QUESTIONS
               You asked:
               Whether the 2014 restatement of the Commonwealth Community Trust (CCT) Endowment Fund
                  Self-Funded Pooled Disability Trust (CCT Master Trust) satisfies the exception to
                  resource counting under section 1917(d)(4)(C) of the Social Security Act (Medicaid
                  pooled trust exception);
               
               Whether the 2016 restatement of the CCT Master Trust satisfies the Medicaid pooled
                  trust exception; and
               
               The date the 2016 restatement became effective.
               SHORT ANSWERS
               The 2014 restatement does not satisfy the pooled trust exception. Per the 2014 provisions,
                  a for-profit corporation Trust Company of Virginia (TCVA)[1] acted as its Trustee (or at least, co-Trustee), and the restatement did not make
                  clear that CCT retained supervisory authority over the management of the beneficiaries’
                  subtrusts.
               
               The 2016 restatement of the CCT Master Trust does not meet the pooled trust exception.
                  Although the 2016 restatement addressed the above concern by shifting the trust’s
                  supervision from TCVA to CCT’s board of directors, the early termination provisions
                  must be clarified to satisfy agency policy.
               
               The 2016 restatement became valid on June 13, 2016, when a majority of CCT’s Board
                  of Directors, including its President, President-Elect, Secretary and Treasurer, signed
                  the document.
               
               BACKGROUND 
               On December 8, 1994, the CCT Endowment Fund Board of Trustees (hereinafter “Board
                  of Directors”) established the CCT Master Trust. 2014 CCT Master Trust Agreement,
                  Preamble Recital 1. CCT created the trust fund to hold the assets of disabled individuals
                  pursuant to 42 U.S.C. § 1396p. Preamble ¶¶ 1 and 2. CCT’s Board of Directors and TCVA
                  amended the CCT Master Trust through the 2014 and 2016 restatements.
               
               The 2014 and 2016 restatements differ in some respects. For instance, the 2016 version
                  adds multiple instances of supervision and/or shifting of responsibility from the
                  TCVA to CCT, and by adding the option for a Medicare Set-Aside (MSA) sub-account.
                  While the option to add the MSA sub-account does not affect the guidance provided
                  in this memorandum, the alteration of numerous terms from “Trustee” to “CCT” satisfies
                  the requirement that the CCT Master Trust be “maintained” by a non-profit association.
               
               S~, a disabled beneficiary, executed a Joinder Agreement to join the CCT Master Trust
                  in July 2014. She established a trust account with $38,710.42 of her assets from the
                  sale of a residence. See S~ Joinder.[2]
               LEGAL STANDARDS
               As a general rule, a trust established after January 1, 2000 with an individual’s
                  assets for his or her own benefit is considered a resource under sections 1613 and
                  1917 of the Act. Social Security Act (Act) §§ 1613(e), 1917(d), 42 U.S.C. §§ 1382b,
                  1396p(d); Program Operations Manual System (POMS) SI 01120.201. The Act provides an exception for certain trusts established under section 1917(d)(4)(A)
                  and (C), commonly known as the Medicaid trust exceptions. See POMS SI 01120.203. There are two types of Medicaid trust exceptions: special needs
                  trusts and pooled trusts (which are also a form of special needs trust). POMS SI 01120.203.A.
               
               To qualify for the Medicaid pooled trust exception, the pooled trust must meet the
                  following conditions:
               
               It contains the assets of a disabled individual;
               Is established and maintained by a non-profit association;
               Has separate accounts maintained for each beneficiary, with assets pooled for investing
                  and management purposes;
               
               Has accounts established solely for the benefit of the disabled individuals;
               Accounts are established through the actions of the individual, a parent, grandparent,
                  legal guardian, or court; and
               
               Provides that to the extent any amounts remaining in the beneficiary’s account upon
                  the beneficiary’s death are not retained by the trust, the trust will pay to the State(s)
                  the amount remaining, up to an amount equal to the total amount of medical assistance
                  paid on behalf of the beneficiary under State Medicaid plan(s). To the extent that
                  the trust does not retain the funds in the account, the State(s) must have priority
                  over payment of other debts and administrative expenses, except for taxes due to the
                  State(s) or Federal government because of the beneficiary’s death and reasonable fees
                  for the administration of the trust estate for actions associated with the termination
                  and wrapping up of the trust.
               
               Act § 1917(d)(4)(C); POMS SI 01120.203.B.2.
               
               In addition to these criteria, in order for the agency not to count a trust as a resource,
                  the beneficiary must not be able to revoke or terminate the trust and then use the
                  funds to meet his/her shelter or food needs. Additionally, the beneficiary must not
                  be able to direct the use of the trust principal for his or her support and maintenance
                  under the terms of the trust. POMS SI 01120.200.D. Finally, if there is an early termination
                  clause (that is, termination before the beneficiary’s death), the trust must provide
                  that it will reimburse states for Medicaid assistance, and that any remaining funds
                  (except for administrative expenses and certain taxes) be disbursed to the beneficiary.
                  POMS SI 01120.199.F.1. However, the early termination clause does not have to satisfy these requirements
                  if the clause allows solely for transfer of the beneficiary’s assets from one Medicaid
                  pooled trust to another Medicaid pooled trust. POMS SI 01120.199.F.2.
               
               ANALYSIS
               The 2014 Restatement of CCT Master Trust[3]
               While CCT, a non-profit association, established the trust, the 2014 restatement is
                  ambiguous regarding the management of the CCT Master Trust. Preamble ¶1. The TCVA,
                  a Virginia corporation, is designated as the “sole acting Trustee,” but both TCVA
                  and the CCT Board of Directors are referred to as “Trustee(s).” Preamble ¶ 1. Either
                  way, the 2014 restatement does not make clear that CCT “maintains” or “manages” the
                  trust.
               
               A Medicaid pooled trust must be established and maintained by a non-profit association.
                  Act §1917(d) (trust must be established and “managed by” nonprofit association); POMS
                  SI 01120.203.B.2.a.
               
               Under Virginia law, a trustee may exercise those powers “conferred by the terms of
                  the trust,” and may exercise certain further powers “except as limited by terms of
                  the trust.” Va. Code Ann. § 64.2-777(A). In addition, the exercise of a power by the
                  trustee is subject to the fiduciary duties prescribed by the Virginia trust code.
                  § 64.2-777(B).[4]
               In accordance with Virginia law, the 2014 CCT Master Trust confers multiple powers
                  upon the Trustee. Because TCVA, instead of CCT, has the “managing” role of the trust
                  (or to the extent that TCVA and CCT’s respective roles are not clear), the 2014 restatement
                  does not satisfy this Medicaid pooled trust criterion.
               
               2016 Restatement of the CCT Master Trust
               Non-Profit Manages the Trust
               The Social Security Act requires that a non-profit association establish and “manage”
                  the Medicaid trust. Act § 1917(d). The POMS provides that the non-profit must establish
                  and “maintain” the trust. POMS SI 01120.203.B.2.a. If a non-profit association employs the services of a for-profit entity, the
                  non-profit association must maintain ultimate managerial control over the trust, but
                  the for-profit entity may handle certain trust functions. POMS SI 01120.225.D. However,
                  the for-profit entity must always be subordinate to the non-profit managers of the
                  pooled trust. Id.
               As detailed in the attached Appendix, the 2016 restatement revised all of the Trustees’
                  powers in the CCT Master Trust to clarify that the Trustee acts only in an administrative,
                  non-supervisory role. While the 2014 version granted management powers to the “Trustees”
                  including both CCT and TCVA, the 2016 restatement clarifies that TCVA is the only
                  Trustee. Preamble ¶1. Moreover, Article 1, Subsections E, F, G and H, and Article
                  2, Subsections D and E now provide that TCVA acts at CCT’s direction. See Appendix ‘A’. The effect of these additions is to shift ultimate managerial control
                  from TCVA to CCT.
               
               The 2016 restatement limits TCVA’s power and effectively eliminates its supervisory
                  and/or discretionary role. Thus, while TCVA has the same fiduciary duties,[5] the 2016 restatement makes clear that CCT controls, directs, or supervises TCVA’s
                  acts. Since CCT has oversight over TCVA, the 2016 restatement is consistent with the
                  Act and the POMS.
               
               Establishment of the Trust, Assets of the Individual and Separate Accounts
               The 2016 restatement satisfies agency policy requiring that the trust accounts be
                  established through the actions of the individual, a parent, grandparent, legal guardian,
                  or court. The trust provides that if a grantor or someone on the grantor’s behalf
                  executes a joinder agreement that incorporates the CCT Master Trust by reference and
                  CCT agrees to the joinder, the trustee will hold, administer, and distribute the income
                  and principal of the assets received in accordance with the CCT Master Trust provisions.
                  The 2016 restatement clarifies that “someone on the grantor’s behalf” is “subject
                  to the limitations of 42 U.S.C. § 1396p regarding a permissible Grantor representative,”
                  meaning that the joinder agreement must be “established through the actions of the
                  individual, a parent, grandparent, legal guardian, or court.” Act, § 1917(d).
               
               The 2016 restatement satisfies the assets of the individual requirement. We note,
                  however, that the trustee may accept for good cause additional assets from “any source”
                  and that the grantor or someone on the grantor’s behalf may add “other property” to
                  the trust fund. Art. 1, §§ I, J. A portion of the trust consisting of a third party’s
                  assets must be evaluated per POMS SI 01120.200. See POMS SI 01120.200.A.2.b.
               
               The 2016 trust satisfies the separate accounts requirement. Under the 2016 restatement,
                  separate sub-accounts will be maintained for each beneficiary, and the funds will
                  be pooled for management and investment purposes. Art. 1, § A; Art. 2, § B; Art. 5,
                  § E. The trustee shall maintain records and accounts for each fund. Art. 2, §§ B,
                  C.
               
               Medicaid Reimbursement
               The 2016 restatement provides that to the extent any amounts remaining in the beneficiary’s
                  account upon the death of the beneficiary are not retained by the trust, the trust
                  will “first” pay to the state the amount remaining, up to an amount equal to the total
                  amount of medical assistance paid on behalf of the beneficiary under State Medicaid
                  plan(s). Art. 1, §§ F, L. The provisions provide for reimbursement to each state in
                  which the beneficiary received Medicaid, and does not limit reimbursement to any state(s).
                  Id.
               According to Article 1, section L, the trustee does not have a duty to make an inquiry
                  concerning any claims for any state other than Virginia and any state in which the
                  beneficiary resides of the date of his death. Art. 1, § L. We do not believe that
                  this language is problematic because the trust also provides that the trustee will
                  reimburse all Medicaid assistance and the POMS does not require a trust to describe
                  the reimbursement process.
               
               Revocability of Trust
               In order for the trust principal not to count as a resource, the beneficiary must
                  not be able to revoke or terminate the trust and then use the funds to meet his/her
                  shelter or food needs. The beneficiary must not be able to direct the use of the trust
                  principal for his or her support and maintenance under the terms of the trust. POMS
                  SI 01120.200.D.
               
               Article 8, Section A provides the CCT Master Trust is irrevocable. In addition, the
                  grantor intends that the trust fund’s income and principal not be considered income
                  or assets of the beneficiary. Art. 1, § C.
               
               In Virginia, the terms of the trust prevail over the provisions of the Uniform Trust
                  Code, except in certain circumstances. Va. Code Ann. § 64.2-703. Virginia law allows
                  a settlor and beneficiaries to consent to the modification or termination of a noncharitable
                  irrevocable trust. Va. Code Ann. § 64.2-729(A). This suggests that a grantor who is
                  the sole beneficiary of a trust may be able to revoke the trust. With respect to S~,
                  however, she has expressly named primary successor beneficiaries. Accordingly, S~
                  does not have the ability to revoke the trust.[6]
               Sole Benefit & Early Termination
               The following provisions state the trust is for the disabled beneficiary’s sole benefit.
                  At CCT’s direction, the trustee “shall regard the Trust Fund as existing solely for
                  the benefit of the Beneficiary and not for the benefit of the residual beneficiaries.”
                  Art. 1, § E. At CCT’s direction, the trustee shall pay or apply so much of the net
                  income or principal of the trust fund to provide for the beneficiary’s needs over
                  and above the basic maintenance and support and medical/dental care the beneficiary
                  receives from the government. Art. 1, § B. The trustee may purchase services and items
                  that promote the beneficiary’s happiness, welfare and development. Art. 1, § B.
               
               However, the early termination provisions in the 2016 restatement do not appear to
                  satisfy agency policy.
               
               An early termination provision must satisfy the following criteria:
               Upon early termination (i.e., termination prior to the beneficiary’s death), the State(s)
                  would receive all amounts remaining in the trust at the time of termination up to
                  an amount equal to the total amount of medical assistance paid on behalf of the individual
                  under the State Medicaid plan(s);
               
               Other than payment for expenses (taxes due to the State or Federal government due
                  to the trust’s termination and reasonable fees and administrative expenses associated
                  with the trust’s termination), no entity other than the trust beneficiary may benefit
                  from the early termination;
               
               And
               The beneficiary does not have the power to terminate the trust.
               POMS SI 01120.199.F.1. However, an early termination clause does not have to satisfy these criteria
                  if the clause solely allows for a transfer of the beneficiary’s assets from one Medicaid
                  pooled trust to another Medicaid pooled trust. POMS SI 01120.199.F.2.
               
               In the 2016 restatement, CCT or the court may terminate the trust during the beneficiary’s
                  lifetime. Art. 1, § G. In that situation, the trustee shall “first” distribute to
                  the states all amounts remaining in the trust at the time of termination up to an
                  amount equal to the total amount of medical assistance paid on behalf of the individual
                  under the state’s Medicaid plan. Art. 1, § G. After reimbursement to the State(s),
                  all remaining funds shall be distributed to the beneficiary and to no entity, other
                  than payment of taxes and administrative expenses allowed by POMS[7] or to another entity as specified in Article 1, section H. Art. 1, § G. Article 1,
                  section H states that the trustee, as directed by CCT, may transfer the entire balance
                  of the trust fund to another 42 U.S.C. § 1396p trust. Art. 1, § H.
               
               This early termination provision does not appear to satisfy POMS SI 01120.199.F.1 or 2. POMS provides that on early termination, the trust proceeds either go the
                  beneficiary after Medicaid reimbursement and payment of permissible administrative
                  expenses, OR the trust proceeds are transferred to another Medicaid pooled trust.
                  Here, however, the language in section G seems to conflate the beneficiary and “another
                  entity” provisions. In addition, the language in section H is problematic because
                  it is overbroad; it does not specify that the transfer must be to another Medicaid
                  pooled trust (i.e., the transfer must be to a section 1396p(d)(4)(C) trust as opposed
                  to section 1396p(d)(4) trust). The provisions (sections G and H) should be clarified
                  to more clearly follow POMS.[8]
               Finally, we note that Article 8, section C provides that if the CCT ceases to exist
                  and is not continued by another non-profit as a legal successor, the trustee may,
                  in its discretion, deliver and pay over the assets in the trust to a non-profit organization
                  that the trustee determines is serving the interests and needs of persons with special
                  needs in a matter consistent with the terms and purpose of this trust. Art. 8, § C.
                  This seems to be an early termination provision because it allows the trust to terminate
                  before a beneficiary’s death. This provision should be revised and clarified to satisfy
                  agency policy on early terminations.
               
               Effective Date of 2016 CCT Master Trust Restatement
               Amendments to the CCPT trust agreement become effective and binding upon written approval
                  of the CCT Board of Directors. Art. 8 § B. Actions by the CCT Board of Directors are
                  valid when approved by a majority of the Directors at an annual meeting, or in the
                  alternative, any decision or action of the Board may be approved without a meeting
                  by the President, President-Elect, Treasurer and Secretary of the Board. Art 4 § L.
                  The 2016 restatement (containing amendments to the CCT Master Trust) was signed by
                  the President, President-Elect, Treasurer and Secretary on June 13, 2016, and a majority
                  of the Board also signed the restatement on that date. As a result, the 2016 restatement
                  became valid on June 13, 2016, regardless of whether it was signed during an annual
                  meeting of the Board.
               
               CONCLUSION
               The 2014 CCT Master Trust did not satisfy the Medicaid Trust exception in part because
                  TCVA, a for-profit entity, managed, or at least co-managed, the trust.
               
               We recommend that the 2016 CCT Master Trust be revised to satisfy the early termination
                  criteria of POMS SI 01120.199.F. Specifically, Article 1, sections G and H should be amended to more clearly delineate
                  between transfer of the assets to the beneficiary on early termination, and transfer
                  of assets to another Medicaid pooled trust (specifically, a section 1396p(d)(4)(C)
                  on early termination. Article 8, section C should also be amended to comply with the
                  early termination criteria.
               
               The 2016 CCT Master Trust became effective June 13, 2016.