EPISODE 19 -Special Needs Trusts and Tri State Health and Rehabilitation Services – November 15, 2022


What kinds of rehab are available near you? Did you know special needs trusts can help pay for rehab? Listen as Bart interviews Brandie about different types of therapy, long-term versus short-term therapy, and therapy and special needs trusts for people who live with disabilities. Bart is the podcast host for Choose Your Path, the Vista Points podcast. List to him interview Brandie, the Admissions and Marketing Director of Tri State Health and Rehabilitation Services.


Greetings from our Middle Tennessee studio. Welcome to today’s Vista Points podcast, “Choose Your Path”, where the Vista Points staff are committed to improving the quality of life for people living with a disability. 

I’m Bart, your podcast host. My role is to walk with you on this journey of discovering and using special needs trusts. If you’re listening to this podcast online, I want you to make the most of your experience. We have a feature to help you understand the podcast. You can turn on closed captioning by clicking C-C in the shadowed box on the video screen. 

We address a variety of topics related to special needs trusts. Today, we will continue to educate you by interviewing a business partner who serves people living with disabilities, chronic illnesses, or who have special needs.

I am glad to welcome Brandie Lambdin, who is the Admissions and Marketing Director of Tri State Health and Rehabilitation Services in Harrogate, Tennessee.

Bart: Hi, Brandie. I have been looking forward to interviewing you for our Vista Points, Choose Your Path, podcast. 

Brandie: Hi Bart. 

Bart: I’ve heard many good things about rehab and your organization’s rehabilitation services. Would you tell us a little about yourself and about Tri State Health and Rehabilitation Services?

Brandie: Yes, I have been involved with both long-term and short-term care for over 21 years. I have a Bachelor’s Degree in Social Work from Eastern Kentucky University. I have worked as a hospital case manager as well as doing admissions for a skilled unit located in the hospital. I currently work at Tri State Health and Rehab, we’re located here in Harrogate, Tennessee. We are 116 bed facility. We offer both long- and short-term therapy for all patients with disabilities. 

Bart: What an introduction! You’ve got an interesting background and lots of experience! Thanks for sharing information on Tri State Health and Rehabilitation Services. Will you tell us a little more about the different types of therapy Tri State specializes in? The physical therapy, speech therapy and occupational therapy?

Brandie:  Yes, we do offer physical therapy, occupational therapy and speech therapy seven days a week. We are currently not having any out-patient services due to the pandemic. Those have not restarted yet. We also offer restorative therapy as well as recreational therapy. And restorative therapy’s primarily for our long-term care patients that have already met their therapy goals, but we just don’t want them to lose what they’ve gained with us.

Bart: Brandie, that’s incredibly helpful. Now that we understand how your company serves its patients, will you tell us more about where? I have heard that Tri State serves three states. What are the states? 

Brandie: We are located in Harrogate, Tennessee, which is the Cumberland Gap Tennessee area. We border Kentucky and Virginia. We are less than a mile from Virginia and a mile from Kentucky, so we do have residents from all three states. 

Bart: We have such amazing resources here in Tennessee and I’m glad you serve the other two states, too. I’m glad to know so many people can benefit from them. While we’re on the subject, would you educate us about rehab? What are the different types of rehab provided by Tri State Health and Rehabilitation Services?

Brandie: Yes, so have a variety of services that we offer. Anywhere from stroke rehab, we have cardiac rehab. We do a lot of strengthening for our patients that may have COPD or congestive heart failure. We also do a post-acute care rehab so anyone that may have had a car wreck or had a fracture orthopedic or something like that. We do those types of rehab as well. 

Bart: Sounds like rehabilitation services help people with all kinds of needs. I’m particularly interested in serving people with disabilities. Please share with our listeners and me how rehab can help a person who is living with a disability.

Brandie:  So our therapy team, once a patient is admitted with us, we do an individualized care plan. And, not everyone has the same needs. So we get with the family, we get with the whole care plan team, and we develop something that works for them. So, take for instance a patient that has Parkinson’s Disease that functions very well at home, but maybe he’s having increased falls or he’s having a hard time feeding himself. So we may get occupational therapy to look at him to see if maybe there’s a certain utensil he can use. Something just to keep him independent with his routine.

Bart: That’s interesting. Do you have a story you could share about serving one of your patients who lives with a disability? 

Brandie: Yes. We currently, or recently, had a young girl in her 20’s that was discharged to the community. But, she was admitted for a rare, nerve disease that left her paralyzed from her waist down. So, after about four months of intense rehab here with us, she was able to go back home. Of course, with assisted devices. We were able to reach out to some of the community resources and help the family get ramps built in the home and things like that. But, the important thing is now that she’s such a success story, she actually comes back to visit with us.

Bart: Thanks for sharing that story with us, Brandie. I hadn’t considered all those possibilities before. This is interesting. I wish everyone could benefit that way. Would you share additional ways people who live with disabilities might benefit from rehab, or rehabilitation services?

Brandie: Yes. Just because we take patients from the hospital doesn’t mean that they can’t come for therapy straight from the home. And, like I said, anyone that may, I keep using Parkinson’s because it’s a common one that we see, someone that may fall a little bit more at home or may just have a little bit of forgetfulness or may some cognitive therapy by our speech department – those patients are welcomed, too. Anything we can do just to better their lives and get them back home and safe with their family.  

Bart: This has opened my eyes! You are sharing with our listeners, and me, how important rehabilitation services are.

Brandie: I think I can speak for everyone here at Tri State when we say we enjoy offering all of our services to everyone to the community just to make sure that anyone with a disability has a good plan and a good, safe discharge. 

Bart: Brandie, let me tell you about how and for what reason a person would want special needs trusts. Then I’ll tell you about how the special needs trust can pay. For special needs trust clients – who we call “the beneficiaries”, rehabilitation services can be paid from their trust when all other resources have been used. Here, I am talking about Medicaid. You see, most people establish special needs trusts when they are needing Medicaid to cover their healthcare needs. In Tennessee, when a person qualifies for SSI – that’s Supplemental Security Income, Medicaid’s automatically given to the person to cover his or her healthcare needs. In Tennessee Medicaid has also got the name TennCare which supplies medical care to its recipients. Both Medicaid and TennCare have distinct services, but people generally use the term Medicaid to refer to both of the services. SSI, also known as Supplemental Security Income, gives the person some money, on a monthly basis, to pay for things as general day-to-day needs come up. 

People who are living with a physical, mental or intellectual disability can preserve their assets, which is their money, in a special needs trust. This is done because if a person has over $2,000 in assets, he or she will not qualify for government benefits. All of this was made law in 1993 to help people living with disabilities.

After a special needs trust is established, the beneficiary can qualify for these government benefits, which I previously said was SSI and Medicaid, and use the money in the special needs trust to pay for items or services their benefits don’t cover. 

So Brandie, a special needs trust can pay for rehabilitation services, such as co-pays and even full rehab service. Allow me to give you an example. 

A young woman, in her 30’s, was involved in a car accident. She received a lawsuit settlement and placed the money in a special needs trust. This move allowed her to qualify for SSI and Medicaid. The woman wanted to have “extra” rehab services so she could continue the therapy after her government benefits paid all that they were permitted. The trustee of her special needs trust worked with the rehab center to arrange payment.

The woman’s rehab bills were sent directly to the trust company who paid them for the beneficiary. The woman was able to benefit from an additional rehab therapy and in turn she continued to physically improve. The woman ended up having six months of additional rehab, all paid with money from the special needs trust. Today, she not only is able to walk, but she has also abandoned her wheelchair and only uses a cane as her aid.

Brandie: Have you found there is a difference on how special needs trusts pay for rehab whether it’s short-term or long-term? 

Bart: Well, Brandie, for a trust to pay for either type of rehab, short-term or long-term, it depends on four factors.  

First – the type of disability the beneficiary has. Some people need more rehab than others, and I’m sure you know that, to help them live a good quality of life. 

Second – the amount of money in the beneficiary’s trust. This can determine the amount of rehab service a beneficiary can have. 

Third – the beneficiary’s other needs. These needs may take precedence over rehab. The beneficiary will receive rehab but the other needs will be paid first and rehab will be paid second.

Fourth, and most importantly – the beneficiary must be prescribed or desire the rehab service. The trustee cannot make the beneficiary participate in rehab. There are times when the beneficiary needs rehab to live a better quality of life but refuses these services. The trustee must respect the beneficiary’s wishes.

Brandie: Wow.  

Bart: Are there classes people can take that are related to rehab? What are these classes and where are they located? 

Brandie: Yes, we currently offer a certified nursing assistant classes right now. That’s the only class currently that we are providing. Those classes usually last anywhere from three and six weeks. And, those are free. 

Bart: That’s so good to know. Rehabilitation is an interesting service!

As we close this podcast episode about health and rehabilitation services, would you give our listeners your closing thoughts about the benefits of rehab for anyone living with a disability?

Brandie: A lot of people think that rehab typically is long-term care. And, that’s not necessarily the truth. So, or, not anymore. I think it’s interesting for . . . I do think it’s important to look at a facility as a whole and just to make sure they do offer the services their loved one needs. It doesn’t need to be a long-term thing. It can also be short-term. I think it’s just important to look into the community because those services are there. 

Bart: Thank you, Brandie. I am glad you could join us today. Our interview’s with Brandie Lambdin, the Admissions and Marketing Director of Tri State Health and Rehabilitation Services. 

Thank you to our listeners for tuning in to today’s episode of Choose Your Path, the Vista Points podcast. I encourage you to subscribe to our YouTube channel so you can be notified as our latest episodes go live on the 1st and the 15th of every month. The Vista Points YouTube channel is named Vista Points SNT, that’s S-N-T as in special needs trust. 

You can also find past podcast episodes on the Vista Points website at vistapoints.org, along with a transcript of each podcast. The website again is vistapoints-dot-O-R-G.

If you don’t already know, the episode topics are in response to listeners’ questions! If you haven’t asked your question yet, I encourage you to ask or share other concerns online or by calling. When you’re online, visit our Facebook page named Vista-Points-Inc, that’s Vista-Points-I-N-C. 

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You are welcome to contact the Vista Points office at 888-422-4076. That number again is 888-422-4076. Each Vista Points team member stands ready to answer your questions and assist you. 

Enjoy your day with your loved one. Regardless of where or when you find us, we walk beside you on your path. Our desire is for people, of any age, who are living with a physical, mental or intellectual disability, to have a good quality of life and to give their family peace of mind, knowing Vista Points is looking out for the beneficiary. I look forward to our next steps together and speaking to you soon.