Who Can Be the Trustee of an Income Trust in South Carolina?
In South Carolina, 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 SCDHHS allows. Per DHHS Form 905, the applicant/beneficiary cannot serve as their own trustee — a separate trustee must be appointed (a family member, an attorney-in-fact under a Durable Power of Attorney, a guardian or conservator, or another willing person). The trustee is responsible for having the income deposited, withdrawing only allowed deductions, and accounting for every dollar in and out; the Statement of Trustee must be signed, witnessed, and notarized, and the trustee is personally liable for any misuse of trust funds. No bond is required. A successor trustee is named by agreement of the beneficiary (or representative) and SCDHHS, or by the probate court if they cannot agree. South Carolina allows the income to flow into the trust account by direct deposit, by depositing the check, or by transfer from another account — each month the income must flow through the account for any month coverage is sought. A $10/month maintenance reserve may be retained for bank charges, a tax return, or trustee compensation if no one will serve without pay (SCDHHS may authorize more). 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 South Carolina-licensed elder-law attorney. This guide is informational only and is not legal advice.
What usually happens
You find the free SCDHHS form, and it looks simple. Then an elder-law attorney quotes $1,000–$2,500 to handle it. So you fill it in yourself, get it signed, and take it to the bank, where the branch has never opened one of these and says no.
Meanwhile the month is running out. In South Carolina, coverage can't start before the month the trust is funded, so a month that slips is another month of private-pay nursing care at $9,034–$9,612.
This applies when the person who needs care has gross monthly income over South Carolina's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.
Free: the questions to ask a South Carolina bank before your first visit
7 questions for a five-minute phone call, so you find out whether a branch knows how to open this account before you make the drive. Emailed now, then 4 short follow-ups over the next 10 days — then we stop.
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 SCDHHS 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 SCDHHS 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 South Carolina setup is the same — see the step-by-step setup and what to say at the bank.
Whoever you name will need this
The trustee is the one who opens the account — and most banks have never seen this type of trust before. Free one-pager: the questions to ask before that first visit, emailed now. Then 4 more short emails over the next 10 days — then we stop.