I. INTRODUCTION
               On April 6, 2007, claimant D~’s (D~) legal guardian executed a J~ Agreement (P~) establishing
                  an account for P~ in the Jewish Family & Children’s Services of Southern Arizona Pooled
                  Trust (JFCS Trust). On November 15, 2012, claimant J~ (J~) also executed a Joinder
                  Agreement (L~) establishing an account for himself in the JFCS Trust.
               
               On November 25, 2013, JFCS and Secured Futures, Inc. (Secured Futures) entered into
                  an Agreement (Trustee Agreement) under which Secured Futures became a co-trustee of
                  the JFCS Trust effective January 31, 2014 and JFCS resigned as co-trustee effective
                  February 1, 2014. Trustee Agreement, ¶¶ 1, 2.
               
               Under the Trustee Agreement, Secured Futures, as successor trustee, “shall operate
                  the [the JFCS Trust] in accordance with the provisions therein and in accordance with”
                  the Secured Futures Pooled Special Needs Trust (SF Trust). Trustee Agreement, ¶ 3.
                  In the event of a conflict between the JFCS Trust and the SF Trust, the JFCS Trust
                  “shall govern and control.” Trustee Agreement, ¶ 3. The Trustee Agreement states that
                  “[u]pon JFCS’s resignation as Co-Trustee, the Beneficiaries shall become beneficiaries
                  of the [SF Trust]” but does not require those beneficiaries to execute Joinder Agreements
                  for the SF Trust. Trustee Agreement, ¶ 4.
               
               P~ and L~ did not execute Joinder Agreements for the SF Trust.
               II. QUESTION
               The P~ and L~ trust accounts are not excepted from resource counting under § 1917(d)(4)(C)
                  of the Act. Specifically, the accounts are subject to the terms of the JFCS Trust,
                  which does not provide for reimbursement to all states that provided medical assistance to the respective beneficiaries during their
                  lifetimes.
               
               III.  SHORT ANSWER
               The P~ and J~ trust accounts are not excepted from resource counting under § 1917(d)(4)(C)
                  of the Act. Specifically, the accounts are subject to the terms of the JFCS Trust,
                  which does not provide for reimbursement to all states that provided medical assistance to the respective beneficiaries during their
                  lifetimes.
               
               IV. RELEVANT TRUST PROVISIONS
               A. JFCS Trust
               The Jewish Family & Children’s Services of Southern Arizona, Inc. (JFCS) established
                  the JFCS Trust on January XX, 2005. On November XX, 2007, JFCS amended and restated
                  the trust.
               
               Article II, Trustee, states that JFCS, a non-profit association, is the trustee of the JFCS Trust. JFCS
                  Trust, Art. II.
               
               Article III, Beneficiary, provides that beneficiaries are disabled individuals who have accounts with the
                  trust; an individual is eligible to participate in the trust if the Social Security
                  Administration (SSA) has determined he or she is disabled or if the Trustee finds
                  that the individual is disabled as defined in the Social Security Act. JFCS Trust,
                  Art. III.
               
               Article V, Irrevocability and Amendment, provides that the trust is irrevocable, although it may be amended by the trustee
                  if necessary to carry out the purposes of the trust or to comply with the requirements
                  of federal or state law to accomplish the purposes of the trust. JFCS Trust, Art.
                  V.
               
               Article VI, Trust Property, states that each beneficiary shall have a separate sub-account solely for his/her
                  benefit. JFCS Trust, Art. VI.A, C & D. To join the trust, a beneficiary (or parent,
                  grandparent or legal guardian) must sign a Joinder Agreement (Joinder). JFCS Trust,
                  Art. VI.B. The Trustee may pool individual sub-accounts for investment and management
                  purposes. JFCS Trust, Art. VI.C. Trust property may not be refunded or withdrawn by
                  the beneficiary or donor once accepted by the trustee and deposited into the trust.
                  JFCS Trust, Art. VI.E (stating “such property transferred shall become irrevocably
                  part of the trust”).
               
               Article VIII, Distributions, addresses how sub-account assets may be used. It provides that the trustee may,
                  in its sole discretion, distribute sub-account income or principal for the beneficiary’s
                  supplemental needs but not for his/her primary support or to supplant or replace public
                  assistance benefits. JFCS Trust, Art. VIII.A-D. Sub-account distributions are to be
                  made to or for the benefit of the beneficiary – and no other persons – during his/her
                  lifetime. JFCS Trust, Art. VIII.E. Distributions may also be made to pay trustee compensation,
                  expenses, and taxes. JFCS Trust, Art. VIII.F.1-3.
               
               Article IX, Distributions Upon the Death of a Beneficiary, addresses disposition of sub-account assets when a beneficiary dies. It provides
                  that, upon the death of a beneficiary, any amounts remaining in his/her sub-account
                  will be retained by the trust in a general account as “surplus trust property” to
                  be used (1) for the benefit of other beneficiaries, or (2) to aid, provide housing,
                  or provide supplemental support services to persons who are indigent and disabled
                  as defined in the Social Security Act. JFCS Trust, Art. IX.A. To the extent the trust
                  does not retain any amounts in the deceased beneficiary’s sub-account, the trustee
                  will “pay to the State (AHCCCS) from such remaining amounts in the account an amount
                  equal to the total amount of medical assistance paid on behalf of the beneficiary
                  under the State’s plan under 42 U.S.C. § 1396(a) et seq.” JFCS Trust, Art. IX.B.
               
               Article XI, Spendthrift Provision, prevents beneficiaries from demanding or directing payment of trust principal or
                  income. It also provides that beneficiaries’ interests shall not be subject to transfer,
                  assignment, or creditors’ claims. JFCS Trust, Art. XI.
               
               Article XII, Construction and Interpretation, states that the trust shall be construed and interpreted in accordance with Arizona
                  State law. JFCS Trust, Art. XII.A. If a beneficiary moves from Arizona to another
                  State and qualifies for SSI or Medicaid benefits in such other State, “references
                  to Arizona or to State in this trust shall also apply to the other State, but the
                  rights of the State of Arizona (AHCCCS) as a remainder beneficiary after the death
                  of any individual beneficiary shall be retained.” JFCS Trust, Art. XII.B.
               
               B. SF Trust
               Secured Futures established the SF Trust on May 30, 2008. Secured Futures amended
                  and restated the SF Trust on February 27, 2009.
               
               Article One defines “beneficiary” as a disabled person within the meaning of 42 U.S.C.
                  § 1382c(a)(3) (Social Security Act § 1614(a)(4)) who has a “Beneficiary Trust Share”
                  account, which is defined as the share or portion of the trust held for the individual
                  beneficiary. [2]
               Article Two, Purpose and Establishment of the Trust, states that the trust’s purpose is to hold the funds of disabled persons for their
                  supplemental needs. SF Trust, Art. Two, § 2.1. Beneficiaries’ funds may be combined
                  for investment and administration purposes, but are deemed to be the share of, and
                  for the benefit of, each individual beneficiary. SF Trust, Art. Two, § 2.2. The trust
                  shall be effective as to any beneficiary upon execution of a Joinder by the beneficiary
                  or other grantor, approval of the Joinder by the trustee, and delivery to the trustee
                  of assets. SF Trust, Art. Two, § 2.3.
               
               Article Five, Irrevocable Trust, states that the trust shall be irrevocable, subject to the trustee’s right to amend
                  the trust under limited circumstances. SF Trust, Art. Five.
               
               Article Six, Establishment, Administration and Disposition of Beneficiary
                     Trust Shares, covers the creation of an individual sub-account, its administration, and its disposition
                  upon the death of the beneficiary, as follows:
               
               Establishment: A beneficiary trust share is created upon the execution of a Joinder by the beneficiary
                  (or other grantor), the trustee’s acceptance of the Joinder, and delivery to the trustee
                  of assets for the sub-account. SF Trust, Art. Six, § 6.1.
               
               Administration: The sub-account is to be used for the beneficiary’s supplemental needs during his/her
                  lifetime and shall not supplant or replace government benefits. SF Trust, Art. Six,
                  § 6.2. All sub-account deposits are irrevocable and non-refundable. SF Trust, Art.
                  Six, § 6.4. The trustee has discretion in making distributions for the beneficiary’s
                  benefit; disbursements may not be assigned or compelled by a beneficiary and sub-account
                  assets may not be made available to his/her creditors. SF Trust, Art. Six, §§ 6.2,
                  6.6, 6.7.
               
               Disposition upon the death of the beneficiary: Upon the death of the beneficiary, any amounts remaining in his/her sub-account
                  shall be used, in the trustee’s discretion, (1) for the benefit of other beneficiaries
                  of the SF Trust, or (2) to provide disabled persons with equipment, medication or
                  services. SF Trust, Art. Six, § 6.12. To the extent sub-account funds are not retained
                  by the trust, such funds shall be used to “repay the Medical Assistance paid by all
                  states on behalf of the Beneficiary under the State Plan under Title XIX of the Social
                  Security Act after allowable administrative expenses and taxes are paid.” SF Trust,
                  Art. Six, § 6.13. After repayment of the medical expenses and payment of expenses
                  and taxes, any funds remaining will be paid to beneficiaries named in the Joinder.
               
               Article Seven, Trustee to Trustee Transfers, addresses the early termination of a beneficiary’s sub-account if the trustee believes
                  either that it cannot fulfill its fiduciary duties to a beneficiary or that the sub-account
                  may become liable for a beneficiary’s basic maintenance and support. SF Trust, Art.
                  Seven, § 7.1. Under such circumstances, the trustee has discretion to transfer the
                  subaccount to (1) a comparable non-profit pooled trust organized under 42 U.S.C. §
                  1396p(d)(4)(C), [3] or (2) a private special needs trust organized under 42 U.S.C. § 1396p(d)(4)(A).
                  SF Trust, Art. Seven, § 7.1(a) & (b).
               
               Article Nine, Termination of the Trust during the Beneficiary’s
                     Lifetime, permits the trustee to terminate the trust if it becomes impossible or impracticable
                  to meet the trust’s objectives due to changes in the law or other unforeseen situations.
                  SF Trust, Art. Nine, § 9.1. Under such circumstances, the trustee may terminate the
                  trust agreement and transfer the sub-accounts to another pooled trust or individual
                  special needs trust as provided in Article Seven. SF Trust, Art. Nine, § 9.1. Any
                  funds not transferred to another trust will be used to repay the medical assistance
                  paid by all States on behalf of the beneficiary and any amounts remaining will be
                  distributed to the beneficiary. SF Trust, Art. Nine, § 9.2.
               
               C. Arizona Amendment to the SF Trust
               On August 24, 2012, Secured Futures further amended the trust to conform with certain
                  provisions of Arizona State law through the Arizona Amended Secured Futures Pooled
                  Special Trust Agreement (Arizona Amendment).
               
               Paragraph 2 states that the SF Trust shall comply with certain provisions of Arizona
                  law. The Arizona Amendment controls if there are conflicts between Arizona law and
                  the trust. Ariz. Amend., ¶ 2.
               
               Paragraph 3 states that the Arizona State Medicaid agency shall be the primary beneficiary
                  of the sub-account if the trust is terminated before or upon the death of the trust
                  beneficiary. Ariz. Amend., ¶ 3.
               
               Paragraph 7 states that the trust share account established for a beneficiary “shall
                  be for the benefit of the trust beneficiary.” Ariz. Amend., ¶ 7.
               
               The Arizona Amendment ratified and reaffirmed the SF Trust in all other respects and
                  stated it shall remain in full force and effect.
               
               V. RELEVANT AUTHORITIES
               A. Social Security Act
               When determining eligibility for SSI, a trust established after January 1, 2000 with
                  an individual’s assets for his or her own benefit is considered a resource under §§
                  1613 and 1917 of the Act. Social Security Act §§ 1613(e), 1917(d). A trust established
                  with the assets of a disabled individual that is part of a pooled trust may be exempted
                  and not counted as a resource under certain circumstances. Social Security Act §§
                  1613(e)(5), 1917(d)(4)(C). To meet this exception: (1) the trust must be managed by
                  a non-profit association; (2) a separate account must be maintained for each beneficiary
                  of the trust; (3) accounts in the trust must be established for the sole benefit of
                  the beneficiaries by a parent, grandparent, legal guardian, by the beneficiaries themselves,
                  or by a court; and (4) upon the beneficiary’s death, the trust must pay the State
                  from any remaining trust balance the total amount of medical assistance paid on behalf
                  of the deceased beneficiary during his or her lifetime. Social Security Act § 1917(d)(4)(C).
               
               B. Program Operations Manual System (POMS)
               Additional guidance is provided in Program Operations Manual System (POMS) SI 01120.201 (Trusts Established with the Assets of an Individual on or after 1/1/00) and POMS
                  SI 01120.203 (Exceptions to Counting Trusts Established on or after 1/1/00). As a general rule,
                  a trust established after January 1, 2000, with the assets of an individual, for his
                  or her own benefit – even if irrevocable – must be counted as a resource. POMS SI 01120.201. Consistent with the Act, however, POMS recognizes there are exceptions, including
                  trusts established to meet the needs of disabled individuals under § 1917(d)(4)(C)
                  of the Act. See  POMS SI 01120.201, SI 01120.203.
               
               To satisfy the pooled trust exception, the trust must be established by an organization
                  that has been established and certified under a State nonprofit statute. POMS SI 01120.203.B.2.c; see Social Security Act § 1917(d)(4)(C)(i). The trust also must maintain a separate account
                  for each trust beneficiary, although the funds may be pooled for investment and management
                  purposes. POMS SI 01120.203.B.2.d; see  Social Security Act § 1917(d)(4)(C)(ii).
               
               POMS also explains that “the trust must contain specific language that provides that,
                  to the extent that amounts remaining in the individual’s account upon death of the
                  individual are not retained by the trust, the trust pays to the State(s) from such
                  remaining amounts in the account an amount equal to the total amount of medical assistance
                  paid on behalf of the individual under the State Medicaid plan(s).” POMS SI 01120.203.B.2.g; see  Social Security Act § 1917(d)(4)(C)(iv). Further, the trust must provide reimbursement
                  to any State(s) that may have provided medical assistance under the State Medicaid
                  plan(s) and payback may not be limited to any particular State(s) or period of time,
                  such as after establishment of the trust. POMS SI 01120.203.B.2.g.
               
               The agency has interpreted “the sole benefit” requirement of § 1917(d)(4)(C) of the
                  Act to mean the trust cannot benefit anyone but that individual from the time of the
                  trust’s establishment through the remainder of the individual’s life. POMS SI 001120.201.F.2.a;
                  see Social Security Act § 1917(d)(4)(C)(iii). Therefore, aside from payments for goods
                  or services for the trust beneficiary and reasonable administrative expenses, the
                  trust must not (1) provide a benefit to any other individual or entity during the
                  disabled individual’s lifetime, or (2) allow for termination of a trust account prior
                  to the individual’s death and payment of the assets to another individual or entity.
                  POMS SI 01120.203.B.2.e. Thus, if the trust contains an early termination clause, it might not be excepted
                  as a resource. See POMS SI 01120.203.B.2.e.
               
               POMS SI 01120.199.F (Early Termination Provisions and Trusts) provides additional guidance as to when
                  an early termination clause renders a trust a countable resource. Trusts established
                  with the resources of an individual that contain an early termination clause are not
                  to be counted as a resource if: (1) the State is designated to receive all amounts
                  remaining in the trust at the time of termination up to the total amount of medical
                  services paid on behalf of the beneficiary by the State, (2) after reimbursement to
                  the State, all remaining funds are to be distributed to the beneficiary with the exception
                  of certain specified expenses, and (3) the beneficiary does not have the power to
                  terminate the trust. POMS SI 01120.199.F. 1. For a pooled trust established under § 1917(d)(4)(C) of the Act, the trust
                  need not meet the above criteria to be excepted as a resource if the early termination
                  clause (1) “solely allows for transfer of the beneficiary’s assets from one [pooled]
                  trust to another [pooled] trust,” and (2) contains specific language precluding disbursements
                  other than to the secondary trust (or for the payment of taxes or reasonable administrative
                  expenses). POMS SI 01120.199.F.2.
               
               VI. ANALYSIS
               As discussed in part A below, it appears that the JFCS Trust is the operative trust
                  for P~ and L~, with Secured Futures serving as trustee; the provisions of the JFCS
                  Trust are discussed in part B of this section.
               
               A. The JFCS Trust Is the Operative Trust for P~ and L~
               The Trustee Agreement made Secured Futures the successor trustee of the JFCS Trust
                  through a two-step process: Secured Futures became a co-trustee with JFCS, and JFCS
                  then resigned. Trustee Agreement, ¶¶ 1, 2. The Trustee Agreement directs Secured Futures
                  to operate the JFCS Trust in accordance with the provisions of both the JFCS Trust
                  and the SF Trust; in the event conflicts arise between the terms of the two trusts,
                  the JFCS Trust “shall govern and control.” Trustee Agreement, ¶ 3.
               
               Although the Trustee Agreement states that the beneficiaries of the JFCS Trust “shall
                  become beneficiaries of the [SF Trust]” (Trustee Agreement, ¶ 4), the agreement does
                  not terminate the JFCS Trust. [4] Instead, it provides that Secured Futures, as successor trustee, will operate the
                  JFCS Trust in accordance with its terms as well as the terms of the SF Trust. Trustee
                  Agreement, ¶ 3. Paragraph 3 therefore appears to impose additional obligations on
                  Secured Futures in how it operates the JFCS Trust (i.e., by requiring compliance with
                  any terms of the SF Trust that are not in the JFCS Trust), but provides that the JFCS
                  Trust controls and any conflicts between the two trusts are resolved in favor of the
                  JFCS Trust. Trustee Agreement, ¶ 3.
               
               Further, the Trustee Agreement does not provide any mechanism for transitioning the
                  beneficiaries of the JFCS Trust into the SF Trust. See Trustee Agreement, ¶ 4 (stating “the Beneficiaries shall become beneficiaries of the
                  [SF Trust]”). For example, the SF Trust requires beneficiaries to sign a Joinder and
                  the trustee to accept the Joinder before an individual may participate in the trust,
                  but the Trustee Agreement does not require beneficiaries of the JFCS Trust to execute
                  Joinders for the SF Trust. [5] See SF Trust, Art. Six, § 6.1.
               
               Accordingly, under the Trustee Agreement, the JFCS Trust is the operative trust for
                  P~ and L~: the JFCS Trust was not terminated, Secured Futures was named its successor
                  trustee, the terms of the JFCS Trust are controlling, and P~ and L~ have not executed
                  Joinders for the SF Trust.
               
               B. The JFCS Trust Meets Some, But Not All, of the Requirements to Be
                     Excepted from Resource Counting
               As discussed above in part A of this section, the JFCS Trust is the operative trust
                  for P~ and L~. The trust, however, does not satisfy all of the requirements to be
                  excepted from resource counting. [6]
               1. The JFCS Trust Is for the Sole Benefit of the
                     Beneficiaries.
               Sub-accounts within the JFCS Trust are for the sole benefit of the beneficiaries as
                  required under the Act, POMS SI 01120.201.F, and POMS SI 01120.203.B.2.e. Article VI of the JFCS Trust states that “a sub-account shall be established
                  solely for the benefit of each qualified individual beneficiary.” JFCS Trust, Art.
                  VI.B. Further, distributions from trust sub-accounts are to be made only to or for
                  the benefit of that beneficiary during his/her lifetime and may not be made to any
                  other persons, such as family or dependents. JFCS Trust Art. VIII.C & E. [7] Finally, a beneficiary may not demand or direct payment from the trust and, further,
                  beneficiaries’ interests are not subject to transfer, assignment, or creditors’ claims.
                  JFCS Trust, Art. XI. Moerover, the JFCS Trust does not contain any provisions permitting
                  the early termination of the trust and, therefore, POMS SI 001120.199.F is inapplicable.
                  Under these provisions, the trust will not benefit anyone but the beneficiary during
                  his/her lifetime. See POMS SI 01120.201.F.2.
               
               2. Upon the Death of the Beneficiary, the JFCS Trust Does Not Require
                     Reimbursement to All States for Medical Assistance to the Beneficiary During
                     His/Her Lifetime, to the Extent Amounts in the Beneficiary’s Account Are Not
                     Retained by the Trust.
               Article IX of the JFCS Trust provides that, upon the death of a beneficiary, any amounts
                  remaining in his/her sub-account will be retained by the trust in a general account
                  to be used for the benefit of other trust beneficiaries or persons who are indigent
                  and disabled. JFCS Trust, Art. IX.A. However, to the extent the trust does not retain
                  amounts remaining in a deceased beneficiary’s sub-account, the trustee will “pay to
                  the State (AHCCCS) from such remaining amounts in the account an amount equal to the
                  total amount of medical assistance paid on behalf of the beneficiary under the State’s
                  plan.” JFCS Trust, Art. IX.B. This provision therefore provides reimbursement only
                  to Arizona’s Medicaid agency, AHCCCS, and not all States that may have provided medical
                  assistance under a State Medicaid plan. See
                     POMS SI 01120.203.B.2.g.
               
               The JFCS Trust does provide, in Article XII, that if a beneficiary moves from Arizona
                  to another State and qualifies for benefits in such other State, “references to Arizona
                  or to State in this trust shall also apply to the other State, but the rights of the
                  State of Arizona (AHCCCS) as a remainder beneficiary after the death of any individual
                  beneficiary shall be retained.” JFCS Trust, Art. XII.B. However, this provision would
                  only result in reimbursement of States to which the beneficiary moved after he/she
                  left Arizona; it does not ensure that States which provided medical assistance before
                  the beneficiary enrolled in the JFCS Trust in Arizona are paid back. See JFCS Trust, Art. XII.B; POMS SI 01120.203.B.2.g (providing that reimbursement for medical assistance cannot be limited to particular
                  State(s) or periods of time, such as after establishment of the trust).
               
               The JFCS Trust therefore does not satisfy § 1917(d)(4)(C)(iv) of the Act and POMS
                  SI 01120.203.B.2.g since it does not ensure that, to the extent the trust does not retain amounts
                  remaining in a beneficiary’s sub-account upon his/her death, all States are reimbursed
                  from any trust balance for the total amount of medical assistance paid on behalf of
                  the beneficiary during his or her lifetime. Instead, it effectively limits Medicaid
                  reimbursement to Arizona and those States to which the beneficiary moves after residing
                  in Arizona. See JFCS Trust, Arts. IX.B & XII.B.
               
               C. The SF Trust Meets Some, But Not All, of the Requirements to Be Excepted
                     from Resource Counting
               Even if the SF Trust (as amended by the Arizona Amendment) were deemed applicable
                  here, it similarly meets some, but not all, of the requirements to be excepted from
                  resource counting. [8] 1. The SF Trust Does Not Satisfy the Requirement that the Trust be for the Sole Benefit
                  of the Beneficiaries.
               
               The early termination provisions of the SF Trust do not fully comply with the requirements
                  of POMS SI 001120.199.F and, therefore, the trust is not for the sole benefit of the
                  beneficiary as required under the Act.
               
               (a) Early Termination Provisions – Article Seven
               Article Seven permits early termination of a beneficiary’s sub-account if the trustee
                  believes that it cannot fulfill its fiduciary duties to a beneficiary or that the
                  sub-account may become liable for a beneficiary’s basic maintenance and support. SF
                  Trust, Art. Seven, § 7.1. This provision allows the trustee to transfer the beneficiary’s
                  sub-account to either (1) a comparable non-profit pooled trust organized under 42
                  U.S.C. § 1396p(d)(4)(C), or (2) a private special needs trust organized under 42 U.S.C.
                  § 1396p(d)(4)(A). SF Trust, Art. Seven, § 7.1(a) & (b).
               
               This early termination provision is problematic for two reasons. First, under § 7.1(a),
                  the subaccount may be transferred to another pooled trust but there is no limiting
                  language as required under POMS SI 01120.199.F.2. See
                     Article Seven, § 7.1(a). Second, under § 7.1(b), the subaccount may be transferred
                  to a private trust established under § 1917(d)(4)(A), which does not comply with the requirement
                  that the sub-account be transferred to a pooled trust established under § 1917(d)(4)(C).
                  [9] [10] SF Trust, Art. Nine, § 9.1. This section of Article Nine therefore does not satisfy
                  the requirements of POMS SI 01120.199.F.2 for the same reasons discussed above in connection with Article Seven’s early
                  termination provisions.
               
               2. Upon the Death of the Beneficiary, the SF Trust Does Not Require Reimbursement
                  to All States for Medical Assistance to the Beneficiary During His/Her Lifetime, to
                  the Extent Amounts in the Beneficiary’s Account Are Not Retained by the Trust.
               
               The Arizona Amendment controls over any conflicting provisions of the SF Trust (Ariz.
                  Amend., ¶ 2). Under its terms, “the Arizona State Medicaid agency shall be the primary
                  beneficiary” of the sub-account if the trust is terminated before or upon the death
                  of the trust beneficiary; it does not ensure that all States which provided medical assistance to the beneficiary are repaid. See Ariz. Amend., ¶ 3; POMS SI 01120.199.F.1. The Arizona Amendment only provides reimbursement to Arizona’s Medicaid agency,
                  not all States that may have provided medical assistance under a State Medicaid plan.
                  See Ariz. Amend., ¶ 3; POMS SI 01120.203.B.2.g. Accordingly, the SF Trust as modified by the Arizona Amendment does not satisfy
                  the requirements set forth in § 1917(d)(4)(C)(iv) of the Act and POMS SI 01120.203.B.2.g.
               
               VII. CONCLUSION 
               The JFCS Trust is the operative trust for P~ and L~. As currently drafted, it does
                  not meet all of the requirements to be excepted from resource counting under the Act
                  with respect to the Medicaid payback requirement. Specifically, upon the beneficiary’s
                  death, the trust does not require reimbursement to all State(s) that provided medical
                  assistance during the beneficiary’s lifetime. See Social Security Act § 1917(d)(4)(C)(iv). This deficiency could be addressed by amending
                  Article IX of the JFCS trust to provide language that, to the extent the JFCS Trust
                  does not retain the amounts remaining in a deceased beneficiary’s sub-account, the
                  trustee will pay to the State(s) an amount equal to the total amount of medical assistance
                  paid on behalf of the individual under the State Medicaid plan(s). In other words,
                  if the JFCS Trust chooses to amend, the amended language should clearly provide for
                  reimbursement to all states that paid medical assistance on behalf of the beneficiary
                  during his or her lifetime and not limit reimbursement to any state. In addition,
                  while not controlling for P~ or L~, we note that the SF Trust (as modified by the
                  Arizona Amendment) also fails to meet the Medicaid payback or “sole benefit” requirements
                  of § 1917(d)(4)(C). These deficiencies could be addressed by revisions to the Arizona
                  Amendment. With respect to Medicaid payback, the trust could revise paragraph 3 of
                  the Arizona Amendment to provide for reimbursement to all states that provided medical
                  assistance during the beneficiary’s lifetime, rather than solely providing for reimbursement
                  to the Arizona State Medicaid agency. See POMS SI 01120.203.B.2.g. With respect to “sole benefit,” Article Seven, § 7.1(a) could be revised to
                  include specific limiting language ensuring that early termination does not result
                  in disbursements to any individual or entity other than to the second pooled trust
                  or to pay for allowable administrative expenses. See POMS SI 01120.199.F.2. Likewise, Article Seven, § 7.1(b) should be deleted so that sub-accounts may
                  only be transferred to pooled trusts pursuant to Article Seven, § 7.1(a), and not
                  private trusts. See POMS SI 01120.199.F.2. With respect to the early termination provision of Article Nine, § 9.2, the
                  language could be revised to provide for distribution solely to the beneficiary after
                  reimbursement to the State(s) and payment of administrative expenses. See POMS SI 01120.199.F.1.