Occupational Therapy Month 2021

Occupational Therapy Month 2021 Each year the month of April is Occupational Therapy Month, which is used to help promote occupational therapy. Although vitally important as a service to those who need it, occupational therapy is not as well known on the healthcare spectrum as some of its’ contemporaries. Beginning in 1980, Occupational Therapy Month has been used to bring attention and recognition to a nearly 100-year-old career rooted in science and evidence-based practice that focuses on practice areas that include Mental Health, Pediatrics, Rehabilitation, Disability, and Participation; Healthy Living Habits; Appropriate Aging; and Vocational Work. The best way to celebrate Occupational Therapy month is by recognizing occupational therapists and the type of work they do and why it is important. Occupational therapy is a process in which a holistic and customized approach is used to help people across the lifespan participate in activities they want and need to do through the therapeutic use of everyday activities (occupations). This type of therapy is focused on adapting an individual’s environment and/or task to fit the person and their specific set of circumstances or disability. Through this approach, occupational therapists enable people of all ages to live life to the fullest by helping promote health, and prevent – or live better with – injury, illness, or disability. Occupational therapy services typically include: an individualized evaluation, during which the client/family and occupational therapist determine the person’s goals; customized intervention to improve the person’s ability to perform daily activities and reach the goals; an outcomes evaluation to ensure that the goals are being met and/or make changes to the intervention plan. Below are some examples of common types of services occupational therapists provide:
  • Helping children with physical and mental disabilities fully participate in school and social situations.
  • Keeping older adult drivers independent and safe in their vehicles by conducting in car assessments, providing recommendations for adaptive equipment, and suggesting appropriate self-restrictions.
  • Offering individuals who are recovering from a stroke multiple ways to regain independence in their activities of daily living (i.e., dressing, bathing, and household chores).
  • Assisting individuals in recovering from an injury to regain the vocational skills necessary to return to their place of employment.
  • Providing support for adults and older adults experiencing physical and cognitive changes.
  • Conducting home evaluations for older adults or individuals with disabilities to prevent falls and promote safety.
  • Helping veterans with community integration by assisting them in overcoming physical injuries such as limb loss and mental challenges, such as traumatic brain injuries and post-traumatic stress disorder.

If you want to get involved and participate in Occupational Therapy Month, take the time to recognize an occupational therapist that you know. You can also go to www.AOTA.org to view educational materials to learn more about the profession and the individuals they support.

World Down Syndrome Day 2021

World Down Syndrome Day

March 21st is a day of celebration and awareness! World Down Syndrome Day (or WDSD) has been around since 2012 and is spearheaded by Down Syndrome International. Its purpose is to educate the world on Down Syndrome and how individuals with Down Syndrome need to be valued and appreciated in their communities. Down Syndrome International has linked up with national charities across the world to develop activities and events to raise awareness and highlight facts of what it is like to have Down Syndrome. The date for WDSD, 3/21, is significant because it symbolizes the triplication (trisomy) of the 21st chromosome, which is Down Syndrome.

Ways to get involved and help raise awareness:

  • Rock Your Socks Campaign:
    • Wear your favorite crazy socks and get noticed! Get your family, friends, classmates, and colleagues to join in with you on the fun and to show support. Make sure to tag #LotsOfSocks on social media to show off your wild and crazy pair.
  • Color it Blue and Yellow:
    • The colors for Down Syndrome awareness are blue and yellow. Wearing blue and/or yellow clothing or lighting something up with blue and yellow colors helps bring awareness to the cause. Other ideas include painting your nails blue and yellow, putting blue and yellow candles in your windows, or changing out your outdoor lightbulbs for blue and yellow ones to light up your house. Whatever you decide, be creative and have fun!
  • Organize or Participate in an Event:
    • Take the initiative and organize your own event that will help raise money and awareness! Plan a bike ride or walk, host a bake sale or raffle, or any other fun event that will help benefit those with Down Syndrome.

By participating and becoming involved in World Down Syndrome Day you are helping educate the public on what Down Syndrome is, encouraging those with Down Syndrome to participate in daily activities, promoting the vital role those with Down Syndrome play in their communities, and dispelling stereotypes.  Fundraising and donations support advocacy, inclusion, and well-being of people with Down Syndrome.

ABLE ACT: Legislation that Gives People With Disabilities the Ability to Save Money

Despite their considerable benefits, ABLE accounts still aren’t widely used. The Stephen Beck Jr. Achieving a Better Life Experience (ABLE) Act of 2014 recognizes the late Mr. Beck who paved the way for a better life for his daughter Natalie, and other persons with disabilities, by empowering millions of eligible Americans with disabilities to save money for their future. The ABLE Act established a tax-advantaged program for individuals and their families to save money for disability related expenses. Before the ABLE Act was passed, many individuals with disabilities were unable to save money to help pay for costly or big-ticket expenses without losing vital public benefits and forced to rely solely on these benefits. ABLE accounts were specifically designed to cover gaps in supports and services. This program allows people of any age who developed a qualifying disability before age 26 to invest up to $15,000 per year in an account that grows tax-free and can be accessed tax-free. An individual who is employed may contribute additional funds under the Able To Work Act. These tax advantaged accounts are very similar to 529 plans for college. Currently, 43 states and the District of Columbia have ABLE, or 529A, programs.  If your state does not have a program or you do not like your resident state’s program, you can open an account in any one of the 26 states that accept outside residents into their program. Each state has unique fees, maximum balance limits, and investment options. One of the biggest advantages of an ABLE account is that people with disabilities can save money in their own name without risking their government benefits. In the past, if they held more than $2,000 in their name, they’d lose their Supplemental Security Income and Medicaid benefits until they spent down the money. Now, they can save up to $100,000 in an ABLE account without affecting their SSI benefits, and ABLE balances of any size don’t affect Medicaid eligibility. Money in an ABLE account can be used for a wide range of goods and services as long as the expense helps improve the health, independence, and/or quality of life for the person with a disability. Withdrawals are tax-free for qualifying disability -related expenses, including, but not limited to housing, education, assistive technology, employment training, healthcare, wellness, basic living expenses, and transportation. An ABLE account can be opened with as little as a $25 investment depending on the state. Plans usually offer a small variety of mutual funds in which money grows tax-free. You can also roll over money from a 529 college-savings account to an ABLE, up to the maximum annual ABLE contribution limit minus any other contributions for the year. This rollover can help families who saved in a 529C before their child was diagnosed with a disability. For families with a loved one with special needs, planning for the future presents numerous challenges.  It’s nearly impossible to predict what the future may hold, and there are many additional costs associated with a disability.  The flexibility of ABLE accounts helps address these uncertainties with savings that can be used to meet each individual’s unique needs without jeopardizing eligibility of means-tested government benefits. To highlight this flexibility, consider the needs of a 7-year-old boy who has been diagnosed with autism. His parents hope that he will eventually go to college, be employed and live on his own. This may or may not be possible.  If possible, he may need to attend a special college or have additional supports at a traditional college. If not possible, he may benefit from a vocational program, job coaching, or other specialized supports.  An ABLE account can be used for all of those possibilities, and his parents can save for the future without knowing exactly how those funds might be spent. With an ABLE account, persons with disabilities can save money for large purchases necessary to improve their lives. Many times these funds are used to purchase costly accessible vehicles.  Other benefits of ABLE accounts are fostering person centered independence, building self-reliance, encouraging employment, and improving quality of life. These accounts provide the opportunity for people with disabilities, who have the ability, to be employed and save and control their own money without jeopardizing their benefits.  Living with a disability presents all sorts of challenges, ABLE accounts may offer solutions. Visit the ABLE National Resource Center (www.ablenrc.org) for a map of each state’s program and other information.  

Get To Know Aunt Bertha

Everyone needs a helping hand sometimes, but finding help can be daunting, and it is often difficult to know where to start. Enter Aunt Bertha. Aunt Bertha’s mission is to help people find the resources they need quickly, with dignity and ease.  Founded in 2010 and initially focusing on the Austin, Texas area, Aunt Bertha is a searchable database designed to pick up where Uncle Sam leaves off.  Anyone can search for help on this free platform at https://www.findhelp.org.  The company was founded by Erine Gray, after his own experience navigating the maze of care necessary to support his mother, who suffered from encephalitis.  The encephalitis caused permanent brain damage, memory impairment, and eventually early onset dementia.  Gray’s experience navigating the health and social services for his mother was eye-opening and made him “see how broken the system really was.”  His vision was for individuals to be able to go online, type in their zip code, and access multiple organizations that could help them. Before Aunt Bertha, no one had ever tried to take on the herculean task of digitizing all of the health and human services across the US.  Over its ten-year history, the company has expanded to serve people in all fifty states, providing information about 453,245 federal, state, and verified non-profit programs. More than 1,200 resources are available for each county in the country.  According to Gray: “It’s meant to be an entry point for finding out what’s available and finding out the enrollment process.” Keeping information current is a moving target with a data operations team constantly researching new and existing programs. Platform users can also suggest changes or program additions.  Since the pandemic, the need is greater than ever, and specific Covid-19 programs have been a focus. The process is fast and easy. To search for free or reduced cost social services, simply go to www.findhelp.org and type in your zip code.   You can then search for programs by categories such as: Food, Housing, Goods, Transit, Health, Money, Care, Education, Work, and Legal.  Results can be further filtered by client age, agency hours of operation, income eligibility, and more. For each program, comprehensive information regarding services offered, populations served, eligibility requirements, documents required, application process, and contact information is provided. The platform also includes a translation widget on each page which enables to page to be translated into any language that Google Translate supports.  There is an integrated, digital application form that easily transfers information to an agency form in just a few clicks. The application information and supporting documents can be saved in the system for future applications, and a dashboard helps you keep track of the programs you have previously applied for. As Gray explains, Aunt Bertha was designed to “solve the information gap….the nonprofits are doing the heavy lifting, offering help and getting people enrolled.  We’re making sure people can find them.”

Holiday Gift Guide For Children With Special Needs

Looking for a gift for a child or teen with special needs?  We are here to help! When shopping for someone with challenges, it is not just about finding something they will like — it is also about finding a gift they can use and enjoy on their own.  It is important to remember that not all items are made for all types of needs, every child is different in their ability level. Mainstream toys and electronic devices are not always compatible with the sensory and motor issues present in some children with special needs.  Some companies make alternatives that often mimic or improve on mainstream items.  They are designed with special needs children and teens in mind but are adapted with switches or larger buttons where needed and provide sensory experiences that are well-suited for those with sensory sensitivities.

To help guide your search, the team at Enabling Devices, a company dedicated to creating products to help people with disabilities participate fully in the world, suggests that you ask the following questions:

  1. Is the item right for the child’s abilities?
  2. Will the child be able to activate the toy by themselves?
  3. Does it appeal to their interests?
  4. Is It Physical?
  5. Do you need a special switch adaptor to activate?
  6. Does the toy encourage interaction with others?
  7. Is it safe for their developmental age?
  8. Is it fragile?
Resources and Websites Websites such as  https://funandfunction.com/  and  https://www.fatbraintoys.com/ do some of the legwork by arranging products by age and diagnosis.  From ADHD to Visual Impairment, they cater to those with cognitive, behavioral, and physical challenges.  eSpecial Needs, https://www.especialneeds.com/, carries a variety of unique special needs toys, including blocks, cognitive play, educational, magnetic activities, fine and gross motor, and pretend play. Ability Path provides a holiday toy guide created by a team of pediatric therapists (https://abilitypath.org/resources/holiday-gift-guide/).  Items are listed in alphabetical order with a description of the developmental benefits associated with each toy. Enabling Devices has a digital catalog filled with toys, games, and electronics specially designed to meet a wide range of special needs. The family-owned company adapts or manufactures all products in the U.S. and provides individualized assistance to guide your selection (https://enablingdevices.com/digital_catalog/). Different Roads to Learning, https://difflearn.com/, founded by the mother of a child with Autism, carries toys and products especially selected to support the autism community. If you are searching for a non-toy/game/electronic idea, consider photos and personalized items.  Photo books and digital frames promote imagination and creativity. They are a unique gift and a great way for children to learn names, faces, counting, emotions and more.  Personalized items with pictures or words are always popular. Whether you choose their name, a favorite phrase, their photo or a photo of their pet, the personalization possibilities are virtually endless. Last, when in doubt, just ask!  If you are not sure what kind of gift they might appreciate, ask them or their parents. Afterall, the greatest gift you can give any family is to let them know that you care for their child.                       

National Family Caregivers Month

November is National Family Caregivers Month, which recognizes the dedication of those who provide around-the-clock care to loved ones.  There are over 53 million Americans who are unpaid caregivers to family, friends, and neighbors. Twenty-seven percent, or nearly a third of adult caregivers, are helping someone with a mental illness. Over half of family caregivers are women and more than a million young people, aged 8 to 18, care for an adult relative on a regular basis.  Caregiving can often have a significant impact on the life of the caregiver in more ways than one. It can make maintaining your physical and mental health more difficult and may put a strain on work and social life.  Providing care around-the-clock can crowd out other areas of your life. To manage stress and prevent burnout: I. Ask for help Caregivers often bring stress upon themselves because they won’t allow others to pitch in. You may be surprised how much support you can get just by asking for it. Don’t downplay what you’re going through or worry about being a burden on others. Ask your neighbors, coworkers, friends, and family for the help you need. Most want to help but are not sure how or when.  Be specific and ask for help with a certain task or at a particular time II. Take Care of Yourself The irony of caregiving is that the person giving so much to others frequently forgets to give themselves the same treatment. Take a few minutes at the end of the day to ask yourself these questions:
  1. Did I get 7-8 hours of sleep last night?
  2. Did I eat 3 meals and a snack today?
  3. Did I drink 8 glasses of water today?
  4. Did I get any exercise today?
  5. Did I spend time on an activity I enjoy today?
  6. Did I spend time with someone other than the person I care for?
If the answer to more than one of these questions is no, it’s time to reevaluate your daily schedule and support. Sleep, proper nutrition, and hobbies are all human necessities, and if you neglect them for too long, you may fall ill yourself.

III. Cultivate outlets for stress

You may spend a significant portion of your time providing care, but it’s important to remember that your identity is so much more than that. Be intentional about keeping your interests alive so you can channel the strain of being a caregiver in a positive way.  Even if you can only get away for 5 minutes at a time, use it to do something you enjoy.

National Disability Employment Awareness Month: 75th Anniversary of Employing People of All Abilities

“Inclusion drives innovation” is the theme for this October’s National Disability Employment Awareness Month (NDEAM), an annual awareness campaign that celebrates the contributions of workers with disabilities and educates the public about the value of a workforce inclusive of their contributions, skills and talents. This year marks the nation’s 75th observance of NDEAM as well as the 30th anniversary of the Americans with Disabilities Act (ADA).  The roots of this month date back to 1945 when Congress enacted a law declaring the first week in October to be “National Employ the Physically Handicapped Week” focusing attention on the return of WWII soldiers with disabilities. Much has changed since then, but the fact that individuals with disabilities want to work and are a vital part of the American workforce remains the central message. People with disabilities are experienced problem solvers with a proven ability to adapt,” said Office of Disability Employment Policy Deputy Assistant Secretary, Jennifer Sheehy. In the current environment where the pandemic has challenged every aspect of our society and economy, “now more than ever, flexibility is important for both workers and employers. National Disability Employment Awareness Month celebrates the ingenuity people with disabilities bring to America’s workplaces.” In 2019, before the pandemic began to affect the U.S. economy, just 33 percent of people with disabilities ages 16 to 64 were employed, compared with 77 percent of people without disabilities. Since March, approximately 1 million US workers with disabilities have lost their jobs. Workers with disabilities represent only about 3 percent of the labor force, but they have experienced disproportionate labor market impacts of the COVID-19 pandemic. The US Bureau of Labor Statistic reported that since March, 1 in 5 workers with disabilities have been dismissed from employment compared to 1 in 7 in the general population. Both the widespread shut down of businesses and the mass shift to “work from home” have directly and negatively impacted employees and job seekers with disabilities, as well as the delivery systems for disability employment services. Many people with disabilities work in businesses identified as essential during the pandemic, such as grocery stores, retail fulfillment centers and healthcare facilities. However, underlying health conditions may put them at greater risk in these public-facing roles. In addition, these essential workers often rely on supports from job coaches and employment specialists to navigate elements of their job responsibilities.  Supported workers need assistance to understand universal precautions, to adjust to changing work responsibilities, manage anxiety and ensure communications are understood. Due to COVID-19 restrictions, many of this critical in-person support was put on hold. Similarly, when the economy shut down earlier this year, many facility-based day rehabilitation programs and pre-vocational programs were forced to shut down. Community-based service providers needed to quickly pivot to provide supports remotely, utilizing various forms of readily available technology, often without complete assurance that remote service delivery would be reimbursed. Despite a relatively quick response from state and federal authorities to enhance flexibility and adjust funding requirements, community-based disability service providers across the country had to shut down programs and furlough staff. It is unclear how many of these programs will reopen. Because of social distancing requirements, some programs are not able to serve enough people right now to be financially feasible and programs that have attempted to reopen have seen low utilization. National Disability Employment Awareness Month reminds us that people with disabilities deserve the same opportunities as everyone else to achieve personal satisfaction, economic security, and independence through employment.   Employment advocates across the country are working to overcome challenges amid the pandemic to keep their clients engaged in training and employed. They are balancing the availability of jobs with the safety of their clients to maintain supported employment and other employment services in local communities so that people with disabilities can have the supports they need to remain successful and safe on their jobs.

Your Vote Counts!

November 3 is Election Day and every vote counts! Voting is one of our most important civil rights, but it is not always accessible for persons with disabilities. According to projections from Rutgers School of Management and Labor Relations, in 2020, more than 38 million eligible voters have disabilities. That is more than 16 percent of the electorate, roughly the population of California. The disability community has incredible potential to influence the outcome of elections and ensure that all candidates address issues that are important to people with disabilities.  Lisa Schur, one of the study authors emphasizes “democracy only works if everyone is able to participate and vote” and notes “the sheer size of the disability electorate makes it clear that people with disabilities and their family members have the potential to swing elections.”  Voters will be electing officials up and down the ballot.  From the presidential election to school board elections, those elected will shape policies important to people with disabilities. Everything from the placement of curb cuts to health care laws can change based on who holds elected office. Due to COVID-19 there are real questions about how voting will work this November.  This year’s push to vote by mail underscores the variety of obstacles for voters with disabilities. Deque Systems, a software company focused on web and mobile accessibility solutions, recently published a report that found most states employ ballot applications that are inaccessible to people with disabilities.  Their findings revealed the process to apply to vote by mail in most states is difficult, if not impossible, for persons with disabilities.  One specific problem identified was trouble with screen reading software that does not clearly convey portions of the application needed for completion. When voting in person, Americans with disabilities also face access issues, including inaccessible polling locations, undertrained poll workers, and non-working voting machines employing assistive technology for people with vision or hearing issues.  People with disabilities may have to take extra steps to vote and advocate for themselves to be able to cast their ballots accessibly, independently, and privately. Clearly that needs to change. Voters with disabilities typically turn out in lower numbers than those without disabilities, but voter turnout among Americans with disabilities surged in 2018 and advocacy groups are hoping to repeat that this year despite the pandemic.  It is important that everyone who can vote has the opportunity to do so.  The deadline to register to vote in the November elections is October 13.  No matter what state or territory you are in, or what your challenges may be, there are resources to help persons with disabilities register, learn their rights, and make a plan to vote. National programs such as the Protections and Advocacy Voter Program, Paralyzed Veterans of America, and REV UP provide resources to ensure full participation in the electoral process for individuals with disabilities, including registering to vote, casting a vote, and accessing polling places.  The Autism Self Advocacy Network (ASAN) has developed a tool kit to assist people with intellectual and developmental disabilities understand the voting process, and Easter Seals has provided a voter checklist. We have provided a list of these resources below: https://www.aapd.com/advocacy/voting/ https://autisticadvocacy.org/policy/toolkits/voting/?utm_campaign=shareaholic&utm_medium=email_this&utm_source=email https://www.easterseals.com/explore-resources/living-with-disability/people-with-disabilities-voting-checklist-at-polls.html https://www.eac.gov/voter_resources/resources_for_voters_with_disabilities.aspx https://www.nonprofitvote.org/voting-in-your-state/special-circumstances/voting-with-a-disability/

Special Education Amid Covid-19

With the onset of Covid-19, educators have found themselves in uncharted territory.  In the spring, when schools closed their doors, they were forced to shift from in-school instruction to online instruction.  For the roughly 7 million American students with special needs, the coronavirus pandemic and its attendant school closures have presented unique challenges.  At school, these students received individualized instruction from trained professionals who understood their unique ways of thinking, perceiving, and processing. Many students had one-on-one professionals with them in the classroom in addition to their special education teacher and also received occupational, speech, and physical therapy.  Following school closures in March, many schools made an effort to continue the services and therapies that help students with disabilities access their education, but others did very little. In a survey released in May by the organization Parent Together, only 1 in 5 families was receiving all the special education services they were entitled to. For many special education students, the tools that other children use for remote learning—Zoom, Microsoft Teams, or printed work packets, are simply not accessible.    For example, students with sensory disabilities often use assistive technology, but many online platforms are not compatible with assistive technology and certain lessons cannot be taught remotely.  For low income families, internet access may be limited or unavailable. They lack printers or even paper to print lessons.  The nature of neurological and learning differences means that many students with special needs find change and inconsistency particularly stressful.  It is more difficult for them to be flexible and go with the flow, and they often do not have the attention to sit in front of a screen. Receiving therapy remotely presents its own challenges.  In some cases, parents were given a video to watch, instructing them how to provide therapies themselves.  In other cases, students did receive real-time virtual therapy, but it required parents to gather a wide array of materials, find a quiet spot in their home, and then guide the child through every step of the therapy.  Neither of these approaches is sustainable, and the therapies were not as effective as in-person sessions. As schools begin reopening, many fear the loss of specialized instruction and therapies, and reliance on family resources has caused special education students to fall behind on the subjects and skills they had been working on before the pandemic. According to Shawn Ullman, Senior Director of National Initiatives at the ARC, “there’s a general belief that students with learning disabilities lost more learning” than other students.  Some of the disparities that plague education are getting wider.  Instead of attending the same school with similar access to supplies and instruction time, students are directly dependent on their home resources.  Parents who work, have less means and/or less education, and their children, are at a significant disadvantage. Solutions to education during a pandemic are complex. The issues inherent in education for those with special needs only add to the complexity.  While some experts have advocated return to in-person learning to mitigate the academic and social losses associated with online learning, some students with disabilities have underlying conditions that make going to school during a pandemic especially risky.  At the same time, many students have behavioral and other needs that are met much more effectively in the structured environment of school.  One thing is certain, the federal government has not waived requirements under the Individuals with Disabilities Education Act, and schools are still required to comply with the services mandated by Individualized Education Programs. If you are concerned that your child is not receiving appropriate services, many advocacy groups are available to provide assistance.

Fighting For Your Child’s Rights

The beginning of school across America has many parents remaining concerned about the success of the year ahead. It’s been widely acknowledged that the level of education being provided to students in 2020 is not likely meeting typical academic standards. And it may take years before we see the costs to this generation’s learning and to the detrimental developmental affects that may result from a remote education. There are risks for almost all kids. But for students with special needs, the shift to online learning created more roadblocks in what is already a long line of barriers for them. Simply put, it’s even harder than usual to get access to the services required for their education. The Individuals with Disabilities Education Act (IDEA), signed into law by President Gerald Ford in 1975, is an extension of the Civil Rights Act. Recognizing that it is not only wrong to deny access to public school based on race, it is equally wrong to deny children with disabilities equal access to an education. And though IDEA sets minimum standards for every state to uphold, enforcing them isn’t so easy and each year fewer than half the states are in compliance with the federal law. The fact is, IDEA is the only federal law that is left to citizens, i.e. parents, to uphold. School districts have come to learn that non-compliance with the law typically costs them nothing, because apart from complaints or lawsuits from families, no one enforces these laws. The common consequence of not providing equal education is only that they must adhere to the law moving forward. In the meantime, the hundreds of pages of rules and constantly updated regulations make it easy for schools to hide the ball under the cup while parents and advocates struggle to stay abreast of the services and accommodations to which their child is entitled. States are not uniform in general when it comes to public education. The federal government has limited power with issues related to school funding, leaving disparities between states. Some school districts make calculated decisions on what they’ll provide, often with little regard for the children in their schools or for the law. The states that spend more money on education tend to have fewer lower-income students, so the poorest people in the country are receiving the fewest services. When the money isn’t there, it’s kids with disabilities that are typically the ones to fall through the cracks. Until schools are required to uphold mandates to provide free appropriate education tailored to individual disabled students’ needs, it will remain the job of parents to stay educated on what their child is entitled to and to work hard to be sure that they’re getting it. And with another year ahead of potentially online or hybrid learning, the work will be that much harder. Parents of children with special needs should contact their school early and often.  

Hope Trust serves clients throughout the United States.