Establishing a Special Needs Trust in North Carolina

What Is a Special Needs Trust?

A Special Needs Trust (SNT), also known as a Supplemental Needs Trust, is a legal arrangement that allows individuals with disabilities to receive income without disrupting their eligibility for public assistance benefits such as Medicaid or Social Security Income (SSI). In North Carolina, establishing an SNT requires careful planning and adherence to both state and federal laws to ensure that the trust operates for the intended purpose without jeopardizing the beneficiary's access to essential government programs.

Types of Special Needs Trusts in North Carolina

There are primarily three types of Special Needs Trusts:

Steps to Establish a Special Needs Trust in North Carolina

  1. Determine the Appropriate Type of Trust: Deciding between first-party, third-party, or pooled trust is crucial based on who will fund the trust and the specific circumstances of the beneficiary.
  2. Select a Trustee: The trustee manages the trust assets and disbursements. It is vital to choose someone who is responsible, financially savvy, and has a genuine interest in the beneficiary's well-being.
  3. Create the Trust Document: A lawyer experienced in special needs planning can draft a trust document that outlines the terms of the trust and ensures compliance with relevant laws.
  4. Fund the Trust: Assets such as cash, securities, real estate, or other valuables can be transferred into the trust.
  5. Maintain Records and Manage the Trust: The trustee must administer the trust according to its terms, which includes keeping detailed records and making disbursements that do not conflict with public benefit eligibility requirements.

Legal Considerations and Challenges

Navigating through the complex web of regulations governing SNTs is challenging. The key legal consideration is ensuring that disbursements from the trust do not count as income to the beneficiary, which could disqualify them from receiving public benefits. Continuous monitoring of evolving laws and policies related to special needs trusts and public assistance programs is essential.

In North Carolina, one historical reference highlighting the importance of proper SNT establishment is the case of Fincher v. North Carolina Department of Health and Human Services. In this 2007 case, the court ruled that distributions from an SNT established for a Medicaid recipient did not necessarily disqualify them from continuing to receive Medicaid benefits. This underscores both the complexity of SNT regulations and their vital role in protecting beneficiaries' interests.


Establishing a Special Needs Trust in North Carolina is a strategic way to ensure financial stability for individuals with disabilities while preserving their access to vital public assistance programs. Given its complexity, it is advisable to seek professional guidance when creating an SNT to navigate legal requirements effectively and tailor a plan that best serves the beneficiary's unique needs.