Tennessee's CHOICES program provides older adults (age 65 and older) & adults with physical disabilities (age 21 and older) who are eligible for needed long-term services and supports in the home/community setting or in a nursing facility.
CHOICES offers services to help a person live in their own home or in the community; these services are considered Home and Community Based Services (HCBS). These services assist individuals with daily living activities and allow people to work and be actively involved in their local community. If needed, CHOICES also provides care in a nursing facility as an alternative to HCBS.
All members in CHOICES are assigned to a group. There are three groups (1, 2 and 3) which provide specific services based on the individual’s needs.
- CHOICES Group 1 is for people of all ages who receive nursing home care.
- CHOICES Group 2 is for adults (age 21 and older) with a physical disability and seniors (age 65 and older) who qualify to receive nursing home care but choose to receive home care services instead.
- CHOICES Group 3 is for adults (age 21 and older) with a disability and seniors (age 65 and older) who don’t qualify for nursing home care but still need care to delay or prevent the need for nursing home care.
To become a CHOICES participant, an applicant must meet the following criteria:
- Medical (Level of Care) Eligibility- This means you need help with daily living activities
- Financial Eligibility- This means you are receiving SSI (Supplemental Security Income) payments or qualify for Medicaid Long-Term Services and Supports
To qualify for and remain in CHOICES Groups 1 and 2, you must:
- Need the level of care provided in a nursing home; AND
- Qualify for Medicaid long- term services and supports.
To qualify for and remain in CHOICES Group 3, you must:
- Be “at risk” of needing the level of care provided in a nursing home unless you receive home care; AND
- Be receiving SSI (Supplemental Security Income) payments or qualify for Medicaid Long-Term Services and Supports. (As of October 1, 2022, based on current appropriations, there is an enrollment target of 1,750 for non-SSI recipients).
To qualify for Medicaid long-term services and supports: (1) Your income can't be more than $2,742 per month for 2023 (three times the SSI Federal Benefit limit; changes annually) If it is, you may be able to set up a Qualifying Income Trust; (2) The total value of things you own can't be more than $2,000 (The home where you live doesn't count); AND (3) You can't have given away or sold anything for less than what it's worth in the last five (5) years.
- The Area Agencies on Aging and Disability (AAAD) can assist applicants not currently enrolled in TennCare in the application process. Additionally, the AAADs serve as a resource for information and education regarding CHOICES and other long-term services and supports.
- If you are interested in applying for CHOICES, contact your local AAAD: Area Agency on Aging and Disability (AAAD) TN Map (Use this map to view AAAD’s by County).
- Call 1-866-836-6678 from anywhere in the state to be automatically directed to your nearest Area Agency.
- Current TennCare Members can contact their MCO for more information on how to apply for CHOICES:
- Personal care visits - short visits of no more than 4 hours when someone will help you do things like get out of bed, take a bath, get dressed, fix and eat meals, or use the bathroom.
- Attendant care - The same kinds of help you get with personal care visits, but for longer periods of time.
- Home-delivered meals – Nutritious meals that can be delivered fresh each day or frozen in bulk.
- Personal Emergency Response System - A call button you can use to get help in an emergency.
- Adult day care - A place that provides supervised care and activities during the day.
- In-home respite care - Someone to stay with you in your home for a short time so your caregiver can get some rest.
- In-patient respite care - A short stay in a nursing home or assisted care living facility so your caregiver can get some rest.
- Assistive technology - Certain low-cost items that help you do things more easily or safely in your home like grabbers to reach things.
- Minor home modifications - Changes to your home that will help you get around more easily and safely like grab bars or a wheelchair ramp.
- Pest control - Spraying your home to take care of an infestation such as for bugs or mice.
- Benefit Counseling – Assistance researching facts needed to decide which health plan would help you get all the care you need.
- Enabling Technology – Various forms of devices and technology to support independent living such as sensors, mobile applications, remote support systems and other smart devices.
- Community-Based Residential Alternatives - places to live that offer care and support for someone who can no longer live alone that include the following:
- Assisted Care Living Facility – A place you live that helps with personal care needs, homemaker services, and taking your medicine. You must pay for your room and board.
- Community Living Supports – A shared home or apartment where you and no more than 3 other people live. The level of support provided depends on your needs and can include hands-on assistance, supervision, transportation, and other supports needed to remain in the community.
- Community Living Supports – Family Model – A shared home or apartment where you and no more than 3 other people live with a trained host family. The level of support provided depends on your needs and can include hands-on assistance, supervision, transportation, and other supports needed to remain in the community.
- Critical Adult Care Home – A home where you and no more than 4 other people live with a health care professional that takes care of special health and long-term care needs. Under state law, this is available only for people who are ventilator dependent or who have traumatic brain injury. You must pay for your room and board.
- Companion Care – Someone you hire who lives with you in your home to help with personal care or homemaker services whenever you need it. This is available only for people in consumer direction who need care throughout the day and night that can’t be provided by unpaid caregivers. And only when it costs no more than other kinds of home care that would meet your needs.
Consumer Direction is a way to obtain the home care you need that provides greater choice and control over WHO provides your care and HOW it is delivered, compared to receiving CHOICES services from a provider agency.
In Consumer Direction, you become the employer of the people who provide your home care services, allowing you to hire, train, and schedule workers yourself instead of going through a provider agency. Although you can hire family members, friends, neighbors, or other acquaintances to provide care in Consumer Direction, there may be some limitations.
Consumer Direct Care Network Tennessee (CDTN) is the Fiscal Employer Agent (FEA) in Tennessee.
- Questions? Contact the LTSS Help Desk at 1-877-224-0219.
- How do I access TennCare Cover Kids and Medicare Savings Programs? Go to TennCare Connect.
- How Do I find a nursing home in Tennessee? Health Facilities Commission.
- I live in a nursing home or assisted care living facility and need help resolving questions or problems with my care. Contact your local district Long Term Care Ombudsman.
- Do you need free legal advocacy services regarding your care? Contact Disability Rights TN.
- Do you need additional information? View the CHOICES Brochure.