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In a case with facts substantially similar to those of a case it ruled on earlier this year, a California appeals court holds that the state’s right to reimbursement for medical care provided to the beneficiaries of special needs trusts (SNTs) is governed by federal law, not by state probate laws and regulations. Elson v. Wells Fargo Bank, et al. (Cal. Ct. App., 2nd Dist., B288796, Aug. 19, 2019).
Micah Elson was the beneficiary of a first-party SNT established with $2.38 million of the settlement proceeds awarded for his medical complications at birth. A court ordered payment of the proceeds into the SNT subject to California Probate Code sections 3604 and 3605. The trust was a “discretionary, spendthrift trust, to supplement public resources and benefits” that included a Medicaid payback provision for all medical assistance to the beneficiary. The trust also provided that the principal and income of the trust were not to be considered part of the beneficiary’s estate.
Micah died in August 2015 at age 10, with more than $1.5 million remaining in the SNT. The State Department of Health Care Services filed a claim under state and federal law for reimbursement of nearly $1.4 million in Medi-Cal (Medicaid) payments for care provided to Micah. Trustee Wells Fargo Bank filed a petition for approval of the final account and seeking instruction on paying the state’s claim. Micah’s parents sought a court order directing the trustee to instead distribute the remaining funds to them.
The parents argued that because Probate Code section 3605(b) requires that SNT assets be treated as part of a beneficiary’s estate, the court should apply the estate recovery rules set forth in former Welfare and Institutions Code section 14009.5, which prohibits the state from seeking reimbursement for medical expenses from the estate of a beneficiary who was younger than 55 when the services were received. The probate court ruled in favor of the Department and his parents appealed. The facts and legal issues are essentially the same as found in Gonzalez v. City National Bank, et al. (Cal. Ct. App., 2nd Dist., B284521, June 24, 2019), and the court applied the same analysis to this case.
The Court of Appeal of the State of California, Second Appellate District, affirms the probate court. The court agrees with its holding in Gonzalez and finds that Congress specifically intended to regulate reimbursements for Medicaid from SNTs without limiting reimbursement to services provided to beneficiaries over age 55. The court concludes that probate code section 3605 does not conflict with federal law and that it permits the Department to recover Micah’s Medi-Cal expenses from the funds remaining in the SNT. The court also concludes that the terms of the trust expressly state that trust assets were not to be considered part of the beneficiary’s estate and that the state is entitled to full reimbursement for Medi-Cal assistance provided during his life.
The read the court’s full opinion, click here.
To read our earlier report on Gonzalez v. City National Bank, et al., click here.
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