September 23, 2011MOPRA Conference

MSNT backgroundSpecial Needs TrustsProtecting BenefitsOpening and using a SNTMSNT ServicesQuestions & Discussion

Financial planning and estate tool Trust account for an individual with a disability

Administered by trustee/co-trustees Protects eligibility for SSI, Medicaid & other public benefits

Trust funds can be used for supplemental needs, NOT basic support needs

First Party or Self-Settled◦ Typical sources of funds

Back payment from Social Security Inheritance Personal Injury Settlement

◦ Medicaid payback required

Third Party◦ Family donors◦ Typically revocable until donor’s death◦ Does not require Medicaid payback

Trust language protects benefits◦ Used only to supplement benefits◦ No distributions that negatively affect benefits

Trust “exception” allowed by Medicaid and SSI regulations

Missouri Statute exempts resource for DMH services

Funds Can Be Used for Wide Range of Living and Health Needs

No Upper Limit on Amount in Trust

Exception for Counting Trust Resources for Persons with Disabilities

◦ Federal Medicaid Regulations Title 42 US Code Section 1396p(d)(4)(A) Title 42 US Code Section 1396p(d)(4)(C)

◦ SSI Section 1917(d)(4)(A) of the Social Security Act Section 1917(d)(4)(C) of the Social Security Act www.ssa.gov

Trust Established with Beneficiary’s Resources (SI 01120.203)◦ MSNT qualifies as Pooled Trust Exception [(d)(4)(C)]

No age restriction Must be established and administered by a non-profit

organization Must be for the sole benefit of individual with a disability May be established by the disabled individual, a parent,

grandparent, legal guardian, or a court State pay-back clause required

◦ If revocable, further criteria apply

All Necessary Documents Available at http://midwestspecialneedstrust.org/trustDocs/default.htm

◦ Master Trust Agreement◦ Beneficiary Background Information Form◦ Waiver of Right to Revoke (for third party only)◦ Enrollment Fee on Sliding Scale up to $500◦ Minimum Trust Deposit of $500◦ Add additional funds at any time

MSNT advises attorney consultation but does not require it

Attorneys Specializing in Special Needs & Estate Planning◦ National Association of Elder Law Attorneys

http://www.naela.org/public/ and click on pink box at right that says Find a Special Needs or Elder Law Attorney

◦ Special Needs Alliance, LLC http://www.specialneedsalliance.com/locate-an-

attorney

Distribution request form signed by co-trustee with appropriate documentation

MSNT reviews each request ◦ Must conform decision-making to fiduciary duties◦ Must assure will not have negative effect on

benefits Processed daily

◦ Authorize bank to prepare check available on next business day

― Checks are sent by MSNT to vendor or to co-trustee―$5 check fee

Periodic distributions can be arranged with appropriate justification

Medical and dental care not covered by Medicaid or health insurance

Private rehabilitative training Durable medical & rehabilitation equipment Supplementary education Entertainment

◦ Concerts◦ Periodic vacations and outings

Transportation of beneficiary or family & friends to visit beneficiary

Pre-paid burial expenses Expenditures to foster interests, talents,

hobbies Personal property, goods and services

◦ Furnishings, telephone/cable, etc. Personal caregiver or respite

◦ In-home support◦ To accompany beneficiary or provide

transportation Attorney fees to create trust or other legal

matters

MSNT will not accept or hold a home in trust Large purchases require board approval

◦ Takes time◦ Scrutiny◦ Example: Car

Documentation and Security agreement Check from MSNT to vendor

Fee Type Amount

Enrollment Fee $500

Annual Asset Value Fee(includes bank admin fees)

2.04% for AV ≤$9,999 plus 1.54% for AV ≥ $10,000

Check Processing Fee $5 per check

Annual Trustee Fee (only when MSNT is sole trustee)

$350

Extraordinary Services Fee $50 per hour, plus mileage, if applicable

Account Closure Fee $100

Charitable Trust Provision at death of life beneficiary

None if trust never used 25% of remainder balance if distributions were

made

Provide consultation on use of trust funds Staff and board knowledgeable about SSI,

Medicaid and services to PWD Smaller amount accepted to open a trust Reasonable administrative fees Investments managed at no additional

charge Minimizes co-trustee burden

Created by Missouri Statute in 1989 as Missouri Family Trust with 2011updates to authorizing statutes

Values-driven board appointed by Governor

Not for profit 501 c 3 Administer trusts for >900 individuals with

disabilities in Missouri & surrounding states

Average trust at opening is about $30,000

Missourians with disabilities with no trust may apply

Grants up to $1000◦ Urgent care◦ Board review

Limitations◦ One award per year◦ Cannot be for medical or dental already completed◦ Must provide a treatment plan with estimated costs from

the intended provider◦ Award must be used within 90 days◦ Payment made directly to the vendor, not the recipient

Application online or by request◦ Contact information on next slide◦ Sponsor or self submission◦ Timelines for submission

Midwest Special Needs Trust1500 Vandiver Drive, Suite 100Columbia, MO 65202

Phone: 573-882-3388Fax: 573-303-5866Email:

mftbt@midwestspecialneedstrust.org Web: www.midwestspecialneedstrust.org