EPISODE 20 –  Medical Services and Resources Paid for by Special Needs Trusts – December 1, 2022


What kinds of medical resources do you need? Do you need an eye doctor, dentist or rehabilitation? Did you know special needs trusts can help pay for each of these medical services? Listen as Bart, who is the podcast host for the Vista Points podcast named Choose Your Path, shares success stories and the steps taken by each for the special needs trust to pay for the needed medical resources.


Greetings from our Middle Tennessee studio…and 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 of any age who are living with a physical, mental, or intellectual disability.

I’m Bart, your podcast host. My role is to walk with you on this journey of discovering and using special needs trusts. In previous episodes, we introduced special needs trusts, what they are, stories of people and the relationships involved, and how special needs trusts impacted their lives.

Today, we will begin this month’s topic of “Resources available to a person who has a special needs trust”.  Think of your own life for a minute. Have you ever needed assistance, perhaps with a health concern? Have you found the benefits of a good massage? Is dental care a concern? Would a nonmedical caregiver provide some care and service that you cannot do on your own? Is therapy needed for a physical ailment, an emotional time, or a mental health crisis? Do you need help booking airplane fares and hotel rooms for an upcoming trip? 

I could go on and on with questions, but I won’t. I think you get the picture. A person who is living with a disability – we call that person a beneficiary – can use money in his or her special needs trust for all these requests. The beneficiary can make a request for a service or an item desired through the special needs trust. 

Most of the time, the trustee will approve the request. However, there are times when the trustee has to say “no”. If this happens, the trustee will offer alternatives that may be just as good or even better.  Stay calm and listen to the trustee. Afterall, the trustee is there to help you by protecting your special needs trust and protecting you. The trustee wants you to live a good quality of life.

A past trust beneficiary called the office and wanted an eye exam and new glasses. He had not seen an eye doctor in well over five years. There was one small obstacle to the beneficiary’s request. He had agoraphobia – fear of open spaces. The beneficiary talked candidly with his trustee. They worked out a gameplan. Through the beneficiary’s government benefits, he would schedule an initial consultation with a therapist. The first visit would be through a Zoom call, thus allowing the beneficiary to remain at home while receiving the needed therapy, for the agoraphobia. After the beneficiary left, he could leave his home without having a panic attack. He would schedule an eye exam. The trustee suggested to the beneficiary to have a friend or family member travel with him as a source of support. If the beneficiary became anxious, the friend could help to calm him so he could make it to the eye exam. 

You are probably wondering if this worked. I’m here to tell you it did… but…not all at once. The beneficiary rescheduled the therapy appointment three times before he went to the first one. After the first therapy appointment, he was able to spread his wings. He made it to all his therapy appointments and had the eyes exammed. The beneficiary could now see very well with his new glasses. His friend is trying now to encourage him to go out to lunch in a restaurant. Taking those first steps can lead to some wonderful adventures and experiences. Thanks to the beneficiary’s special needs trust, the co-pays for the therapy visits were paid with his trust. His new glasses were not covered by his government benefits or insurance. The special needs trust paid for his glasses. 

There is a quote from a Prezi website related to glasses. It goes like this. “Usually, glasses are associated with having some semblance of intelligence, as well as having the understanding that law and order are a necessity. They are also used to help people see more clearly in which “sight” is a metaphor for knowledge.” I’ll have you know that when this quote was shared with the beneficiary, he thought about it for a minute, then his chest puffed up as he stood a little straighter. He told me that he was a smart man and now people were going to be able to see it in him. 

Nonmedical caregivers can make a world of difference in the life of a person living with a disability. It doesn’t matter what age the beneficiary is. We’ve had children who are only a few months in age and adults who need a little help. What does matter is the type of care these two people receive.

Nonmedical care can be paid using the beneficiary’s trust funds. The billing can be set up, sent directly to the trustee for request of payment. The entire billing and payment process is relatively simple, yet the amount of care the beneficiary receiving is insurmountable.

Many beneficiaries, due to their individual illness, are hospitalized for short periods of time. When they are ready to be discharged, the hospital social worker will ask that the beneficiary be placed, for a few weeks, in a rehabilitation facility. This will allow the beneficiary to gain strength, be taken care of on a 24-hour basis and learn techniques to deal with his or her conditions. It sounds like a win-win situation, doesn’t it?

Serving as a trustee affords the opportunity to see into each beneficiary’s life, learn their fears, and trust their judgment, whether the trustee agrees with the beneficiary’s decision or not. Let me tell you about a beneficiary, Andrea, who was in this predicament.  

Andrea was severely overweight. She carried approximately 450 pounds on her 5-foot 7-inch frame. She had always been a heavy kid. As an adult, she gained weight while she cared for her mom. She was exhausted. Andrea’s mom died suddenly. Andrea was left to fend for herself. She relied on her special needs trust officer to help her learn how to care for herself. The trustee arranged to have her nonmedical care to help Andrea clean the house, do the laundry, bathe, dress, and eat.  

Andrea was admitted to the hospital about four months after her mother died. Upon the day of discharge, the hospital social worker requested that Andrea be moved to a rehab facility where the staff could help her learn to care for her bed sores and also help her to regain her strength to walk. They would also monitor her food intake and help her to lose some weight.  

Andrea refused to transfer to the rehab facility against her family’s and the social worker’s better judgement. She stated that she just “wanted to go home”. Because Andrea did not have a conservator, she was of sound mind, the hospital released her.  They worked with the nonmedical homecare company, teaching the caregiver how to clean and dress the bedsore. A week after discharge, the trustee checking in on Andrea and got a full report from the nonmedical caregiving company. Andrea was doing quite well. She was glad to be home. She was exercising every day and now could walk around the house with the aid of a walker. Without the trustee continuing the nonmedical homecare, Andrea would not have been able to care for herself. Her health could have deteriorated. Today, Andrea has continued to exercise and lose weight. She is down to 375 pounds. She states that she feels better and hopes to continue losing weight so she can feel even better.

What would have happened to Andrea if she had gone to rehab or been at home and her health had worsened? For the trustee, Andrea’s family and the case manager assigned to Andrea care, the decision would be to move her permanently to a nursing home. Because of her weight and her lack of mobility, finding the right facility could be difficult. Andrea qualified for a “foster family” to take care of her but because of her size and ambulation difficulties, no household had the size of furniture that would hold Andrea. Their cars were also too small to hold Andrea. This is why a nursing home was the best choice, given all the variables.

The trustee contacted a placement service to help locate a nursing home that had the qualifications to accept Andrea where she could thrive. The trustee wanted Andrea to be able make new friends close to her age. She was 44 years old. Andrea wanted to be able to travel short distances, see a movie in a theater, and go to the zoo. She was very scared to leave her home. After all, she had lived there for 22 years with her mom. Now, everything was being turned upside down. 

The placement company worked with Andrea’s case manager to find a nursing home that had younger people as residents and a place where her government benefits would pay for her care the rest of her life. A great nursing home in Knoxville, Tennessee fit the bill. It was difficult for Andrea to move to Chattanooga, where she was quite comfortable, to Knoxville, where she didn’t know a soul.  

I’ll let you in on a secret. Andrea thrived in the nursing home. From her room, she could see the Smoky Mountains. She had the trustee, of her special needs trust, purchase a camera for her. Each morning she would take a few photos of the beautiful sunrises over the Smokies. A year after her arrival, the nursing home’s activity director planned an art show. Andrea was asked to showcase her sunrise photos for the show. She was so proud and delighted. Never in her life had Andrea been the featured individual. 

Word got out about the upcoming art show. Reporters came and interviewed Andrea about her stunning photography. There was even a write-up in the newspaper and a TV scene. On the day of the art show, Andrea was dressed in new clothes, even was able to find some new shoes to fit her. She had a wonderful time. She overcame her anxiety of being around new people. She was the life of the party.  To commemorate Andrea’s success, the nursing home team had a photo of Andrea, all dressed up and holding one of her Smoky Mountain sunrise photos, framed. You can find that beautiful photo of Andrea hanging in her living room. If you ask her about it, she is happy to share the experience with you. She is all smiles!

Speaking of smiles, do you think people living with a disability get dental care? Well, of course they do. Sometimes it is difficult find a dentist who can care for the beneficiary’s oral care. Situations such as traveling to the dentist, being able to hold still while the dentist provides the care, and being able to understand the dentist’s requests, while receiving the care, can all play a factor in the ability to have good dental care.

A trustee can help the beneficiary to find a good dentist that can provide the proper care. There are dentists who specialize in dental care for special needs children. Others have vans equipped with a dental office, x-ray machine, and all the dental tools. Some dentists provide specific hours where they will see a patient who has a disability. They will spend extra time with the beneficiary in a more calm, less rushed environment. Lastly, there are dentists that provide sedation for the patient. This can relieve anxiety. The patient can relax and receive the needed dental care.  

No matter what a beneficiary is needing, the trustee is there to help. After all, it is the trustee’s fiduciary responsibility to see that the beneficiary lives a good quality of life. This also gives the family and the caregiver peace of mind knowing the beneficiary is in good hands.

Each of us with Vista Points is here for you. I am a volunteer, and I believe the Vista Points staff are dedicated, educated, personable, multi-talented, and most important to me, understanding. I want them on my side. And in fact, I do have them on my side. I am living with a disability. They are walking with me along my path just as I know they will for you, your client, your loved one who is living with a disability. 

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

Each episode creates awareness and provides education about special needs trusts. You can find past episodes on the Vista Points website at vistapoints.org, as well as a transcription of each podcast. The episodes’ topics are in response to listeners’ questions! If you haven’t asked your questions yet, I encourage you to ask or share concerns online. When you’re online, visit the Facebook page named VistaPointsInc and send a direct message, otherwise known as a D-M, to VistaPointsInc, that’s Vista-Points-I-N-C.

You can also call the Vista Points office at 888-422-4076. That number is 888-422-4076. Each of the Vista Points team wants to answer your questions and assist you in whatever way they can.

Enjoy your day with your loved one. Come back for more or look into past episodes of Choose Your Path. Regardless of where or when you find us, we walk beside you on your path. I look forward to sharing more information with you on how special needs trusts can be of benefit to someone, of any age, who is living with a physical, mental, or intellectual disability.  

Until we meet again….Cheers!