The Role of Special Needs Trusts in Elder Law Planning in West Virginia

Planning for the future becomes significantly more complex when a family member lives with a disability. For many West Virginia families, the greatest fear is not just about who will provide care, but how that care will be funded without jeopardizing the government benefits that the individual relies upon. You might be concerned that leaving an inheritance to a child or spouse with special needs could accidentally disqualify them from Medicaid or Supplemental Security Income (SSI). This is a valid concern, as even a modest inheritance can disrupt eligibility for these essential programs.

What Is a Special Needs Trust and Why Is It Necessary?

A Special Needs Trust (SNT), often referred to as a supplemental needs trust, is a legal arrangement designed to hold assets for the benefit of a person with a disability. The primary objective is to manage resources for that individual while maintaining their eligibility for public benefits.

In West Virginia, programs like Medicaid (including the I/D/D Waiver) and SSI are means-tested. This means the beneficiary must have limited income and resources to qualify. If a parent leaves a sum of money directly to a child receiving these benefits, that money counts as an asset. The result is often an immediate suspension of benefits until those funds are “spent down” to poverty levels.

An SNT solves this problem by holding the assets legally separate from the beneficiary. The trustee controls the funds and uses them to pay for goods and services that the government does not cover. Because the beneficiary does not own the money directly and cannot demand cash from the trustee, the government does not count the trust assets against the individual’s resource limits.

The Intersection of Elder Law and Special Needs Trusts and Planning

Elder law involves more than just drafting wills for seniors; it encompasses the broader picture of long-term care, asset protection, special needs trusts, and family support. When an elderly parent cares for an adult child with disabilities, or when a senior spouse requires Medicaid for nursing home care but wants to provide for a disabled partner, the stakes are high.

West Virginia families often face two distinct scenarios where SNTs play a major role:

• Protecting an Inheritance: Parents want to leave assets to their disabled adult child without causing them to lose their existing health coverage or monthly income.
• Protecting a Settlement or Windfall: A person with a disability might receive a personal injury settlement or an unexpected inheritance. Without an SNT, receiving these funds directly would trigger a loss of benefits.

By integrating an SNT into an estate plan, families ensure that the inheritance serves as a safety net rather than a stumbling block. It allows the funds to pay for extra therapies, better medical equipment, or even simple comforts like cable TV or internet access—things that Medicaid typically will not fund.

Distinguishing Between Third-Party and First-Party Trusts

Determining which type of trust is appropriate depends entirely on whose money is funding the trust. West Virginia law treats these two vehicles differently, particularly regarding what happens to the money when the beneficiary passes away.

Third-Party Special Needs Trusts

This is the most common tool for parents planning a child. A third-party SNT is funded with assets that never belonged to the beneficiary. Typically, these funds come from parents, grandparents, or other relatives.

• Funding Source: Assets come from anyone except the beneficiary.
• Payback Rule: There is no Medicaid payback requirement. When the beneficiary dies, the person who created the trust can designate where the remaining funds go (e.g., to other children or a charity).
• Set up: These can be established through a will (testamentary) or as a standalone living trust.

First-Party Special Needs Trusts

Also known as a “self-settled” or “(d)(4)(A)” trust, this is funded with the beneficiary’s own assets. This usually occurs when a disabled individual receives a lawsuit settlement or an unconditional inheritance.

• Funding Source: The beneficiary’s own money (even if technically established by a parent, grandparent, court, or the individual themselves).
• Payback Rule: This trust must contain a provision stating that upon the beneficiary’s death, the state of West Virginia will be reimbursed for Medicaid benefits paid during the beneficiary’s lifetime. Only after the state is paid can other heirs receive anything.
• Age Limit: Under federal law, these trusts must generally be established before the beneficiary turns 65.

Key Responsibilities of a Trustee in West Virginia

Selecting the right trustee is perhaps the most significant decision in the planning process. The trustee has total discretion over distributions, meaning the beneficiary cannot force the trustee to pay for anything. This discretion is what protects the assets from being counted by the Social Security Administration or the West Virginia Department of Health and Human Resources (DHHR).

The trustee must handle several complex duties:

• Compliance with Benefit Rules: The trustee must know what counts as income for SSI purposes. For example, giving the beneficiary cash directly will reduce their SSI payment dollar-for-dollar.
• Prudent Investment: Assets must be managed wisely to ensure they last for the beneficiary’s lifetime.
• Tax Filings: The trust is a taxable entity. The trustee must ensure annual returns are filed.
• Record Keeping: Detailed accounting is required to show that funds were used for the sole benefit of the individual with disabilities.

Many families choose a professional trustee or a bank trust department to handle these technical requirements, sometimes pairing them with a family member who serves as a “Trust Protector” or advisor to handle the personal side of the beneficiary’s needs.

Permissible Distributions: What Can the Trust Buy?

One common misconception is that the money in a Special Needs Trust can only be used for medical expenses. In reality, the purpose of the trust is to improve the beneficiary’s quality of life. The list of allowable expenses is quite broad, provided the payments are made directly to the provider and not given as cash to the beneficiary.

An SNT can typically pay for:

• Transportation: Purchasing a vehicle, paying for insurance, gas, or modifications for accessibility.
• Education and Training: Tuition, tutoring, or vocational training programs.
• Electronic Equipment: Computers, tablets, televisions, and internet service.
• Recreation and Travel: Tickets to movies or concerts, hobby supplies, and travel expenses for the beneficiary (and a companion if medically necessary).
• Personal Care Services: Haircuts, massage therapy, or health club memberships.
• Medical Costs: Dental work, physical therapy, or eyeglasses are not covered by Medicaid.
• Home Goods: Furniture, appliances, and cleaning supplies.

The goal is to supplement what the government provides, filling the gaps to ensure the individual lives a full and comfortable life.

Avoiding the In-Kind Support and Maintenance Trap

Trustees must be particularly careful regarding food and shelter. Under SSI rules, if a third party (including a trust) pays for a beneficiary’s food or shelter, it is considered “In-Kind Support and Maintenance” (ISM).

While paying for rent or groceries from the trust is allowed, it will likely result in a reduction of the beneficiary’s monthly SSI check (up to a specific cap). In some cases, this reduction is acceptable because the value of the housing provided by the trust far exceeds the amount lost in the SSI payment. However, this is a strategic calculation that requires careful analysis. A trustee unaware of these rules might accidentally trigger a reduction in benefits without realizing the consequences.

The POOLED Trust Option

For some West Virginia families, establishing a standalone SNT might not be cost-effective, especially if the amount of money being protected is relatively small. In these instances, a Pooled Special Needs Trust might be the appropriate solution.

A pooled trust is managed by a non-profit organization. The assets of many beneficiaries are “pooled” together for investment purposes, which lowers administrative costs, but each beneficiary has their own sub-account.

• Management: Professional management by the non-profit eliminates the burden on family members.
• Transfer: West Virginia allows individuals over age 65 to transfer assets to a pooled trust, though this may still trigger a transfer penalty for Medicaid nursing home coverage, depending on the timing.
• Remainder: When the beneficiary dies, the funds usually stay with the non-profit to support other individuals with disabilities, or they are used to reimburse the state for Medicaid expenses.

Common Mistakes to Avoid in West Virginia Planning for Special Needs Trusts

Creating a Special Needs Trust is a precise legal task. Small errors can render the trust ineffective, exposing the assets to creditors or the government.

• The “Kitchen Table” Trust: Using a generic trust form found online rarely works. These forms often lack the specific language required by the Social Security Administration or West Virginia Medicaid policy manuals.
• Commingling Funds: A trustee should never mix trust funds with their own personal funds. This breach of fiduciary duty can lead to legal removal and liability.
• Direct Cash Distributions: Giving the beneficiary a debit card linked to the trust or handing them cash for the weekend is strictly prohibited. This converts protected trust assets into countable income.
• Failing to Update Estate Plans: Sometimes, well-meaning grandparents or siblings leave money directly to the disabled individual in their own wills, bypassing the carefully created SNT. Extended family members must be informed to direct any inheritance into the existing Special Needs Trust.

How to Implement Special Needs Trusts in West Virginia

The process begins with a comprehensive review of the beneficiary’s current benefits and future needs. Because these trusts interact with federal and state regulations, drafting them requires specific knowledge of how West Virginia implements these programs.

The implementation process generally follows these steps:

• Identify the Goal: Determine if the trust is for a settlement (First-Party) or an inheritance (Third-Party).
• Select the Trustee: Choose a reliable individual or corporate fiduciary who acknowledges the complexity of the role.
• Draft the Trust Instrument: The document must contain specific language regarding the trustee’s discretion and the prohibition of cash distributions.
• Fund the Trust: Assets are retitled into the name of the trust. For Third-Party trusts, this often happens upon the death of the parents via a beneficiary designation or will provision.
• Notify Agencies: Once funded, the existence of the trust must be properly reported to the Social Security Administration and West Virginia DHHR to ensure they recognize it as an exempt asset.

Securing Your Family’s Future with Special Needs Trusts

The laws surrounding special needs trusts, disability benefits and estate planning are designed to ensure safety nets are preserved for those who need them most. However, the rules are rigid. A properly constructed Special Needs Trust provides a way to enhance the life of a loved one with disabilities without sacrificing the essential medical and financial support they receive from the government. At Hewitt Law PLLC, we recognize that every family’s situation is unique. We are dedicated to helping you create a plan that provides peace of mind and security for your most vulnerable loved ones. Contact us today to discuss how we can assist you in establishing a Special Needs Trust tailored to your specific needs.