Pooled Income Trusts

Pooled Income Trusts and Medicaid Home CareSecurity Administration. Consumers under sixty-five
Disabled persons of any age receiving communitywho have received either a Social Security disability
Medicaid services - including home care, adult-day carefinding or a Group 1 Disability Approval from Medicaid
and prescription drugs - are now able to use virtually allare also not required to have another disability review
of their income to pay for their living expenses bybut must provide documentation of disability findings.For
participating in a pooled-income trust. It is no longerthose whose disability has not yet been established,
necessary for consumers to contribute their "excess"Medicaid will make the determination on the basis of
income to the Medicaid system as a "spend-down."completed and signed forms LDSS-1151, DSS-486T
The pooled trust is proving to be a popular planning tooland MAP-252F.In order for a person to participate in
for persons in need of long-term health-care servicesthe trust, a joinder agreement between the beneficiary
for whom the excess-income option did not workand the trust must be completed.
because it would not allow them sufficient money toThe agreement must be signed by the disabled
live in the community and qualify for Medicaid. Theindividual (who must have capacity), or by a parent,
program works as follows:o Suppose Mr. Smith has agrandparent, guardian or a person acting under a
monthly income of $1,745 in Social Security anddurable power-of-attorney (with specific authority for
pension income and is utilizing Medicaid home care andjoining a pooled trust), or the agreement must be
adult day-care services. Under present (2007)approved by the court. To initiate the process of
Medicaid guidelines he is only allowed to keep $745 ofconserving his "excess" income the individual
that income.o Currently his monthly surplus is $1,000beneficiary should deposit into his separate trust
($1,745 - $745 = $1,000). He is sending a check eachaccount the equivalent of two months' excess income
month for that amount to the appropriate health-care(one month as a deposit and the other as working
provider as a contribution toward the cost of his care.ocapital).While there are no restrictions attached to the
After Mr. Smith joins the pooled-income trust his $1,000establishment or addition of funds to an
check will be sent to the trust office. He will keep $720already-established pooled trust by an individual under
as he does now. Mr. Smith's expenses for rent, food,sixty-five, there are restrictions on the transfer of
utilities, clothing, etc. will be paid by the trust accordingfunds into a pooled trust by an individual sixty-five or
to instructions from Mr. Smith or his representative. Mr.older. If a disabled individual either first establishes or
Smith's Medicaid services will not be affected.Theadds funds to an already existing pooled trust after he
pooled-income trust contains the assets of a numberturns sixty-five that transfer of assets is subject to the
of disabled individuals and is managed by a non-profitappropriate penalty period for Medicaid coverage of
organization that maintains separate accounts fornursing facility services. Please see the article on
each individual. It is effectively a supplemental-needsMedicaid Update - The Good News.
trust that receives the beneficiary's monthly incomeAll pooled-income trust cases must be reviewed by
and redistributes it on his behalf as directed by thegovernment attorneys before a final determination of
beneficiary or his representative.eligibility is made. Before proceeding with the
Generally, consumers of any age (including those agepooled-income trust, individuals and their families are
sixty-five or older) who wish to establish pooled-truststrongly encouraged to consult with an attorney who
accounts are required to have a disability evaluation ashas knowledge of and experience in planning for
part of the eligibility determination process unless theylong-term-care needs.
have already been determined disabled by the Social