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In 2000 a lawsuit was filed by the advocacy group, Tennessee Protection and Advocacy, on behalf of Medicaid-eligible citizens of Tennessee who were on the DIDD Waiting List for services, or who had been denied the opportunity to apply for services.

A settlement agreement was signed on June 15, 2004 requiring DMDRS to seek approval of a new Self-Determination Waiver, which was approved by the Centers for Medicare and Medicaid Services in January 2005.

Case managers are assigned to each person on the waiting list to assist them with accessing services, as well as other generic resources within their communities. Also, DIDD is required to inform persons what type services are available and how to apply for them.

The Consumer Directed Supports Program was instituted to provide a small amount of money for individuals and their families to use to purchase services and supports while on the waiting list.