Alice and Glenn signed a joint will leaving all assets to the surviving spouse. If at the time of death, there was not a surviving spouse, the property was to go to their daughter Elenore, in trust for her lifetime. After Elenore's death, the assets would go to Glenn and Alice's granddaughters, Ds. In May 1982, after the death of Glenn, Alice signed a codicil to the will appointing Elenore's daughters, Ds as trustees for the testamentary trust. After the death of Alice, Elenore was forty-seven years old. Elenore began receiving Title XIX benefits under the Iowa medical assistance program in 1995. She continued receiving those benefits until her death on July 19, 2006. Ds completed a final report and accounting for the Elenore Gist Trust. P then filed a claim in probate court against the trust for the amounts it paid under Title XIX. P claimed Gist owed $396,570.20 to the State for services she received under Title XIX. The district court found the trust was a discretionary support trust set up for Elenore Gist and as such, it should be used to repay her Title XIX debt. Ds appealed.

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