paul m. deutsch & associates, p.a. life care plan dob: d/a ...€¦ · layla maloney projected...

Layla MaloneyProjected Evaluations

Life Care Plan

Item / Service Age Year Purpose Cost Recommended ByCommentFrequency/

Replacement

DOB: May 4, 1996May 28, 2001Nov 18, 2005Total Blindness

D/A:

Primary Disability:Date Prepared:

Paul M. Deutsch & Associates, P.A.10 Windsormere Way, Suite 400Oviedo, FL 32765(407) 977-3223 Fax (407) 977-0311

Rehabilitation /Long-Term NeedsAssessment

Long Term Care Planning

Per Year

Paul M. Deutsch,Ph.D., CRC, CCM,CLCP, FIALCP Lic.Mental Hlth. Couns.(Chptr. 491 Psych.Pract. Act.)

Ending

2 X already accomplished during2/16/04 evaluation and 11/16/05telephone update. Eval at age 16 toassist with long term goal planning asshe progresses through high school.$3,000 - $4,000 excluding expenses.

Beginning Per Unit

A life care plan is a dynamic document based upon published standards of practice, comprehensive assessment, data analysis, and research, which provides an organized,concise plan for current and future needs, with associated costs, for individuals who have experienced catastrophic injury or have chronic health care needs. (IALCP –International Academy of Life Care Planners, 2003. Definition established during the 2000 Life Care Planning Summit)

Through the development of a comprehensive Life Care Plan, a clear, concise, and sensible presentation of the complex requirements of the patient are identified as a means ofdocumenting current and future medical needs for individuals who have experienced catastrophic injury or have chronic health care needs.

The goals of a comprehensive Life Care Plan are to: improve and maintain the clinical state of the patient; prevent secondary complications; provide the clinical and physicalenvironment for optimal recovery; provide support for the family; and to provide a disability management program aimed at preventing unnecessary complications and minimizingthe long-term care needs of the patient.

3 X Only

1

7 2/16/04

16 2012

Psychological Evaluate forpsychosocial adjustmentissues and formulate atreatment plan to helpwith adjustment anddevelopment of copingskills.

$120 - $200

Per Year


Ending

Beginning Per Unit

The emotional impact of vision loss can be devastating, and the extent of distress is not predictable by the degree of vision loss. Even moderate vision loss decreases function,and loss of functional ability directly correlates with depression. Patients with any amount of vision loss often experience fear, isolation, anger, a sense of inadequacy, loss ofcontrol, and some level of depression. Some patients require psychological counseling to manage the anger and depression triggered by vision loss, optimally with a therapistexperienced in or with a special interest in vision loss. Psychologists and social workers may be important contributors to the rehabilitation process. Nonmedical visionrehabilitation professionals, including certified low-vision therapists, rehabilitation teachers, and orientation and mobility specialists may be part of the team. A multidisciplinaryteam approach is recommended because it is most effective in addressing the various functional and psychological problems caused by vision loss. Involving families in therehabilitation process is usually beneficial to all. Source: American Academy of Ophthalmology (AAO). Vision rehabilitation for adults. San Francisco (CA): American Academyof Ophthalmology (AAO); 2001 Feb.

1 X / 3-4 Yearsthrough age 30

2

9 2005

30 2026

Growth Trend To Be Determined By Economist. Table 2 Copyright ©1994. page 1


Life Care Plan


Replacement


D/A:



Occupational TherapyEvaluation

Assess need foractivities of daily livingtraining, appropriateassistive technology andadaptive equipment.

$224 - $300

$224 - $300Per Year

Paul M. Deutsch,Ph.D., CRC, CCM,CLCP, FIALCP &Andrea Zotovas,M.D.

Ending

Beginning Per Unit

Occupational Therapy: Assistive Technology assessment and evaluation providers are most often licensed and or certified in related fields such as Physical Therapy,Occupational Therapy, and Speech/Language Pathology. Rehabilitation Engineers, while not certified/licensed, have engineering or technology backgrounds. OccupationalTherapists are professionals who have training and expertise in clinically recognized areas. All practicing therapists must pass standardized tests and be certified or licensed intheir field. Qualified therapists have a working knowledge of assistive technology foundations, devices, and applications, and can complete a formal AT assessment which maybe required by your funding source. Standards for formal AT assessments vary, but a good assessment should verify a need for assistive technology and verify that therecommended AT will meet that need. Source; TechACCESS Home Page. What is an Assistive Technology Assessment? http://www.techaccess-ri.org/assess1.htm

A proper and adequate rehabilitation program can reverse many disabling conditions or can help patients cope with deficits that cannot be reversed by medical care.Rehabilitation addresses the patient's physical, psychological, and environmental needs. It is achieved by restoring the patient's physical functions and/or modifying thepatient's physical and social environment. The main types of rehabilitation are physical, occupational, and speech therapy. Occupational therapy helps the patient regain theability to do normal everyday tasks. This may be achieved by restoring old skills or teaching the patient new skills to adjust to disabilities through adaptive equipment, orthotics,and modification of the patient's home environment. Occupational therapy may be prescribed to rehabilitate a patient after amputation, arthritis, cancer, cardiac disease, headinjuries, neurological injuries, orthopedic injuries, pulmonary disease, spinal cord disease, stroke, and other injuries/illnesses. The duration of the occupational therapy programvaries depending on the injury/illness being treated and the patient's response to therapy. Source: Smith, Joseph F., Dr. Rehabilitation.http://www.chclibrary.org/micromed/00063410.html

Yearly throughDevelopmentalYears

3

9 2005

18 2014

Orientation and MobilityEvaluation

Assessment for trainingneeds in orientation andmobility with cane andguide dog.

$100 - $200

$400 - $800Per Year


Ending

Beginning Per Unit

Children who have significant visual impairments are required to use other sensory modalities to compensate for their lack of sight. This is especially true when they walk. Twoforms of sensory input are used to walk safely within familiar and unfamiliar environments: tactile information and acoustical information. Orientation and mobility training isprovided to teach children how to learn to walk through familiar and unfamiliar environments safely. Training is done in a variety of real-world situations, including hallways,furnished rooms, and cross walks. Training is time consuming, sometimes risky, and limited to the number of environments available to the student and the O&M TrainingSpecialist. Source: Inman, Dean P., Ph.D.; Loge, Ken, M.S. Teaching Orientation and Mobility Skills to Deaf-Blind Children Using Computer Generated Simulated SoundEnvironments. Oregon Research Institute. Eugene, Oregon.

4 X / Year duringthedevelopmentalyears

4

9 2005

18 2014



Life Care Plan


Replacement


D/A:



Recreation TherapyEvaluation

Assessment for adaptiverecreational pursuits $250 - $350

Per Year


Ending

Includes supplies and equipment forstart up.

Beginning Per Unit

In the areas of physical medicine and rehabilitation, studies have documented these Recreational Therapy outcomes: Improved physical health; Reduced complications relatedto secondary disability; Improved long-term health status and reduced health risk factors; Improved cognitive functioning; Improved psychosocial health and well-being; Reducedreliance on the health care system; Increased life satisfaction; High-quality social relationships; Decreased depression; Increased self-efficacy, self-confidence, and adjustmentto disability; Improved self-esteem; Increased ability to use activity to cope with stress from hospitalization/illness; Decreased social isolation; Increased perceived quality of life;Improved community functioning and ability to overcome barriers. Source: Sorensen, Beth, MS, TRS/CTRS, CCM; Luken, Karen, MS, TRS/CTRS. Improving FunctionalOutcomes with Recreational Therapy. The Case Manager, September/October 1999, pages 48 – 52.

1 X / 2 yearsthrough age 18;then 1 X / 6 yearsthrough age 75

5

9 2005

75 2071

Vocational Evaluation Routine assessment

Per Year


Ending

Initial evaluation at age 16 forexploratory purposes: $300 - $650. Fullevaluation at age 18: $1,100 - $1,250.

Beginning Per Unit2 X Only

6

16 2012

18 2014


Layla MaloneyProjected Therapeutic Modalities

Life Care Plan


Replacement


D/A:



Play Therapy / IndividualCounseling (as ageappropriate)

Routine intervention$100 - $120

Per Year


Ending

$2,600 - $3,120 for 26 sessions now;then $1,300 $1,560 for 13 sessions atages 10, 12, 14, 16, 18 and 20.Thereafter $440 - $660 / year forsupport.

Beginning Per Unit


1 X / week for 26weeks now; then1 X / week for 13weeks at ages10, 12, 14, 16, 18and 20. Then 4-6X/year thereafter. 7

9 2005

Life Exp.

FamilyCounseling/Education

Aid in acceptance ofLayla’s disability and helpfamily become strongdisability advocates forLayla.

$100 - $120

Per Year


Ending

$1,300 - $1,560 for 13 sessions now;then $600 $720 for 6 sessions at ages10, 12, 14, 16, 18 and 20.

Beginning Per Unit


1 X / week for 13weeks now; then2 X / month for 3months at ages10, 12, 14, 16, 18and 20.

8

9 2005

20 2016



Life Care Plan


Replacement


D/A:



Occupational Therapy Address activities of dailyliving skills and train withadaptive equipment andtechnology.

$192 - $224

Per Year

Andrea Zotovas,M.D.

Ending

$18,432 - $21,504 / year through age18; then $1,248 - $2,080 every 2 yearsfor training with new equipment.

Beginning Per Unit

Occupational Therapy: Assistive Technology assessment and evaluation providers are most often licensed and or certified in related fields such as Physical Therapy,Occupational Therapy, and Speech/Language Pathology. Rehabilitation Engineers, while not certified/licensed, have engineering or technology backgrounds. OccupationalTherapists are professionals who have training and expertise in clinically recognized areas. All practicing therapists must pass standardized tests and be certified or licensed intheir field. Qualified therapists have a working knowledge of assistive technology foundations, devices, and applications, and can complete a formal AT assessment which maybe required by your funding source. Standards for formal AT assessments vary, but a good assessment should verify a need for assistive technology and verify that therecommended AT will meet that need. Source; TechACCESS Home Page. What is an Assistive Technology Assessment? http://www.techaccess-ri.org/assess1.htm

A proper and adequate rehabilitation program can reverse many disabling conditions or can help patients cope with deficits that cannot be reversed by medical care.Rehabilitation addresses the patient's physical, psychological, and environmental needs. It is achieved by restoring the patient's physical functions and/or modifying thepatient's physical and social environment. The main types of rehabilitation are physical, occupational, and speech therapy. Occupational therapy helps the patient regain theability to do normal everyday tasks. This may be achieved by restoring old skills or teaching the patient new skills to adjust to disabilities through adaptive equipment, orthotics,and modification of the patient's home environment. Occupational therapy may be prescribed to rehabilitate a patient after amputation, arthritis, cancer, cardiac disease, headinjuries, neurological injuries, orthopedic injuries, pulmonary disease, spinal cord disease, stroke, and other injuries/illnesses. The duration of the occupational therapy programvaries depending on the injury/illness being treated and the patient's response to therapy. Source: Smith, Joseph F., Dr. Rehabilitation.http://www.chclibrary.org/micromed/00063410.html

2 X / week for 48weeks throughage 18; then 6 to10 sessionsevery 2 yearsthereafter.

9

9 2005

70 2066

Orientation and MobilityTraining

Train with cane and guidedog to be able toambulate safely withindifferent environments.

$192 - $224

Per Year


Ending

$18,432 - $21,504 / year through age18; $2,080 - $2,496 / year through age70.

Beginning Per Unit

Children who have significant visual impairments are required to use other sensory modalities to compensate for their lack of sight. This is especially true when they walk. Twoforms of sensory input are used to walk safely within familiar and unfamiliar environments: tactile information and acoustical information. Orientation and mobility training isprovided to teach children how to learn to walk through familiar and unfamiliar environments safely. Training is done in a variety of real-world situations, including hallways,furnished rooms, and cross walks. Training is time consuming, sometimes risky, and limited to the number of environments available to the student and the O&M TrainingSpecialist. Source: Inman, Dean P., Ph.D.; Loge, Ken, M.S. Teaching Orientation and Mobility Skills to Deaf-Blind Children Using Computer Generated Simulated SoundEnvironments. Oregon Research Institute. Eugene, Oregon.

2 X / week for 48weeks / yearthrough age 18,then 10-12sessions per yearthereafter.

10

9 2005

70 2066



Life Care Plan


Replacement


D/A:



Career Guidance andCounseling

Assistance in careerplanning and execution. $600 - $1680

Per Year


Ending

Unit cost is total for 12 to 24 hours ofcounseling.

Beginning Per Unit

Allowance for two to three programs of Career Guidance and Counseling over her work life. More frequent job changes, etc. may result in the need for additional programs ofcounseling and guidance, but anticipate that sufficient skills will be learned throughout these programs to carry over. Career guidance to include: (A) career exploration; (B)career decision making; (C) matching of interests, job satisfiers, motivators, and abilities to available alternatives vocationally or avocationally; (D) goal setting; (E) job seekingskills training; and (F) Counseling post placement to help ensure success.

2-3 timesbetween age18-55.

11

18 2014

55 2051


Layla MaloneyDiagnostic/Educational Testing

Life Care Plan


Replacement


D/A:



Special EducationServices

Special Education as maybe required due toblindness.

$0

Per Year


Ending

Costs covered under IDEA -Individual’s with Disability EducationAct.

Beginning Per Unit

NOTE: Layla is bright and I expect her to be mainstreamed with supplemental help from a vision teacher under IDEA.

Throughoutprimary andsecondaryschool.

12

9 2005

18 2014

Bachelor’s DegreeProgram

The higher hereducational developmentthe lower her loss ofearning capacity will be.

$15000 - $18000

Per Year


Ending

Beginning Per Unit

NOTE: Although Layla may well have expected to enter college pre-morbidly and would have had to find a way to cover tuition, books and supplies, I have entered this into the lifecare plan because it is the only effective way to lower the significant impact that her visual impairment will otherwise have on her earning capacity.

4 year program

13

18 2014

22 2018


Layla MaloneyOrthopedic Equipment

Life Care Plan


Replacement


D/A:



Adjusting Folding SupportCane for the Blind

Mobility and Orientation$134

Per Year

Paul M. Deutsch,Ph.D., CRC, CCM,CLCP, FIALCPbased on medicalinformation andclient interview

Ending

Unit cost is total for 3 canes.Beginning Per Unit

Tactile information derives from a cane held close to the ground, from the hands which can discern shape, texture, location, temperature, and function of objects found in theenvironment, and through the feet which provide information about the floor over which one is walking, the distance from one place to another, and a means for learning the correctpath to take to get from where one is and where one wants to be. Acoustical information provides information about the nature of sound generators in the environment and theirlocation. Skillful individuals can also use echoic information, which can reveal where non sound-generating objects are located in the environment as well. Source: Stirnweis,Sandra FBC O&M Instructor. WELCOME TO THE FBC (Foundation for Blind Children) ORIENTATION & MOBILITY PROGRAM.www.the-fbc.org/programs/orientationAndMobility/

1 X / 2-3 Years

14

9 2005

Life Exp.

Cane Accessories Safety and ease in use$15 - $20

Per Year


Ending

Blinking Safety Light - $11; Cane handloop - $4; etc.

Beginning Per Unit1 X / 2-3 Years

15

9 2005

Life Exp.


Layla MaloneyAids for Independent Function

Life Care Plan


Replacement


D/A:



Computer Schoolwork andVocational Endeavors $1500 - $1800

Per Year


Ending


16

9 2005

Life Exp.

Maintenance and/orUpgrade of Computer

Maintain and UpgradeEquipment $125 - $190

Per Year


Ending

Except in new purchase years.Beginning Per Unit1 X / Year

17

10 2006

Life Exp.

Voice RecognitionSoftware

Operate computer withvoice commands $199 - $225

Per Year


Ending

Dragon Naturally Speaking allows theuser to talk to their computer and havethe words instantly appear at 160 wordsper minute in virtually any Windowsbased application.

Beginning Per Unit1 X / 2 Years dueto technologychanges

18

9 2005

Life Exp.

Screen Reader Softwarefor Computer

Screen reader$895 - $1029

Per Year


Ending

JAWS screen reading softwarefeatures support for Internet Explorer,installs speech synthesizer, and willaccess today’s popular softwareapplications and the Internet.

Beginning Per Unit1 X / 2 Years dueto technologychanges

19

9 2005

Life Exp.



Life Care Plan


Replacement


D/A:



Braille TranslationSoftware

This software willtranslate print to Brailleand Braille to print.

$595 - $625

Per Year


Ending

Beginning Per Unit

Braille Literacy: This term has been adopted by the blindness community in many countries as the central concept for advocating that children be taught good Braille skills atan early age. Advocates equate Braille literacy with literacy for sighted people and point to some critical statistics to bolster their position. In the United States, unemployment forblind and visually impaired people runs at approximately 73%. Conversely, only 26% of the blind people available for work have jobs. However, among those with good Brailleskills, 90% have jobs. The logic then runs that if children are taught Braille literacy, their opportunities for gainful employment more than triple. Source: Braille Plus, Inc.,www.brailleplus.net

1 X / 2 Years dueto technologychanges

20

9 2005

Life Exp.

Braille Display Displays information oncomputer screen in Brailleso that it can be readtactilely.

$5495 - $5999

Per Year


Ending

Beginning Per Unit


1 X / 5-7 Years

21

9 2005

Life Exp.



Life Care Plan


Replacement


D/A:



Maintenance of BrailleDisplay

Maintain equipment

$200 - $400Per Year


Ending

Maintenance on equipment begins oneyear after each new item is purchased.

Beginning Per Unit


1 X / Year

22

10 2006

Life Exp.

Scanner for VisualImpairment

Visual Aid$250 - $300

Per Year


Ending

Allows printed page to be scanned intocomputer so the information can thenbe verbally communicated to the user.


23

9 2005

Life Exp.

Note Taker Pocket PC devices thatreplace the laptop forusers who are blind. Itworks as a complete wordprocessor to a personalorganizer.

$1895 - $5995

Per Year


Ending

There are numerous note takers on themarket, such as: PACmate TNS, BrailleLite 2000, Braille Lite 40, Type Lite,BrailleNote BT 32, just to name a few.

Beginning Per Unit


1 X / 3-4 Years

24

9 2005

Life Exp.



Life Care Plan


Replacement


D/A:



Maintenance of NoteTaker

Maintain/UpgradeEquipment $200 - $350

$200 - $350Per Year


Ending


Beginning Per Unit


1 X / Year

25

10 2006

Life Exp.

Braille Embosser / Printer Prints in Braille$2495 - $4095

Per Year


Ending

Enables user to produce Braille, largeor small print, or a combination of Brailleand Print from a text documentprepared on the computer - ideal formemos, reports, and other printedcommunication.

Beginning Per Unit


1 X / 4-6 Years

26

9 2005

Life Exp.



Life Care Plan


Replacement


D/A:



Maintenance of BrailleEmbosser / Printer

Maintain/UpgradeEquipment

$150 - $250Per Year


Ending


Beginning Per Unit


1 X / Year

27

10 2006

Life Exp.

Reading Machine Stand alone readingmachine that can be usedwith books, magazines,recipes and even typedcorrespondence.

$2750 - $3330

Per Year


Ending


28

9 2005

Life Exp.

Maintenance of ReadingMachine

Maintain equipment

$150 - $250Per Year


Ending


Beginning Per Unit1 X / Year

29

10 2006

Life Exp.

Tape Player for Books onTape

Reading$0 - $0

Per Year


Ending

No cost - funded through the Library ofCongress.

Beginning Per UnitAs needed

30

9 2005

Life Exp.



Life Care Plan


Replacement


D/A:



Miscellaneous Aids forthe Blind

Below are examples ofaides for independentfunctioning for personswith total loss of vision.

$1500 - $2000

Per Year


Ending

This list is meant to be examples only,not a complete list of available items.Not all the items listed are ageappropriate at this time.

Beginning Per Unit

Talking Kitchen Scale - $80; Talking Money Identifier/Color Identifier/Voice Recorder - $350; Hands-Free Voice Control Remote - $90; Talking Cell Phone Accessibility 2 - $240;Voice Activated Phone Dialer - $240; Voiced Labels Reader (Scanner) - $200; Talking Alarm Clock - $50; Leather Wallet Money Organizer - $22; Liquid Level Indicator II - $15;Oven / Hot Water Mitt - $20; Cutting Board with Food Chute - $10; Talking Cooking Thermometer - $35; Easy Release Cake Pan - $5; Deluxe Cutter Set - $4; Auto Flip Spatula - $17;Tactile Meat Thermometer - $15; Safety Food Turner Tongs - $4; Tactile Marked Mixing Bowl with Measuring Cup and Spoon - $12; Spice Auto-Measure Carousel - $25; TakingMedicine Bottle - $70; Braille Steel Tape Measure - $26; Auto Hammer - $25; Braille Watch - $100; Aluminum Braille Clothing Identifiers - $27; Click Pocket Money Brailler - $10;Compact 3x5 Tactile Filing System - $11; Fashion Range Identi-Buttons - $3; Indenti-Buttons Clothing Identifiers (3 sets)- $9; Merriam-Webster’s Speaking Collegiate Dictionary -$120; Braille Writing Slates (2 each)- $20; Eraser for Brailler - $4; 3M Braille Labeler - $35; Writing Guides (Check, Full Page, Letter, Signature) - $60.

Every 3-4 YearsAllowance

31

9 2005

Life Exp.

Canine Companion forIndependence

Enhance Independence$0 - $0

Per Year


Ending

For information purposes: $20,000 isthe assessed value for breeding,training and matching the dog with aspecific individual.

Beginning Per Unit

Through clinical observation, anecdotal reports, and retrospective and cross sectional studies, preliminary support was found for the conclusion that Assistance Dogs (AD) havea positive impact on individuals’ health, psychological well-being, social interactions, performance of activities and participation in various life roles in the home and in thecommunity. It is possible that the use of ADs among individuals with disabilities may actually save money. Individuals partnered with an AD may be more likely than nonusers tolive and work independently. They may have less need for hired caretakers, have better psychological and health functioning resulting in lowered healthcare costs, and requireless assistance from social agencies. Source: Sachs-Ericsson, N.; Hanse, N.; Fitzgerald, S. Benefits of Assistance Dogs: A Review. Rehabilitation Psychology 2002, Vol. 47,No. 3, 251-277.

1 X / 7-9 Years

32

9 2005

Life Exp.

Canine Companion -Maintenance and Upkeep

Maintain and Upkeep ofCanine Companion

$1830 - $2330Per Year


Ending

Vet $1,000-$1,500/year; Food:$360/year; Grooming: $420/year;Equipment (Harness/Leash): $50/year.

Beginning Per Unit1 X / Year

33

9 2005

Life Exp.


Layla MaloneySupplies

Life Care Plan


Replacement


D/A:



Miscellaneous Supplies Labeling, writing, etc.

$250 - $300Per Year


Ending

Transparent Vinyl Labeling Tape - $4;Braille Paper - $24

Beginning Per UnitAnnual allowance

34

9 2005

Life Exp.


Layla MaloneyMedications

Life Care Plan


Replacement


D/A:



Medications PrescribedPharmaceuticals $0 - $0

$0 - $0Per Year


Ending

Currently no prescription medicationsare utilized.

Beginning Per UnitSee Note

35

9 2005

Life Exp.


Layla MaloneyHome Care / Facility Care

Life Care Plan


Replacement


D/A:



Case Management Assist in implementationof Life Care Plan, assistwith Layla’s transitionthrough life phases;support.

$72 - $79

Per Year


Ending

$453 to $906 for first three months;then $906 to $1,812 / year through age22; thereafter $302 to $453 / year forsupport.

Beginning Per Unit

For Private Hire Options only: In order to assist Layla in finding appropriate candidates and maintaining a proper schedule for the attendants, additional case managementwill be required. It is anticipated the case manager would be required at least 8-10 hours per month in order to maintain the private hire and the responsibilities attached thereto.$7,248 to $9,060 per year.

2-4 hours / monthfor 3 months;then 1-2 hours /month throughage 22; thereafter4-6 hours / year.

36

9 2005

Life Exp.

Respite Care Services Respite Care Needs$19 - $24

$8208 - $10368Per Year


Ending

Beginning Per Unit

NOTE: Another Option would be to consider a "privately-hired" individual, who is a HHA, and trained to provide the type of care Layla needs. HHAs in Layla’s geographical areaearn a mean hourly wage of $9.03 (Source: U.S. Department of Labor, Bureau of Labor Statistics, Occupational Employment Statistics, May 2004 State OccupationalEmployment and Wage Estimates, Florida. www.bls.gov.) We must also add in an additional 25% factor to that hourly rate to cover matching social security, quarterlyunemployment compensation, worker’s compensation and appropriate accounting/administrative costs. Therefore, the total hourly rate would be $11.28 per hour, or $4,873 year,based on 432 hours per year.

1 weekend permonth for 36hours. (432hours / year)

37

9 2005

16 2012

NOW THROUGH AGE18: Attendant CareServices

Assist with activities ofdaily living, transport totherapy, etc.

$19 - $24

$20805 - $26280Per Year


Ending

Attendant care should be adjusteddownward by 93 hours form age 7through age 16, to avoid overlap withrespite care and summer camp.

Beginning Per Unit

NOTE: Another Option would be to consider a "privately-hired" individual, who is a HHA, and trained to provide the type of care Layla needs. HHAs in Layla’s geographical areaearn a mean hourly wage of $9.03 (Source: U.S. Department of Labor, Bureau of Labor Statistics, Occupational Employment Statistics, May 2004 State OccupationalEmployment and Wage Estimates, Florida. www.bls.gov.) We must also add in an additional 25% factor to that hourly rate to cover matching social security, quarterlyunemployment compensation, worker’s compensation and appropriate accounting/administrative costs. Therefore, the total hourly rate would be $11.28 per hour, or $12,352 peryear, based on 1095 hours per year.

3 hours per day, 7days per week(1095 hours peryear).

38

9 2005

18 2014



Life Care Plan


Replacement


D/A:



Interior/Exterior HomeMaintenance

Interior/ExteriorMaintenance of Home $65 - $95

$3380 - $4940Per Year


Ending

Assumes own home.Beginning Per Unit1 X / Yearallowance basedon weekly service

39

18 2014

Life Exp.

Housecleaning Cleaning of Dorm room,Apartment or Home $50 - $60

$2600 - $3120Per Year


Ending

Beginning Per UnitRegular weeklyservice

40

18 2014

Life Exp.

AGE 19 ThroughAGE 65: AttendantCare Services

Assist with activities ofdaily living $19 - $24

$27740 - $35040Per Year


Ending

Beginning Per Unit


4 hours per day, 7days per week(1460 hours peryear).

41

19 2015

65 2061



Life Care Plan


Replacement


D/A:



AGE 66 ThroughAGE 75: AttendantCare Services

Assist with activities ofdaily living $19 - $24

$41610 - $52560Per Year


Ending

Beginning Per Unit


6 hours per day(2190 hours peryear)

42

66 2062

75 2071

AGE 76 ThroughLIFE: Live-In AttendantCare Services

Assist with activities ofdaily living

Per Year


Ending

See below for costing information.Beginning Per Unit

NOTE: There are no live-in services available in Layla’s geographical area; therefore, to provide coverage for her needs, we must provide for 24 hours per day of care. There aretwo options available to an individual requiring long-term care of this nature. The first option is to provide 24 hours per day of care, contracted through an agency, which canprovide the employee (Nurse aide), all of the costs associated with having an employee which include items such as unemployment taxes, matching Social Security, Liability andWorker’s Compensation Insurance, Accountant Services for tax provisions, administrative costs which include background investigations, advertisement, screening, plusback-up assistance as needed. Hiring a 24-hour attendant through an agency will cost $19 to $24 / hour, or $166,440 to $210,240 / year, based on 24 hours per day, 8760 hoursper year.

The Second Option is to consider a "privately-hired" individual, one that the family or Layla hires. HHAs in Layla’s geographical area earn a mean hourly wage of $9.03 (Source:U.S. Department of Labor, Bureau of Labor Statistics, Occupational Employment Statistics, May 2004 State Occupational Employment and Wage Estimates, Florida.www.bls.gov.) We must also add in an additional 25% factor to that hourly rate to cover matching social security, quarterly unemployment compensation, worker’s compensationand appropriate accounting/administrative costs. Therefore, the total hourly rate would be $11.28 per hour, or $98,813 year, based on 8760 hours per year.

Live-In careservices

43

76 2072

Life Exp.


Layla MaloneyFuture Medical Care Routine

Life Care Plan


Replacement


D/A:



Ophthalmology Assessment of condition$75 - $250

Per Year

Andrea Zotovas,M.D.

Ending

$150 - $500 / year through age 18; then$75 - $250 / year thereafter.

Beginning Per Unit2 X / Year throughage 18; then 1 X /year

44

9 2005

Life Exp.

Neurologist Monitor shunt andneurological functioning $65 - $168

Per Year

Andrea Zotovas,M.D.

Ending

Beginning Per Unit2 X / year throughage 18; then 1 X /1-2 yearsthereafter

45

9 2005

Life Exp.

Neurosurgeon Monitor shunt$75 - $250

Per Year

Based on officerecord of Dr. DarralJameson dated7/16/03 and reviewby Andrea Zotovas,M.D.

Ending

Beginning Per Unit1 X / 2 Years

46

9 2005

Life Exp.

Psychiatrist Evaluate need to treatdepression and ADHDmedically.

$220 - $250

Per Year

Andrea Zotovas,M.D.

Ending

Beginning Per Unit1 X now forevaluation. Theneed for furthertreatment to bedetermined.

47

9 2005

9 2005

Podiatrist Foot/Nail Care due toVisual Deficits $50 - $60

$330 - $440Per Year

Andrea Zotovas,M.D.

Ending

To begin at approximately the age anindividual would provide their own nailcare.

Beginning Per Unit6-8 X/Year

48

12 2008

Life Exp.


Layla MaloneyFuture Medical Care Aggressive Treatment

Life Care Plan


Replacement


D/A:



Shunt Series Radiologic evaluation ofshunt. $240 - $276

Per Year

Andrea Zotovas,M.D.

Ending

Pending recommendations fromtreating physicians.


49

9 2005

Life Exp.

CT / MRI of Brain Monitor shunt, swelling,etc. $950 - $1570

Per Year

Andrea Zotovas,M.D.

Ending

Pending recommendations fromtreating physicians.


50

9 2005

Life Exp.

Shunt Revisions Maintain shuntfunctioning to controlintracranial pressure.

$20799 - $40140

Per Year

Andrea Zotovas,M.D.

Ending

Beginning Per Unit4-6 X over courseof life expectancydue tomalfunctions.

51

9 2005

Life Exp.


Layla MaloneyTransportation

Life Care Plan


Replacement


D/A:



Transportation Services Transport services, taxi,driver, etc.

$5000 - $5200Per Year


Ending


52

16 2012

Life Exp.


Layla MaloneyLeisure Time/Recreational

Life Care Plan


Replacement


D/A:



Camp for the VisuallyImpaired

Leisure Pursuits

$500 - $1240Per Year


Ending

Beginning Per Unit1 X / Year for one12 day session

53

9 2005

16 2012

Adapted Games forVisually Impaired

Recreation and inclusion

$150 - $250Per Year


Ending

Examples include but are not limited to:Backgammon in Braille, Monopoly inBraille, Braille Dominoes , LeapPad,etc.


54

9 2005

Life Exp.


paul m. deutsch & associates, p.a. life care plan dob: d/a ...€¦ · layla maloney projected...

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