Legal and financial planning

Supported decision-making

Supported decision-making (SDM) means a person keeps full legal authority over their own decisions, and chooses trusted people — family, friends, professionals — to help them understand information, weigh options, and communicate a choice. It’s built for exactly the situation many families face: someone needs help thinking a decision through, not someone else making it for them.

Tennessee does not currently have a stand-alone supported decision-making statute creating its own legal status, the way a few other states do — confirm this is still accurate, since it can change. What Tennessee does have: 2018 conservatorship reforms directing courts toward the “least restrictive alternative,” defined broadly enough to include SDM-style support, and the Tennessee Center for Decision-Making Support (a partnership of The Arc Tennessee and Disability Rights Tennessee), offering free information, limited one-on-one help, and template support agreements at tndecisionmaking.org.

A written SDM agreement isn’t a court order — it works because the person, their supporters, and the institutions they deal with (a doctor’s office, a bank) agree to honor it. It may not carry the same weight as a power of attorney or conservatorship for some formal purposes, which is worth discussing with an attorney once bigger decisions — a lease, a major medical choice — are involved.

Powers of attorney and related documents

These are three different tools, easily confused:

• Power of attorney (POA) lets someone else handle financial or legal matters — paying bills, managing an account, signing specific documents — on the person’s behalf.
• Durable power of attorney is a POA written to keep working even if the person later can’t make decisions themselves — an ordinary POA can end at exactly the moment it’s needed most, so “durable” matters.
• Healthcare agent (medical power of attorney / advance directive) lets someone make medical decisions when the person can’t communicate their own wishes in the moment — a separate document from financial POA.
• HIPAA release is narrower still: it lets a named person receive medical information from a provider, without making them a decision-maker.

None of these require a conservatorship, and a person can sign them as long as they understand what they’re agreeing to — the standard is understanding the document, not a diagnosis. A Tennessee attorney can prepare documents that banks, hospitals, and other institutions here will actually honor.

Conservatorship in Tennessee

Conservatorship is a court proceeding where a judge decides someone lacks the capacity to make certain decisions, and assigns those decisions to a conservator. Tennessee law offers two shapes: limited conservatorship, covering only the specific decisions the court identifies, and full conservatorship, covering decision-making broadly. Courts must use the least restrictive option that adequately protects the person, and reconsider or end a conservatorship once it’s no longer necessary.

The process involves filing a petition, a court-ordered evaluation, and a hearing at which the respondent (the person the petition is about) has the right to legal representation, including a court-appointed attorney ad litem, the right to attend, and the right to appeal — a real hearing with real rights attached, not a paperwork formality.

Cost varies by county and how contested the case is — expect filing fees, attorney’s fees, and sometimes an evaluation or guardian ad litem fee. Check current costs with a local attorney or your county clerk. Disability Rights Tennessee (800-342-1660) is a reasonable first call if a family isn’t sure conservatorship is the right tool yet.

Representative payee

A representative payee manages one specific thing: someone’s SSI or Social Security payment, when Social Security determines the beneficiary can’t manage it themselves. It’s narrower than conservatorship — payee authority covers that benefit payment, not medical decisions, contracts, or general legal affairs.

Social Security is supposed to give the beneficiary an early opportunity to help choose their own payee, and a payee must use the money for the beneficiary’s current and foreseeable needs, not their own. Many autistic adults never need a payee at all; others use one for SSI specifically while keeping every other decision fully their own.

Special-needs trusts

A trust only avoids counting as the beneficiary’s own resource for SSI purposes if it’s written so they cannot revoke it or direct its principal toward their own support. Get this wrong and the trust counts against SSI’s $2,000 resource limit, defeating the purpose.

• First-party (self-settled) special-needs trust — funded with the disabled person’s own money, such as a settlement or an inheritance already received in their name; specific legal requirements and tighter regulation apply.
• Third-party special-needs trust — funded by someone else, such as a parent or grandparent, generally with more flexibility, including about what happens to remaining funds later.
• Pooled trust — run by a nonprofit that manages many beneficiaries’ funds together for investment, while keeping a separate sub-account per person.

This is why inheritances need planning ahead of time: a relative who leaves money directly to a person receiving SSI — even with the best intentions — can push them over the resource limit and cost them SSI and TennCare until it’s spent down. A will or estate plan should route anything meant for that person through a properly drafted trust instead of a direct bequest.

ABLE TN vs. a trust

An ABLE TN account and a special-needs trust solve overlapping but different problems. ABLE TN is simpler to open and manage day to day, and balances under $100,000 don’t count against SSI’s resource limit at all — good for everyday, flexible spending on disability expenses. Eligibility requires disability onset before age 46 (raised from 26 as of January 1, 2026) and either current SSI/SSDI receipt or a physician’s documentation of a qualifying disability.

A trust, by contrast, can hold much larger sums — an inheritance, a settlement — without the same dollar ceiling, but it needs an attorney to draft correctly and typically more oversight to administer. Many families end up using both: an ABLE TN account for accessible, everyday funds, and a trust for larger assets. Ask an attorney or benefits counselor how the two would interact for a specific amount of money.

Letters of intent

A letter of intent isn’t a legal document — no court or bank requires it — but it may be the single most useful thing in the folder for whoever steps in to help later, especially in an emergency. Write in plain language, and update it as things change. Worth including:

• Daily routines, and what a good day and a hard day each look like
• How this person communicates — speech, AAC, gestures, written word — and what not to assume
• Medical history, current providers, medications, and known triggers or safety concerns
• Likes, dislikes, comfort items, and sensory needs
• People who matter — friends, family, a faith community — and how to reach them
• Education and work history, interests, and goals
• Any preferences the person has expressed about future living situations or care

Keep a copy with your other documents and give one to anyone who might need to step in — a sibling, a future conservator or agent, a trusted friend.

Finding help

Disability Rights Tennessee is the state’s federally designated protection and advocacy organization — free help across all 95 counties, including legal representation, self-advocacy resources, and referrals. 800-342-1660.

Legal Aid Society of Middle Tennessee and the Cumberlands provides free civil legal help across 48 Middle Tennessee counties, including Rutherford County, through a Murfreesboro regional office; appointments are required. Murfreesboro: 615-890-0905. Statewide intake: 800-238-1443.

For families who don’t qualify for free legal aid, look for an attorney whose practice includes special-needs planning — trusts, ABLE accounts, conservatorship alternatives — rather than general estate planning; benefits-eligibility rules are specific enough that experience matters. A local bar association’s lawyer-referral service is a reasonable place to start, or ask Legal Aid or Disability Rights Tennessee for a pointer.

• Based on what [name] can do independently, does supported decision-making or a power of attorney cover what we need, or is conservatorship the right tool?
• If conservatorship fits, should it be limited to specific decisions, or full?
• What will this cost, from filing through the first required accounting?
• Does [name] need a special-needs trust — first-party or third-party — and how would it interact with an ABLE TN account?
• Who should serve as successor trustee, agent, or conservator if the first person named can no longer serve?
• What happens to [name]’s SSI or TennCare if a relative names them directly in a will?
• How and when should these documents be reviewed or updated?
• Can [name] take part in this meeting directly, with whatever communication support they need?