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Miller Trust Guide
KY · Guide

Who Can Be the Trustee of a Miller Trust in Kentucky?

In Kentucky, the trustee of a Miller Trust (Qualified Income Trust) is whoever manages the trust account — depositing the applicant's income each month and paying out only what DMS allows. Kentucky's regulation (907 KAR 20:030) never states who may, or may not, serve as trustee of a Qualifying Income Trust, and never addresses whether the individual can serve as their own trustee -- the word "trustee" doesn't appear anywhere in the QIT-specific subsection at all. What the regulation does require is that every expenditure from the trust be verified by the department as allowable before it's paid (Section 3(5)(e)). DCBS's own internal procedures manual goes further than the regulation's text and frames this as an ongoing trustee obligation: "the trustee must consult with Medicaid on payments from the trust before they are made" (DCBS Ops Manual Vol. IVA, MS 3505 SS A(6)) -- but that's the department's operational gloss, not language in the regulation itself. In practice, most families name a third party (a spouse, adult child, or agent under power of attorney) rather than the individual themselves. Confirm the trustee question directly with your drafting attorney -- this guide does not treat self-trusteeship as either confirmed permitted or barred by Kentucky's rule text. The trustee does not have to be a lawyer or a professional; for the core setup this is a role most families fill themselves. For a complex situation, consult a Kentucky-licensed elder-law attorney. This guide is informational only and is not legal advice.

The trustee does not have to be an attorney or a professional fiduciary. Managing a Qualified Income Trust is an operational job, not a legal one: open the account, move the applicant's income through it each month, and pay out only what DMS allows — the same short list of tasks every month.

What the trustee does each month

  • Deposits the applicant's income — Social Security, pension, and any other named sources — into the dedicated trust account.
  • Pays out only the amounts DMS permits: typically the applicant's personal-needs allowance of $60/month, any spousal allowance, and the applicant's share of medical and care costs.
  • Keeps simple records of what went in and what came out, so the trust stays compliant and Medicaid has no reason to question it.

Name a backup trustee

Many families name a successor trustee when they set the trust up, so that if the first trustee cannot continue, the trust keeps running without interruption. Either way the Kentucky setup is the same — see the step-by-step setup and what to say at the bank.

The Kentucky denial traps that cost families a month of coverage

Most denials are paperwork, not eligibility. This free one-pager lists every DMS denial trap with the citation behind it — emailed now. We'll also send 4 short follow-ups over the next 3 weeks (the bank step, the trustee role, when to call an attorney) — then we stop. No ongoing newsletter.

Email only — we never ask for income, age, or family details, and never sell your address.

Common questions

Does the trustee of a Kentucky Miller Trust have to be a lawyer?
No. Managing a Qualified Income Trust is an administrative task — opening the dedicated account, depositing the applicant's income each month, and paying out only the amounts DMS allows. Kentucky's regulation (907 KAR 20:030) never states who may, or may not, serve as trustee of a Qualifying Income Trust, and never addresses whether the individual can serve as their own trustee -- the word "trustee" doesn't appear anywhere in the QIT-specific subsection at all. For advice on your specific situation, consult a Kentucky-licensed elder-law attorney.