An educational seminar provided by: An Overview of Special Needs Settlement Planning A presentation for the Academy of Special Needs Planners Hall Rd., Suite 470 ▪ Sterling Heights, MI Phone: ▪ Fax:
Helps recipients of settlement proceeds: Achieve their post-loss goals Transition successfully into their post-settlement financial lives Assist litigators to finalize settlements What Is Settlement Planning?
Settlement Planning Working with litigators to: Set Client Expectations Preparing Motions & Orders Settlement approval MSPA Issues Appear as GAL Probate issues Guardiansh ips Conservato rships Protectiv e Orders Decedent Estates Settlements Trusts
Settlement Planning Working with the settlement team to execute a plan that includes: Lien Resolution / Repayment Special Needs Planning Coordinati on of Benefits Estate Planning Financial Planning Tax Planning
Why Special Needs Planning? Planning for the future finances, care, advocacy, and protection for a person with a disability Issues that generally arise concern: Lifetime financial and personal care Understanding what public benefits used to meet current and future care needs Maintaining the ongoing care Addressing unmet needs Medical Personal
Work With a Settlement Planning Team No single professional can address all of the issues At a minimum, the following experts should be consulted: Special Needs/Estate Planning Attorney Financial Lien Resolution Attorney Structured Settlement Broker Medicare Set-Aside Specialist Certified Public Accountant or Enrolled Agent Financial Planner Other (Life Care Planner / Case Manager)
Working as a Team Provides a very real and long lasting benefit for Plaintiffs Start Working Together Early Sets Appropriate Expectations for Plaintiffs Saves Time for all Professionals Credibility for Plaintiff’s Attorney Better Overall Service Financial, Tax, and Legal professionals working together can provide a comprehensive plan Avoids mistakes
When to Involve Special-Needs Settlement Planning Professionals Date of Loss / Injury Retain Lawyer / File Suit Trial/Arbitration/Settlement Resolution Possible Qualified Settlement Fund Lien Resolution Distribution to Client Best Practice Typical
What If The Individual Isn’t Disabled BUT Receives Public Benefits? As this group expands, this will become more of an issue Special Needs Planners will need to become more adept or coordinate with Elder Law Planners There are planning options available Spend-down Trusts Annuities Gifting Promissory notes All of the above
Do All Persons with Disabilities Require Special Planning? Only those individuals who meet the definition of disability for public benefit programs require planning SSI & Medicaid NOT SSDI & Medicare
Who Requires Settlement Planning? Minors Adults who lack capacity Adults with disabilities Only those who meet the definition of disability for public benefit programs require special needs planning Plaintiffs receiving public benefits Only certain public benefit programs require planning
Can Other Plaintiffs Be Helped With Settlement Planning Even those persons who may not require settlement planning can benefit: Adults with little to no experience in financial management Spendthrifts Elderly - over age 65 may need “elder law” planning Everyone should have a complete estate plan
Why Public Benefits for Persons With Disability Planning is Needed Litigation recovery paid directly to an individual would eliminate eligibility for SSI and Medicaid Counted as income in month of receipt Counted as resource first day of next month Medicare-Set-Aside Accounts are Countable Assets Loss of Medicaid can be devastating Generally the only source of medical and community services available to the disabled Individual
Facts Needed By Attorney To Do Special Needs Planning Type of Public Benefits? Type of Disability? Age of Person with a Disability? Legal Capacity? Parent or Grandparent Alive, Well, and Willing to Help? Amount of Assets At Issue? Living Situation Ability to Work
Public Benefit Programs for Persons with Disabilities Needs-Based Public Benefits: Supplemental Security Income (SSI) Medicaid Entitlement Public Benefits: Social Security Disability Income (SSDI) Social Security – Adult Disabled Survivor Medicare Other benefit programs Section 8 Veteran Benefits Food Stamps General Assistance Waiver Services
If only public benefit programs are SSDI, Social Security, or Medicare No special needs planning is required. Although, it may still be helpful to plan in some circumstances However, watch out for dual eligibility, meaning that person with a disability receives both SSDI and SSI or Medicare and Medicaid There is often lots of confusion from the person with a disability and their families as to what types of benefits the person receives so important to investigate
Special Needs Trusts Basic Planning Tools
Guardianships Conservatorships Protective Order / One-time Conservatorships Structured Settlements Decedent Estates
First-Party Special Needs Trusts Special Needs Trusts (SNT) are the only planning tool that allows an individual to preserve litigation proceeds AND to preserve eligibility for needs-based public benefits First-Party SNTs are: (d)(4)(A) SNT (a/k/a Litigation or Payback SNT) (d)(4)(C) SNT (a/k/a Pooled Trust)
(d)(4)(A) Special Needs Trust Authorized by 42 U.S.C. §1396p(d)(4)(A) and has the following characteristics: Must be Irrevocable Must be established by parent, grandparent, legal guardian, or court Must be for the sole benefit of a person with a disability who is under the age of 65 Must provide that on the death of the beneficiary, the trustee must repay Medicaid for all benefits received by the beneficiary during his or her lifetime to the extent that funds remain in the trust at the beneficiary's death.
PRO’s (d)(4)(A) Special Needs Trust Control Choice of Trustee Choice of Investment Options Integrates well with structured settlements Integrates well with a MSA account Family has an opportunity to inherit More easily accepting of non-liquid assets
CON’s (d)(4)(A) Special Needs Trust Limited to under age 65 Control Choice of Trustee may be inappropriate Investments could be too aggressive; result in a loss of principal Cannot be executed by an individual with capacity Often results in Probate Court involvement to establish trust and possible court supervision; bond Very costly to maintain; No cap on fees Family can inherit Often over-used: small amount of funding Poor drafting or administration Practice Tip! Appoint a Trust Protector Appoint a profession as Trust Protector if a family member is Trustee Appoint a family member as Trust Protector if a professional is Trustee
(d)(4)(A) Special Needs Trust Change in Social Security’s Program Operations Manual System (POMS) Early termination clause Upon early termination (i.e., termination prior to the death of the beneficiary), the State(s), as primary assignee, would receive all amounts remaining in the trust at the time of termination up to an amount equal to the total amount of medical assistance paid on behalf of the individual under the State Medicaid plan(s) Other than payment for those expenses listed in SI F.3. in this section, no entity other than the trust beneficiary may benefit from the early termination
(d)(4)(C) Special Needs Trust Authorized by 42 U.S.C. §1396p(d)(4)(C) and has the following characteristics: Irrevocable Established and managed by a non-profit association. Separate account is maintained for each beneficiary; pooled for purposes of investment and management Established by the individual, parent, grandparent, legal guardian, or by a court. Residual funds after death are retained by the trust or repaid to the State for medical assistance paid on behalf of the beneficiary.
PRO’s (d)(4)(C) Pooled Trust Can be executed by an individual with capacity No Court supervision required Professional Administration Additional advocacy and resources Often fees are capped Perfect for small settlements Integrates well with structured settlements Flexible in a variety of situations Choice of paying back state or leaving to charity Easier and lower cost to establish
CON’s (d)(4)(C) Pooled Trust Client has lack of control if administration is poor or relationship breaks down Fees Percentage Hourly Flat Investment information may not be accessible Not always accepting of non-liquid assets; depend on the Trustee Practice Tip! Ask for a Trust Protector Appoint a family member as Trust Protector with the authority to change the Trustee
What Can a SNT Pay For? Special Needs Trusts can pay for expenses NOT covered by governmental benefit programs: Clothing Telephone, Internet, Cable Furniture, Audio/Video/Computer Equipment Periodic outings and vacations Pre-need funeral and burial expenses Taxes
What Can’t a SNT Pay For? A SNT CANNOT give cash directly to Beneficiary (this includes gift cards) If SNT pays for food, shelter or medical care already being provided by SSI or Medicaid it will reduce (or eliminate) public benefits. Shelter is defined as food, gas, electricity, water, sewer, heating fuel, garbage removal, real estate taxes, rent or mortgage
Special Needs Settlement Planning Advanced Tools and Skills QSF MSA SPT Qualified Settlement Fund Medicare Set-Aside Settlement Preservation Trust
Advanced Settlement Planning Utilizing Qualified Settlement Funds (QSF) Can be formed by either side (plaintiff or defense) Allows for immediate payment of settlement or judgment proceeds by defendant Preserves all options for the injury victim(s) and other claimants without defense involvement Multiple claimants can resolve their respective damages Lien resolution Medicare-Set-Aside allocations Structured settlements Special Needs Trusts Settlement Preservation Trusts
Advanced Settlement Planning MSA and Liability Cases No CMS guidance Duty to protect Medicare’s future interests No double-dipping Drafting Motions and Orders in relation to MSPA Consulting for PI attorney and Structure Brokers
MSA / SNT Planning Encourage proper allocation of liability settlements Non-Economic Damages = Pain and Suffering Economic Damages Wages Attendant care Conditional medical payments Future medical Allocate between Medicare vs. Non-Medicare MSA to receive future Medicare injury related medical expenses Structures Practice Tip! MSA’s are COUNTABLE assets for Medicaid eligibility
MSA / SNT Planning
Alternatives in Special Needs Planning Alternative Tools: VA Trusts Settlement Preservation Trust Elder Law
Alternatives to Special Needs Trusts Veterans Affairs Aid & Attendance Different eligibility requirements than Medicaid Medical Financial Available to a surviving spouse and dependents; including step-children Caveat: Must be certified by VA
Alternatives to Special Needs Trusts Adults Settlement Preservation Trusts Purely discretionary; helps in the following situations: Chronic or pending divorce Job loss / Unemployment “Lottery” effect Future eligibility = Reform Flexible drafting Not to be used to defraud creditors
Settlement for the Elderly Traditional Elder Law Tools MAPT Annuities Gifting Pooled Trust? Estate Planning
Settlements for Minors Small Settlement = Structures Drip vs. Lump Sum Avoids fees and cost of Probate Court Helps protect the minor’s funds Static Beware of back- loading It’s my money and I want it NOW!
Settlements for Minors Large Settlement = Settlement Preservation Trust May be utilized if disability is uncertain Allows for maturity Decreases “Lottery” effect Varies by jurisdiction; state by state; county by county Prevents claims by future creditors/spouses
Conclusion Working with persons with disabilities very satisfying and rewarding Preserving public benefits; Providing lifetime financial support by purchasing items and services that make life more rewarding; Providing a system of advocacy to preserve civil rights; Establishing an efficient, knowledgeable, and long- term management team; Providing a safe and clean living arrangement; and Providing avenues for enjoying all social and recreational activities that enhance the quality of life
An educational seminar provided by: Thank You A presentation for the Academy of Special Needs Planners Hall Rd., Suite 470 ▪ Sterling Heights, MI Phone: ▪ Fax: