Planning for Your Special Needs Child with a Letter of Intent

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Give your family continuity and comfort by writing a letter of intent (LOI) for your special needs child. As a parent, the most valuable asset your child has is you and your ability to care for them. You, like no other, fully understand the nuances of your child’s coping mechanisms and what can trigger adverse outcomes. A letter of intent is meant to convey these broad personality traits as well as practical details of your child’s life so that in your absence, another family member or caretaker can make sound decisions about your child’s forward care. Don’t think a letter of intent is something to write when you get older. Parents of all ages with special needs children should have a letter of intent, review it annually, and update its contents if appropriate. Accidents and illness that may befall you are as prevalent a need to have a letter of intent as is your eventual death.

What is a Letter of Intent?

Though an LOI is not a legal document, it is one of the most important documents a parent can prepare for the future well-being of their special needs child. The letter plays a central role in your child’s special needs plan by putting your perspective on the details of their life. You can begin your letter by identifying the categories you want to address and then filling in details. There are templates of LOI available on the internet, and you might want to use one as a starting point for your letter if you feel overwhelmed and need some structure to begin.

The letter’s purpose is to guide a trustee, family member, or guardian tasked with the care of your dependent child. You will need to sort through feelings and expectations as well as noting people, places, and services that relate to your child. You may want to spend a week taking notes throughout your day as you interact with your child to think through some of the broader issues, documenting how you feel about your child and their future. The Special Needs Alliance has identified some excellent categories to include in your letter of intent. Each category can be found in the boldface type.

Letter of Intent: Family History

Outlining your family history is an excellent place to begin. When and where you were born and raised. If you are married, describe when and how you met. Include anecdotes about your grandparents, brothers and sisters, other relatives and special friends. Incorporate when and where your child was born and raised. List their siblings, and who was particularly special to them. Don’t overlook special family pets that may have a significant impact on your child. Recount fond memories, favorite times, and feelings about your child. Provide contact information for family members and friends. Follow the family history section with a general overview, summarizing your child’s life to the present and your thoughts and hopes about how you envision your child’s future.

Letter of Intent: Daily Schedule

Next, provide the details of your child’s daily schedule to give context to their caregiver. What are the best ways to communicate with your child and how to best manage their behaviors? Do they have hot button words that should be avoided? Who are your child’s teachers, aides, bus drivers, social service providers, or employers? Be as descriptive as possible about your child’s favorite activities and events and also include what your child doesn’t like. Some children love to rake leaves but get frustrated when tasked with folding the laundry, and these details are useful for future caregivers.

Letter of Intent: Assistant with Personal Care

Does your child require assistance with personal care? What size clothing do they wear? What are their personality traits? Do they participate in social activities? What upsets your child? What situations are best to avoid? How do you want a guardian to discuss your death or incapacity? These are some of the questions you can answer in your letter of intent. You can detail your child’s food likes and dislikes, including any allergies they may have. Did you make your child a special birthday cake? What are your traditional family holiday menus? Compile recipes or describe any specific way food should be prepared or served. Remember that some foods can affect the medications that your child may take.

Letter of Intent: Medical Care

Next, broach the topic of medical care. Include the detail of your child’s specific disability(s), medical history, and include the medical history of immediate family members. Name all medications your child takes and describe how they are administered and for what purpose they are given. Include any allergies your child may have. Provide a list of their current doctors, therapists, hospitals, and clinics. Include how often your child has medical and therapy appointments and describe the purposes of and goals for these sessions. List all of your child’s current health insurance information. If your child has medical records that can be retrieved online, provide the accounts username, password, and any other relevant data.

Letter of Intent: Education

If your child is still in school, describe their educational life. What have their experiences been, and what do you desire for their future education? Note what school your child attends and what schools would you like your child to attend in the future. Does the school provide specialized services to your child? Does your child participate in extracurricular activities? Address your wishes regarding the type of education you prefer they receive, such as vocational or academic. If there are specific programs or teachers, you want to be involved in your child’s overall life plan, name them, and provide contact information.

Letter of Intent: Employment

If your child is employed or you hope them to be in the future, describe how you envision their employment. What types of work and work environments would be beneficial to your child?

Letter of Intent: Government Benefits

List all government benefits your child receives. These benefits may include Medicaid, Medicare, Supplemental Security Income (SSI), Social Security Disability Insurance (SSDI), Supplemental Nutrition Assistance Program (SNAP, aka food stamps), and any housing assistance. Provide your child and both parents Social Security numbers. Give agency contact information, your child’s case numbers, and discuss the recertification process of each benefit. Include all reporting requirements and important dates so that benefits do not lapse. Provide copies of financial documents.

Letter of Intent: Residential & Social Environment

How do you imagine your child’s residential environment? Is it your plan for your child to remain with family, friends, or will there be an organization tasked with their living situation? If your child is unable to stay with the family, what is your hope for an alternative living environment? If they are placed in a group home, would you like it to be in your current community? Should the living arrangements be in a smaller or larger setting? Does your child want to live alone or have roommates?

What type of social environment does your child prefer? Do they enjoy sports, movies, or video games? Can your child be given spending money, and how have they fared handling cash in the past? Does your child travel to visit family or take vacations? With whom do they travel most successfully and happily? Include a description of your child’s religious environment. Does your child routinely attend services? What church, synagogue, or mosque do they frequent? What local clergy might know your family and your child?

What are your desires for your child’s final arrangements? Does your child have a will and any advance directives? Where are these legal documents? Have you planned for a funeral, burial or cremation, cemetery, gravestone, or religious service? Is there someone specific you prefer to officiate the ceremony?

As your letter of intent takes shape, you might realize there is other information you want to share to provide the best guidance to the person who will care for your child. In your annual review of your LOI, you may find some passages unnecessary as your child grows up. You may want to include new detail as your child’s personality develops. Think of it as a living document to be edited, added to, whatever you think will serve your child’s interests best. Put your letter of intent with your other relevant legal and personal documents. Writing a letter of intent can be a very emotional experience and a difficult document to write because you must think about how your child will live in the world without you, their parent. Approach this letter as a gift to your child and their future. You know your child better than anyone else. Even in your absence, you can still help to guide their future life, hopes, and dreams.

We help families create legal plans for loved ones with special needs. If you would like to discuss your particular needs, please don’t hesitate to reach out. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your special needs planning.

Telehealth Services Added to Medicare

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The Centers for Medicare & Medicaid Services (CMS) recently announced that it has increased access to Medicare telehealth services in response to the COVID-19 pandemic. This means that Medicare beneficiaries can receive more benefits from their doctors without having to travel to a healthcare facility.

The terms “telehealth” and “telemedicine” refer to the ability to exchange medical information from one site to another through electronic communication to improve a patient’s health.  With the rapid rise of COVID-19 cases, there is the urgency to expand the use of technology to help people who need routine care. Telehealth will keep vulnerable beneficiaries and those with mild symptoms in their home, but with access to the care they need by phone and video rather than requiring an office visit.

Prior to this change, Medicare would only pay for telehealth on a limited basis, and only for persons in a designated rural area. Now Medicare beneficiaries will be able to receive the following services through telehealth: common office visits, mental health counseling, and preventive health screenings. This will help keep more of the at-risk population (Medicare beneficiaries) able to visit with a doctor from home, rather than traveling to a doctor’s office or hospital which puts the beneficiary and others at risk. Telehealth visits will be treated the same as regular, in-person visits and will be paid by Medicare at the same rates.

These changes go into effect for services starting March 6, 2020, and will continue for the duration of the COVID-19 Public Health Emergency. For more information, view the fact sheet prepared by CMS.

Better access to telehealth is a big step in getting Medicare beneficiaries appropriate care in the least restrictive way. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with any questions on your planning.

Are Millennials Onboard with Financial Planning?

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Living through this economic volatility, not seen since the Great Depression, gave rise to the fiscally conservative millennial mindset. Millennials include fiscally conservative, savings oriented, and future planners seeking financial freedom as core attributes. A large part of millennials’ formative years was influenced by the US sub-prime mortgage crisis beginning in 2007, shortly followed by an international banking crisis, which led to what became known as the Great Recession. The millennial generation would have ranged from ages 11 – 26 years of age when this economic downturn began. The other socio-economic force that continues to shape the millennial fiscal mindset is the student loan crisis. Cbinsights.com finds 41 percent of millennials carry student loan debt for which there is no personal bankruptcy relief. This debt crisis places unique financial pressures on nearly half of a generation, and many are seeking new ways to manage their income, debt, and future savings.

This conservative mindset has underpinnings of investment optimism about achieving financial goals according to reporting by the Union Bank of Switzerland Investor Watch report (UBS), and millennial goals are different from generations before them. The definitions of what being successful include a focus on personal success rather than maxing out returns on investments. This personal success is a balance of financial, relationship, and experiential factors, prioritizing long-term financial considerations like retirement or caregiving aging parents. Millennials understand their number one goal is to attain financial freedom, with a conscience. The UBS report goes on to say that 78 percent of millennials are more likely than other generations to believe income is a critical success factor and feel that income should be about 220,000 dollars to be considered a success. Millennials are also more apt to think money can buy happiness because their pursuit of money is geared toward financial freedom rather than excessive accumulation.

UBS Investor Watch Report

According to Forbes, many mid-life millennials (late 20’s and 30’s) are changing the order of, or opting out of traditional family and financial milestones of their predecessor generations. Some will have children before marriage; others will resolve all debt (think student loans) before entering into homeownership, and most will invest with sustainability and environmental concerns at the forefront of decision making. As the oldest millennials turn age 40 in 2020, many are conducting personal financial checkups, taking stock of their assets, liabilities, and insurance needs. Re-evaluation of and adjustments to financial plans help to ensure financial goals can be met.

Though most millennials do not yet have a professional financial advisor, ten self-directed steps can help to evaluate your current financial plans and make any necessary adjustments.

  • Specifically, relist your financial goals and work backward from them to see what financial processes you need to put in place to achieve those goals. Embrace learning and be patient as you track your spending, pay yourself first, and break long term goals into short achievable steps.
  • Think about life insurance. What will happen to your family or loved ones in the event your family has to survive without you and the income you provide? A death benefit will provide financial stability and help them to survive.
  • If you have not already done so, make a will and include medical directives, and consider a durable power of attorney should you become incapacitated.
  • Revisit the parameters of your current budget, and if you are willing, get outside professional input as most people’s expenses are higher than they think. There is a human tendency to overlook some existing expenditures and not be aggressive enough when it is time to make cuts in spending.
  • Assess and update your investment choices. Particularly pay attention to your 401(k) plan and other retirement savings vehicles like IRAs. Confirm they are aligned to your risk tolerance and perhaps reduce the number of high-risk equities into slower, high-dividend stocks. Look at the advantages of adding an annuity into your 401(k) plan and other changes that the SECURE Act of 2020 brings to retirement planning. Understand that the old model of 60 – 40 equities to bond ratio is no longer deemed advisable.
  • If you have excessive credit card debt, address it now. Pay down the highest interest balance(s) first if you are servicing debt as opposed to attacking a principal payment.
  • Do you have student loans? Again, pay down the highest-interest loans first by monthly auto-deducting it from your checking account. Explore the possibility of consolidating multiple student loans into one payment and negotiate a lower rate and longer time to pay lower monthly payments.
  • Weigh the costs of homeownership. Some millennials, particularly those without children, may prefer not to be anchored to home real estate, maintaining the flexibility of movement for job opportunities. Those who want a home must assess financial responsibilities beyond the costs of a mortgage and real estate tax, considering the workload and cost of home upkeep.
  • Review your health insurance, and be sure it is adequate to cover your family’s needs. Children especially are subject to many doctor visits and requirements for attending school with proper vaccinations. If you are fortunate enough to have health insurance through your employer, check that the deductible and co-insurance options make the most sense for your situation.
  • Finally, take a good look at your health situation. While this doesn’t sound related to finances in the long run, it is. Is your diet unhealthy, and are you overweight? These factors potentially set you up for the likelihood of diabetes two and future joint and mobility problems. Are your cholesterol and blood pressure numbers in a healthy range? Do you need to reduce alcohol intake? Do you work out consistently in the three formats you need, which are weight training (strength building), aerobic exercise, and a stretching routine like yoga? Being as physically healthy as possible reduces overall health costs.

Millennials are at the cusp of their middle age planning stage of life and realizing that life’s priorities are a moving target.  While the above pertains to millennials, the importance of planning – both legal and financial – is critical at any age.

We help families of all ages plan for what is important to them, and to make sure their plans and wishes and properly documented. Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you with your planning.

The Top Trends for Senior Living

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As the silver tsunami of baby boomers continues to enter the senior living and care organizations markets, the general response has been uncertainty as to how to meet changing and varied senior needs while maintaining profitability.  Health Dimensions Group (HDG ) has released its list for 2020 entitled “Top Trends in Aging Services: Preparing for Historic Changes.” Owners and operators of senior living facilities must become responsive and make changes that are swift and diverse.

New Senior Housing Projects

Actuaries used to define senior housing construction projections and schedules are based on population data that are five or more years out. These metrics attempt to address occupancy and growth challenges as senior living occupancy rates fluctuated between the 86 – 88 percent mark for 2019 according to new data from the National Investment Center for Seniors Housing & Care (NIC). The third quarter of 2019 set a record for the highest demand of net new senior housing units while the construction data indicates a slowdown is near. The population projections of 2015 are not in accord with the latest senior housing demand. More cost-effective construction options and the repurposing of existing real estate is becoming a necessity to offset occupancy pressures and saturated markets.

Alternative Living Care Options

For lower-income seniors, alternative living care models, including the Program of All-Inclusive Care for the Elderly (PACE), integrate Medicare and Medicaid financing; provide a comprehensive service delivery system. This coordination of care is an effort to defer or avoid seniors moving into a long-term care fee-for-service facility. Implementing this program and other, less costly models of care can help to address lower-income senior housing issues. These models will continue to leverage technology to drive innovation and efficiencies, as well as address workforce shortages.

Middle-Income Seniors

The most challenging market segment for senior living is that of middle-income seniors. Those seniors without sufficient resources for long-term care but who are also not in a position to qualify for Medicaid seem to face some of the most significant issues as it relates to housing and healthcare costs. According to McKnight’s Senior Living, investors and operators focus on the upper end of income distribution as their preferred targeted residents while leaving state and local programs to provide for low-income seniors. This scenario leaves a large portion of middle-income seniors whose living needs are not adequately being addressed.

Technology for Seniors

Applied digital technologies are changing the senior living sector, and the race to seize substantial market share in the active adult and under-addressed middle-class needs has not gone unnoticed by tech behemoths like Apple and Amazon. Alexis Ohanian, the co-founder of Reddit, who runs a venture capital firm, is predicting that a significant change is imminent for senior living. New startups, heavy on innovation and technology, will bring major disruption to existing senior living models and facilities very soon.

Investments in Senior Living Facilities

Existing operators and investors of aging senior living facilities are increasing investment in a wide range of offerings and services to remain operationally sound and competitive. One service strategy is to partner with home health agencies that provide therapy under Medicare Part B while a senior resident ages in place. Another is to create more public spaces within facilities. The creation of roof-top restaurants and park spaces on the property can increase senior socialization alleviating depression, which is a contributing factor to downward health spirals for seniors. Smartwatch technology that acts as a smart key for residents as well as a movement and health monitor reduces the number of daily interactions with staff and provides a way for loved ones to monitor their spouse or parent remotely. Creating more job flexibility for staff and dramatically increasing wages for hourly positions is a necessity to recruit and retain competent staff in a tight labor force.

While many of the baby boomers are still below the average age of residents that live in traditional senior communities, demographics point to the fact that the senior living industry will soon be under more pressure than ever to provide for a diverse and increasingly particular population. Market sector opportunities in middle-income senior living will drive innovation as competition increases, and companies vie for market share. These opportunities to realize new solutions will positively affect the entire senior income spectrum for housing.

We help seniors come up with comprehensive plans to address the aging process and the challenges that come with it. We welcome the opportunity to talk with you about your particular needs.

Contact our office by calling us at (318) 255-1760 and schedule an appointment to discuss how we can help you.