What Can a Qualified Income Trust Pay For in Georgia?
Georgia's official form (Form 948) tells the trustee to pay out the trust "monthly and totally" in a set order: the personal needs allowance, any allowance for a spouse or dependent children, medical expenses not paid by a third party, bank fees, and then the balance to the nursing home as Patient Liability. Any excess income stays in the trust. Every item below is cited to DCH's own published rules; where DCH 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 a Georgia Qualified Income Trust each month, and the trustee may pay it out only for the purposes DCH allows. Paying for anything else can put eligibility at risk. Here is the list, with the DCH source for each item.
What DCH's rules allow
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Personal needs allowance
$70 a month, or another amount DCH or DHS allows.
Source: DCH Form 948, distribution clause B(1)
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Allowance for a spouse or dependent children
A sum approved by DCH or DHS as the minimum monthly maintenance allowance for the spouse and any dependent children.
Source: DCH Form 948, distribution clause B(2)
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Medical expenses
Necessary medical expenses not subject to third-party payment.
Source: DCH Form 948, distribution clause B(3)
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Bank fees
Bank fees, paid directly from the QIT account.
Source: DCH Form 948, distribution clause B(4); Form 946
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Patient Liability to the nursing home
The balance, applied to the cost of nursing home care.
Source: DCH Form 948, distribution clause B(5)
The order payments are made in
Form 948 sets the order: personal needs allowance, spouse or dependent allowance, medical expenses, bank fees, then the balance to Patient Liability, with any excess income accumulating in the trust. Form 946 lists the same allowable disbursements with Patient Liability shown first.
Trustee and bank fees
Georgia's form provides for no trustee fee. Bank fees are the only fee Form 948 lists, and Form 946's list of allowable QIT disbursements likewise names bank fees paid directly from the QIT account and no trustee fee.
What the trust can't be used for
DFCS policy (Section 2407) says the only allowable disbursements are the Patient Liability or cost share, the personal needs allowance, diversion to a spouse or dependent children, and medical expenses not covered by Medicaid, and that inappropriate payments such as lawyer fees or mortgage payments will invalidate the QIT. (Form 948 and Form 946 also list bank fees.)
Timing, and money left over
Excess income accumulates in the trust (Form 948). If the beneficiary is discharged, money accumulated before discharge goes to reimburse DCH rather than to the beneficiary (Form 948). DFCS treats excess income left in the QIT after payments for the beneficiary's care as subject to the transfer-of-assets penalty (Section 2407).
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 DCH asks.
Related: who can be the trustee in Georgia, 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.