HomeMy WebLinkAbout01-03-11~_ ~
DEC 2 $ 2010
In the Court of Common Pleas of Cumberland County, Pennsylvania
Orphans' Court Division
In re: Estate of Constance L. O'Neill,
an adult individual, '~
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petitioner, by her Sister and ~ ~_
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Next Friend, Margaret L. Mathe No. °~~~ ~ '- ~. ~~ ~
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DECREE -+
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AND NOW, in consideration of the within petition of Margaret Mathe, the Con~ta ~e L. O'Neill
Special Needs Trust is hereby established this day of ~ P c , ~0 a by Order
of the Orphans' Court of Cumberland County, Pennsylvania, pursuant to 42 USt~A
§1396p(d)(4){A), as a Special Needs Trust for the sole benefit of Constance L. O"N ill (the
"beneficiary"), an individual under 65 years of age who is disabled as defined b~ t ~ SSI criteria
in 42 U.S.C.A. § 1382c(a)(3), upon the following terms and conditions:
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I. This Trust shall be funded by the assets of the beneficiary listed in Schedule a, algng with such
other assets of the beneficiary as may be added. No public assistance or ~dcial Security
benefits paid to the beneficiary shall be added to the trust.
II. This Trust shall be administered in compliance with the provisions of 61~ P~. C.S. § 1414
("Special Needs Trusts") and 55 Pa. Code § 178.7{f)1.
III. The Trustee of this Trust shall be the beneficiary's sister, Margaret M I t e of 1316 N.
Harvard Ave., Arlington Heights, IL, 60004. In the event the Trustee should re~ig or be unable
to act as Trustee, a successor shall be appointed the Orphans' Court of Cunhb r~land County,
Pennsylvania. ',
1 (1) A trust containing the assets of an individual under 65 years of age who ~s disabled as
defined by the SSI criteria in 42 U.S.C.A. § 1382c(a)(3), if the trust was establisF~e~ for the
benefit of the individual by a parent, grandparent, legal guardian of the individual, nr a court
and the trust contains a provision that the Commonwealth will receive the amdu t~ remaining
in the trust upon the death of the individual, up to an amount equal to the total) o~f MA benefits
paid on behalf of the individual ~,
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IV. During the beneficiary's lifetime, distributions of income and/or principal shall be made for
the sole benefit of the beneficiary. This trust is intended to satisfy the ben{efiiciary's non-
support needs. This trust is not intended to displace any source of income otfnerrwise available
to the beneficiary for her basic support (such as food and shelter), including ahy',governmental
assistance program to which she is or may be entitled. It is intended to be ~ discretionary
spendthrift trust created to increase the beneficiary's quality of life.
No part of the corpus of this trust shall be used to supplant or replace any public-assistance
benefits for which the beneficiary is eligible.
For the purposes of this provision, non-support purchases include, but are not jli iced to dental
care; unreimbursable medical and dental expenses, including plastic an{~ $constructive
surgery, diagnostic work and treatment, rehabilitative training and experimehtal medical
services; psychiatric/psychological services; occupational therapy; prosthetic' d ~-ices; dietary
needs and supplements; the differential in cost between shelter for a shared and private group
home or room; custodial care or supplemental nursing care; recreation, culty~ral .experiences,
outings and travel, including payment for others to accompany the beneficiary; ~ei,lephone and
television, including cable television; reading and educational materials; exetci d equipment;
unreimbursed therapy; and related insurance.
V. Upon the death of the beneficiary, Trustee shall obtain a determinat~gn from the
Department of Public Welfare of the Department's claim, if any, for Madi al Assistance
payments which had been made on behalf of the beneficiary while the trust wra in existence.
Trustee shall then pay over and distribute the then-remaining principal and $n accumulated
and undistributed income to the Pennsylvania Department of Public Welfare i~o repay the
amount of Medical Assistance paid on behalf of the beneficiary while the trustl,w ~ inexistence.
If there is any amount to be distributed following the payment of the claim of nth Department,
such remainder shall be distributed to the bene#iciary's heirs at law.
VI. No income or principal shall be assignable by the beneficiary or available toj, ar~ybne having a
claim against the beneficiary before actual payment to the beneficia,lry.l Under no
circumstances can the beneficiary compel a distribution from the trust for any pur~p~ose
VII. This trust shall be irrevocable. No part of this trust instrument shall be alt~red'~or amended
without order of this Court.