1915(c) HCBS Waivers

Tennessee's 1915(c) waiver programs provide Home and Community Based Services (HCBS) for people with intellectual disabilities as an alternative to institutional care, which includes care in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID).

TennCare’s Division of Long-Term Services and Supports (LTSS) is responsible for the administrative oversight of the 1915(c) waiver programs, and the Department of Intellectual and Developmental Disabilities (DIDD) is the state agency contracted with TennCare to perform day-to-day operation of the 1915(c) waiver programs.

Tennessee has three 1915(c) waivers:

These waivers are closed to new enrollment as of July 1, 2016, with limited exceptions in the CAC and SW waivers. Click on the CAC waiver and SW waiver below for more information on who is eligible to enroll in these waivers.

To view the 1915(c) waiver benefits, view the benefits table.

The CAC waiver offers home and community services that are designed to support a person’s independence and integration into the community. A person-centered planning process is used to choose services based on the person’s individually identified goals and need for specific services to advance toward, achieve, or sustain those goals. The CAC waiver serves specific populations and is open to new enrollment with specific criteria.

Out of the Arlington case, the CAC waiver—originally called the Arlington Waiver due to only serving Arlington class members—was implemented in 2000. In 2015, the waiver name was changed to CAC to expand eligibility outside of the Arlington class.

  • Individuals with intellectual disabilities who are former members of the certified class in the United States vs. the State of Tennessee (Arlington Developmental Center);
  • Individuals with intellectual disabilities who are former members of the certified class in the United States vs. the State of Tennessee (Clover Bottom Developmental Center);
  • Individuals with intellectual disabilities who have discharged from the Harold Jordan Center following a stay of at least 90 days; and
  • Individuals with intellectual disabilities who transitioned from the SW waiver upon its renewal on January 1, 2020, because they were identified as receiving services over the individual cost cap for the SW waiver.

The SD waiver offers home and community services that are designed to support a person’s independence and integration into the community. A person-centered planning process is used to choose services based on the person’s individually identified goals and need for specific services to advance toward, achieve, or sustain those goals. The SD waiver serves specific populations and is closed to new enrollment.

The SD waiver includes the opportunity for participants to directly manage selected services through self-direction. Click on self-direction below for more information on self-direction opportunities under the SD waiver.

The SD waiver was implemented in 2005 to offer additional participant flexibility, including self-direction of certain services—the ability to hire and manage staff that deliver these services, using a fiscal employer agent to manage administrative operations, including payroll and tax functions.

  • Adults with intellectual disabilities who live in their own home, in a home with their family, or in a home with a non-related caregiver. Therefore, the SD waiver does not include residential services (Family Model, Residential Habilitation, and Supported Living) that are available under the other two waivers.

Self-Direction offers SD waiver participants the opportunity to direct and manage (or to have a representative direct and manage) certain aspects of eligible services—primarily the hiring, firing, and day-to-day supervision of workers delivering the self-directed service(s). Self-Direction participants and/or their self-direction representative also manage the budget for self-directed service(s).

SD waiver participants may choose to self-direct one or more of the following services:

  • Individual Transportation
  • Respite
  • Personal Assistance

The SW waiver offers home and community services that are designed to support a person’s independence and integration into the community. A person-centered planning process is used to choose services based on the person’s individually identified goals and need for specific services to advance toward, achieve, or sustain those goals. The SW waiver serves specific populations and is open to new enrollment with specific criteria.

Implemented in 1987, the SW waiver was the first 1915(c) waiver in Tennessee for people with intellectual disabilities. It remains the largest of the three 1915(c) waivers in the state.

  • Adults with intellectual disabilities
  • Individuals participating in the State’s Money Follows the Person (MFP) program who are transitioning from an ICF/IID following a stay of at least ninety (90) days and but for the availability of Medical Residential services through the SW waiver, would require placement in an ICF/IID

To enroll in the SW waiver, an applicant must meet the following criteria:

  • Meet TennCare ICF/IID level of care criteria and financial eligibility criteria and have a Pre-Admission Evaluation (PAE) approved by TennCare;
  • Have been assessed and found to have an intellectual disability manifested before eighteen (18) years of age, as specified in Tennessee State law; and
  • Are participating in the State’s MFP program, transitioning from an ICF/IID following a stay of at least ninety (90) days, and but for the availability of Medical Residential services through the SW waiver, would require placement in an ICF/IID.

If you meet these criteria and want to enroll in the SW waiver, contact your MCO:

  • BlueCare: 888-747-8955
  • United Healthcare Community Plan: 800-690-1606
  • Wellpoint (formerly known as Amerigroup): 833-731-2153
  • ICFs/IID provide active treatment through intensive specialized supports and services designed to assist individuals with intellectual disabilities to develop increased skills and independence in life areas where the individual needs additional supports to live in a more independent, integrated setting.
  • Many individuals who reside in ICFs/IID have transitioned out of large state institutions and have complex support needs that require a more intensive level of support.
  • There are two categories of ICFs/IID in Tennessee: public and private.
    • Public ICFs/IID are state (DIDD) owned and operated.
    • Private ICFs/IID are operated by individual ICF/IID provider agencies.