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Long-Term Services & Supports

Self Determination Waiver Program

 

Self-Determination Waiver

The Self-Determination Waiver (0427.R02) serves children and adults with intellectual disabilities and children under age six with developmental delay who qualify for and, absent the provision of services provided under the Self-Determination waiver, would require placement in a private ICF/IID.

The Self-Determination Waiver Program affords persons supported the opportunity to directly manage selected services, including the recruitment and management of service providers. Participants and families (as appropriate) electing self-direction are empowered and have the responsibility for managing, in accordance with waiver service definitions and limitations, a self-determination budget affording flexibility in service design and delivery. 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 Self-Determination Waiver offers a continuum of services that are selected by each individual pursuant to a person-centered planning process and support each person’s independence and full integration into the community, including opportunities to seek employment and work in competitive, integrated settings and engage in community life. Services are delivered in a manner which ensures each individual’s rights of privacy, dignity, respect and freedom from coercion and restraint; optimizes individual initiative, autonomy, and independence in making life choices; and are delivered in a manner that comports fully with standards applicable to HCBS settings delivered under Section 1915(c) of the Social Security Act, including those requirements applicable to provider-owned or controlled homes, except as supported by the individual’s specific assessed need and set forth in the person-centered Independent Support Plan.

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:

a. Meet TennCare ICF/IID level of care criteria (TennCare Rule 1200-13-1-.15) and financial eligibility criteria and have a Pre-Admission Evaluation approved by TennCare;

b. Have been assessed and found to:

i. Have an intellectual disability manifested before eighteen (18) years of age, as specified in Tennessee State law (Tennessee Code Annotated, Title 33-1-101); OR

ii. Have a developmental disability, which is defined as a condition of substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting an intellectual disability and be a child five (5) years of age or younger; AND

c. Do not require residential waiver services (e.g., family model, residential habilitation, supported living) and have an established non-institutional place of residence where they live with their family, a non-related caregiver or in their own home.

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
  • Emergency Assistance
  • Employment and 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