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Long-Term Services & Supports

Self Determination Waiver Program


The Self-Determination Waiver (0427.R01) serves Tennessee citizens with intellectual disabilities who have moderate service needs that can be met with a cost-effective array of home and community services that complement other supports available to them in their homes and the community. The Self-Determination Waiver Program affords participants the opportunity to lead the person-centered planning process and directly manage selected services, including the recruitment and management of service providers. Participants and families (as appropriate) electing self-determination are empowered and have the responsibility for managing a self-determination budget affording flexibility in service design and delivery.

The target population for this waiver consists of children with developmental delays and children and adults with intellectual disability who meet ICF/IID level of care criteria. The Self-Determination Waiver Program serves persons who have an established non-institutional place of residence where they live with their family, a non-related caregiver or in their own home and whose needs can be met effectively by the combination of waiver services through this program and natural and other supports available to them. The Self-Determination Waiver does not include residential services such as supported living.

The Department of Intellectual and Developmental Disabilities (DIDD) serves as the Operational Administrative Agency for this waiver, which is administered under the oversight of the Bureau of TennCare.

To enroll in this program, the participant must:

Live in Tennessee; be financially eligible for Medicaid; meet Medicaid criteria for payment of ICF/IID care and for waiver services; have adequate caregiver support to assure the participant's health and safety; and not need staff-supported residential services.

If you qualify for care in an ICF/IID, you will have the right to choose between care in the home and institutional ICF/IID care. If you choose to receive HCBS waiver program services in the home, you will still be eligible to receive your regular TennCare benefits. The following waiver services are available based on assessed participant need:

  • Adult Dental Services
  • Personal Assistance
  • Personal Emergency Response Systems
  • Physical Therapy Services
  • Behavioral Respite Services
  • Behavior Services
  • Day Services
  • Respite
  • Environmental Accessibility Modifications
  • Specialized Medical Equipment & Supplies & Assistive Technology
  • Individual Transportation Services
  • Nutrition Services
  • Semi-Independent Living Services
  • Speech, Language, & Hearing Services
  • Occupational Therapy Services
  • Nursing Services
  • Orientation and Mobility Services for Impaired Vision