Advanced Special Needs Trusts (2024 Edition)

Kyla Groff Kelim, Principal | Aging

Kyla Groff Kelim is an elder law attorney and principal of Aging in Alabama, an elder law firm in Fairhope, Alabama, and prolific regional and national speaker, dedicating her practice to consultation and advocacy on topics of interest to seniors, their families, caretakers and professionals assisting them, to protect their life’s work. The firm and aims to protect their clients’ life’s work by proactive planning and assisting those in need due to catastrophic illness or injury as they navigate the often treacherous administrative schemes of nursing home Medicaid, Medicare and Social Security. Ms. Kelim provides consultations throughout the Southeast United States. She has practiced in Florida and Alabama for more than 30 years. Ms. Kelim earned her B.S. degree from the University of New Orleans and her J.D. degree from Cumberland School of Law at Samford University in Birmingham, Alabama. She lives in Fairhope with her husband, Patrick and their two sons, Payton and Pierce.

I. Introduction to Special Needs Trusts (SNTs) | 2:00pm – 2:30pm

• Types of Special Needs Trusts
• Alternatives to SNTs
• Aligning your client’s needs and goals with the regulations
• Assessing the Beneficiary’s Disability and Needs
• Determining How Much to, and NOT to, Place into Trust

II. Drafting the SNT: Sample Provisions Review and Analysis | 2:30pm – 3:00pm

• Drafting the Letter of Intent – Why it’s Important
• Essential Provisions of the Trust
• Which Provisions to Avoid and Why
• What Items can be Purchased with Trust Funds?
• Funding In-Home Care
• Ten Rookie Drafting Mistakes Everyone’s Made and Could Have Avoided
• Revising Existing SNTs

Break | 3:00pm – 3:10pm

III. Alternatives to SNTs | 3:10pm – 3:40pm

• Using the Affordable Care Act
  • Can your client with disabilities choose private health insurance through the ACA?
  • Coverage for Persons with Pre-Existing Condition
  • Elimination of Annual or Lifetime Caps
  • Coverage for Children Up to Age Twenty-Six
  • Limits on Out-of-Pocket Payments
  • Subsidies to Purchase Private Health Insurance
  • Benefits of Private Health Insurance for Special Needs Individuals
  • When Remaining on Medicaid may be Preferred
  • Medicaid Expansion – Know Your State
    1. Changes to Asset/Resource Test
    2. Section 1915(c): Waiver for Long-Term, Non-Institutional Care
• ABLE Acccounts
  • ABLE Act: Federal Rules and Related Federal Legislation
  • State ABLE Programs Progress
  • ABLE Account Eligibility
  • Contribution Limits
  • Qualified Expenses

IV. Navigating Public Benefits Eligibility | 3:40pm – 4:10pm

• Medical Assistance: Medicaid
• Supplemental Security Income (SSI)
• Medicare and Social Security Disability Insurance (SSDI)
• HUD Housing
• Other Benefits
• Assessing Beneficiary’s needs
• Setting realistic expectations
• Avoid Pitfalls

Break | 4:10pm – 4:20pm

VI. Ethics | 4:20pm – 5:20pm

• Who is the client?
• Conflicts and Duties
• Confidentiality
• HIPAA and related disability issues
• Appropriately representing the disabled client