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DEPARTMENT FOR AGING AND REHABILITATIVE SERVICES AUXILIARY GRANT PROGRAM NON-SSI RESOURCE ELIGIBILITY 11/18 CHAPTER E PAGE 115 If the trust was established… And contains… Then follow instructions in: assets were transferred into the trust before 1/1/00

Only the assets of the individual and the trust is a Special Needs Trust Established under Section 1917(d)(4)(A) of the Act Trust Policy A

Only the assets of the individual and the trust is a Pooled Trust Established under Section 1917(d)(4)(C) of the Act

Trust Policy A

Assets of a third party and assets of the individual when a portion of the individual’s assets that were transferred into the trust were transferred before 1/1/00 Trust Policy A

Assets of a third party and assets of the individual when a portion of the individual’s assets that were transferred into the trust were transferred on or after 1/1/00 Trust Policy B for the individual’s portion

Trust Policy A for the third party’s portion