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									The State of Special Needs Planning:
How to Expand Your Practice in 2008

      Academy of Special Needs Planners
                Presented by
        Vincent J. Russo, Co-Founder
Incorporating Special Needs in
    an Elder Law Practice
              The “Need”
 Improvements in Medicine and Medical
  – Increasing survival rate
  – People with special needs are living longer
 Better Diagnosis
  – Autism
           The “Awareness”
 “Out of the House / Out of the Institution”
 Organizations providing Advocacy and
 Communities respond
 My personal experience with my daughter,
         The Beginnings of
       Special Needs Planning
 The Americans With Disabilities Act of
 1990 (ADA)
  – Civil Rights law that prohibits discrimination
    based on disability Similar protections as the
    Civil Rights Act of 1964
 OBRA 1993 - Medicaid
  – Exempt Transfers
  – Exempt Trusts
          The Beginnings of
        Special Needs Planning
 Arkansas Dept of Health and Human Services v.
  Ahlborn, 126 S. Ct. 1752 (U.S. 2006)
  – Limits the Medicaid Recovery only to that portion of
    proceeds allocated for medical expenses
  – No recovery for pain and suffering
 Right to die matters involving young adults
  – Karen Quinlan - age 21 pvs, died age 31
  – Nancy Cruzan - accident 26, died age 33
  – Terry Schiavo - incident 27, died age 41
           The Evolution of
        Special Needs Planning
 Types of Issues Involved Medical
 Malpractice Settlement for a child
  – Parents planning for a child who is developmentally
 New Field of Law
  – Lawyers USA
  – Better medical diagnosis, advances in medicine,
    changes in the law
    Transition from Elder Law to
      Special Needs Planning
 Representing People with Care Needs
 Government Benefits
  – Medicaid and Medicare
 Estate Planning
  – Advance Directives
  – Wills and Trusts
 Decision Making
  – Guardianships
 Role of Special Needs Attorney

 Preserving your child’s financial security
  and quality of life
 Addressing key issues:
  – Understanding the role of public benefits
  – Making decisions about the future
  – Using estate planning/trusts to protect assets
Public Benefits at a Glance:
Supplemental Security Income (SSI)
 – Means tested: Limited income and assets

        Social Security (SS)
Social Security Disability Insurance
   – Not means tested but subject to work
        credits or parents’ eligibility
Public Benefits at a Glance:
     Medical Coverage
          – Automatic with SSI

      – Must Apply for SS/SSDI

      –   After two years of SSDI
  Supplemental Security Income

 Must meet SSA’s definition of “disability”
  and have limited assets/income
 Provides monthly income for food/shelter
 Gateway to Medicaid / in-home support
Social Security (SS) / Social Security
    Disability Insurance (SSDI)
 Social Security for individuals:
  – Disabled before age 22 and
  – With parents eligible based on their work record who
    are retired, disabled or deceased
 SSDI for individuals with work record
 Social Security benefits may reduce or
  eliminate SSI benefits
  Medical Assistance & Support

 Medicaid:
  – SSI recipients receive automatically
  – Covers “medically necessary” services, equipment,
  – In-home services needed to live at home: personal
    care, housekeeping, cooking, transportation to
 Medicare:
  – Medical coverage, including doctors, hospital, skilled
How Benefits Work Together

 SSI    Pathway   Medicaid

SSDI    Pathway   Medicare
How to Have a Successful
 Special Needs Practice
         Being Successful:
      Expanding Your Practice
 Government benefit planning
 Trust planning and administration
 Tax planning
 Guardianships
 Fiduciary Services
  Being Successful: Branding
 Branding of Law Firm in the Community
  – Families
  – Special Needs Organizations
  – Professional Community
 Steps towards Branding
  – Seminars, Articles, Newsletters / E-Blasts
  – Website
  – Involvement in Special Needs Organizations
           Being Successful:
  Talking the Talk, Walking the Walk
 Understanding the Client’s Needs
 Knowledge and Experience
 Training of Attorneys and Staff
     – Continuing Legal Education
     – In Person conferences
     – Telephonic conferences
     – Participating in ListServs
   “Doing Well by Doing Good”
 Creating a niche in the community
 “Supercharging” the benefit to families
 Feeling good about the practice of law
 Making your practice financially rewarding
 Giving back to the community
 Networking With Professionals
 Financial Planners
 Insurance Agents
 Doctors, Social Workers, Care Managers
 Personal Injury and Medical Malpractice
 Networking With Professionals
 Seminars
  – Professional
  – Consumer
 Being a Resource
 Publishing Articles
 Joining Networking Groups
 Participating in Community Service
ASNP: Making A Difference
         ASNP: Who Are We
 First Open Membership Attorney
  Organization focusing on special needs
  with 200 members
 Co-Founders
  – Harry Margolis, Vincent J. Russo and Diedre
 Advisory Board
  – Michael Gilfix, A. Frank Johns, Patti Dudek,
    Bill Browning, Ira Wiesner, Tim Nay
            ASNP: Mission
 Support Attorneys providing services
 Provide information and resources to
  people with disabilities and their families
 Connecting consumers -with special
  needs attorneys and providing information
 Working closely with the Providers of
  Services to the Special Needs Community
      ASNP: Member Driven
 Our goal to make information accessible
 and convenient to our members
  – Reliable resource - being on the cutting edge
  – Leverage the best technology - content and
    info – utilizing the website and listservs
           ASNP - Services
 Consumer Reference Materials
 Information
   – Cases in database, knowledge bank
 Education
  – Monthly telephone conference calls
  – Annual meeting
  – Ask program
              ASNP - Services
 List Serv
 Tools for Practice Development
  – E Newsletter
  – E client letter
  – Workshops
 Access to the Community
  – Consumer website
           ASNP - Programs
 Annual Conference
  – March 27 – 29, 2008
 ASK Program
  – October 16, 2008
 Monthly Teleconferences - upcoming
  – March 11th - (d)(4)(C) Pooled Trusts
  – April 8th - Insurance Needs within a Special
    Needs Practice: Long-Term Care Life
            ASNP: Join Us
 Opportunity to make a difference in lives of
  the people you serve
 Expand your estate planning and elder law
  practice by working with a community of
  professionals and extended family
 Seeking attorneys who really care and
  want to make a difference

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