as a helpful guide for anyone managing a special needs trust for a person with a mental or physical disability. It includes what trustees need to know about:

• Public benefits programs (SSI, SSDI, Medicare, Medicaid);
• Taxes and special needs trusts;
• Payment of recreation, transportation and medical costs;
• Housing subsidies;
• Duties of a trustee.

The book was revised, updated and expanded in 2010 to cover all 50 states.

Why did you write Special Needs Trusts: A Guide for Trustees?

Barbara: We are a group of lawyers who were meeting regularly to discuss issues in our practices. As the parent of a young adult with developmental disabilities and over 30 years of experience writing and managing special needs trusts, I knew that a trust was an important piece of planning for the future because it can assure a good quality of life beyond government benefits. My colleagues were also serving families that included a person with a disability. Special needs trusts were often on our agenda. Some clients didn’t understand what to do with the trusts they had been given to manage for their disabled family members. Others were afraid to spend any money for fear of getting into trouble with the government. One client just put the money in the bank under her own name. We decided to write an instruction letter of 8-10 pages for trustees, but there was so much we thought trustees should know. The project became The Special Needs Trust Administration Manual in 2004. Then, in 2010, it was updated to cover and apply to all 50 states.

Do people need a lawyer for a special needs trust?

Barbara: You need a lawyer to write the trust. It helps to have a lawyer at every stage of the process. Folks need to remember that someone—a relative, friend or client—is depending on them to run the trust properly and look after their interests. Often people with disabilities have very little—just an SSI check and Medicaid insurance. They are completely dependent on these benefits and can’t afford to lose them. For public benefit reasons, it’s essential to have an attorney in the state where you are running the trust; there can be subtle differences in the way these programs are managed in each state and even in different regions within the state. It’s best to have a local person who knows the ins-and-outs for your geographic area.

For more information about Managing a Special Needs Trust: a Guide for Trustees, visit www.disabilitiesbooks.com.

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Many individuals are not aware that the privacy act they sign at a doctor’s office can have a big effect on their future health needs. Should a person become ill or incapacitated, and their spouse or loved one is not named as a patient’s representative, the Health Insurance Portability and Accountability Act (HIPAA) does not allow access to an individual’s medical records to unauthorized people. An experienced elder law attorney can help can individuals make sure they have the right legal documents created to prevent these issues from happening. Taking the time to create these documents early on is advised. An attorney will create a health care proxy with a HIPAA clause and a power of attorney (POA) document to establish who is the personal representative that can access medical records and make health care decisions. This is especially important if the POA is a “springing” POA that only gets used when an individual becomes incapacitated. An attorney will help make sure the right HIPAA release forms are created and disclosure of medical records will not be an issue in the years to come.

Littman Krooks LLP counsels individuals and families to plan for their health care wishes and financial matters as part of a comprehensive estate plan. Our New York City, White Plains and Fishkill estate planning attorneys and elder law attorneys are accomplished in asset preservation, trusts, and government benefits.

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Changes to New York’s Medicaid program will take effect in December 2011 in New York City and in January 2012 for upstate residents. The changes are as follows:

–          Children ages 6-18 are now eligible for Medicaid at the same income level as younger children – 133% of the federal poverty limit. The change should decrease the need for families to move their children between Medicaid and Child Health Plus after their sixth birthday. It is viewed as a step in the direction of the simplifications required by the Affordable Care Act.

–          Medicaid recipients receiving Social Security as their only source of income will not need to renew their Medicaid cases, if their resources were below 85% of the Medicaid resource level at the last renewal or at application, whichever was later (the Medicaid resource level is $13,800 for a single person and $20,100 for a couple). SSI-related recipients should receive a notice informing them that their Medicaid coverage will continue unchanged and explaining that they do not need to respond to the mailing unless they have change to report in income, resources, health insurance or residence.

To learn more about New York special needs planning, visit www.littmankrooks.com/special-needs-planning/ or www.specialneedsnewyork.com.

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The Department of Transportation (DOT) has introduced supplementary consumer protection requirements for airline passengers in an effort to make flying more convenient and hassle-free.

The proposal by the DOT would require airlines to make their websites accessible to individuals with disabilities and ensure that their ticket agents do the same. This proposal would also require airlines to make automated kiosks at U.S. airports accessible to passengers with disabilities.

This plan is the latest in a series of DOT steps to carry out the Air Carrier Access Act, and to ensure equal access to air transportation for all travelers.
These new requirements will expand travel opportunities for individuals with disabilities and allow for easier access at airports.

To learn more about New York special needs planning, visit http://www.littmankrooks.com/special-needs-planning/ or https://www.specialneedsnewyork.com.

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

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

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

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

To learn more about New York special needs planning, visit http://www.littmankrooks.com/special-needs-planning/ or https://www.specialneedsnewyork.com.

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By Susan Hendler, Owner of Sociable Kidz (Mamaroneck, NY)

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

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

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

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

Children need to feel good about themselves and have the inner confidence and self-esteem in order to stand up to a bully.

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

Posted in New York Special Needs | Comments Off on Follow up: The Importance of Self-Esteem with Children and Bullying

People with disabilities have some new, powerful devices to make daily living easier. The Human Engineering Research Laboratories (HERL) is a part of the VA Pittsburgh Healthcare System and has created robotic arms, better wheelchairs, and other mobility devices. Their Personal Mobility and Manipulation Appliance helps wheelchair users read a magazine, use a vending machine, and accomplish many other daily tasks. Their Strongarm device can be mounted to a power wheelchair and is able to lift up to 250 pounds. This can be extremely helpful when moving the disabled person from the wheelchair to a couch, and opening things such as doors and microwaves.

HERL has also designed a better wheelchair for people with special needs who participate in sports and recreation activities. Their field games throwing chair for the discus, shotput, and javelin has a better base and stability for these activities. These wheelchairs have been tested at big competitions and accommodate different abilities and body types.

“We try to address the clear and real needs of Veterans now and in the future,” said HERL director Rory Cooper, who is also a longtime National Veterans Wheelchair Games athlete. “One of the unique things about HERL is that we’ve been able to respond to the needs of Vietnam and World War II Veterans as they age, as well as OEF/OIF Veterans.”

HERL is dedicated to research and advanced engineering to improve the lives of people with disabilities. They strive to create devices that are reliable, safe, and help people have the most independence.

New York special needs law firm Littman Krooks LLP helps disabled veterans and people with special needs get access to specialized wheelchairs and government benefits. Our New York City, White Plains or Fishkill Special Needs attorneys have substantial experience in comprehensive estate planning, special needs trusts, and long-term asset preservation for people with disabilities. To learn more about our New York special needs planning services, visit http://www.littmankrooks.com/special-needs-planning.

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The Centers for Disease Control (CDC) has approved a new medical diagnosis code for wandering. Individuals with autism, intellectual disabilities, and related conditions are more prone to wandering, which exposes them to potentially harmful and life-threatening dangers. The new code is listed as V40.31 – wandering in diseases classified elsewhere.

“It is our hope that the recognition of wandering as a medical diagnosis will bring opportunities for the development of resources including training for schools and caregivers, emergency search personnel protocols, financial assistance for safety equipment and support and education for families,” said Lori McIlwain, the board chair of the National Autism Association.

Health care professionals can start to use the new code in October in medical records. The CDC wants to gain better data with the new code to understand the prevalence of this behavior. Autism Spectrum Disorders (ASD) are noted for affecting an individual’s social, behavioral, and communication skills. ASDs begin in childhood and can last throughout a person’s lifetime. Individuals who are prone to wandering need extra care to monitor them. Behavioral intervention early on is needed to help the individual lessen these behaviors and make progress.

The National Autism Association conducted an online poll and 92 percent of parents said that their autistic child had a tendency to wander. Exposure to the outdoor elements, drowning, and other factors put the individual at risk for an injury or death. Speaking with your health care provider about your child’s behavior and what resources there are can help turn the situation around. It is also advised to speak with a qualified special needs attorney to learn about and access much-needed resources for your child.

Littman Krooks LLP counsels families with special needs planning. Our New York City, White Plains or Fishkill Special Needs attorneys can assist with Medicaid planning, special needs trusts, comprehensive estate planning, and special education advocacy matters. In addition, our New York Special Needs Trust attorneys can assist clients with long-term care and asset preservation and protection planning for loved ones with disabilities that need around-the-clock care.

To learn more about New York special needs planning, visit www.specialneedsnewyork.com, or http://www.littmankrooks.com/special-needs-planning.

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Tags: autism

Founded by Public Safety Officers, Project Lifesaver International (PLI), is an organization whose sole mission is to provide a timely response to save the lives of adults and children with Autism, Alzheimer’s, Down syndrome, Dementia, and other conditions, who wander. Started in 1999, PLI has offered public outreach programs to educate others about wandering. They have also provided equipment, training, certification and support to law enforcement and public safety officials through the country. These trainings include in-depth information on the use of specialized electronic search and rescue equipment technology and most importantly, how to communicate with people with cognitive or developmental conditions. PLI has over 1200 agencies in 45 participating states. They have performed 2,421 searches in the last 11 years with no serious injuries or fatalities ever reported.

How it works:

• If you are a family member or a caregiver of a loved one that wanders:  Call (757) 546-5502 or contact your local agency to enroll your loved one in Project Lifesaver to receive a small personal transmitter (which can be worn around an ankle or wrist) which emits an individualized tracking signal. If a registered client goes missing, the caregiver notifies their local Project Lifesaver agency, and a trained emergency team responds to the wanderer’s area. The recovery time for a person wearing a transmitter is approximately 30 minutes, (95% less time than a standard operational procedure).

Typical costs to enroll will vary by agency and location.   Ask your local agency if they participate in grant funding to find out about wristbands at discounted rates or at no charge.

• If you are an agency that would like to receive Project Lifesaver training: Submit a letter of intent to PLI. A sample letter of intent can be found here. Training can include two days of on-site instruction (for up to 15 people in your agency), provided by a State Coordinator or by PLI’s own staff. Each new agency will also receive training on Alzheimer’s, Autism, and other disorders, to help when responding to a missing client. Costs may vary on agency and location.

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

Visit www.littmankrooks.com/blog/, www.elderlawnewyork.com/blog/ , and www.specialneedsnewyork.com/blog/

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A new study, Genetic Heritability and Shared Environmental Factors Among Twin Pairs With Autism, released by the United States National Institutes of Health confirms that environmental factors play a huge role in the exponential rise in autism rates, and that previous efforts to prove that genes alone cause autism have been overstated.

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

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

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

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

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

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