The 2024 Pooled Medicaid Payback Trust Starter Kit contains all of the forms and instructions necessary to establish a new Pooled Medicaid Payback Trust. It includes: 

• Attorney Instructions for the PMPT
• Pooled Medicaid Payback Trust Joinder Application
• 2024 Joinder and Deposit Processing Schedule
• Investment Questionnaire
• Attorney Acknowledgment
• W-9
• Notice to Beneficiaries Age 65 or Older and Their Legal Counsel
• Opt-Out of Paper Statements 
• Deposit Instructions
• Trust Comparison Fee Schedule (2022 update)
• About Trusts
• Tax Notice
• Pooled Medicaid Payback Trust Agreement (13th Restatement)

Community Fund has partnerships with four Ohio nonprofits: Jewish Federation of Cleveland, Hattie Larlham, ADD, and The Arc of Ohio.

One of the following Joinder Agreements should be used if the person establishing the Pooled Medicaid Payback Trust wishes for the named organization to receive trust funds at the death of the Beneficiary: 

• Jewish Federation of Cleveland Pooled Medicaid Payback Trust Joinder Application
• Hattie Larlham Pooled Medicaid Payback Trust Joinder Application
• ADD Pooled Medicaid Payback Trust Joinder Application
• The ARC of Ohio Pooled Medicaid Payback Trust Joinder Application

Information Sheets

• Information Sheet on How to Set Up a Trust with Community Fund Ohio
• Information Sheet on Pooled Medicaid Payback Trusts
• Information Sheet on Nonprofit Partners
• Information Sheet for Attorneys