Considering Care Management for Your Child With Special Needs

When establishing a special needs trust (SNT) for your child, it's important to consider how much care the child may need in the future and who will oversee any arrangements related to that care. In many cases, either a family member or the SNT trustee can assume responsibility for care management. But when care needs are significant or family members cannot be available, parents may wish to include instructions in the SNT documentation for the trustee to retain a professional care manager. This can help ensure that care decisions will be handled professionally and consistently throughout the beneficiary's life while allowing the trustee to focus on other responsibilities.

What Is a Care Manager?

A care manager is a professional with the expertise necessary to develop, implement and monitor a plan for all aspects of an individual's care. Often trained in nursing or social work, care managers are available primarily through private care management companies, many of which also deliver services to the elderly. Generally, a care manager will be knowledgeable about everything from health care and rehabilitation options to residential alternatives. Care managers also should be familiar with the alternatives for funding an individual's care -- both private resources and public benefits.

What Does a Care Manager Do?

A care manager coordinates, monitors and advocates for services to help ensure that an individual with special needs can maintain the greatest possible degree of independence, safety and comfort at the most reasonable cost. Working closely with family members as well as financial advisors, attorneys, health care providers, the SNT trustee and others involved in the individual's care, the care manager may:

• Assess the individual's needs based on a visit to the home and one-on-one interviews.
• Develop, or help the family develop, a care plan covering living arrangements, medical and therapeutic needs, social preferences, educational opportunities and other relevant issues.
• Implement the plan. This may include coordinating physical therapy, medical care, social services and equipment needs; improving the home's safety and comfort through repairs or modifications; and hiring home health aides or training family caregivers.
• Work with the SNT trustee to ensure that private and public resources are used appropriately, helping to preserve trust assets and avoid improper distributions that could jeopardize the beneficiary's eligibility for benefits.
• Address emergency or crisis situations.
• Consider housing alternatives and oversee placement, handling such details as admissions paperwork and moving arrangements.
• Monitor care in the home or at residential facilities and recommend changes as necessary.

The services offered by care managers may vary, as will their credentials and certifications. For example, some care managers are certified by sources such as the National Academy of Certified Care Managers (www.naccm.net).  

Talk to your special needs planner about the need for a care manager.