Aging and Disability Network of Saratoga County Meeting Minutes 7/10/18

Aging and Disability Network of Saratoga County Meeting Minutes 7/10/18

Present: Patrick Harrington (Saratoga County Office for the Aging), Shelli Crogan (Interim Healthcare), Kim Anderson Swire (Shenendehowa Neighbors Connecting), Mary Moller (Center for Excellence of Alzheimer’s Disease Albany Med), Kasey Manning (SAIL),Denise DiNoto (Consumer Directed Choices), Blaise Bryant (Consumer Directed Choices), Caitlin St. George (The Eddy), Donna Rudzinski (Shenendehowa Village), Kimberly Arnold (Eddy Alzheimer’s Services), Jane Kerr Sussman (Saratoga Senior Center), Eric Weber (Saratoga Dept. of Social Services- Adult Protective), Ben Nichols (Saratoga County OFA), Denise Yannaci (Saratoga County OFA), Jess Flynn (Eddy Daybreak Adult Day Services), Amy Ponessa (Saratoga Hospital), Mary Rickard (Saratoga OFA), Kym Hance (Herzog Law).

Introductions and Announcements – There will be NO August Meeting. The next Aging and Disability Network meeting will be held on Tuesday September 11^th from 2-330pm at the Malta Community Center. Doris Green, Director of NYS Caregiving and Respite Coalition will speak about the agency.

Today’s Speaker and Topic: Sarah Szewczyk, Director of Marketing, NYSARC Trust Services: “Using a Pooled Trust for Medicaid Eligibility.”

Who is ARC New York?

·         Serving people with developmental disabilities in NYS since 1949

·         45 years’ experience administering supplemental needs trusts

·         Extensive knowledge of disability benefits and eligibility protection

·         Leader in developing and administering pooled SNTs

·         NY’s original provider of Medicaid income spend-down trusts

·         Trust administration for Eddy Community Trust

·         Trust has helped more than 19,000 people protect benefits

What is a Pooled Supplemental Needs Trust (SNT)?

A pooled trust is an irrevocable SNT that under Federal and NYS law allows people with disabilities and disabling chronic health conditions to protect excess funds in order to become financially eligible for government benefits like Community Medicaid and/or SSI.

Funds in a trust can be used to provide for quality of life purchases that a person’s benefits do NOT provide.

1^st Party Pooled Trust Overview:

·         Trustee must be a non-profit organization

·         In NYS, a financial institution must act as co-Trustee

·         Funds are pooled for investment purposes

·         Activity is tracked individually in sub-trust accounts

·         Trust is irrevocable and account terminates upon death of beneficiary

·         Under Federal statute, any funds not retained by the trust must go to the state that provided Medicaid services.

Benefits of a Pooled Trust:

·         Qualify and maintain eligibility for Medicaid to get community health benefits and long- term services

·         Protect funds for supplemental needs that enhance quality of life

·         Get long term care without a complete loss of resources

·         People can get care in the community and afford to live independently

·         Helps people transition home following short-term rehab

·         Benefits allow people to participate in adult day health and home care services

Using a Pooled Trust for Income Spend -Down:

“Income received by an individual and placed into a pooled SNT in the same month will be disregarded for Medicaid eligibility purposes.”

2018 NY Medicaid Income Limits

·         Individual- $842/month(+20)

·         Couple - $1233/month(+20)

2018 NY Medicaid Resource Limits

·         Ind -$15,150

·         Couple- $22,200

Examples of Monthly Income – Social Security, Pension, IRA Distribution, Disabled Adult Child or Survivor’s Benefits

Using a Pooled Trust for Excess Resources (Assets):

For someone on SSI receiving as little as $2000 could jeopardize that person’s eligibility for benefits

2018 NY SSI Resource Limits

·         Individual- $2000/month

·         Couple- $3,000/month

2018 NY Medicaid Resource Limits

·         Ind - $15,150

·         Couple- $22,200

Common Resource Examples: Direct Inheritance, Retroactive Social Security benefit, Lump sum or structured settlement, other monetary gifts

Case Study:

·         Maria is 80 years old and lives independently in her home

·         She has dementia and needs help with activities of daily living

·         Her monthly income from her pension and social security is $500 over the limit to qualify for Community Medicaid but she can’t afford to private pay for the care she needs

·         If she gives her excess income to Medicaid each month she will struggle to afford her living expenses to stay in her home

How it Works?

1.       Transfer/protect resources through planning solutions

2.        Obtain determination of disability from DOH

3.        Apply for Medicaid

4.        Apply for a pooled trust

5.        Deposit monthly surplus income (NAMI) into pooled trust

6.        Medicaid covers the amount of care per assessed need

7.       Funds in the pooled trust will pay for living and other expenses

*The order of these steps may vary

Obtain Determination of Disability:

·         County DSS will ask for proof of disability to qualify for benefits

·         Show proof with an award letter for wither SSDI or SSI benefits

·         If the beneficiary does not receive these benefits or has not otherwise been deemed disabled, you will need to complete some forms and contact DSS for a disability determination

·         Forms are available on www.health.ny.gov

Establishing a Pooled Trust:

·         NYSARC Community Trusts already established and approved by Social Security Administration.

·         Simply submit completed Joinder Agreement, Social Security documentation and initial funding

·         Open with as little as $300 (includes $200 one-time enrollment fee

·         Joinder Agreement creates sub-trust account and may be signed by individual, POA, Guardian, Parent/Grandparent

Account Approval:

Upon approval of Joinder Agreement and receipt of funds:

·         Sub-trust account established

·         Executed documents must be submitted by the beneficiary to local DSS office and/or provider(s)

·         Trust sends “Welcome Binder” and follows up with introductory phone call

·         Beneficiary and/or authorized contact can submit disbursement requests for distributions

Trust Administration:

·         All disbursements must be for sole benefit of the trust Beneficiary

·         Disbursements are paid directly to third parties (individuals or a licensed business)

·         Disbursements must be substantiated by supporting documentation

·         Electronic deposits and automated payments can automate the process

·         Account terminates upon passing of the trust beneficiary

·         No disbursements can be made after death in accordance with federal SSA POMS policy

Eligible Disbursements (non SSI):

·         Rent/Mortgage/Property Tax

·         Condo Maintenance

·         Home/Renters Insurance

·         Repairs/maintenance

·         Utility bills

·         Furniture

·         Groceries for beneficiary

·         Transportation/Vehicle expenses (owned by Beneficiary)

·         Irrevocable pre-need funeral plan

·         Uncovered Medical Expenses /OTC Items

·         Entertainment/Recreation

·         Other personal needs

Prohibited Disbursements:

·         Cash to beneficiary or bank accounts

·         Items for others (sole benefits)

·         Capital improvements to property not owned by beneficiary

·         Leases between spouses

·         Leases with POA when POA signs as landlord and tenant

·         Both rent and mortgage/property taxes, etc.

·         Items covered by government benefits

·         Alcohol, tobacco, firearms, illegal activity, bail, restitution

·         Disbursements after death of Beneficiary

Reporting and Tracking Trust Activity:

·         Account statements sent monthly- copies to family and services providers as requested

·         Track trust activity 24/7 with Online Portal or automated phone line

·         Verification of deposits automated to designated agencies upon request

·         Full detailed activity history when requested by Medicaid/DSS

·         Medicaid may require disbursement documentation, including receipts, invoices, etc.

·         Trustee/Administrator handles Trust tax reporting

What happens if a Beneficiary enters a Nursing Home?

·         If simply a Rehab period:

·         Beneficiary will give monthly surplus to NH during rehab period

·         Deposits to Trust restart after return home

·         If permanent placement:

·         Stop deposits and use balance until funds depleted

·         Surplus income now goes to Medicaid to cover cost of NH

What happens once the Beneficiary passes?

·         Sub-trust accounts terminate upon the death of the Beneficiary

·         In accordance with Federal and State statutes, no disbursements may be made after passing

·         Any remaining funds must be paid to the State that provided Medicaid services or retained by the trust to further the purpose of the trust

How NYSARC uses retained funds:

·         Retained funds are used to support unfunded guardianship and recreational programs for people with disabilities at The ARC New York chapters across NYS

·         Guardianship services support hundreds of people with intellectual and developmental disabilities who would otherwise have no legal guardian or advocate

If you have additional questions about this information please don’t hesitate to contact us:

Professional line: (518) 860-1258 (NOTE: different number than what we handed out at meeting)

www.nysarctrustservices.org