Mississippi Administrative Code › Title 23 - Division of Medicaid › Part 103 - Resources › Chapter 5 - Trust Provisions › Rule 23-103-5.16 - Special Needs Trust (SNT) and Pooled Trust Guidelines and Restrictions

Current through June 25, 2024
The MS Division of Medicaid has established guidelines and
				  restrictions regarding payments and distributions from a SNT or pooled trust
				  that must be followed in order for either type of trust to meet or continue to
				  meet the conditions for exception. Medicaid eligibility of the disabled
				  individual may be affected if these guidelines are not followed.
A. Payments for medical expenses that are not
				paid by Medicaid are allowed to be made from the trust. One exception is the
				cost differential between that of a private room and a semi-private room in an
				institutional setting is not an allowable expense.
B. Gifts must not be made from either type of
				trust.
C. Compensation paid to a
				family member from either type of trust for services rendered as a trustee must
				be reasonable under the circumstances.
D. Compensation paid to a family member from
				either type of trust for services rendered as a caretaker to the beneficiary
				must be reasonable under the circumstances and not exceed rates charged by
				agencies in the geographic area for the same or similar services. For a parent,
				the services must be over and above normal parental responsibilities.
E. The purchase of residential real property
				by the trust is allowable if the residence serves as the beneficiary's place of
				residence. The trust must be the owner of any real property purchased by the
				trust. Additions or improvements to existing property owned by another
				individual will be allowed if made for the benefit of the beneficiary. The
				trust must have a lien on the property for the cost of the additions or
				improvements.
F. The purchase of a
				vehicle by the trust is allowed only if it is the only household vehicle or is
				specially equipped to allow the beneficiary to operate the vehicle or to be
				transported in the vehicle. If the vehicle will be used for other than the
				beneficiary, all expenses relating to the vehicle must be prorated between the
				trust and anyone other than the beneficiary that uses the vehicle. If the
				vehicle is placed in the name of anyone other than the beneficiary, the trust
				must have a lien on the vehicle title.
G. Payments for vacations and other
				non-medical trips for the beneficiary must be reasonable under the
				circumstances and considering the size of the trust.
H. Payments for recreational opportunities,
				family visits or visits to friends for the beneficiary must be reasonable under
				the circumstances. Payments for family members to visit the beneficiary may be
				made if the visit is for purposes of ensuring the safety and well-being of the
				beneficiary.
I. Payments for
				non-medical expenses such as radios, televisions, audio or video equipment,
				computer equipment or other electronic devices and/or equipment must be made
				for the primary benefit of the beneficiary and reasonable under the
				circumstances and considering the size of the trust.
J. The pre-need payment of burial expenses,
				the purchase of pre-need burial contracts or the payment of burial insurance
				premiums are allowable, but if such arrangements have not been made prior to
				the passing of the beneficiary, they must not be paid until after reimbursement
				has been made to Medicaid.
K.
				Payments for the following items will produce In Kind Support and Maintenance
				(ISM) for the beneficiary: food, rent, mortgage payments (including property
				insurance required by the mortgage holder), real property taxes (less any tax
				rebate/credit), heating fuel, gas electricity, water, sewer, garbage removal.
				ISM is considered income and may affect eligibility for Medicaid-only
				beneficiaries or reduce SSI benefits.
L. Distributions from either type of trust
				directly to the beneficiary or to the beneficiary's bank account will be
				considered income to the beneficiary in the month in which the distribution is
				made. Direct distributions must be reported and may result in loss of coverage
				for Medicaid-only beneficiaries or reduction and possible loss of SSI
				benefits.
42 U.S.C. §
											1396p(d); Miss. Code Ann.
				  §
										43-13-121.