Skip to Main Content

Find COVID-19 Information and Resources

Breaking Ground 97 - Chyna's Journey through Employment and Community First (ECF) CHOICES

by Zennia Nesmith, Membership Account Specialist for Blue Cross Blue Shield Tennessee in Chattanooga, and graduate of the 2017-18 Partners in Policymaking Leadership Institute

My daughter Chyna’s journey started at a transition meeting two years ago, at a local high school. At that meeting, I met a community advocate named Virginia, who told me about a program called ECF – Employment and Community First CHOICES. Virginia gave me the information to do an intake form online. I had no idea what it was; the program had started the year prior but was still fairly new. I did the intake form that following week and the next day received a call from a really nice lady who set up an appointment in our home. 

Ten days later, Chyna and I and an ECF coordinator named Kristen had a meeting. It felt strange, because they asked a lot of questions of Chyna directly, and then Chyna would look at me to answer, since she was almost completely dependent on me at the time. I was very honest and told them I didn’t know much about the program. Not knowing what questions to ask and not really being equipped at that time to advocate for my daughter, Kristen had to help me a lot. 

I was given a listing of providers in my area. One stood out because they were so open with information over the phone. I agreed to meet with the ECF service provider, and we selected provider-centered support. The provider would choose supports to help Chyna learn skills for independence and employment. We all sat down and talked some more about what Chyna wanted. It was a little uneasy in the beginning, because all of the people were talking to Chyna and not to me. At the time, I figured I knew what was best for her, but boy was I wrong!

We set up a plan with our first provider, and it worked well for a long time. Chyna was becoming less dependent on her stepfather and me, and getting integrated in her community. She was doing things I never imagined she could do. 

Sometimes providers have to change the way they provide services. Chyna’s ECF provider did this in May 2018 because of a lack of staff, so we had to go elsewhere. I looked at some local providers and wasn’t happy with what I saw. In meeting with some, it seemed like they wanted to keep Chyna busy, but not necessarily prepare her for employment.

Finally, we met with a provider from Cleveland, Tennessee, and they appeared to line up with what we needed. We started services with them, but due to the office being located in Cleveland and us in Chattanooga, it was difficult to get things coordinated for Chyna’s needs. I had to speak with Chyna’s coordinator to see what her other options were;  it had to be whatever was best for Chyna.

We discussed consumer direction, which is different than provider-centered support. In many ways, it gives the family and individual more control over their services. The family has to work harder and take on some additional responsibilities, though there is some assistance provided by the ECF program. We were assigned a broker with the Public Partnership agency, who handled the background checks and the portal to filling out the application for support staff, which is all done online. The broker came to our home and trained our initial staff and me. They also handled all the payroll issues for our support staff. We were able to decide how much we wanted to pay Chyna’s staff person, but, obviously, the more we paid, the less hours of service we’d be able to receive. We developed a plan based on what we were doing when the provider-centered services were going well. I went around our community and found things for Chyna to do: mostly activities that would prepare Chyna for work, including opportunities for her to volunteer. 

I also hired three mentors to work with her, each with a specific role in decreasing Chyna’s dependency. She has a mentor that goes with her to social gatherings with her friends. She has a mentor who supports her in her volunteer activities, as a job coach to assist her in building her skills. She also has a mentor who is a peer, a college student her same age, who encourages Chyna’s independence. We have a Google calendar that we all share to keep up with Chyna’s activities from week to week. It took a lot to get it established, but this works best for Chyna.

The most important thing to know about any program is that it’s not going to be perfect for all of your needs. But if you see that it’s not perfect, don’t give up, and keep an open mind. Reach for positive outcomes and try to figure out what you can do to make it work better.