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3. Designated for medical expenses - This term allows the trustee to use the trust to pay the medical expenses of the beneficiary. The amount of the trust that is designated for medical expenses is considered an available asset to the beneficiary. Payments are a third party resource. Refer to MA-2400, Third Party Recovery, to report availability to NC Medicaid. 4. Income beneficiary - This term allows payments to the beneficiary from the proceeds of the trust. The principal is not available for disbursement. 5. Ultimate beneficiary - This term means the entire principal of the trust will be available at a specific point in time. 6. Exculpatory clause - Language in the trust that legally limits the authority of the trustee to distribute funds from a trust if the distribution would jeopardize eligibility for government programs, including Medicaid. E. Procedures 1. Obtain a copy of the trust document and any supporting documentation detailing investments and distributions from the a/b, the a/b’s legal representative, trustee, or attorney. 2. Review the trust document to determine: • The type of trust, • The date the trust was established, and • Whose assets were used to create the trust, and • Who is the beneficiary, and • The value of the trust when it was created, and • What disbursements can be made from the trust principal or proceeds, and • Any special provisions. 3. Contact the trustee to verify: • The current value of the trust, and • Actual disbursements paid from the trust in the base period, and • To whom the disbursements were made, and • The dates of disbursement. 4. Consult with your agency/county attorney for any questions regarding the terms of the trust. 5. Contact OST for assistance in determining how the trust affects Medicaid eligibility. F. Determine Countable Income to the A/B (Also refer to MA-2250, Income) 81