Who Can Be the Trustee of an Income-Only Trust in Arizona?
In Arizona, 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 AHCCCS allows. Arizona's own policy (AHCCCS EPM Chapter 803) does not name who may or may not serve as trustee of an Income-Only Trust -- it defines the trustee's duties and reporting obligations (45-day advance notice of trust-income or disbursement changes, monthly disbursements, no loans or gifts to third parties) without restricting who can hold the role. DE-819 tells applicants they "may be able to get help creating a Special Treatment Trust from your attorney" and directs questions to the local ALTCS office, but does not state that the customer cannot self-trustee. In practice, many families use a third party -- a spouse or adult child -- rather than the customer, both because general trust law disfavors a sole beneficiary also serving as sole trustee (the "merger" doctrine) and because a separate trustee is the one who signs bank paperwork and handles the required AHCCCS notifications. Confirm the trustee question directly with the drafting attorney -- this kit does not treat self-trusteeship as either confirmed permitted or barred by Arizona'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 an Arizona-licensed elder-law attorney. This guide is informational only and is not legal advice.
What usually happens
Arizona doesn't publish a fill-in form, so the trust has to be drafted to AHCCCS's requirements, and an elder-law attorney quotes $1,000–$2,500 to research and draft it. Once it's signed, you take it to the bank, where the branch has never opened one of these and says no.
Meanwhile the month is running out. In Arizona, 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 $7,604–$10,494.
This applies when the person who needs care has gross monthly income over Arizona's income cap of $2,982, whether you're their child, their spouse, or a professional helping them.
Free: the questions to ask an Arizona bank before your first visit
6 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 AHCCCS 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 AHCCCS permits: typically the applicant's personal-needs allowance of $149.1/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.
For the full list of payments AHCCCS allows, with the source for each, see what the trust can pay for in Arizona.
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 Arizona 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.