Last week, theUnited Cerebral Palsy Association (UCP) released its 2013 The Case for Inclusion report. The UCP, a group which “educates advocates and provides support services to ensure a life without limits for people with a spectrum of disabilities[i]” has released The Case for Inclusion report annually since 2006. It provides a snapshot of the performance of individual states in regards to the Medicaid programs/services offered to Americans with intellectual and developmental disabilities.  The report “examines data and outcomes for all 50 states and D.C., ranking each on a set of key indicators, including how people with disabilities live and participate in their communities, if they are satisfied with their lives, and how easily the services and supports they need are accessed.[ii]” It also ranks individual states based on their performance and in comparison to the performance of other states. Those states which have performed particularly well are identified in the hopes that their policies and practices are replicated.

2013 Results

The results of this year’s The Case for Inclusion report are mixed; according to the report’s website, all states have room to improve, however there are states that remain consistently at the bottom of the rankings. They do note that despite economic restraints, many states have improved in terms of the services they offer individuals with disabilities.

For example, although 38 states now meet the “80/80” rule (UCP identifies this as a community standard meaning that 80% of all individuals with ID/DD are served in the community, and 80% of all resources spent on those with ID/DD are for community support), the number of states which have at least one third of the population with intellectual and developmental disabilities employed in competitive positions has dropped to 10 (down from last year’s count of 17). Arizona was ranked as the top performing state for 2013, followed by New Hampshire and Oregon. Mississippi was ranked last at 51, with Arkansas being ranked at 50, and Texas at 49.

The UCP highlights the following “significant takeaways” from the 2013 Report[iii]:

• All states still have room for improvement, but some states have consistently remained at the bottom since 2007, including Arkansas (#50), Illinois (#48), Mississippi (#51) and Texas (#49). While these states need real attention, they are not reflective of the real improvement in Inclusion for the vast majority of states, as highlighted below.
• As of 2011, 13 states have no state institutions to seclude those with ID/DD, including Alabama (new this year), Alaska, Hawaii, Maine, Michigan, Minnesota (which closed its last remaining institution in June 2011), New Hampshire, New Mexico, Oregon, Rhode Island, Vermont, West Virginia and DC.
• 21 states now meet the 80% Home-like Setting standard, which means that at least 80% of all individuals with ID/DD are served in settings such as their own home, a family home, family foster care or small group settings like shared apartments with fewer than three residents.
• 34 states participate in the National Core Indicators (NCI) model a comprehensive quality assurance program that includes standard measures to assess outcomes of services (nationalcoreindicators.org).
• Only 15 states were supporting a large share of families through family support (at least 200 families per 100,000 of population).
• Waiting lists for residential and community services are high and show the unmet need.

How can I use this report?

The UCP has organized the data it used to compile the Case for Inclusion report in a searchable index on the report’s website. Those wishing to find out information on individual states can visit the State Scorecards while others who wish to see how well each state performed in relation to each other can have a look at the state ranking map. Visitors to this website can also compare state and national data, advocate for areas needing improvement, and download the reports from previous years.

Overall, the organization urges people to use the report and its findings in their own, individual advocacy efforts. According to the organization, advocates “should use this information to educate other advocates, providers, families and individuals, policymakers and state administrations on key achievements and areas needing improvement within each state. The facts and figures can support policy reforms and frame debates about resource allocation for the ID/DD population. Advocates can also use the information to prioritize those areas that need the most immediate attention. Lastly, advocates can use the facts to support adequate and ongoing funding to maintain high quality outcomes, eliminate waiting lists and close large institutions.[iv]”

If you have any questions on this or any other topic pertaining to special needs planning, please do not hesitate to contact us. We love to meet new people, and are always happy to help. As well, stay tuned to our website over the next couple of weeks for the launch our very own Housing Report!  This report, a database of various independent living/housing programs available nationwide to individuals with disabilities, will be hosted on our website and will be available to users via subscription. If you are interested in using this database, send us an email and we will notify you when we launch.

From the staff of M&L Special Needs Planning, LLC thanks for visiting our website today – happy Thursday!

A few weeks ago, M&L Special Needs Planning, LLC posted a blog titled “Back to Basics: Obamacare for Individuals with Disabilities”. In this blog, we briefly outlined the various changes taking place to the health care system under the Affordable Care Act, with a focus on the reforms that we felt were particularly beneficial to individuals and families with special needs. One of these reforms included the expansion of Medicaid and, in turn, the expansion and extension of the Money Follows the Person program.

In case you aren’t familiar with this program, it was introduced as a “Rebalancing Demonstration Program” under the Deficit Reduction Act of 2005. The program, which was given up to 1.75 billion and slated to run until the end of the 2011 fiscal year, was designed to help States shift Medicaid’s long-term care spending from institutional care to home and community based services[i]. Essentially, the Money Follows the Person program provides funding to help States with the process of transitioning Medicaid recipients – such as individuals with disabilities, or elders requiring long term care – from institutional settings into community settings.

As mentioned, the Affordable Care Act of 2010 both extended and expanded the program. In a letter written by the Center for Medicaid and Medicaid Services, the expansion and extension “provides an opportunity for those states that are presently participating in the program to continue building and strengthening their MFP [Money Follows the Person] Demonstration Programs, and for additional states to participate.[ii]” An additional 2.25 billion federal dollars were appropriated for the program, and it was extended it from its original termination date (the end of the 2011 fiscal year) to the end of the 2016 fiscal year. A number of other changes were made as well, including the allocation of extra funds for research and evaluation of the program. The Act also changed the eligibility requirements of the program – the original requirements stated that applicants must have had a six month (consecutive) stay in an institution in order to be eligible; under the Act the minimum stay has been reduced to 90 consecutive days. This change is perhaps the most important to the special needs community, as it significantly widened the applicant pool.

How does the Money Follows the Person Program work?

Many people who currently receive long term care would prefer to receive these supports in home and community settings rather than in institutional settings. Often, however, the decisions regarding long term care are influenced by federal and state Medicaid policy – as States have traditionally relied on institutional settings to deliver these services, many people find themselves forced to turn to institutional settings to receive long term care. The primary purpose of the Money Follows the Person program is to change this state reliance on institutions, and help those who currently receive long term care to make the decision as to where they would like to receive those services and supports. States who participate in the program receive grants to develop programs and systems to deliver these services and supports outside of institutions and to improve home and community based services. This reduced reliance on institutional settings, and increased use of home and community based services is one of the four program goals identified on the Medicaid.gov website. The program also intends to eliminate barriers in State law, Medicaid plans, and budgets that restrict the use of Medicaid funds for those who want to choose where to get long term care, to strengthen the ability of Medicaid programs to provide home and community based services to those who wish to leave institutional settings, and to offer quality assurance for the home and community based long term care services being offered.[iii]

Program Eligibility Requirements

Currently, 45 states and the District of Columbia participate in the program (note: see endnote 4[iv] for a list of participating states). Each state administers its own Money Follows the Person program, with federal funding. Individuals should review the program objectives, qualifications and goals that are pertinent to their home state; a Google search will reveal the programs in each state. In Washington, D.C., for example the program is available to “individuals with intellectual disabilities residing in long-term care settings, such as Intermediate Care Facilities for Persons with Intellectual Disabilities (ICF/ID), who are eligible for the DDA Home and Community Based Services (DDA HCBS) waiver, and individuals living in nursing facilities, who are eligible for assistance through the Elderly and Physical Disability (EPD) Home and Community-Based Services waiver.[v] In order to qualify for the program, an applicant must have stayed in an institution for a minimum of 90 consecutive days, been supported by Medicaid to stay in a long-term care facility for 30 days, be interested in receiving services and supports in the community, and be eligible for one of D.C.’s Medicaid Home and Community Based Services Waiver Programs.

If you have any questions about the Money Follows the Person program, or any other government benefit program, please contact us! We are always happy to help. You may also wish to have a look at our Understanding SSI/Medicaid & SSDI/Medicare workshop, which we offer free of charge at various locations and times throughout the year.

Thanks for taking the time to drop by our blog this week; have a great day!

Thursday, May 2nd, 2013

In a letter to the President (dated January of 2010), John R. Vaughn, Chairperson of the National Council on Disability, wrote “Affordable, accessible, and appropriate housing is critical and integral to making a community more livable for people with disabilities.[i]” According to the report which accompanied the letter, titled The State of Housing in America in the 21st Century: A Disability Perspective, more than one third of households in 2007 reported having one or more persons with disabilities[ii]. The same document reports that “creating and sustaining safe, accessible, affordable and integrated housing [for persons with disabilities] continues to involve challenging and complex barriers that arise from the interaction of poverty, inaccessibility, funding rules related to acquiring supportive services, and a disability policy system rooted in the outmoded model of segregating people with disabilities from the community mainstream.[iii]”

It is clear that access to affordable and appropriate housing is, and will continue to be, a serious issue for people with disabilities. Here at M&L Special Needs Planning, we feel that preparing for future housing needs and researching the different housing options available to individuals with disabilities is a vital part of the special needs planning process. In fact, planning for future housing needs is an integral part of our Comprehensive Special Needs Financial Life Plan service. As well, as a part of our commitment to providing high quality, special needs planning services, we are currently putting the finishing touches on our very own Housing Report. This report will provide users with information on housing and/or independent living programs that currently exist across the country, and will be launched on our website mid-2013.

In advance of this launch, however, we have prepared a discussion of the various options that individuals with disabilities and their families may consider when planning for future housing needs. These options include, but aren’t limited to, remaining at home, renting another location, purchasing a home, licensed facilities and/or group homes, adult foster care (as a part of family living), and  intentional communities.

Remaining at home: Individuals with disabilities may feel that remaining in their family home (or the home in which they spent their childhood) is the best possible housing option for their situation. In some cases, home renovations or additions may be completed to ensure the individual can live with the utmost autonomy – obtaining supported living services may be necessary. Examples of this may include a house which has been donated or left to the individual, an apartment in the family home or on the family property, or a granny flat on the property (can be referred to as elder care housing option or ECHO).  This choice has a number of benefits – the individual is familiar with the home and the community, and may have the opportunity to remain living in close contact with family members who have provided support and assistance in the past. Choosing to remain at home does come with its own set of drawbacks, however. It may not be an affordable option for those who do not have an apartment or a flat on the property, or there may not be enough space on the property for ECHO housing.

Renting another location: Those who value the privacy of maintaining a household but do not wish to remain in the family home or purchase a house may wish to consider renting – either alone or with others. Renting alone is optimal in terms of privacy and independence, but can be costly. For those moving from the family home, loneliness and a lack of in-home support may also be important factors to consider. In addition to this, finding an apartment which is accessible and appropriate may be difficult, depending on your location. Shared housing offers a cost effective choice, as well as built in companionship. For individuals wishing to rent a property, in-house supports, or supported living, may be necessary. In some cases, organizations in the special needs or disability communities may offer rental locations to individuals, and there are various government programs available to help subsidize housing costs. The Housing and Urban Development Department (www.hud.gov) is a valuable resource for individuals with disabilities who wish to pursue this option.

Purchasing a home: Some individuals who wish to maintain their own residence may purchase a home.  This can be a very expensive option, and would require the individual to be responsible for home maintenance and repairs. Shared housing is a possibility which would significantly lower home ownership costs – either the home owner rents space to other individuals, or a structured ownership plan is developed where two or more individuals purchase the home together. In this case, agreements are made with different outcomes in mind; i.e. to account for changes such as an owner choosing to pursue a different housing option, or death. In some cases, owners may form a corporation and purchase shares in the ownership of the home. There are a number of different funding programs and incentives that could combine to make this option viable for low income buyers, such as government funding programs to lower payments and first time homebuyer programs. However, if the individual chooses to pursue this option, funds must be acquired for the closing costs of the home, i.e. down payment, real estate fees, and legal fees. As with renting and staying in the family home, supported living arrangements may be required. Examples of this housing option include ownership by individual, tenants in common, or limited equity cooperative.

Licensed Facilities/Group homes: Licensed facilities/ groups homes must follow specific regulations and licensing requirements of their funding source. These regulations are directly related to the number of residents in the facility, as well as health and safety regulations. For most individuals, the biggest drawback to group homes and licensed facilities is the lack of privacy, and the lack of control over the workings of the facility, i.e. structure, staff, other residents, etc. On the positive side, these facilities have 24/7 professional staff, and offer security and stability to the individual and the individual’s family members. There are many opportunities for socialization, and companionship is not an issue. As well, all housing costs are included, i.e. there are no hidden costs or surprise expenditures.

Adult Foster Care, as a part of Family Living: In this situation, the individual would live in a home that is not their original family home. The owners of the home are responsible for the room, board, and care of the individual (as appropriate to the needs of the individual). The home may offer housing to one or more individuals with disabilities. As a part of their responsibility, the home owners may acquire supported living assistance, or respite care for the individual(s).  There are a number of positives associated with this option; living in a family home offers, of course, a home like setting for the individual. Additionally, this option can provide stability, which may lead to a permanency of relationships. Housing can be acquired more quickly with this option, and there are typically fewer numbers of residents in this setting than in a licensed facility or group home. Because it is a home setting, there are a number of considerations – conflicting personalities can lead to conflict in the home, therefore there must be an opportunity for all individuals involved to meet and express comfort with this living arrangement. As well, all individuals in the home must be educated and trained in relation to providing the individual with the level of care necessary to meet his or her needs. Examples of this type of housing option include domiciliary care or “dom care” providers.

Intentional Communities: “An intentional community is a group of people who have chosen to live together with a common purpose, working cooperatively to create a lifestyle that reflects their shared core values. The people may live together on a piece of rural land, in a suburban home, or in an urban neighborhood, and they may share a single residence or live in a cluster of dwellings.[iv]” There are four models of intentional housing – intergenerational communities as intervention, co-op housing, the farmstead, and housing collaborations with universities and colleges. Due to the complexity of the various models of intentional communities, next week’s blog will be devoted to an in-depth discussion of the details, benefits, and drawbacks of each model under this housing option.

When considering housing options for individuals with disabilities, it is important to remember that the housing needs of individuals are varied and personal; each person deserves to live comfortably, in a situation that suits his or her personality, needs, and medical conditions. If you have any questions regarding housing options for yourself, or your family member with special needs please contact us – we are more than happy to help! Also, if you would like to complete a Comprehensive Special Needs Financial Life Plan, in which we include planning for future housing needs, we would be more than happy to provide a consultation.

Thanks for dropping by our blog today, and stay tuned for the launch of our Housing Report in mid-2013. Have a great day!

In March of this year, the Kaiser Family Foundation released the results of its latest Kaiser Health Tracking Poll. The poll, which “tracks the public’s experiences in the health care system, their ranking of health as a policy priority and their views on health care reform options[i]” revealed some surprising results. According to the survey, “…three years after passage [of the law], a majority of Americans (57%) say that they do not have enough information about the Affordable Care Act to understand how it will affect them.[ii]” To read the results of the Kaiser Health Tracking Poll in full, please click here. Considering the controversy that still surrounds Obamacare, it isn’t really surprising that this level of confusion still exists. Despite the 64 million hits that results from a Google search of “Obamacare”, sifting through the millions of blogs, articles, and documents that are political, biased, and often inaccurate to find relevant, concise and accurate information can be challenging.

In July of last year, M&L Special Needs Planning published a blog titled What Obamacare Really does for Individuals with Disabilities. In the interest of further clarification (and in light of this recent survey) we have decided to revisit this topic, and provide a more in-depth analysis of Obamacare and how it can affect you, your family, and your family member with special needs.

Obamacare: The Essentials

The primary purpose of Obamacare is to ensure that every American can access affordable health care insurance.  In order to reach that goal, the Act first proposes to ensure that every American has access to health insurance. As basic as this sounds, due to pre-existing condition clauses and lifetime limit clauses, insurance companies were previously able to decline or cut coverage to certain individuals, therefore limiting access to health insurance for many Americans. The solution as outlined in the Affordable Care Act, which began July 1^st, 2010, was the Pre-Existing Condition Insurance Plan (PICP) which “provides health insurance options to individuals who have been uninsured for a period of at least six months – this program is intended to act as a “bridge” to 2014, when all discrimination against pre-existing conditions will be prohibited.[iii]”   As well, “under the health care law, job-based and new individual plans are no longer allowed to deny or exclude coverage to any child under age 19 based on a pre-existing condition, including a disability.[iv]” This new law is incredibly beneficial to all Americans, but particularly to families and individuals with special needs, who no longer need to worry about switching employment, moving, or suddenly losing coverage and struggling to find a new health care insurance provider.

The next step outlined by the act was to make insurance affordable. Here is where it gets a bit tricky. Obamacare proposes a number of ways to ensure that Americans can access affordable health insurance, including mandatory insurance coverage, an expansion of Medicaid, and health insurance exchanges.

Mandatory Health Insurance, or individual/employer responsibility, is perhaps the most controversial of all the reforms enacted under Obamacare. Under the Affordable Care Act, beginning in 2014, all Americans must have health insurance coverage, either through a personally purchased insurance plan, an employee insurance plan, or a government program. Americans who do not have insurance after this time will be subject to a tax penalty. (Note:  Americans who currently have health insurance coverage and who would like to remain on the same plan are able to do so.) As well, beginning in 2014, employers with more than 50 employees are subject to a responsibility fee if they do not offer affordable insurance coverage to their employees. Businesses with less than 50 employees are exempt from this, but are eligible to receive a tax credit should they offer health insurance to their employees.  Those Americans who aren’t offered insurance by their employers, or can’t afford to purchase insurance either from a private insurance company or via the health insurance exchange may qualify for free or low cost insurance under Medicaid or other programs, or they may be exempt from individual responsibility. To access information regarding exemptions from individual responsibility, please click here. Details regarding the tax penalties for those who fail to obtain health insurance can be accessed here.

Medicaid is a state run program which offers health insurance coverage to individuals, families and children with lower incomes, older people, and individuals with disabilities. Currently, Medicaid eligibility requirements vary from state to state, although most states do provide an income cut off level as an eligibility requirement. Beginning in 2014, the Medicaid expansion ensures that most individuals in all states with incomes of $15,000 per annum and less are eligible for Medicaid health insurance coverage.

The Health Insurance Exchange (also known as the Health Insurance Marketplace) proposed by Obamacare is “a new transparent and competitive insurance marketplace where individuals and small businesses can buy affordable and qualified health benefit plans[v].” It is intended to allow consumers to choose their health insurance plans by comparing price, benefits, and quality of each plan, via an online shopping site. As a part of Obamacare’s commitment to promoting transparency, all information and plans on the health insurance marketplace will be in plain language – clear, concise, and easy to understand.  Enrollment for the insurance exchange begins in 2013. However, it is important to note that when the Supreme Court delivered its ruling on the Affordable Care Act in 2012, it stipulated that state participation in the health exchanges be voluntary. As a result, each state will have a marketplace, but it will choose whether it will be state run, or supported by the Department of Health and Human Services. Please click here to access information on which states will be participating. To determine if you are eligible to enroll, or to access information on how to begin preparing for enrollment, please visit the healthcare.gov website for information.

Obamacare and Individuals with Disabilities

As we wrote in our earlier blog, the reforms proposed under Obamacare that are especially beneficial to individuals with disabilities include the elimination of the pre-existing condition clause, the age increase for children on a parental insurance plan, the elimination of the coverage limit, and inclusion of preventative services in health insurance plans.

According to the healthcare.gov website, under the section “The Affordable Care Act for Individuals with Disabilities”, Obamacare contains a number of other reforms that may be beneficial to individuals with disabilities, including additional funding to “extend and enhance” the Money Follows the Person program (a program which works with individuals with disabilities towards the goal of transitioning from institutional to community life). It also proposes to improve Medicaid home-and-community based services such as the Community First Choice Program, by giving incentives to states to offer home and community based services as care alternatives to institutions, and by improving the option for states to create Home and Community Based Service Plans. In addition to this, Obamacare also expresses a commitment to assuring “accessible, affordable, quality care to individuals with disabilities, by investing in preventative care (ensuring that health insurance plans include things such as cancer screenings and wellness checks), improving access to diagnostic equipment, fighting health disparities, and improving the coordination of care for populations with complex health needs[vi].

To read about these and other reforms in greater detail, please visit the healthcare.gov website.

Additional Information and Resources

As previously mentioned, finding a resource which provides clear, unbiased, and accurate information can be a challenge. Throughout the course of our research, we found these articles and websites to be particularly helpful:

• What You Should Know about the Affordable Care Act
• What is the Patient Protection and Affordable Care Act of 2010?
• Kaiser Family Foundation website
• Healthcare.gov Website

Hopefully, this has helped to clarify some of the confusion surrounding Obamacare.  If you should have any questions regarding this topic, please visit our previously published blogs titled What Obamacare Really Does for Individuals with Disabilities, and Obamacare Update: Changes to Expect in 2013. Of course, feel free to call, email or leave a comment with any questions or suggestions you may have regarding this or any other special needs planning topic.

Thanks for stopping by our blog today; have a wonderful Thursday!

“Until one has loved an animal, a part of one’s soul remains unawakened.” Those words, spoken by French author, poet and journalist Anatole France, refer to the incredible connection that can exist between a human and an animal. History, both literal and fictional, is littered with references to emotional links between man and animal, pet and pet owner. In fact, Americans feel so strongly about this connection that the American Veterinarian Medical Association has called it the Human-Animal Bond, and defined it as “a mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors that are essential to the health and well-being of both. This includes, but is not limited to, emotional, psychological, and physical interactions of people, animals, and the environment.[i]”

Considering the health benefits that are purported to accompany pet ownership – the Center for Disease Control claims that “pets decrease blood pressure, cholesterol, triglyceride levels, and feelings of loneliness, while increasing the likelihood of exercise and socialization[ii]” – it is not surprising that medical professionals have considered applying the positive influence that animals have on the human psyche in other ways. In fact, in the last few decades therapists have done just that – in the mid 1980’s these concepts surrounding the human-animal bond led to the development of Animal Assisted Interventions, and the popularity of these therapeutic practices has been growing steadily ever since.

What are Animal Assisted Interventions?

Animal Assisted Interventions is a term which includes a number of different therapies – it encompasses animal assisted activities, animal assisted therapies, service animals, companion animals, and residential animals.

Animal assisted activities are activities in which animals and patients participate, with the intention of providing opportunities for the patient to grow, learn, and/or develop relationships with the animal, other patients, and/or therapist. Animal Assisted Therapy (AAT), the more formalized animal assisted intervention, relies on the supervised use of trained animals (with specific characteristics) to help a patient realize a specific goal in a therapeutic setting. Service animals, most commonly canine, can be trained to aid people who have a disability or illness (i.e. visual disability, seizures, diabetes, etc.) live a normal life by increasing mobility, independence, and alerting the owner to physical concerns, among other things. Residential animals are those who live in treatment facilities, and can encourage and motivate patients to attend and anticipate treatment sessions. The residential animal may or may not be included in individualized therapeutic treatment. Please click here to read the Guidelines for Animal Assisted Interventions laid out by the American Veterinarian Medical Association.

Horses and dogs are most commonly associated with Animal Assisted Therapy, but this is no doubt directly related to the relative ease of accessibility of these animals. In truth, the species of animal that can be used in animal assisted therapy is as varied as the illness or disabilities which this therapy tries to treat. Dolphins, cats, and rabbits, guinea pigs, hamsters, and chicks, as well as horses and dogs, have been known to participate in animal therapy – as the animal used in the therapy is chosen based on specific characteristics they may possess, then the type of animal used is directly relevant to the purpose of the therapy. For example, cats are smaller, less intimidating, and often less active than dogs, so they may be used in individualized therapy sessions where the patient is uncomfortable with excessive stimuli. Conversely, a dog may be used over a cat in a group therapy session, as dogs typically enjoy interacting with multiple people at the same time.

What can Animal Assisted Intervention treat? How can AAI help my Child with Special Needs?

An Animal Assisted Intervention can be a part of a treatment plan to effectively combat a wide variety of illnesses, conditions, and disabilities. The most important aspect of any animal assisted intervention is the facilitation of a trusting relationship between the patient and the animal, which in turn leads to a development of trust and openness between the patient, the animal and the therapist. Animal Assisted therapies have been used to treat a wide range of physical illnesses and disabilities, for example multiple sclerosis, muscular dystrophy, and paralysis, to name a few, but it is also used to treat mental and emotional illness, such as schizophrenia, bi-polar disorder, anorexia, etc.  Animal Assisted Therapy has also been used to treat patients with autism, obsessive compulsive disorder, and Down syndrome. For more information on the benefits of Animal Assisted Therapy and the conditions it can be used to treat, please click here.

Parents of children with special needs may wish to pay attention to Animal Assisted Interventions for a number of reasons; evidence[iii] has been offered that animals can improve the emotional and physical health of patients, as well as motivating patients to reach developmental and therapeutic goals. There is no doubt that animals can teach children important lessons about responsibility, compassion, empathy, and loyalty. An animal can also offer non-judgmental acceptance, support, and unconditional love to a child with special needs- this acceptance may be a powerful motivator for a child with special needs. For example, children who are non-verbal may wish to learn speak in order to communicate with the animal. Equine and dolphin therapy may encourage children who have difficulties with mobility to develop skills that will enable them to interact with the animal – in fact, horseback riding has been known to help develop muscles that help with mobility. Equine therapy also offers support and companionship to children with Autism, without the social demands of a human relationship (i.e. eye contact, language, etc). For more information, check out this great article on the benefits of animal assisted therapy when treating specific conditions.

Perhaps the most important aspect of Animal Assisted Intervention lies in the emotional boost that comes from interacting with animals. The sense of well-being, relaxation, unconditional love and support that results in bonding with an animal ensures that every animal assisted intervention is worthwhile. Please click here for advice on finding a qualified animal intervention therapist  in your area. You may also wish to read this great article by Dr. Andrew Weil on Animal Assisted Therapy for addition information.

If you have any questions on this or any other topic related to special needs planning, please don’t hesitate to send an email or give us a call. We love hearing from you! Also, you may wish to check out our next workshop, Navigating the Financial World of the Family with Special Needs on April 30^th, 2013 at the TCL Treatment and Learning Center in Rockville, MD. Please click here to register for this free workshop.

Thanks for stopping by our blog today…from all of us to all of you, happy Saturday!

We recently had the pleasure of interviewing certified financial planner Maedi Tanham Carney regarding her business and website dedicated to financial planning for special needs.  Ms. Carney has been certified as a financial planner since 1992 and has a background in commercial real estate and finance, having earned her degree from the University of Denver in Colorado.  Her company, M&L Special Needs Planning, LLC is named after her two daughters, Emily and Ellie.

Just a brief review of her website will reveal the many resources she has put together in her efforts to support and assist families who are trying to create a special needs financial life plan. Among these resources are several workshops of which, we wanted to highlight just a couple, to give you an idea of the kinds of materials she has put together for families with special needs.

“Navigating the Financial World  of the Family with Special Needs” is designed as a complete overview of the life journey for the family with special needs. It was developed to examine the unique process of providing and planning for the individual with special needs and the entire family. In the presentation, it is discussed how completing a comprehensive special need financial life plan will enable the family to be proactive in providing for the entire family’s financial future.

“Understanding SSI/Medicaid & SSDI/Medicare” revolves around understanding various government benefit programs such as SSI/Medicaid and SSDI/Medicare. Ms. Carney is certified as a Certified Work Incentive Coordinator (CWIC) which means she completed a 4 day intensive training and examination/analysis process of these government benefit programs. A CWIC is trained in benefit counseling to help families learn how to qualify and receive these valuable benefits for their family member with special needs.

Maedi works tirelessly to help families develop a long term life plan that includes planning for two generations; allocating funds for the parents (retirement, investments, home purchase planning, insurance etc), sibling’s educational and other needs, and providing for the child with special needs entire life.  She does this by creating a visual representation of the family’s assets, resources, and net worth and helps them to calculate what deficiencies they might have so she can assist in developing a game plan to address those deficiencies.

She also helps families to identify any supplemental expenses that may be needed for their child with special needs in the future. This allows for a life plan that enables their children to live independently or with the required assistance and supports identified.  These types of supplemental expenses might include things such as the cost of an independent living program, therapies, transportation, special diets, additional supports etc.  Her comprehensive approach walks parents through this discovery process to create a life plan that is specific to their needs.

She suggests that parents take care of the legal and financial aspects of planning simultaneously. However, sometimes it is important to focus on the legal first, such as the creation of the special needs trust, a revocable trust, a will, a durable power of attorney for financial and medical, advanced health directives and the HIPPA form. In addition, a serious look at their life insurance requirements is an absolutely essential element in developing a meaningful plan for a family. Lastly, the parents must complete a beneficiary review making sure assets are not left directly to the individual with special needs but to their special needs trust in order to not disqualify the child from government benefits.

Maedi also discussed the importance of creating the Letter of Intent for your child with special needs. This morally binding document communicates your desires and concerns for your special needs child to future (or current) caregiver(s). It includes what a will or trust cannot – the intangibles which are the parent’s wishes/vision for their child with special needs future. Essentially if something happens to the primary caregivers, this document is used for the future caregiver to step directly into the parent’s shoes.

When asked for her feedback on the unique challenges of the divorced parents of a child with special needs, she affirmed how critically important it is that continued communication between the estranged parents occurs to ensure their child with disabilities maintains access to much needed government benefit programs.  A lack of communication between divorced parents could put their child in the precarious position where they lose their benefits at the worst possible time – upon the death of one or both of their parents.

Maedi Tanham Carney’s website www.specialneedsplanning.net is a treasure trove of useful and practical information and resources and I highly recommend you take some time to visit.

Written by Keith Caldwell of Failure to Plan and edited by M&L Special Needs Planning, LLC.

Brace yourselves, parents – summer vacation is coming! In just a few short months June will be here and, before you know it, your house will be full of children anxious to celebrate their two, golden months of freedom.

For many parents, these two months represent a lot of additional work – summer vacation brings with it worries regarding organizing child care, summer camps, and daily activities for their children. For parents of children with special needs, these worries are amplified. Many children with special needs are often anxious regarding change, and require stability and structure in their daily routine in order to thrive. Additionally, it is important to ensure that children with special needs don’t lose valuable skills they acquired throughout the year during the natural educational regression that children experience while away from school.

So, how do families with special needs cope with these increased worries and demands during the summer period? We feel the solution is, of course, proper planning! Here at M&L Special Needs Planning, we approach summer vacation the same way every year– with a white board calendar, a number of different colored dry erase markers, and a list of important dates. These dates can include vacation days for you and your partner, statutory holidays, family commitments, etc. Using one color for each family member, pencil in this information on your calendar. If a family vacation comprises a large part of the summer plans for you and your children, our blog Vacation Tips for Families with Special Needs  offers as few suggestions as to how to plan a great family vacation.

Now that you have a visual of the summer schedule for your family, you can begin planning your children’s activities in earnest. For many parents, summer camp (either a day camp or a sleep away camp) is the obvious option. If a summer camp seems like the best option for your child with special needs, check out the Family Village website – it is a great resource of special needs camps in the United States. The website includes a brief description of each camp and a link to each camp’s individual website. Another great resource is Camppage.com – this site offers search options depending on the gender, age and interests of your child. Getting recommendations from local special needs organizations, parents of your child’s classmates, or your child’s school are also a great ways to find special needs summer camps – and if those giving the recommendation are familiar with your child’s needs and interests, so much the better.

For camps that aren’t specifically designed for children with special needs, your local Parks and Recreation Department is a good place to start looking – a quick Google search should reveal the websites for the various Parks and Recreation Departments in your state and town. Please click here to see a listing for Maryland.  As well, country clubs, schools, and universities in the area may offer great summer day programs. If you do decide to opt for a mainstream camp, it is a good idea to research the facilities and staff of the camps being considered, to ensure that the camp you choose is a good fit for the needs of your child. Shawna Ackerman has put together a great list of considerations and questions to ask yourself, and the camp, in regards to their ability to care for your special needs child. Click here to access the checklist that she has put together.  If you are not sure whether to send your child to a camp for children with special needs or not, check out this article on About.com, which outlines the pros and cons of a camp for special needs.

For some families, a camp may not be the best option. If your child thrives on stability and security, live in or drop in child care providers may be a better option for you. If this is the case, you may wish to research daily activities that your child care provider can bring your child to. Again, the local Parks and Recreation Department is a great resource, as well as local swimming pools, country clubs, YMCAs, and child care facilities. As well, check with your local library. They may offer summer reading and socialization programs designed to keep children reading during the break and if not, a trip to the library on a rainy afternoon is an excellent way for your child to continue developing literacy and socialization skills.

The best possible schedule for your summer will probably be a combination of camp, daily activities, family vacation, and live in or drop in child care. Ensure that your child with special needs is aware of the schedule for the summer – discussing plans, researching camps and activities with your child and enlisting your child’s help in planning his or her summer can help to alleviate anxiety about the transition from the school environment.

Quick Ideas for Summer Planning

• Contact your child’s school for recommendations on summer activities; some schools for special education offer their own summer camp programs or summer sessions.
• Speak to parents of your child’s classmates regarding their summer plans. Signing your child up for a summer camp or activity that a classmate is attending may give them a feeling of stability, and lessen anxiety.
• Suggest scheduling play dates with your children’s classmates during a time of the summer when you child won’t be occupied with camp or other activities. Play dates can help your child socialize and retain ties with classmates, with the added benefit of sharing childcare among parents
• Contact the special education department of a local university or college; students may wish to obtain employment during the summer months, and their education and experience will benefit your child and your family.
• Check with your child’s doctor, therapist, or the members of any organizations for special needs that your or your family is familiar with. They may be aware of a great program that would suit the interests of your child, or be able to recommend a child care provider who has experience working with children with special needs.

If you have any suggestions or questions on planning a summer schedule, or any other special needs planning topic, don’t hesitate to drop us a line! You may also wish to check out our services page, or look for any free workshops we have scheduled to take place over the summer months. We are always looking for new venues to present our workshops, so if you are interested in having us deliver a workshop in your area, let us know – we love meeting new people, and we are willing to travel.

Thanks to all of you for taking the time from your busy schedule to read our blog today; hopefully we have provided you with some good ideas, and a plan of action for organizing your family’s summer schedule. Have a great weekend!

It is no secret that many families with special needs bear large financial burdens. The cost of therapy, medicines, medical devices, and specialized medical equipment can place a strain on a family’s financial situation, which can in turn lead to stress and anxiety. A fail-safe way to reduce this financial strain is to ensure that you are taking advantage of all of the available tax deductions and credits available to families with special needs. As the deadline for filing personal tax returns in the United States is less than three weeks away – April 15^th, 2013 – the staff at M&L Special Needs Planning decided to put together a list of tax tips for families with special needs in the hope that we can help you ease this year’s tax burden.

Note: The staff of M&L Special Needs Planning are not tax professionals. This blog is intended for information purposes only.

Deducting Medical Expenses

The high costs associated with medical appointments, therapies, medicines, and specialized medical equipment may come in handy for this year’s tax return. For 2012, a taxpayer can claim medical expenses as a deduction if the total of the expenses exceed 7.5% of the taxpayer’s AGI (Adjusted Gross Income). The term “medical expenses” is used to define a wide variety of different costs incurred as a result of a medical condition. Under Tax Topic 502 on the IRS website, medical expenses are described as including “payments for the diagnosis, cure, mitigation, treatment, or prevention of disease, or payments for treatments affecting any structure or function of the body.” These expenses include things such as fees to medical professionals, prescribed medications,  fees for in house treatments at qualifying facilities (for example, nursing home fees), hospital fees, eye glasses, dental expenses, etc. In some cases, transportation and expenses related to essential medical appointments or conferences relevant to the medical condition are also deductible. For a full listing of the expenses which qualify, please click here.

In certain cases, costs incurred though securing special education for children with special needs may also qualify as a medical expense. The IRS states “you can include in medical expenses fees you pay on a doctor’s recommendation for a child’s tutoring by a teacher who is specially trained and qualified to work with children who have learning disabilities caused by mental or physical impairments, including nervous system disorders.” This regulation also states that tuition, meals, and lodging expenses associated with attending a special education school can be included under medical expenses. The key phrase to recognize from this regulation is that a doctor must recommend that the child attend this school. Also, as the IRS states, “overcoming the learning disabilities must be a principle reason for attending the school, and any ordinary education received must be incidental to the special education provided.” In other words, to use an example also provided by the IRS, if your child attends a school to learn braille, or lip reading, as well as the other school subjects, then the expenses associated with the school qualify. If your child has dyslexia, and attends a school with a smaller student-to-teacher ratio simply for the overall improvement in the quality of education, then the costs associated with attending that school do not qualify. If you have any questions regarding whether or not the school your child is attending qualifies, then contact that school directly. To see this regulation on the IRS website, please click here.

Another deduction that may be of particular interest to parents of children with special needs is related to food. According to the IRS, the cost of specialized food recommended by a doctor (i.e. a gluten free diet) may be used as a deduction – it has to be medically relevant, and only the cost of the specialized food over and above the cost of similar items is deductible. For example, if the cost of gluten free muffins is $10, and the cost of other muffins is $5.00, then only $5.00 can be used as a deduction.  You can see this rule here. Although the information falls under the heading of weight loss, the regulation states that certain foods can qualify as a medical expense if they alleviate or treat an illness, or the need for the food is substantiated by a physician.

Credits

Finding an eligible tax deduction is always great, but finding a tax credit you are eligible for is undeniably better. While deductions reduce the amount of income that is subject to tax, a credit will reduce the amount of income tax you may have to pay. For this reason, we draw your attention to two tax credits which may be of particular important to families with special needs: the Dependent Child Care Credit, and the Earned Income Credit.

The Child and Dependent Care Credit is intended to offset the costs of childcare for those working, or looking for work. This credit may be applied when you pay fees associated with child care for your dependents. These fees can include day care, day camp, afterschool care, etc. Qualifying tax payers can receive up to $3000 per dependent, but the credit limit is $6000 for all dependents. The dependent must be either under the age of 13, or be a spouse or dependent that is unable to care for him or herself. Children with special needs are not subject to the age limit. For more information on the Child and Dependent Care Credit, please visit the IRS website.

The Earned Income Tax Credit is a benefit for those who work and have a low to moderate income. This credit can also be claimed on your tax return if you have a qualifying child. Qualifying children must be under the age of 19, or under the age of 24 if attending an educational institution full-time, or be permanently disabled (there is no age limit if the child has a disability). For more information on the Earned Income Tax Credit, please visit the IRS’ Earned Income Tax Credit information page. Also available on the IRS website is a tool which will help you determine if you qualify, and if so the amount of the credit that you will receive. Please click here to use this tool.

If you already have your return for 2012 filed, (lucky you), please keep in mind these important changes for 2013 tax returns:

• A 0.9% tax hike for high wage earners ( more than $200,000/year single, or $250,000 for a couple)
• New 2.3% Medical Device Tax
• Medical expenses need to add up to 10% if Americans want to claim a deduction; that amount has risen from  7.5% in 2012
• Flexible Spending Account (FSA) change – previously uncapped, as of 2013 the FSA contributions are now limited to $2500 per year.

For more information about these changes, please refer to a blog we published titled Obamacare Update: Changes to Expect in 2013.

Thanks to all of you who took the time to read this blog today. We hope that you found it informative and helpful. If you have any questions, comments, or suggestions regarding this blog, or any other topic related to special needs financial planning, don’t hesitate to send us an email, leave a comment, or give us a call! From all of us to all of you, happy tax time!