Over the Resource Limit for SSI or Medicaid? - YouTube

[Acoustic music]

[NYSARC Logo and tagline: Enhancing the lives of people with disabilities since 1972]

[Over the resource limit for SSI or Medicaid?]

If you are working with someone who is over the resource limit for SSI or Medicaid, you

have a few options to help them spend that money down below the limits in order to maintain

the person’s eligibility for services.

NYSARC Trust Services administers pooled special needs trusts and each year we help thousands

of people with disabilities and qualifying adults protect funds in order to maintain

their financial eligibility for means-tested government benefits.

In this video, we will explain how a NYSARC Community Trust can help the people you serve

in these situations.

We will review common scenarios where you might consider using a trust, answer frequently

asked questions, and demonstrate the unique advantages of this program.

Which can help the people you serve save time and money, while maximizing trust funds to

improve their quality of life.

[When to use a NYSARC Community Trust?]

People with disabilities who receive Supplemental Security Income and Medicaid benefits often

have to spend down funds in their name in order to stay below the financial limits for these vital programs.

these vital programs.

This can make it challenging for people with disabilities to save money and plan for the future.

Because a single person receiving SSI benefits, can never have more than $2,000 in their name.

If the person only receives Medicaid services, they can have more money available to them

because the financial limits for Medicaid are higher.

But, these limits can still be difficult to maintain when someone receives a large sum

of money.

This happens most commonly when a person receives money directly, from a retroactive social

security payment, an inheritance from a loved one, or a settlement award from a personal

injury or medical malpractice lawsuit.

A person may also have excess resources accruing on a regular basis due to unspent funds from

Social Security Survivor’s benefits or disabled adult child (DAC) benefits, wages and unemployment

benefits, and other windfalls of money, such as lottery winnings or monetary gifts from

family members.

When a person is over the resource limit for one of these programs, the first thing to

consider is whether you can appropriately spend the funds quickly on purchases of items

and services that the person wants or needs, like adaptive equipment that is not covered

by their benefits or something recreational like taking a trip or paying for the person’s

admission to Summer camp.

An irrevocable pre-need funeral arrangement can be a great option when you are considering

ways to spend down those funds.

Another option, would be to transfer the funds out of a person’s name and deposit them

into a vehicle that protects someone’s eligibility for benefits, like a special needs trust,

pooled trust, or ABLE account.

[What is a NYSARC Community Trust?]

NYSARC Community Trusts  are irrevocable first-party 

pooled special needs trusts, also commonly

known as supplemental needs trusts.

These are called first-party trusts because it is the person with a disability’s own

money funding the trust.

The funds in a pooled trust are managed by not-for-profit organizations, like NYSARC,

for the benefit of a person with a disability known as the trust beneficiary.

Pooled trusts are designed for people with 

disabilities to protect  their financial eligibility

for benefits without having to forgo money or assets they are entitled to.

By depositing those funds into a pooled trust this allows people with disabilities to use

that money to provide for future wants and needs that will improve a person’s quality

of life without causing a  reduction or interruption 

in their services.

[Benefits of a NYSARC Community Trust]

And there are many advantages to choosing a pooled trust in these situations when you

need to protect excess resources.

Pooled trusts are quick and easy to establish with low minimum funding requirements, and

the costs to set up and maintain the account are typically very low, making them a great

option for any amount of money, but especially for modest sums of money.

And pooled trusts do more than just protect a person’s eligibility for these vital programs.

Beneficiaries also receive the added benefit of working with a professionally trained trustee

and investing their funds with a pool of other people who are also participating in the trust.

Funds in the trust are pooled for investment and management purposes, which is how we maintain

such low costs for our beneficiaries.

However, each person you are working with will have their own sub-trust account with

NYSARC Trust Services with a management board of trustees who provide oversight of trust

distributions.

So that gives the benefit  of having a professionally 

trained organization who knows the rules of

Social Security and Medicaid and has years 

of experience working with  people with disabilities

and protecting government benefits.

Our knowledgeable team of representatives 

help guide the people we  serve in making appropriate

distributions and we assist with the day-to-day management of assets in the trust.

A financial institution, appointed by NYSARC, 

serves as a co-trustee to  manage trust investments.

Funds are invested using a balanced objective and each beneficiary owns a pro-rata share

of the investments.

This way the funds have opportunity to grow and that money can provide a greater financial

benefit to the individual over time.

Our co-trustee Key Private Bank provides the financial management and has more than 190

years of extensive fiduciary and wealth management experience.

As trustees, we have a legal obligation and fiduciary responsibility to the beneficiary

to protect that trust.

This not only benefits the beneficiaries we serve, it provides peace of mind to their

family members.

Relieving their concerns about selecting an appropriate trustee or worrying about who

will care for their child when they can no longer support them financially.

[How to Establish a NYSARC Community Trust?]

To create the trust, the beneficiary must complete and sign the Joinder Agreement, which

is the application to join the trust, and have it notarized.

Then attach some supporting documentation and fund the trust with a minimum of $300.

If the beneficiary is unable to sign the Joinder Agreement, the account can be established

by someone with the legal authority to sign and fund the trust on their behalf, such as

a parent, grandparent, legal guardian, agent under power of attorney, or the court.

A rep payee can also fund the trust exclusively with Social Security funds.

Check out the flow chart in the resources section of our website to help guide you in

determining who can establish and fund a trust in this situation and contact us with questions.

[Will there be a transfer penalty?]

Because there are no age limits on using pooled trusts, someone of any age can establish a

NYSARC Community Trust.

However, depending on a person’s benefits there may be a penalty for transferring funds

to a pooled trust or ABLE account after the individual is over the age of 65.

For SSI recipients, the penalty is a maximum of 36 months and it is calculated by dividing

the total amount transferred by the amount of the person’s monthly SSI payment.

So if a person is receiving a large enough amount of money, it may still be in their

best interest to deposit those funds into a trust.

The money in the trust can then cover their basic needs while they wait out the penalty

period.

If the person you are working with is unable to sign the Joinder Agreement or they are

over the age of 65 and receiving SSI benefits, contact us to discuss their options before

getting started with an application.

[What can the trust pay for?]

A key goal of the trust is to preserve funds to protect a person’s benefit eligibility

and to provide the best quality of life possible by paying for goods and services that a person’s

benefits don't provide.

So, what that means is that the trust cannot pay for the types of medical services that

a person receives through Medicaid or if a person receives SSI the money cannot be used

to pay for food and housing expenses without impacting their SSI benefits.

A good example would be when someone lives in a residential facility; trust money cannot

be used to pay for the services or basic needs that that facility is required to provide,

like allowance for clothing and furniture.

However, the trust can pay for items once someone’s personal funds are exhausted or

contribute towards the cost of purchasing a special piece of furniture that a person

would like.

Distributions from the trust must also be for the primary benefit of the trust beneficiary.

This means we cannot buy gifts for other people and distributions from the trust must be for

items and services for that individual.

However, the Social Security Administration does not expect people to live in isolation

and recognizes that certain purchases may allow incidental benefits to third parties.

For example, the trust could purchase a TV for a beneficiary.

Their family or other residents in their home might watch that TV with them, but the purchase

should be for their primary benefit.

The trust typically would not purchase a TV for the living room of a residential facility.

Beyond that, the money can be used for so many things.

There are truly infinite ways to use the funds in a trust to benefit the individuals we serve.

A lot of the time we are using it for uncovered medical expenses, such as assistive technologies

or therapies that aren’t covered by Medicaid.

The trust can pay for care management and companionship services provided by a third-party

agency if the person needs someone to accompany them to an appointment or medical procedure.

And it can also be things that are purely life-enhancing, like travel and recreation,

an iPad or computer for entertainment, tickets to a baseball game, or admission to an art

or music class the individual would like to take.

Really anything, that for the specific individual, is going to enhance their quality of life,

so it’s very unique to the individual.

In order to protect a person’s eligibility for benefits, the trust cannot give money

to the individual directly or their spouse.

This would undo the protection that the trust creates by making those funds available to

them.

For that reason, disbursements must be made payable to third parties, either to pay a

business or to reimburse someone, such as a family member or close friend, who made

a purchase for our beneficiary.

The trust cannot reimburse the beneficiary, their spouse, or a person’s legal Guardian.

All disbursements are made at the sole discretion of the Trustees in accordance with Federal

and State guidelines.

This is to ensure that distributions from the trust will not adversely impact someone's

eligibility for public benefits.

If you ever have a question about how to use the funds appropriately or you are unsure

if an expense is eligible for payment from the trust, give us a call and we would be

happy to assist you.

NYSARC works closely with our beneficiaries, their family, guardians, and service providers

to understand each person’s individual needs.

These individuals can be authorized on an account to have oversight and also assist

with submitting disbursement requests.

This gives families a way to be actively involved in their loved one’s trust without having

to take on the legal responsibility of serving as trustee.

We also offer an easy-to-use online portal and an automated phone system where beneficiaries

and authorized contacts can monitor trust account activity at their convenience.

[How do I submit disbursement requests?]

Once you are ready to begin using the funds in a trust account, you can submit a request

to the trust for review.

To submit disbursement requests, an authorized individual must complete and sign a disbursement

request form and attach a  bill in the beneficiary’s 

name, a receipt, or other proof of payment

for an expense that was incurred in the last 90 days.

Disbursement requests are typically processed in a few business days, as long as you provide

all required documentation and no follow up is needed.

However, there are certain purchases that are more complex and they may take a little

longer to process, like purchasing adaptive equipment or a vehicle for example.

[What happens to the funds when the trust closes?]

Pooled trusts are irrevocable to protect a person’s eligibility for benefits.

But, a person can opt-out of using the trust.

If there is a balance in the trust, that person can continue to submit requests during their

lifetime to spend down the funds on eligible expenses.

Upon the passing of the trust beneficiary, under Federal and New York State statute,

NYSARC is required to close the trust account and no payments can be made out of the trust

after the date of death.

Any funds left in the trust at that time are typically retained by NYSARC Trust Services

to provide services to people with disabilities served by Chapters of the Arc New York.

This provides our Chapters with the means to offer unfunded programs and recreational

opportunities to the people  we serve and administer 

a nationally-recognized Corporate Guardianship

program.

If NYSARC did not retain the funds, that money would typically go to repay the State(s) that

provided Medicaid services on behalf of the individual.

However, we do have a program where a portion of the remaining money can go to residual

beneficiaries if funds are left over after paying off the full amount of a person’s

Medicaid lien.

We’ve covered a lot in this video and we understand you probably have many questions,

so please reach out to us.

We also have a great resource section on our website at nysarctrustservices.org, where

you can get helpful information, watch other videos and trainings, and review frequently

asked questions about our trust programs.

There are so many factors to consider when a person receives money that could affect

their eligibility for services.

We encourage attorneys, providers, and families to look at all of the options available to

them to protect a person’s benefit eligibility.

If you know someone in one of these situations and you want to discuss if a pooled trust

would be a good fit, give us a call.

We are here to be a resource to you, your staff, and the families you serve.

[Do you have questions? Call Customer Service at 518-439-8323. We will gladly assist you.]

[Acoustic music]

[NYSARC Logo and tagline: Enhancing the lives of people with disabilities since 1972]