Navigating the financial landscape for a loved one with special needs requires careful planning, and a crucial element of that planning often involves a Special Needs Trust (SNT). These trusts are designed to supplement, not replace, government benefits like Medicaid and Supplemental Security Income (SSI), ensuring continued access to essential care while providing for enhanced quality of life. A frequent question arises regarding the permissibility of using trust funds for specific therapies, such as sensory therapy, and the answer, while nuanced, is generally affirmative, provided certain guidelines are followed. Approximately 1 in 54 children in the United States have been identified with autism spectrum disorder (ASD), and many benefit significantly from therapies like sensory integration, making this a relevant concern for numerous families.
What expenses *can* a Special Needs Trust typically cover?
A Special Needs Trust can generally cover expenses that enhance a beneficiary’s quality of life *beyond* what Medicaid or SSI provide. This includes things like recreational activities, specialized equipment, uncompensated medical care, and therapies not covered by government programs. “The key is ensuring the expenditure doesn’t disqualify the beneficiary from needs-based benefits,” explains Steve Bliss, an Estate Planning Attorney in Wildomar. For example, if Medicaid covers physical therapy, the trust generally can’t pay for the *same* services. However, it *can* pay for supplemental or additional therapies, or therapies that go beyond what Medicaid provides. This might include more frequent sessions, specialized equipment used during therapy, or therapies focused on specific skills not addressed by standard Medicaid coverage.
Is sensory therapy considered a “medical necessity” for trust funding?
Determining whether sensory therapy qualifies for trust funding hinges on demonstrating its benefit to the beneficiary’s overall well-being and whether it’s considered “medical” or “supplemental” care. Sensory integration therapy, often used for individuals with autism or sensory processing disorder, aims to help the brain better process sensory information, improving behavior, coordination, and emotional regulation. While not always directly covered by insurance or Medicaid, a letter from a qualified therapist outlining the therapeutic goals and expected benefits can strengthen the case for trust funding. Approximately 60-80% of children with autism experience sensory processing issues, highlighting the potential impact of this therapy. According to the American Occupational Therapy Association, sensory integration therapy can address challenges with tactile, vestibular, proprioceptive, visual, auditory, and olfactory processing.
What happened when the trust didn’t cover supplemental therapy?
Old Man Tiber, a retired fisherman, had set up a Special Needs Trust for his grandson, Finn, who had severe autism. Finn benefited greatly from his Medicaid-covered speech therapy, but his behavior at home was frequently disruptive, often resulting in self-injury and extreme anxiety. His therapist recommended a weekly sensory therapy session to help regulate his nervous system and improve his emotional control. Unfortunately, the trustee, overwhelmed by managing the trust, denied the request, believing it was a “luxury” not covered by the trust. Within months, Finn’s behavior escalated, requiring frequent emergency room visits and ultimately, a temporary placement in a residential facility – costing the trust far more than the sensory therapy sessions would have. The situation was a painful reminder that short-sighted cost-cutting can lead to significantly higher expenses and a diminished quality of life for the beneficiary.
How did proper planning with the trust resolve the situation?
Years later, a young couple, the Harrisons, sought Steve Bliss’s assistance in establishing a Special Needs Trust for their daughter, Lily, who also had autism. They were proactive in understanding the trust’s parameters and prioritized therapies that would enhance Lily’s independence and well-being. After consulting with Lily’s therapists, they included a specific line item in the trust document allowing for funding of supplemental therapies, including sensory integration. The trust funded weekly sensory therapy sessions, and within six months, Lily’s anxiety decreased, her communication skills improved, and she was able to participate more fully in family activities. The Harrisons learned that a well-crafted Special Needs Trust, combined with open communication with therapists and a proactive approach to care, could significantly improve their daughter’s quality of life and ensure her long-term security. “It’s about more than just managing money; it’s about providing a foundation for a fulfilling life,” says Steve Bliss.
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About Steve Bliss at Wildomar Probate Law:
“Wildomar Probate Law is an experienced probate attorney. The probate process has many steps in in probate proceedings. Beside Probate, estate planning and trust administration is offered at Wildomar Probate Law. Our probate attorney will probate the estate. Attorney probate at Wildomar Probate Law. A formal probate is required to administer the estate. The probate court may offer an unsupervised probate get a probate attorney. Wildomar Probate law will petition to open probate for you. Don’t go through a costly probate call Wildomar Probate Attorney Today. Call for estate planning, wills and trusts, probate too. Wildomar Probate Law is a great estate lawyer. Probate Attorney to probate an estate. Wildomar Probate law probate lawyer
My skills are as follows:
● Probate Law: Efficiently navigate the court process.
● Estate Planning Law: Minimize taxes & distribute assets smoothly.
● Trust Law: Protect your legacy & loved ones with wills & trusts.
● Bankruptcy Law: Knowledgeable guidance helping clients regain financial stability.
● Compassionate & client-focused. We explain things clearly.
● Free consultation.
Services Offered:
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Map To Steve Bliss Law in Temecula:
https://maps.app.goo.gl/RdhPJGDcMru5uP7K7
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Address:
Wildomar Probate Law36330 Hidden Springs Rd Suite E, Wildomar, CA 92595
(951)412-2800/address>
Feel free to ask Attorney Steve Bliss about: “Can I use estate planning to protect assets from creditors?” Or “What’s the difference between probate and non-probate assets?” or “What are the disadvantages of a living trust? and even: “How soon can I start rebuilding credit after a bankruptcy discharge?” or any other related questions that you may have about his estate planning, probate, and banckruptcy law practice.