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I do not want mom to go to a nursing home; I would rather care for her here with me but need help. I would like to get mom on Medicaid to assist with paying for that help, but need to set up a Miller Trust (QIT) because she is over the income cap for Florida. Since the funds in the trust must be used for her care, can she legally pay me as a caregiver from that trust? If so, then that would be taxable income for me, correct?

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The specifics vary from state to state. Research the terms "qualified income trust [name of your state]". Here is the rule in Georgia, for example:

(1) all of the income placed in the trust be disbursed in the month received, and (2) that the only disbursements from the trust shall be for (a) the Beneficiary's "personal needs allowance" as amended from time to time, (b) a spousal allocation in favor of a community spouse, if any, (c) payment to the nursing home provider, if Beneficiary is institutionalized, and (d) medical expenses not subject to third party payment.
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Answers in kinda backward order:
If you are paid by Medicaid (with or without your mother's miller trust providing part of the money), it would be taxable income. You would need to pay the appropriate income and payroll taxes. You would need to file the appropriate state and federal taxing authority reports on your mother's behalf.
You really need to talk to attorney and here's why: if you are the power of attorney for your parent, and you are trustee for the miller trust - which is a variant of special needs trust - you can't take actions that enrich yourself at the expense of your vulnerable adult. You could be seen as abusing the fiduciary duty that you have as Power of attorney and Trustee. If your parent has dementia and cannot consent to a caregiver contract, you can't write a contract as her caregiver using your power of attorney to create a contract between her (really yourself) and yourself. Comprende? A lawyer versed in medicaid and elder law will be able to determine if a caregiver contract can be legally executed and the appropriate amount of payment. Is your plan to pay yourself for full time hours using the Miller Trust to supplement or deposit Medicaid money in and make up a difference? Community Medicaid will not pay for 40 hours a week care (much less 24/7 care if that's what she is requiring). You really need to discuss your plans in full detail with an expert in Florida medicaid to avoid any mistakes that might cause transfer penalty or disqualify mother.
You might find a better use to get Agency caregiver to give you a chance to work part time or get a break. Take care of yourself too but don't create future problems that your mother's funds paid to a lawyer can help you with.
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This is a tricky question because a Miller trust is normally used to qualify for a NH with help from Medicaid if the income is a little too much. I wondered why not just have your mother pay your directly after making a caregiver contract. Medicaid doesn't generally cover care in the home except a small amount that can be available in some instances. Some states won't allow family to receive even this small amount, so you would have to check with the rules of your state. The amount of money is small, so may not be approaching the amount that would be meaningful to you. I don't know if a Miller trust would be useful for community Medicaid. We have a couple of people on the group who know more about community Medicaid, so maybe they will know the answer.
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I think you need to ask an attorney knowledgeable about Medicaid. I am not aware of any program that allows Medicaid funds to be used to pay family members for care. However, you might be able to have your mother pay you directly with a caregiver contact and a lot of documentation.
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The Miller trust has only one beneficiary.... Medicaid

However...why do a Miller trust at this time? Since all of their medical expenses are deducted first...they may still quality for Medicaid assistance after self pay for some of it.

Yes...all taxes must be paid. Withholding taxes, Medicare, soc. Sec., etc. this can be a pain for individuals...try looking into a payroll service to handle it all for you. Somewhere like HomeWork Solutions.
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Guestshopadmin - What you said here: "if you are the power of attorney for your parent, and you are trustee for the miller trust - which is a variant of special needs trust - you can't take actions that enrich yourself at the expense of your vulnerable adult." makes complete sense!! I guess what I was trying to do was let myself get paid something since I had to quit working, while hoping Medicaid would chip in and pay for some assistance here at home...

I have been sent a flyer for an elderly day care program at one of the local assisted living places. I may take advantage of that for now. Perhaps a day or two break a month will keep me going where I won't need as much help as I think I do. :)
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I'm sure income is taxable. Make an appointment with a supervisor at Medicaid they have your answer. Many loop holes exist. For example, if a family member is receiving public assistance and you are watching their kids while they are on a job placement that family member can get paid by dept of social service. I know this doesn't answer your question but it speaks to the unknown as it relates to pay outs by the govt. also a person applying for public assistance of a foster child gets to keep the foster care monies and also gets to collect full public assistance .so you see there are loop holes. I would speak to a Supervisor III (3) at DSS or perhaps you or mom qualifies for legal services for free. Entitlement services all have different criteria especially when it comes to what is counted as an asset.
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Hi bratcat20 - I live in New York and had to move my mom on to Medicaid. Mom's care became higher than I could handle on my own and limited private paid aides. When the POA for mom announced mom had no more money for the aides, I had not choice but to move her on to Medicaid.
Mom lives with me and does not own a personal home. She does own commercial property and several businesses that were all put into a trust over 5 years ago. So that trust protects those properties. New York has what they call Community Medicaid. I know there are a number of other states that also offer this type of Medicaid, of course every state calls it something different. This is for people who want to stay home and not go into a nursing home.
I had to hire a Medicaid attorney (primarily because of the trust) and a private paid care manager. It all took some time, but it was much faster moving with these people involved. I had to set up an approved trust for mom because she made more than was allowed in New York between her Social Security and small pension. Because mom lives with me, I am paid, thru the trust, a monthly rent. The attorney drew up a rental agreement that was signed off by the POA. So that check comes to me directly from the trust.
I was also given 24/7 aide service thru Medicaid, which was a miracle! I think it's called CDPAP or something like that. So I use an agency approved by Medicaid who pays the aides. I can hire the aides or the agency can hire them, but either way, the aides are employees of this agency but are responsible to me. I control who is hired, training, etc. Now, thru this program I can be paid as a caregiver as long as I go on their payroll and become an employee of theirs. The community Medicaid allows family members to get paid except for the spouse.
Although it took a lot of time and money to get where I am today with mom, it was absolutely worth it. The monies spent will come back ten fold with the 24/7 aides being paid for by Medicaid.
I hope that explanation helps you out. Let me know if I can be of any other help to you. Take care of yourself.
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I'm not sure I understand your answer. Beneficiary is only after the person is deceased. So I understand that at death whatever is in that account goes back to medicaid. Until then, monies are drawn out to pay for nursing home care, etc.

In Florida, the income cap is $2200 before any deductions, so one has to have the trust to qualify for medicaid if their income is above that. Perhaps it's different in other states, but not Florida.

I appreciate your time and input, but I think I'm still needing an answer to the question about paying me from that account. 😊
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Guestshopadmin - while I understand your point regarding entering a caregiver agreement with yourself (as POA) and someone with dementia - I think it's crazy that we automatically associate this type of arrangement with financial abuse. I'm not an attorney, but I don't see why this arrangement is an issue if the person with dementia is still capable of signing and understanding the agreement. Or if the POA has ability to create caregiver agreements. As long as the care services provided are fair market value, why do we consider this an issue? Especially if it prolongs the person from needing government assistance. This may not be the case for the OPs situation, but I feel like I've read similar mentions about POA and caregiver agreements. I suppose I don't understand why this seems to be so frowned upon.
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