Lewis v. Magee Women's Hospital of UPMC

67 Pa. D. & C.4th 362, 2004 Pa. Dist. & Cnty. Dec. LEXIS 172
CourtPennsylvania Court of Common Pleas, Alleghany County
DecidedJuly 26, 2004
Docketno. GD02-5238
StatusPublished

This text of 67 Pa. D. & C.4th 362 (Lewis v. Magee Women's Hospital of UPMC) is published on Counsel Stack Legal Research, covering Pennsylvania Court of Common Pleas, Alleghany County primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Lewis v. Magee Women's Hospital of UPMC, 67 Pa. D. & C.4th 362, 2004 Pa. Dist. & Cnty. Dec. LEXIS 172 (Pa. Super. Ct. 2004).

Opinion

WETTICK JR., A.J.,

The objection of the Department of Public Welfare (DPW) to a petition for leave to settle and discontinue minor’s claims is the subject of this opinion and order of court. The issue which this opinion addresses is whether funds for a settlement may be placed in a pooled trust rather than a special needs trust.

Petitioners are the parents of Zackery Lewis, a minor with permanent and significant mental and physical disabilities. They seek court permission to have the full amount of a partial settlement of Zackery’s medical malpractice action, less attorney fees, a Medicaid lien and expenses, paid to a pooled trust for the benefit of Zackery. DPW contends that the use of a pooled trust is inappropriate in this case; instead, a special needs trust must be used.1

Zackery Lewis (date of birth — 9/22/92) presently lives with his parents. He has acute and long-term medical problems, including significant respiratory problems, feeding problems, and mild to moderate mental retardation. He will never live or work independently because of these medical problems. In their petition for leave to settle and discontinue their son’s claims, Zackery’s parents seek court permission to have the full amount of the net settlement funds of nearly $1.85 million paid into a [365]*365pooled trust with The Family Trust.2 DPW contends that a special needs trust is more appropriate for Zackery and that this court should exercise its supervisory discretion to require the use of a special needs trust instead of a pooled trust.

Historically, Medicaid benefits have been “last resort” benefits. See generally, Waldman v. Candia, 722 A.2d 581, 585 (N.J. Super. Ct. App. Div. 1999); Calvanese v. Calvanese, 710 N.E.2d 1079, 1080 (N.Y. 1999). A person with assets, including trust assets, was not eligible for Medicaid benefits until that person exhausted those assets. Thus, it was difficult to create trusts for a disabled relative that would supplement, rather than supplant, Medicaid benefits.

Through a 1993 amendment to the Social Security Act governing Medicaid, Congress now permits the use of special needs trusts and pooled trusts to benefit persons considered to be disabled.3 The purpose of these trusts is to provide for the supplemental needs of persons with disabilities whose basic needs are to be met, in large part, through the Medicaid program. Funds placed in these trusts may not be considered “available” resources for purposes of assessing the beneficiary’s eligibility for Medicaid benefits. 42 U.S.C. §1396p(d)(4).

A special needs trust, also referred to as a payback trust, is a trust established by a parent, grandparent, legal guardian, or a court for the benefit of one person [366]*366with disabilities. A major feature of the special needs trust is that upon the death of the beneficiary, the Commonwealth of Pennsylvania will receive from any remaining funds in the trust the amount of Medicaid payments made on behalf of the beneficiary during his or her lifetime.4

A pooled trust, on the other hand, is created for more than one person with disabilities. In Pennsylvania, this type of trust is governed by the Pooled Trust Act, 62 P.S. § 1965.1 et seq.5 The Act provides that a pooled trust must meet the following requirements: it contains assets of more than one beneficiary; each beneficiary has a disability; the trust is managed by a nonprofit corporation; and a separate account is maintained for each beneficiary of the trust, but, for purposes of investment and management of funds, these accounts are pooled by the trust. Accounts in the trust may be established by a parent, grandparent, or legal guardian of an individual with a disability, by an individual with a disability, or by a court. A primary difference between a special needs trust and a pooled trust is that with a pooled trust, upon the death of the beneficiary, the amounts remaining in the beneficiary’s account may be retained by the trust for the benefit of other beneficiaries or other individuals with disabilities. This money retained by the trust is not available to the Commonwealth to repay the Medicaid payments made during the beneficiary’s lifetime.6

[367]*367In this case, the pooled trust into which Zackery’s parents seek to deposit the funds is managed by The Family Trust (a nonprofit corporation). The Family Trust is a mission-based trust with a professional staff of social workers, investment experts, corporate counsel, and volunteer board members. Its mission is to serve people with disabilities and, through trust management, help them lead more fulfilling lives than would be possible at poverty levels. It works with each beneficiary to enable him or her to lead a productive life in the community.

The Family Trust serves over 700 individuals with combined assets of over $12 million. It requires only a minimum balance of $200 for a disabled person to become a beneficiary. Most of The Family Trust’s beneficiaries are persons with modest means.

If the request of Zackery’s parents for a court order authorizing the deposit of the settlement funds into The Family Trust is granted, most of the net proceeds from the settlement will be used to purchase an annuity that will guarantee Zackery a revenue stream through his lifetime. (The funds not used to purchase an annuity will be paid directly into the pooled trust.) The Family Trust will receive and manage this revenue stream for Zackery’s benefit.

DPW’s primary disagreement with the use of a pooled trust, rather than a special needs trust, has to do with [368]*368what occurs upon the death of the beneficiary. DPW contends that I should prohibit the use of a pooled trust because it does not serve the interests of the taxpayers of Pennsylvania. While the use of a pooled trust should be permitted where assets within a beneficiary’s account are minimal, DPW contends that the obligation to repay medical assistance should not be voided where it is likely that significant funds will remain upon the beneficiary’s death.

DPW contends that a pooled trust is a useful device to obtain professional management services for small estates. But a special needs trust best serves the interests of the taxpayers and persons with disabilities where there is sufficient money to afford an independent fiduciary that is concerned only with the beneficiary’s best interests.

There is nothing in the federal or Pennsylvania legislation which supports DPW’s position that any standard other than the best interests of the person with disabilities governs a petition to settle and discontinue a minor’s claims.

The legislation does not place any limits on the amount of money a person may place in a pooled trust. There is nothing in the federal or state legislation which directs me to give priority to taxpayer interests. There is nothing in the legislation that requires me to find that a pooled trust is inappropriate because it does not provide the same protections to the taxpayers as a special needs trust.

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Related

Waldman v. Candia
722 A.2d 581 (New Jersey Superior Court App Division, 1999)
Calvanese v. Calvanese
710 N.E.2d 1079 (New York Court of Appeals, 1999)

Cite This Page — Counsel Stack

Bluebook (online)
67 Pa. D. & C.4th 362, 2004 Pa. Dist. & Cnty. Dec. LEXIS 172, Counsel Stack Legal Research, https://law.counselstack.com/opinion/lewis-v-magee-womens-hospital-of-upmc-pactcomplallegh-2004.