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A Special Needs Trust (SNT), or supplemental needs trust, is a legal vehicle enabling assets to be held on behalf of someone with disabilities without affecting their eligibility for means-tested benefits. Assets held by the trust are not considered a “resource” when qualifying for the type of government benefits that are restricted to people with “resources” below a certain level, such as Social Security Income (SSI) and Medicaid. An SNT provides for the maintenance of an individual with disabilities, by supplementing, rather than replacing, government benefits. A beneficiary will keep government benefits and still be able to access their Special Needs Trust. Most beneficiaries of a Special Needs Trust are eligible for, or seeking eligibility for, Supplemental Security Income (SSI) payments. In many states, receipt of SSI payments automatically qualifies one for Medicaid. Many other government programs explicitly rely on SSI eligibility rules.

In determining SSI eligibility, a single person cannot have more than $2000 in available assets to qualify for SSI. Some types of assets are not counted when determining eligibility. Examples of “non-countable” assets include a beneficiary’s home, one automobile, household furnishings, prepaid burial amounts up to $1500 set aside for funeral expenses, or life insurance in that amount.

For Special Needs Trusts, the term “disability” refers to the standard used to determine eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits: the inability to perform any substantial, gainful employment. “Incapacity” of a beneficiary is important to consider as well. Not every disability will result in an incapacity finding, and it is possible for a Special Needs Trust beneficiary to be disabled, but not incapacitated. Special Needs Trusts are Irrevocable, whereas no one has reserved the power to revoke the trust.

A First Party Special Needs Trust, or self-settled Special Needs Trust, is created with assets that belong to an individual with disabilities. Examples of funds in a First Party Special Needs Trust include a personal injury settlement or unplanned inheritance. A person creating a First Party Special Needs Trust must be under age 65 at the time that the trust is established. Funds remaining in a First Party Trust are subject to a Medicaid payback. Upon the death of the beneficiary, funds remaining in the trust must first be used to reimburse Medicaid for services to that individual, paid by Medicaid, before any remaining funds can be distributed to anyone else.

A Third-Party Special Needs Trust is created with assets from a donor. Examples of a donor are parents, grandparents, other relatives, or friends of the beneficiary. A Third-Party Special Needs Trust is often used to hold an inheritance or gift. A Third-Party Special Needs Trust does not have a Medicaid payback. Upon the death of the beneficiary, there is no requirement to use residual funds to reimburse Medicaid for services provided to the individual. The donor of the funds may designate how remainder funds are to be allocated.

A Pooled Special Needs Trust is a good option for small estates or in instances where it is difficult to identify a trustee. Unlike PLAN of MA & RI, many financial institutions do not handle small Special Needs Trusts and charge fees that are not cost-effective for small trusts. A Pooled SNT is an option to give families access to highly skilled trustees. Under OBRA-93 regulations, Pooled Trusts or (d)(4)(c) were established and are required to be administered by a non-profit 501(c)3. The non-profit develops a Master Trust which serves as an “umbrella” trust document for every beneficiary who enrolls by signing and executing a Joinder Agreement. Every beneficiary in a Pooled SNT has their own sub account. Funds are “pooled” for investment purposes only. Pooled SNT’s can be either First Party or Third Party.

Future Funded Special Needs Trusts are usually funded by a donor’s Estate.

There are Government Benefits Programs that are available to assist individuals with special needs. These programs vary from state to state. Some of the major programs are:

Medicaid provides basic medical care to low-income individuals. Most states also have “waiver” Medicaid programs covering residential, day care, career, and other services.

Supplemental Security Income (SSI) provides funds for food and shelter to individuals with disabilities. To qualify, a person must have less than $2,000 in “countable assets.”

Social Security Disability Insurance (SSDI) requires that participants have been unable to work for at least a year due to their disability. Benefits are based on the individual’s income history and the number of quarters they have worked and contributed to the program.

Disabled Adult Child (DAC) requires a determination that the onset of the participant’s disability
occurred before age 22, that the person is unmarried, and that the participant has a parent who has a disability, is retired, or deceased and who qualifies for Social Security himself/herself.

Supplemental Nutrition Assistance Program (SNAP/Food Stamps) has eligibility guidelines similar to SSI.

Special Needs Trusts (SNTs) have traditionally been used to accumulate resources without affecting eligibility for benefits. The Federal government empowered states with ABLE accounts, a savings tool that also enables individuals and their families to set aside funds without endangering important benefits. ABLE accounts are limited to the amount that can be deposited into them annually and benefits can be suspended upon reaching a certain dollar amount. Special Needs Trusts do not have limits of deposit. ABLE accounts are subject to a Medicaid Clawback Provision and IRS Regulations.
Special Needs Trusts can be used to fund ABLE accounts, which allows them to work well together.

The Planned Lifetime Assistance Network of Massachusetts and Rhode Island, Inc. (PLAN) is a non-
profit, professional trustee organization proudly serving people with all types of disabilities-whether
due to illness, injuries, or age. For the past 52 years, our team of licensed social workers, attorneys, and investment experts have helped people with significant challenges make effective use of the financial resources available to them in-order to maintain a comfortable, healthy, and fulfilling life. Feel free to reach out to us anytime.

MA: 617-244-5552 RI: 401-234-8444

www.planofma-ri.org

An image of the LGBTQIA+ Progress Pride Flag

Caregiving can be a challenging, but rewarding process. When it comes to older LGBTQIA+ adults, there are several ways to become a better ally and meet the unique needs of the community:

1. Educate yourself.

Older LGBTQIA+ adults have all been impacted by events including the AIDS epidemic and rise of the LGBTQIA+ rights movement. Spending time learning about such things can give a better understanding about the experiences of LGBTQIA+ elders. There are also many trainings and resources available to learn about different gender and sexual identities as they relate to older adults. Although LGBTQIA+ elders can provide information about their identity, it’s important for you to take learning into your own hands. Relying on the LGBTQIA+ elder you are caring for to educate you on the issues can feel burdensome and frustrating for them. Find reliable sources from reputable organizations that are well versed in LGBTQIA+ topics.

2. Find LGBTQIA+-affirming providers.

It is crucial to find health providers who understand and know how to treat LGBTQIA+ community members, especially elders. There can be a lot of anxiety with this process due to things like previous negative experiences and lack of support from trained providers. As a caregiver, becoming an advocate for the LGBTQIA+ elder in your life means assisting with navigating this search. Resources like the LGBT Resource Guide from the Worcester LGBT Elder Network can be a great place to start. You can also contact your local Agency on Aging for additional paths to take. The GLMA Provider Directory and HRC Healthcare Equality Index can also offer insight on providers knowledgeable about health and LGBTQIA+ older adults.

3. Take time to listen.

Empathy and understanding play key roles in making older adults feel supported, especially those who identify as LGBTQIA+. There can be a lot of things for an older adult to unpack as they navigate their identity and aging. Actively listening to stories and concerns from LGBTQIA+ elders is a great way to know how you can best support their journey. It’s extremely important, however, to respect the conversations you have with who you are caring for. Some people may not feel comfortable coming out publicly or discussing past traumas. Be mindful of this as you care for LGBTQIA+ older adults.

4. Help find ways to connect with the local LGBTQIA+ community.

Social isolation is at an all-time high with the COVID-19 pandemic, especially among older LGBTQIA+ adults. Lack of in person support and interaction can negatively impact a person’s well-being. Luckily, many organizations are working on creative ways to help LGBTQIA+ elders reconnect. Local community groups, like the Worcester LGBT Elder Network and 508 Pride, as well as larger organizations like SAGE are excellent places to start. Additionally, in-person Pride celebrations and gatherings are beginning to re-emerge, creating opportunities for LGBTQIA+ elders to have a sense of community.

There are many factors that go into caring for an LGBTQIA+ elder, but you are not alone. Continuing to increase your understanding of the LGBTQIA+ community is essential to providing the care our older communities need!

Sources:
HIV.gov
American Psychological Association
American Medical Association
Movement Advancement Project
Worcester LGBT Elder Network
SAGEUSA

1. Learn about its history.
   Older Americans Month began in 1963 when the National Council of Senior Citizens met with John F. Kennedy. They advocated for the needs of older adults, which led to the month of May being designated as “Senior Citizens Month.” The name was ultimately changed to Older Americans Month.Every May, the Administration for Community Living encourages others to honor and acknowledge the contributions of older adults in the United States. It is a time to recognize and support the diverse aging populations of our communities. The theme for 2021 is “Communities of Strength.”
2. Connect with an older adult in your community.
   Senior isolation has been at an all-time high with the challenges and restrictions of the COVID-19 pandemic. As communities, we can work to combat this. There are many ways to safely interact with older adults including phone calls, letters, emails, smaller gatherings. Everyone’s communication style is different, but we all need connection.
3. Volunteer.Want to give back? Find a local community organization, council on aging, or assisted living facility and see if there are any opportunities to volunteer. Spend your time supporting your neighbors. It makes our communities stronger when people help each other.
4. Watch Eldercare 2021.If you’re looking to educate yourself further on issues impacting older adults, check out Eldercare 2021, presented by CMAA and the Worcester County Sheriff’s Office. Eldercare 2021 is a virtual broadcast event which features presentations on topics ranging from elder law to senior mental health. It also has a collection of local resources to help you find answers and information. Click here to watch the program on Youtube.
5. Help Worcester become Age-Friendly.We are partnering with local organizations, businesses, and community members to make Worcester a safe, inclusive place for all populations, particularly older adults. Our goal is to have Worcester become officially recognized as an Age-Friendly Community. The Age-Friendly Worcester Initiative focuses on improving things like access to housing, support for caregivers, community engagement, social inclusion, and transportation. We’re looking for community members and organizations who are interested in these efforts, including you! For more information or to get involved, email Ethan Belding at ebelding@seniorconnection.org.

No matter what you do, May is a time to honor and recognize the accomplishments and contributions older adults across the country. To learn more about Older Americans Month, visit the ACL website.