Frequently Asked Questions
Q: Do you have to be employed to get into Employment and Community First CHOICES?
A: No! Employment and Community First CHOICES is built on the belief that employment has many positive benefits for people. These include higher income, better health and quality of life, and greater opportunity to make friends and be part of their community. We recognize that sometimes people will need to experience those benefits first-hand in order to realize they exist. As long as people who qualify to enroll in the program aren’t fundamentally opposed to exploring the opportunity to work, with needed supports they will get from program, they may qualify for priority enrollment in Employment and Community First CHOICES.
Q: Can people with more significant disabilities be served in Employment and Community First CHOICES?
A: Yes! Employment and Community First CHOICES is for people with I/DD, including people with significant medical and behavior support needs. The groups targeted for priority enrollment in Employment and Community First CHOICES include people who have complex health problems or who have behavior needs that place themselves or others at risk. Benefits in the program offer an array of services, including residential supports, up to 24 hours a day based on the needs of each person.
Q: Can people with more significant disabilities work?
A: Yes! Every person can be supported to work, regardless of their level of disability. No one is presumed ineligible for employment services or incapable of working—alongside people who don’t have disabilities and for the same wages. Groups that are able to enroll in the program first, based on interest, desire or need to obtain or maintain employment don’t exclude anyone, regardless of their level of disability. The array of employment services available in Employment and Community First CHOICES is extensive, and reflects what we know works for people with I/DD. These services create a pathway to employment, even for people with the most significant disabilities. Providers are paid more to provide employment services like Job Development and Job Coaching for people with more significant disabilities to help cover the cost of additional supports the person may need to work.
Q: Can people get residential services in Employment and Community First CHOICES?
A: Yes! Benefits in the program include residential supports, up to 24 hours a day, based on the needs of each person. The residential services are called Community Living Supports. These services offer support with activities of daily living and other tasks that help a person with I/DD live in the community and engage in community life. The services are usually provided in a small shared living arrangement or with a family (not the person’s own family) who will provide the supports the person needs. The person pays for their room and board. The rates paid to provide these services depend on the level of support the person needs. Providers are paid more to provide Community Living Supports for people who need more hours of support or have complex medical or behavioral needs.
Q: How do I apply for Employment and Community First CHOICES?
A: You can apply for the program at the following link: https://tpaes.tenncare.tn.gov/tmtrack/ecf/index.htm
For additional information about how to apply for the program, please visit: /tenncare/long-term-services-supports/employment-and-community-first-choices/self-referral-form.html
Q: Can I hire my own workers to provide services I need?
A: Some of the services in Employment and Community First CHOICES can be provided through Consumer Direction. In Consumer Direction, the member or member’s advocate actually employs the people who give some of their support services—they work for the person receiving services (instead of a provider). This means that the person receiving services must do the things an employer would do. When using Consumer Directions, you hire, train, schedule, supervise, and even fire workers.
Q: What are Groups 7 & 8?
A: Intensive Behavioral Family Supports (This is sometimes called “Group 7.”)
This group is for a small number of children under age 21 who live with their family and have I/DD and severe behavior support needs that place the child or others at risk of serious harm. The behaviors are so challenging that the child is at risk of being placed outside the home. This group provides mental health treatment and other services in the home with the family. (The family must be willing to be part of the child’s treatment.) The services will train and support the family to support the child so they can keep living safely together.
Comprehensive Behavioral Supports for Employment and Community Living (This is sometimes called “Group 8.”)
This group is for a small number of adults who have I/DD and severe behavior support needs and are moving into the community from a place with lots of structure and supervision. This could be coming from a mental health hospital, the foster care system, jail, or a nursing home. These services are mostly for adults age 21 or older. But sometimes, a person age 18-20 can get them too. They combine 24/7 residential services with mental health treatment and support. People are usually in this group short-term. Once the person is stable in the community, they will move to a different benefit group that can safely meet their needs.
Q: What’s the I/DD Integration?
A: The Department of Intellectual and Developmental Disabilities (DIDD) and the Division of TennCare will integrate and align all Medicaid long-term services and supports (LTSS) programs for people with intellectual and developmental disabilities (I/DD), including the Section 1915c HCBS waivers, the Employment and Community First CHOICES Program, and Intermediate Care Facility Services for Individuals with Intellectual Disabilities (ICF/IID) , for the first time, under the direct operational leadership, management and oversight of DIDD. TennCare will seek approval from CMS for the integration of I/DD services as part of the TennCare waiver renewal process. While we have no control over the timeline in receiving a decision from CMS, we hope to begin implementation on July 1, 2021.
Under the transformed service delivery system for people with I/DD, all long-term services and supports (LTSS) for individuals with I/DD will be part of the managed care program. They will be administered through the managed care program under the direct operational leadership, management, and oversight of DIDD. TennCare will contract with DIDD to serve as the operational lead agency for all I/DD programs and services.
TennCare and DIDD, will in turn, contract jointly with Managed Care Organizations, with DIDD leading the day-to-day management and oversight of the MCO contracts for I/DD benefits, and TennCare working alongside DIDD and continuing to lead management and oversight of other integrated benefit components for the I/DD population—physical and behavioral health, pharmacy, and dental services, in consultation and partnership with DIDD.