Herman HECKER, Appellant, v. STARK COUNTY SOCIAL SERVICE BOARD and North Dakota Department of Human Services, Appellees.
Civ. No. 940180.
Supreme Court of North Dakota.
Dec. 20, 1994.
Opinion Denying Rehearing Feb. 8, 1995.
527 N.W.2d 226
Jean R. Mullen, Asst. Atty. Gen., Bismarck, for appellee.
December 20, 1994.
LEVINE, Justice.
Herman Hecker appeals from an order affirming the Stark County Social Service Board‘s denial of medicaid benefits. The appeal presents the question whether a parent may establish a trust to benefit her adult developmentally disabled son which provides funds for his special needs that are not provided for by public assistance without making him ineligible to receive medicaid benefits. We hold she may, and we reverse and remand.
FACTS
The facts are not in dispute. Herman Hecker is a single, fifty-four-year-old, developmentally disabled male residing in a group home. Herman is the sole beneficiary оf a trust [Hecker trust] established in 1984 by his now-deceased mother, Wilhelmina Hecker. The trust agreement was amended and restated in 1987 and describes the grantor‘s intent and the trustee‘s discretion as follows:
“III.
“(a) Introduction. It is the Grantor‘s primary concern in creating this Trust that it continue in existence as a supplemental fund to public assistance for her handicapped child, Herman Hecker, hereinafter referred to as the ‘beneficiary‘, throughout his life as she would provide if she were personally present.1 ...
“(b) Special Needs. The Trustee shall pay to or apply to the benefit of the beneficiary, for his lifetime, such amounts from the principal or income, up to the whole thereof, as the Trustee in the Trustee‘s sole discretion may from time to time deem necessary or advisable for the satisfaction of the beneficiary‘s special needs. Any income not distributed shall be added to principal. As used in this instrument, ‘special needs’ refers to the requisites for maintaining the beneficiary‘s good health, safety, and welfare when, in the sole discretion of the Trustee, such requisites are not deemed provided by any public agency, office, or department of the State of North Dakota, or of any other state, or of the United States. ‘Special needs’ include, but are not limited to, medical and dental expenses, clothing and equipment, programs of training, education, treatment, and essential dietary needs to the extent that such needs are not provided by any government entity.”
Herman appealed from the Board‘s denial to the North Dakota Department of Human Services [Department]. The Department, after a hearing, upheld the Board‘s denial of medicaid benefits. The hearing officer found that the trust created by Herman‘s mother was a support trust and, consequently, “deemed” to be available to Herman as a means of support.
Herman appealed from the Department‘s order to the district court, which affirmed the decision of the Department, holding that the trust, created by Herman‘s mother, is a support trust and, therefore, deemed an available asset pursuant to section 75-02-02.1-31(3)(b) of the North Dakota Administrative Code.
On appeal to this court, Herman argues that the Department‘s finding that the trust is a support trust is in error. He argues that the trust is a discretionary trust, not a support trust and, therefore, is not an available asset for determining medicaid eligibility. The Department contends that at least one purpose of the trust is Herman‘s support and, therefore, it is a support trust within the meaning of the Department‘s regulations. Consequently, the Department argues, the full value of the corpus of the trust may be considered available to Herman for his support and considered in determining his eligibility for medicaid.
Three issues are presented in this appeal: 1) whether the Hecker trust is a support or a discretionary trust; 2) whether the Department may, by administrative regulation, overrule a trust settlor‘s intent; and 3) if not, whether the Hecker trust violates federal and North Dakota public policy.
NATURE OF THE TRUST
When construing a trust instrument, our primary objective is to ascertain the settlor‘s intent. Matter of Larson, 341 N.W.2d 627 (N.D.1983). Intent is a question of fact. Matter of Estate of Klein, 434 N.W.2d 560 (N.D.1989); McGuire v. Gaffney, 314 N.W.2d 851 (N.D.1982). As this is an appeal from an administrative agency decision, we review the record and the determination of the agency, not that of the district court. Bohac v. Graham, 424 N.W.2d 144 (N.D.1988). We will affirm the finding of the agency unless its factual conclusions are not supported by a preponderance of the evidence. Hins v. Lucas Western, 484 N.W.2d 491 (N.D.1992). In deciding whether there is a preponderance of the evidence in support of the agency‘s findings of fact, “[w]e determine only whether a reasoning mind reasonably could have determined that the factual conclusions reached were proved by the weight of the evidence from the entire record.” Power Fuels, Inc. v. Elkin, 283 N.W.2d 214, 220 (N.D.1979).
A support trust is one which essentially provides that the trustee “shall pay or аpply only so much of the income and principal or either as is necessary for the education or support of a beneficiary.” Restatement (Second) of Trusts § 128 cmt. l (1959). See Bohac, 424 N.W.2d 144. A support trust permits a beneficiary to compel distributions of income, corpus, or both, for expenses necessary for the beneficiary‘s support. Id.; Chenot v. Bordeleanu, 561 A.2d 891 (R.I.1989); In the Matter of Leona Carlisle Trust, 498 N.W.2d 260 (Minn.App.1993). If the Hecker trust reasonably could have been interpreted to be a support trust, then the Department may consider it as an asset when evaluating Herman‘s eligibility for assistance. See
Whether a trust is a support or a discretionary trust depends on the settlor‘s intent. Bohac, 424 N.W.2d at 146. See also Restatement (Second) of Trusts § 128. Our duty is to uphold and implement the settlor‘s intent to the extent it does not contravene public policy. Leona Carlisle Trust, 498 N.W.2d 260; Tidrow v. Dir., Mo. State Div. of Family Services, 688 S.W.2d 9 (Mo.App.1985). When a trust instrument is unambiguous, the settlor‘s intent is asсertained from the language of the trust document itself. Bohac, 424 N.W.2d 144. Whether or not a trust is ambiguous is a question of law, fully reviewable on appeal. Klein, 434 N.W.2d 560.
The Hecker trust instrument authorizes the trustee to “pay to or apply to the benefit of [Herman], for his lifetime, such amounts from the principal or income, up to the whole thereof, as the Trustee in the Trustee‘s sole discretion may from time to time deem necessary or advisable for the satisfaction of [Herman‘s] special needs.” (Emphasis added.) The trust language defines “special needs” as “the requisites for maintaining the beneficiary‘s good health, safety, and welfare when, in the sole discretion of the Trustee, such requisites are not deemed provided by any public agency....” (Emphasis added.) Although the Hecker trust‘s definition of special needs includes medical and dental expenses, clothing, and education, items associated with support of a beneficiary, this language does not limit the trustee‘s absolute discretionary power. See Chenot, 561 A.2d 891. In fact, the trust, in contrast to a general support trust, permits the trustee, in his sole discretion, to invade the trust when and if the trustee deems it necessary for Herman‘s welfare. Compare Bohac. v. Graham, 424 N.W.2d 144 (N.D.1988). At all times, the trustee retains the discretionary power to determine when and to what extent that power will be exercised. See Lineback by Hutchens v. Stout, 79 N.C.App. 292, 339 S.E.2d 103 (1986); Leona Carlisle Trust, 498 N.W.2d 260. Indeed, the trustee has the power to make no distribution at all to Herman and Herman cannot compel the trustee to make distributions under the terms of the trust instrument. The ability to discriminate against one or all beneficiaries is characteristic of a discretionary trust. Zeoli v. Comm‘r of Soc. Serv., 179 Conn. 83, 425 A.2d 553 (1979); In re Johannes Trust, 191 Mich.App. 514, 479 N.W.2d 25 (1991).
Other plain language in the trust instrument demonstrates Wilhelmina Hecker‘s clear intent that the trust not be used for Herman‘s primary support. The trust unequivocally states that it is to be “a supplemental fund to public assistance,” and that
“[i]t is the Grantor‘s express intent that because the beneficiary is developmentally disabled and unable to support and maintain himself independently, the Trustee shall, in the exercise of the Trustee‘s best judgment, seek support and maintеnance from all available public resources, including the appropriate Regional Center for the developmentally disabled. In making distributions for the special needs defined herein, [the] Trustee shall take into consideration the applicable resource limitations of the public assistance programs for which the beneficiary is eligible.”
This language plainly indicates an intent not to provide primary support or maintenance for the beneficiary. Compare Bohac, 424 N.W.2d 144. Rather, this language is consistent with what a number of jurisdictions now refer to as a special needs trust or supplemental needs trust [SNT]. See
Special needs trusts and supplemental needs trusts are recognized as means for individuals to provide for persons who do not have the ability to be self-supporting and to whom the individuals owe no duty of support. See Silber, supra. Both supplemental needs trusts and special needs trusts require that public assistance be used for the primary support of the beneficiary with the trustees to provide only for the beneficiary‘s particular “special” or additional needs that public assistance does not provide. See, e.g., Young v. Dept. of Public Welfare, 416 Mass. 629, 624 N.E.2d 110 (1993). The majority of jurisdictions facing this issue holds that these types of trusts do not disqualify a beneficiary from receiving public assistance if the settlor‘s intention is clear that trust distributions are only to supplement, and not supplant, public assistance benefits. See, e.g., Application of Garbow, 155 Misc.2d 1001, 591 N.Y.S.2d 754 (Sur.1992).
We conclude that Wilhelmina Hecker unambiguously created a discretionary trust to be used as a secondary or supplemental source of income for Herman‘s needs which are not met by public assistance. The Department‘s finding that it is a support trust is contradicted by the plain language of the trust instrument and thus is not supported by a preponderance of the evidence.
EFFECT OF ADMINISTRATIVE REGULATION
The Department contends that
The Department‘s regulation says:
“a. For purposes of this subsection, ‘support trust’ means a trust which has, as a purpose, the provision of support or care to a beneficiary. The purpose of a support trust is indicated by language such as ‘to provide for the care, support, and maintenance of...‘; ‘to provide as necessary for the support of...‘; or ‘as my trustee may deem necessary for the support, maintenance, medical expenses, care, comfort, and general welfare‘. No particular language is necessary, but words such as ‘care‘, ‘maintenance‘, ‘medical needs‘, or ‘support’ are usually present. The term includes trusts which mаy also be called ‘discretionary support trusts’ or ‘discretionary trusts‘, so long as support is a trust purpose. This subsection applies without regard to:
(1) Whether or not the support trust is irrevocable or is established for purposes other than to enable a beneficiary to qualify for medicaid or any other benefit program where availability of benefits requires the establishment of financial need; or
(2) Whether or not the discretion is actually exercised.
“(b) Except as provided in subdivisions c and d, the amount from a support trust deemed available to the beneficiary, the beneficiary‘s spouse, and the beneficiary‘s children is the maximum amount of payments that may be permitted under the terms of the trust to be distributed to the beneficiary, assuming the full exercise of discretion by the trustee or trusteеs for the distribution of the maximum amount to the beneficiary.”
NDAC § 75-02-02.1-31(3)(a) ,(b) . (Emphasis added.)
The Department argues that its regulation permits it to deem the entire corpus of the trust as available to Herman for his support.3
Herman concedes that an applicant bears the burden of establishing eligibility for benefits. See Wagner v. Sheridan Cty. Soc. Serv. Bd., 518 N.W.2d 724 (N.D.1994). However, he argues that the underlined portion of
The Department is authorized to рromulgate eligibility standards for medical assistance benefits generally under
The underlined portion of
We have found no other state which has established, absent an explicit legislative directive, an administrative regulation deeming available to an applicant the assets of a discretionary trust. The Department argues that its regulation is proper and points to
In addition, we note that subdivision (2) of
The federal regulations define available assets similarly. See
Medicaid is a cooperative federal-state program that provides medical assistance to persons who lack sufficient income or resources to provide for their own medically necessary care.
The Department argues that North Dakota participates in the medicaid program as a “§ 209(b)” state which permits it to promulgate more restrictive eligibility methodology. However, while § 209(b) states may elect to provide more restrictive eligibility guidelines for their group of “categorically needy” recipients,
No federal regulations address specifically whether trust assets of a discretionary trust, such as the Hecker trust, may be deemed available for determining medicaid eligibility. See Miller v. Ibarra, 746 F.Supp. 19 (D.Colo. 1990); Leona Carlisle Trust, 498 N.W.2d 260. However, “availability” under the SSI guidelines requires that an applicant have an actual legal ability to obtain the resources. See
Herman has no legal ability to compel distributions from the Hecker trust because the trustee has absolute discretion over any and all payments to Herman. Consequently, under the federal definition of “available,” this trust would not qualify as Herman‘s available resource.
Absent the Department‘s regulation, Herman would qualify for medicaid. The regulation is more restrictive than the federally prescribed financial methodology because it renders Herman, who is otherwise qualified for medicaid, ineligible, and, consequently, it is invalid. See
We conclude that the underlined portion of
PUBLIC POLICY
The Department argues that even if
“Trusts may provide that trust benefits are intended only for a beneficiary‘s ‘special needs‘, and require the trustee to take into consideration the availability of public benefits and resources, including medicaid. Some trusts may provide that the trust is not to be used to supplant or replace public benefits, including medicaid benefits. Some trusts may contain terms which attempt to declare or make the determination of the availability of trust assets for medicaid рurposes. If a medicaid-qualifying trust or support trust contains such terms, the amount available to the medicaid applicant or recipient is the amount provided in subsection 2 or 3, assuming, for the purposes of making that determination, that the applicant or recipient is ineligible for medicaid.”5
Interpretation and application of administrative regulations is a question of law, fully reviewable on appeal. Americana Healthcare Centers-Minot and Fargo v. N.D. Dept. of Human Services, 510 N.W.2d 592 (N.D.1994). We accord some deference to reasonable agency interpretation of a regulation when that interpretation does not contradict the clear and unambiguous language of the regulation. Id.
Section 75-02-02.1-31(7), NDAC, on its face, applies only to support trusts and medicaid-qualifying trusts. We have determined that the Hecker trust is a discretionary trust, not subject to Herman‘s demands for distribution, and subsection (7) does not apply to discretionary trusts. See id.
Nor is the Hecker trust a Medicaid Qualifying Trust [MQT]. An MQT is a trust established, other than by will, by an individual or an individual‘s spouse, under which the individual is a beneficiary.
Courts look to constitutional and statutory provisions to find public policy, see Ressler v. Humane Society of Grand Forks, 480 N.W.2d 429 (N.D.1992); Gabriel v. Minnesota Mutual Fire and Casualty Co., 506 N.W.2d 73 (N.D.1993), as well as to judicial decisions. See e.g., Rueckert v. Rueckert, 499 N.W.2d 863 (N.D.1993). The Department cannot pronounce public policy that contradicts judicial precedent absent explicit legislative direction. Public Service Com‘m, 160 N.W.2d 534. See also Moore v. N.D. Workermen‘s Comp. Bureau, 374 N.W.2d 71 (N.D.1985) [administrative agencies do not initiate policy but follow the policy created by the law which guides the agency].
The Department argues that even if
The cases relied upon by the Department are distinguishable on their facts. McMullen was an appeal brought by Joshua McMullen, a minor, whose mother was receiving Aid for Families With Dependent Children [AFDC] benefits. 470 N.W.2d 196. Joshua had received a sizeable money settlement as a result of injuries he sustained in an automobile accident. Id. The court order approving the settlement permitted disbursement of the trust proceeds only when Joshua reached the age of majority. Id. Joshua, at the request of the Department of Human Services, sought a declaratory judgment that the proceeds of the settlement were not available for his support and thus, could not be considered by the Department in determining his mother‘s eligibility for AFDC. Id. We held that if the trustee were required to disburse the proceeds for Joshua‘s support, they could properly be considered in determining Joshua‘s mother‘s AFDC eligibility. Id. In so doing, we acknowledged that the “decisions and the regulations on welfare eligibility” require recipients to use their own “available income and resources” first, before recеiving public assistance. Id. at 201 (emphasis added). However, in contrast to Joshua McMullen, Herman has never had a legal right to the proceeds of the Hecker trust, nor is there any question that he cannot compel distribution of income or principal because the trustee has complete discretion as to those distributions. See Leona Carlisle Trust, 498 N.W.2d 260. Thus, neither McMullen, nor its underlying public policy, makes the Hecker trust unenforceable.
In Pennell, we rejected a father‘s request to reduce his child support obligation because the government‘s deep pockets would bear the extra costs of supporting his quadriplegic daughter. 415 N.W.2d 497. Unlike Ms. Hecker, Pennell had a statutory and court-ordered duty to provide support for his minor daughter. Wilhelmina Hecker had no similar obligation to support her adult dis-
Finally, in Bohac, the trust at issue was a support trust which gave the beneficiary the right to compel distributions for his support. 424 N.W.2d 144.6 Herman enjoys no similar right under his mother‘s trust. A beneficiary has no legal interest in a discretionary trust, nor does he have the right under the terms of the trust instrument to compel payments. Thus, Herman‘s interest in the trust does not permit him to actually access the trust funds, unlike Bohac‘s interest in the support trust, and, consequently, the funds may not be used for his support.
Second, while we accept the Department‘s position that medicaid should be a benefit of last resort, see
Herman‘s situation is more akin to a parallel line of Pennsylvania cases holding that a discretionary trust is not an available asset for medical assistance eligibility. See Lang v. Commonwealth, Dept. of Public Welfare, 515 Pa. 428, 528 A.2d 1335 (1987). In Lang, the applicant was mentally disabled and institutionalized. Id. The Pennsylvania court characterized the assets of the discretionary trust of which the applicant was a beneficiary as unavailable to the beneficiary because the beneficiary could not compel payments for support. Id. Also important in Lang, Pennsylvaniа had a statute, similar to our own, that relieved parents and other relatives from financial responsibility for disabled persons over the age of eighteen. Id.
Third, the Department argues that persons with substantial assets would prefer supporting their relatives incapable of self-support rather than forcing them to rely on public assistance. That may be true for some, but obviously, not all. Indeed, many jurisdictions reject that proposition outright on the ground that the notion of public assistance as charity is anachronistic. See, e.g., Estate of Escher, 94 Misc.2d 952, 407 N.Y.S.2d 106 (Sur.Ct.1978); Town of Randolph v. Roberts, 346 Mass. 578, 195 N.E.2d 72 (1964); Lang, 528 A.2d 1335.
As our last word on the subject, we adopt the reasoning of the Wisconsin Supreme Court which we believe is sound, sensiblе and just:
“We know of no public policy to prohibit a person who is not liable for the support of a charity patient in a public institution to give to the patient extra comforts or luxuries or, at need, necessities which the institution does not furnish nor do we find a public policy to seize such gifts before the patient has received them.” In re Wright‘s Will, 12 Wis.2d 375, 107 N.W.2d 146, 149 (1961).
CONCLUSION
We conclude that the assets of this discretionary trust are not “available” for purposes of determining Herman‘s medicaid eligibility and the Department, absent legislative authority, cannot include them in evaluating Herman‘s available assets. To hold differently would place otherwise qualified applicants for medicaid in an untenable position, forcing the sеttlor to either deplete the corpus of the trust to below $3,000.00 or to leave the applicant stranded—unable to compel payments under the trust instrument and unable to qualify for public assistance. Leona Carlisle Trust, 498 N.W.2d 260; Trust Co. of Okla., 825 P.2d 1295, cert. denied ___ U.S. ___, 113 S.Ct. 300, 121 L.Ed.2d 224. Such a result is not required by our law, would nullify the settlor‘s intent, and would run contrary to our public policy. Consequently, we reverse and remand the district court judgment with instructions to remand to the Department for a redetermination of Herman‘s eligibility for medicaid benefits without considering the value of the corpus as an asset.
NEUMANN and MESCHKE, JJ., concur.
VANDE WALLE, Chief Justice, dissenting.
In a dissent in Nielsen v. Cass County Social Services Bd., 395 N.W.2d 157, 162 (N.D.1986), I stated that “I am not yet willing to concede that our society, at least in North Dakota, is at a place where we should assume that decedеnts would cast their relatives on the welfare roles to reserve their estate for other family members.” The majority, relying on cases from other jurisdictions, takes a big step in reforming what I believe to be the North Dakota ethos.
Relying on Bohac v. Graham, 424 N.W.2d 144 (N.D.1988), the majority holds the administrative regulation which defines eligibility for medical assistance benefits is void
I dissent consistent with the reasons set forth in my dissent in Nielsen v. Cass County Social Services Bd., supra.
SANDSTROM, J., concur.
ON PETITION FOR REHEARING.
February 8, 1995.
LEVINE, Justice.
On petition for rehearing, the North Dakota Department of Human Services, relying on Mowbray v. Kozlowski, 914 F.2d 593 (4th Cir.1990), argues that North Dakota, as a § 209(b) state, may use eligibility criteria pertaining to “medically needy” applicants for medicaid benefits which are more restrictive than those of the Supplemental Security Income (SSI) program and that the underlined portion of
In any event, we need not decide that issue because North Dakota‘s § 209(b) status does not rescue the underlined portion of the Department‘s regulation from invalidation. The federal regulations governing state participation in the medicaid program require that states consider only those assets of an applicant which are actually available to the applicant.
Full resolution of the effect of North Dakota‘s § 209(b) status on the validity of the Department‘s medicaid eligibility criteria can await another day when the answer will directly affect the outcome of the parties’ dispute.
Petition denied.
NEUMANN and MESCHKE, JJ., concur.
VANDE WALLE, C.J., and SANDSTROM, J.: We adhere to our previous dissent.
Notes
“Only such assets as are actually available will be considered. Assets are actually available when at the disposal of an applicant, recipient, or responsible relative; when the applicant, recipient, or responsible relative has a legal interest in a liquidated sum and has the legal ability to make the sum available for support, maintenance, or medical care; or when the applicant, recipient, or responsible relative has the lawful power to make the asset available, or to cause the asset to be made available. Assets will be reasonably evaluated. A determination that an asset is deemed avail-
