I applied in January with the VA to pay my siblings for In Home Care as they live with her and she is bed ridden and has dementia. I was appointed federal fiduciary for her. My question is once the VA approves the payment to them and the backpay(thousands of dollars) since January comes available to her fiduciary account, what can this be used for and is this considered income according to Medicaid($2000 maximum per month in her checking account). I have been currently paying my siblings each month($1,000 total) as proof they are getting paid for their services since January. Any advise would help.