THE REVERE ADVOCATE – FRiDAy, July 12, 2024 Page 15 CHA | FROM Page 3 to-reach populations in local communities. • CHA’s Community Behavioral Health Centers (CBHC) — located at CHA Cambridge Hospital and CHA Malden Care Center — off er behavioral health care designed to expand access to routine, urgent and crisis treatment for mental health conditions and substance use disorders. Services include a 24-hour Access and Crisis Line, Urgent Care, open daily, and 24/7 mobile crisis services in individuals’ homes, schools or other community locations. • CHA’s Department of Community Health works collaboratively with healthcare providers, residents, community-based organizations and city leaders to assess community health status, identify challenged areas, build action plans and provide leadership around health issues that impact the community. • CHA’s Revere Care Center’s Mobile Market provides fresh produce and other staples to families facing food insecurity. Created in partnership with The Greater Boston Food Bank, Tufts BEACON | FROM Page 14 meals permanent with the Legislature, and the combination of state and federal funding means that breakfasts and lunches are available to all students to help them stay healthy and succeed in school.” ---Gov. Maura Healey releasing data from the fi rst year of state-funded universal free school meals, showing major increases in student participaHealth Plan and other community partners, it distributed more than 100,000 pounds of fresh, nutritious food to families over the past year. • CHA’s primary service area includes some of the most racially, ethnically and linguistically diverse municipalities in Massachusetts, with 44 percent of CHA patients speaking a language other than English. To respond to their linguistic and cultural needs, CHA has established one of the most advanced multilingual interpreter programs in the nation. Additionally, providing pathways to healthcare careers for underrepresented communities is a major area of focus for CHA. “Great care is only great if everyone can access it,” said Vikas Saini, MD, president of the Lown Institute. “We need hospitals to be strong community partners — and these hospitals at the top on our list are showing the way.” The Lown Institute’s Hospitals Index for Social Responsibility is the only ranking to include metrics of health equity and value of care alongside patient outcomes, creating a holistic view of hospitals as total community partners. In tion compared to before the COVID-19 pandemic. HOW LONG WAS LAST WEEK’S SESSION? Beacon Hill Roll Call tracks the length of time that the House and Senate were in session each week. Many legislators say that legislative sessions are only one aspect of the Legislature’s job and that a lot of important work is done outside of the House and Sena er matters that are important to their districts. For Advertising with Results, call The Advocate Newspapers at 617-387-2200 or Info@advocatenews.net the fi fth annual rankings, the 2024-25 Lown Institute Hospitals Index evaluates hospitals on over 50 measures, including novel metrics like community benefi t, racial inclusivity and avoidance of substance abuse. Some of the data sources: Medicare fee-for-service and Medicare Advantage claims, CMS patient safety data and hospital cost reports, and IRS 990 forms. Full methodology can be found on the Lown Institute website. More about the Lown Institute: This nonpartisan think tank generates bold ideas for a radically better system of health. Learn more at www. LownHospitalsIndex.org. More about Cambridge Health Alliance: CHA includes two hospital campuses, a network of primary care and specialty practices and the Cambridge Public Health Department. CHA patients have seamless access to advanced care through the system’s affi liation with Beth Israel Lahey Health. CHA is a Harvard Medical School teaching affi liate and is also affi liated with the Harvard School of Public Health, the Harvard School of Dental Medicine and the Tufts University School of Medicine. Critics say that the Legislature does not meet regularly or long enough to debate and vote in public view on the thousands of pieces of legislation that have been fi led. They note that the infrequency and brief length of sessions are misguided and lead to irresponsible late-night sessions and a mad rush to act on dozens of bills in the days immediately preceding the end of an annual session. During the week July 1-5. the House met for a total of 27 minutes and the Senate met for a total of 15 minutes. Mon. July 1 House 11:00 a.m. to 11:13 a.m. Senate 11:12 a.m. to 11:18 a.m. Tues. July 2 House 11:00 a.m. to 11:06 a.m. No Senate session Wed. July 3 House 11:03 a.m. to 11:11 a.m. Senate 11:03 a.m. to 11:12 a.m. Thurs. July 4 No House session No Senate session Fri. July 5 No House session No Senate session Bob Katzen welcomes feedback at bob@beaconhillrollcall.com Bob founded Beacon Hill Roll Call in 1975 and was inducted into the New England Newspaper and Press Association (NENPA) Hall of Fame in 2019. CAN A SETTLOR OF AN IRREVOCABLE MEDICAID QUALIFYING TRUST RECEIVE PRINCIPAL DISTRIBUTIONS? T he Trustee of an irrevocable trust is prohibited from distributing any principal from the Trust to the Settlor (the person creating the Trust) in order for the Trust assets not to be counted for MassHealth purposes. A typical irrevocable Trust, will however, provide for the income generated from the underlying Trust assets to be distributed to the Settlor. In this instance, the Settlor would be the income benefi ciary. The Settlor or Settlors, as the case may be, would presumably be paying for monthly living expenses with other sources of monthly income such as pension income and social security income. The interest and dividend income generated from the Trust’s liquid assets and net rental income, assuming rental real estate was also placed inside the irrevocable Trust, would be additional sources of monthly income to be utilized by the Settlor in order to meet his or her monthly expenses. The Settlors would have to look to other assets held outside of the irrevocable Trust in order to gain access to needed resources. For example, an IRA or a 401(k) account. These assets are typically not funded into an irrevocable Trust as they would fi rst have to be liquidated with corresponding income taxes to be paid. That situation could be a last resort if the Settlor needed to qualify for MassHealth. Sometimes, people will gradually cash out these retirement accounts in order to stretch out the income over several years, thereby saving a lot of money in taxes. If a $300,000 IRA, for example, needed to be cashed out in one year in order to transfer to a spouse for MassHealth eligibility, the taxes in that one year would be substantial. There is also typically a provision in the irrevocable Trust that would allow for a distribution of principal to a member of a class consisting of children and grandchildren. This is a way to get principal out of the irrevocable Trust. However, under no circumstances, can the distribution of principal go to the Settlor. I suppose at that point, once funds are in the hands of the children or grandchildren, they are free to do what they want with the money, including possibility purchasing something that might just benefi t the Settlor. Of course, a child or grandchild can certainly do that with his or her own money anyway. So it should not make a diff erence in a situation where funds are distributed from such a Trust to a child or grandchild and those funds are actually used to purchase goods or services for the Settlor. There is always a risk that the child will take the money and run. But when the Settlor reserves a “special power of appointment, exercisable via his or her Last Will and Testament, the Settlor could effectively disinherit a child or grandchild by “appointing” the Trust principal to someone else. This special power of appointment ends up giving a lot of control to the Settlor over the ultimate distribution of Trust assets. Joseph D. Cataldo is an Estate Planning/Elder Law Attorney, Certified Public Accountant, Certified Financial Planner, AICPA Personal Financial Specialist and holds a Master’s Degree in Taxation.
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