Adult Medicaid Manual MA-2230 FINANCIAL RESOURCES

XIV. A/R IS A BENEFICIARY OF A TRUST

Use the following information as a Guide to Trust.

TYPE OF TRUST	REVOCABLE		IRREVOCABLE			SPECIAL NEEDS OR POOLED
ASSET SOURCE	CREATED WITH ASSETS OF NON-A/R*	CREATED WITH ASSETS OF A/R	CREATED WITH ASSETS OF NON-A/R	CREATED WITH ASSETS OF A/R	CREATED WITH ASSETS OF A/R	CREATED WITH ASSETS OF A/R OR NON-AR
DATE CREATED	ANY DATE	ANY DATE	ANY DATE	PRIOR TO 4-1-94	4-1-94 OR LATER	4-1-94 OR LATER
RESERVE	NO RESERVE VALUE	CURRENT PRINCIPAL	AMOUNT OF PRINCIPAL THAT CAN BE DISBURSED BASED ON THE TERMS OF THE TRUST. IF THE TERMS ALLOW TRUSTEE DISCRETION, COUNT THE AMOUNT HE AGREES TO MAKE AVAILABLE.	AMOUNT OF PRINCIPAL THAT CAN BE DISBURSED BASED ON THE TERMS OF THE TRUST (THIS MEANS ALLOW EXCULPATORY CLAUSES). IF THERE ARE NO RESTRICTIONS, COUNT TOTAL PRINCIPAL THAT CAN BE DISBURSED.	TOTAL AMOUNT THAT CAN BE DISBURSED UNDER ANY CIRCUMSTANCES. (DISREGARD EXCULPATORY CLAUSES AND ANY RESTRICTIONS ON TIME OR USE OF DISBURSEMENTS)	NO RESERVE VALUE
TRANSFER	NO TRANSFER	TOTAL AMOUNT DISBURSED TO ANYONE OTHER THAN THE A/R	NO TRANSFER	AMOUNT THAT IS UNAVAILABLE TO THE A/R BASED ON THE TERMS PLUS AMOUNT DISBURSED TO ANYONE OTHER THAN THE A/R	ANY PORTION OF THE TRUST THAT IS NOT COUNTED IN RESERVE IS CONSIDERED A TRANSFER	NO TRANSFER
INCOME	ACTUAL PAYMENTS TO THE A/R OR PAYMENTS TO A PROVIDER FOR FOOD, CLOTHING OR SHELTER IN THE BASE PERIOD

* Any time a/r is used it means a/r or spouse