What Can a Qualifying Income Trust Pay For in Alaska?
Alaska's Division of Public Assistance says the trustee pays the cost-of-care amount the caseworker sets, and may pay the beneficiary a personal needs or living allowance by check, allowances for a spouse or minor children, and other listed uses such as uncovered medical expenses, taxes or child support. A trustee who fails to pay toward the cost of care makes the trust invalid. Every item below is cited to DPA's own published rules; where DPA says nothing about an item, this page says so instead of filling the gap. This guide is informational only and is not legal or financial advice.
Income goes into an Alaska Qualifying Income Trust each month, and the trustee may pay it out only for the purposes DPA allows. Paying for anything else can put eligibility at risk. Here is the list, with the DPA source for each item.
What DPA's rules allow
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Cost of care
The trustee is responsible for paying the cost-of-care obligation from the trust; the caseworker notifies the recipient of that amount and of the allowed personal needs allowance.
Source: DPA brochure MED-21, Trustee Information
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Personal needs allowance in a nursing home
$200 a month.
Source: DPA brochure MED-23; DPA Medicaid Standards
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Living allowance on a home and community-based waiver
Up to $1,656 a month in a private home, or $1,396 in an assisted living facility.
Source: DPA brochure MED-23
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How the allowance is paid
The trustee issues the beneficiary a check.
Source: DPA brochure MED-23
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Allowances for a spouse or minor children
Spouses of nursing home or waiver recipients may receive a spousal allowance, and a dependent allowance for minor children; the spouse's own income is considered.
Source: DPA brochure MED-23
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Other allowable uses
DPA lists uncovered medical expenses, taxes and child support among the allowable uses, and says to refer to the trust document for specific guidelines.
Source: DPA brochure MED-23
Trustee and bank fees
Alaska's brochures and rules say nothing about trustee fees while the beneficiary is alive. When the trust ends, 7 AAC 100.608(a) lets it pay outstanding legal and administrative fees for establishing and maintaining the trust before paying the state.
What the trust can't be used for
Payments from the trust used for shelter reduce what the beneficiary may receive from it and can affect eligibility or the cost-of-care amount (MED-23, MED-21). The trust may hold only income, the applicant can't be its trustee, and a trustee who doesn't pay toward the cost of care, or doesn't follow the trust's terms, makes it invalid (7 AAC 100.604 and 100.610).
Timing, and money left over
Accumulated interest is part of the trust (7 AAC 100.610). If funding stops, the trustee keeps the trust intact until it ends and the state is reimbursed (7 AAC 100.604(e)). DPA asks to review current bank statements each year (MED-21).
Keeping the monthly record
The trustee is the one who has to show that the trust paid only these items. A month-by-month record of every deposit and every payment, checked against the bank statement, is what makes that easy to show when DPA asks.
Related: who can be the trustee in Alaska, what happens to the money at death, and the Miller Trust trustee guide for how the monthly cycle works in every state.
Trust not open yet? The account comes first
None of these payments can start until the trust account exists, and most branches have never opened one. Free one-pager: the questions to ask before you drive to a branch, emailed now. Then 4 more short emails over the next 10 days — then we stop.