Navigating the complexities of special needs trusts requires careful consideration, particularly when it comes to allowable expenses. While seemingly straightforward, funding items like biometric medication tracking tools demands a nuanced understanding of trust provisions and the beneficiary’s overall well-being. These tools, which utilize technology to monitor medication adherence, are becoming increasingly popular, but their payment through a special needs trust isn’t always automatic. It hinges on whether the trust document explicitly allows such expenditures, or if they fall within the broader scope of maintaining the beneficiary’s health and welfare, as determined by the trustee.
What Expenses *Can* a Special Needs Trust Typically Cover?
Special needs trusts are designed to supplement, not replace, government benefits like Supplemental Security Income (SSI) and Medicaid. Therefore, funds *cannot* be used for necessities already covered by these programs, such as basic medical care, housing, and food. However, a trust can pay for “quality of life” enhancements. This includes things like recreation, travel, education, and specialized therapies *not* covered by government assistance. It can also cover attendant care, personal care items, and modifications to the beneficiary’s home to improve accessibility. Generally, anything that improves the beneficiary’s health, comfort, and overall well-being, without jeopardizing their eligibility for public benefits, is a potential allowable expense. Trust documents often include a broad “health, education, maintenance and support” clause, giving the trustee discretion to approve expenses falling within this scope.
Could Biometric Medication Tracking Be Considered a Valid Expense?
The key to determining if a biometric medication tracking tool is an allowable expense is its direct connection to the beneficiary’s health and well-being. If the beneficiary has a condition that requires strict medication adherence to prevent serious health consequences, the tool could be argued as a medically necessary item. The trustee would need to document this necessity, perhaps with a letter from the beneficiary’s physician. However, it’s not a simple yes or no. The cost of the tool, as well as any ongoing subscription fees, needs to be reasonable. Furthermore, the trustee must ensure the tool doesn’t create a situation where the beneficiary appears to be managing their own medications, which could impact their SSI eligibility. According to recent studies, medication non-adherence costs the US healthcare system an estimated $300 billion annually, making adherence tools potentially valuable, but also raising questions about reasonable expense allocation.
A Story of Balancing Care and Compliance
I recall a client, David, whose son, Michael, lived with autism and epilepsy. Michael often forgot to take his medication, leading to dangerous seizures. David wanted to use trust funds to purchase a smart pill dispenser with biometric verification to ensure Michael took his medication on time. Initially, there was concern about whether this fell within the bounds of the trust, fearing it could be perceived as Michael self-managing his medications. We worked with Michael’s neurologist, who provided a detailed letter explaining the critical importance of consistent medication adherence for Michael’s condition and confirming the device would be monitored by a caregiver. The neurologist specifically outlined the tool as a means to *prevent* medical crises, rather than simply manage an existing condition. With this documentation, the trustee approved the purchase, ensuring a caregiver was responsible for loading and monitoring the device, maintaining Michael’s eligibility for benefits while significantly improving his safety and quality of life.
What Happens When Things Don’t Go As Planned?
On the flip side, I remember a situation with a client, Susan, where her brother, Thomas, had a cognitive disability and struggled with his diabetes medication. Susan unilaterally purchased an expensive biometric tracking system without obtaining prior approval from the trustee or consulting with her brother’s doctor. When she submitted the expense report, it was denied. The trustee argued that the purchase wasn’t pre-approved, and there wasn’t sufficient documentation to demonstrate medical necessity. Susan was upset, and the situation created tension within the family. Ultimately, she had to appeal the decision, gather the necessary documentation, and demonstrate how the tool would directly improve her brother’s health and prevent potential hospitalizations. The delay caused unnecessary stress and highlighted the importance of clear communication and pre-approval processes.
Navigating these complexities requires a proactive and informed approach. Trustees must prioritize the beneficiary’s well-being while adhering to the terms of the trust and ensuring compliance with government regulations. Consulting with an experienced estate planning attorney, like Steve Bliss, can provide valuable guidance and help ensure that decisions are made in the best interests of the beneficiary.
720 N Broadway #107, Escondido, CA 92025Steven F. Bliss ESQ. can be reached at (760) 884-4044 to discuss your specific needs and circumstances.
Don’t leave the future of your loved one’s care to chance. Contact Steve Bliss today for a comprehensive estate plan that provides peace of mind and ensures their needs are met, now and in the future. Let us help you build a legacy of care and security.