Expanding Creative Horizons

For people with disabilities who dream of turning their creative passions into careers, Tennessee’s Employment and Community First (ECF) CHOICES program, CHOICES, and 1915(c) waiver programs are opening new doors. These Medicaid waiver programs provide long-term services and supports to people with disabilities, ensuring they can gain employment, live independently, and participate fully in their communities. While there is a referral list for some of these programs, people with urgent needs may receive priority access.

TennCare enhanced its self-employment services to provide more comprehensive support for entrepreneurs, including artists, photographers, jewelry makers, and others pursuing creative businesses.

“Follow your dreams, no matter what they are,” says Kelly Kuhns, Employment Specialist with TennCare. “Even if you don’t know yet what your dreams are – we hope you will discover them through one of our services.”

The enhanced self-employment supports emerged from years of collaboration between TennCare, the Managed Care Organizations (MCOs), service providers, and families. Previously, providers lacked detailed guidance for helping people start businesses. These programs now provide comprehensive, step-by-step guidance throughout the entire process of business planning and launch.

“We did a lot of research with the Small Business Development Center and other self-employment experts to lay out every single step of starting a business,” Kuhns explains. The result is a framework that helps providers walk aspiring business owners through everything from market research to financial planning.

Shannon Nehus, Assistant Deputy of Programs with TennCare, notes that providers now have “more time to spend working with the individual in their selfemployment journey,” thanks to higher service rates. This means more personalized support as people develop their business concepts and plans.

The employment programs meet people wherever they are in their journey toward employment. Someone unsure about working can start with “Exploration” services to determine whether or not they want to work. Those already creating art as a hobby could move directly into planning their business. Kuhns says, “If they love to paint or make jewelry, they might move on to Self-Employment Exploration to determine if owning a business is truly right for them.”

For artists, the flexibility of self-employment can remove common barriers to traditional jobs. “This allows the flexibility for someone to work at their own pace on their own time in their own environment,” Kuhns says. “Transportation can be a huge barrier, so this opportunity alleviates the need to go somewhere if they’re able to paint or work on jewelry at home.” These programs already have success stories, including a photographer who travels internationally for his work and a jewelry artist building her business. Their experiences show how creative entrepreneurs can thrive with the right supports.

While these programs don’t fund business start-up costs directly, they help people develop solid business plans that they can potentially use to seek start-up capital through Vocational Rehabilitation (VR) services. “There is a partnership where we can all work together,” explains Kuhns. “We can talk about where everyone is in the process and then move seamlessly into the next service with another agency.”

Getting Started

These programs create individualized support plans based on each person’s goals and needs. As Nehus explains, “People can choose which services they want and in what order, which makes their plan unique to them.”

“Anything is possible,” emphasizes Kuhns. “We meet people wherever they are in their journey – whether that means earning a small paycheck every couple weeks to support their hobbies or beginning to pay rent and work toward living independently one day. Our services support goals of all kinds, from greater independence to long-term employment and everything in between.”