Special Needs Trust Template

No public assistance benefits for the beneficiary of this trust shall be added to this trust.
5. Supplemental
It is further Settlor's intention that no part of the interest earned by or the corpus of the
trust created herein shall be used to supplant or replace public assistance benefits of
any county, state, federal or other governmental agency which has a legal responsibility
to serve persons with disabilities.
For purposes of determining the beneficiary's ________ [
Medicaid or equivalent state
program
] or any other public benefits programs eligibility, no part of the principal or
income of the trust estate shall be considered available to said beneficiary. In the event
the Trustee is requested by any department or agency administering ________
[
Medicaid or equivalent state program] or any other benefits to release principal or
income of the trust to or on behalf of a beneficiary to pay for equipment, medication, or
services which ________ [
Medicaid or equivalent state program] or any other
government benefit program is authorized to provide, or in the event the Trustee is
requested by any department or agency administering ________ [
Medicaid or equivalent
state program
] or any other benefits to petition the court or any other administrative
agency for the release of trust principal or income for this purpose, the Trustee is
authorized to deny such request and is authorized to defend, at the expense of the trust
estate, any contest or other attack of any nature of the provisions of or on sub-parts 1
through 8 inclusive of this section.
In addition, it is Settlor's hope, which is precatory, and not mandatory, that the trust
property shall be expended for such advocates, both legal and non-legal, as may be
necessary in order to protect any and all rights of the beneficiary as well as to protect the
integrity of this trust.
6. Termination
This trust shall cease and terminate upon the depletion of its assets or upon the death of
the beneficiary of this trust. If terminating on the death of the beneficiary, the Trustee
shall distribute any remaining principal and income to ________ [
name of charity], a
nonprofit charity, to be used for charitable purposes of the organization as its governing
board in its sole discretion shall determine.
7. Ineligibility
In determining whether the existence of the trust has the effect of rendering said
beneficiary ineligible for SSI, ________ [
Medicaid or equivalent state program], or other
public benefits, the Trustee is hereby granted full and complete discretion to initiate
either administrative or judicial proceedings, or both, for the purpose of determining
eligibility, and all costs relating thereto, including reasonable attorney fees, shall be a
proper charge to the trust estate.
8. Expenses
Upon the death of ________ [Name of Beneficiary], the Trustee, in the Trustee's sole
discretion, may pay all or any expenses of such beneficiary's funeral, and expenses
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