To Their Child’s Wellness & Independence · 1. Set-up the information loop 2. Structure for...
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To Their Child’s Wellness & Independence
Transcript of To Their Child’s Wellness & Independence · 1. Set-up the information loop 2. Structure for...
To Their Child’s Wellness & Independence
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Approach
Share: ◦ Insights
◦ Lessons
◦ Advice
Outcome Goals:
1. Enlighten & inform 2. Help avoid the pitfalls 3. Urge you be proactive 4. Offer a roadmap 5. Help long term planning
Leave you with a to-do list for follow-up action…
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Age 18-24 years
Away from home?
Doorstep of adulthood
Last stage of dependency
There’s no manual
No one tells you…
Hope blindness is real
Well-intended actions can hurt
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Have a mental health diagnosis?
Experienced first-onset psychosis?
1 year into the journey?
3+ years into the journey?
Maintaining independence?
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Acceptance: There is no ‘cure’
Recovery = Stability (it’s a journey)
An ounce of prevention is worth $$ cure
Success is a 3-way street:
◦ Them, you & providers
In-person, proactive advocacy is key
Be vigilant in support of the wellness model
Find out about (and access) resources early
Keep track, maintain records & plan ahead
Your self-care is part of the process
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Creating Your Parent’s Resource Guide:
1. Set-up the information loop
2. Structure for financial independence
3. Supervise the WRAP plan/team
4. Learn advocacy rights & build network
5. Arrange resources in advance
6. Plan for the long term
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Independent adulthood = 18 yrs Have health care releases on file (IVC)
Have current picture & copies of DrLic & college ID
Set up ‘find my phone’
Get room/apt, mailbox & car keys
Have PWs: Debit account, college e-mail, etc.
Receive their school grades
Have contact Info:
◦ 2 close friends, HC providers, faculty advisor/boss
Be connected to their social media
Set-up POAs (HC at least)
‘We can neither confirm nor deny’
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Pay tuition
Provide an allowance
Pay for cell phone
Pay health care Insurance
Pay for car and/or auto insurance
Pay travel and/or term-abroad costs
Co-sign a lease
Take child as a tax dependent
You have Leverage & Liability
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Set-up a Special Needs Trust (SNT)… Now
Stop claiming dependent status on taxes
◦ Child files own tax return, claiming self
Make child their own ‘FRP’ (financially responsible
person for health ins, tuition, auto, etc.)
Restructure leases, etc. to eliminate co-signs
De-link bank accounts
Stop paying their bills
Limit cash allowance ($66/mo. is SSI allowable!)
Discourage cash work (10yrs SS wages = SSDI eligibility)
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The Problem With Money
Lots is luxury
Some is bad
None = support
Payments Are Considered Income, affecting:
Eligibility for support services: ◦ Medical, food, housing, transportn. & living assistance
Availability of care plan discounts/scholarships
Take steps early to create an independent adult!
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“An irrevocable fund to supplement, not supplant, impair or diminish any benefits or assistance provided by any Federal, State or community entity”
‘Supplemental Needs’ = services & expenses not covered or available…
Basic needs covered:
Housing or residential, including furnishings, utilities, internet and TV service
Medical, vision and/or dental care
Attendant care, support services, therapeutic care: And, professional services
Transportation, including vehicle purchase, costs and operating expenses
Social needs/recreation, educational and/or vocational support
Trustee has sole discretion concerning distributions… in the beneficiaries
best interest
It’s expected that the Beneficiary will always strive toward independence and may require moderate assistance with basic living needs… SNT’s primary objective is to support (his) efforts remain as independent as possible, and to maintain a high level of health and emotional well-being
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A Wellness Toolbox
Daily maintenance plan
Triggers and what I can do
Early warning signs that things are breaking down
Crisis plan or advance directive
Post crisis planning
Make It A Working Document As Plans Change
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The Care Team
Person
Parents & Supporters
HC Team (Psych/PCP)
◦ Student Health Care
◦ Disability Services
Community Team
◦ NAMI, ACTT, etc.
Insurance Company
Attorney
CIT team
DHHS
The Content
Therapeutic Care
Medication Management
Community Care/Services
Housing & transportation
Social and recreational
Work and volunteering
Diet and exercise
Stress control
= Life Balance!
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Confirm Diagnosis
Depression
Anxiety
Bi-Polar (20 codes!)
Schizophrenia
Schizo-Affective
DSM-5*
300.02
300.0
296.43
295.90
295.70
Arrange Assessments
Get/confirm codes SMI/SPMI: Find out
what’s needed…
*Diagnostic and Statistical Manual of Mental Disorders DSM-5 (2013)
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Circle Of Engagement
Health Care System
Hospitals and treatment programs
Public/Private support agencies
Schools and universities
Attorneys & Courts
Law enforcement
Guardianship
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Academic Accessibility
Connection Support Groups
Resource Network
Volunteering
SNAP
Discount Bus
Rent Assistance
Crisis Center
Behavioral HC
Peer Living Room
Supported Work
Counseling & Advocacy
Med Management
Community Providers
Member Discount
Group Exercise
Meet-Up Groups
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NOW HIPPA PP&ACA IVC ROI POA SNT FRP CIT
LATER CCBC ACTT SNAP SSI/SSDI SMI/SPMI LME/MCO PSRR MVA & DC
Hurdles & Resources In The Journey
Refer Pg. 22
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Have eligibility assessments completed (now)
Behavioral Health Providers: Private/Public collaboration
Student Accessibility Services ◦ Academic accommodations
◦ Study aids & tutoring
◦ Labs (neurofeedback)
◦ Housing
NC DHHS ◦ ACTT
◦ Medicaid
Know Law Enforcement ◦ Local CITs
◦ Diversion Programs (≠ Jail)
Missing: endangered or vulnerable (NC DPS) ◦ Dial 101 or 999
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Have Complete Medical History ◦ Prior to Age 22, and after
◦ Evaluations, treatment& medication records
◦ Medication adherence (Pursue LAIs)
Explore TCLI* ◦ Housing, services & employment
Learn about SSI/SSDI
Study Guardianship ◦ Estate (financials), Person (health & wellness)
Set-Up Spec Needs Trust for LTC
*TCLI: Transition To Community Living *SSI/SSDI: Supplemental Security Income, Social Security Disability Income
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IVC: Involuntary Commitment
ROI: Release of Information
SNT: Special Needs Trust
FRP: Financially Responsible Person
CIT: Crisis Intervention Team (Police)
CCBC: Continuum of Community Based Care (evaluation)
ACTT: Assertive Community Treatment Team
SMI/SPMI: Serious Mental Illness/Serious Persistent MI
LME: Local Management Entity (i.e. Vaya, Trillium & Alliance
PSRR: Pre-Screening Residential Review (TCLI evaluation)
MVA: Missing Vulnerable Adult
