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IDD Program Integration

The Department of Intellectual and Developmental Disabilities and TennCare jointly announced that 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) will, for the first time, be aligned under the direct operational leadership, management and oversight of DIDD.

The primary goal of this integration will be to finally and fully achieve a single, seamless, person-centered system of service delivery system for people with I/DD that supports them to increase their independence, fully participate in their communities, and achieve their competitive, integrated employment goals. In addition:

  • This change will allow DIDD to leverage its expertise and passion in supporting people with I/DD to positively impact all Medicaid-funded programs that serve them.
  • It will enable the person-centered alignment of critical incident management, quality assurance and improvement, direct support workforce training and qualifications, and provider qualifications and enrollment/credentialing processes—reducing administrative burden for providers and minimizing some of the restrictive and burdensome expectations that have resulted from the impact of longstanding litigation.
  • Further success will be achieved through the use of value-based reimbursement aligned with system values and outcomes that is specifically designed to support independence, integration and competitive integrated employment through the use of effective person-centered planning, enabling technology and the development of natural supports.

By leveraging managed care partnerships the state will yield an estimated $34 million increase in revenues, which will help fill budget gaps without negatively impacting provider rates or services to people and families that may otherwise be necessary in these challenging times.

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 September 1, 2021. DIDD and TennCare are committed to hearing input from the people, families, providers and other stakeholders as we contemplate modifications to the existing 1915 (c ) waivers and work to design a single, seamless system for persons with intellectual and developmental disabilities.

Webex Recordings

IDD Integration Overview and Next Steps: Families - October 13, 2020

IDD Integration Overview and Next Steps: Stakeholders - October 2, 2020

Person and Family-Focused IDD Integration WebEx - August 20, 2020

IDD Program Integration for Families and Stakeholders WebEx - July 28, 2020

IDD Program Integration for Families and Stakeholders WebEx - July 21, 2020

Overview of Proposed 1915 (c) HCBS Waiver Amendments: Stakeholders March 8, 2021

Overview of Proposed 1915 (c) HCBS Waiver Amendments Family Focus Presentation - March 11, 2021

Additional Resources

Overview of Proposed Amendments and Changes to Integrate and Transform Long-Term Services and Supports (LTSS) for People with Intellectual and Developmental Disabilities (I/DD)

Person-Centered I/DD Program Integration Concept Paper

I/DD Program Integration Frequently Asked Questions

DIDD and TennCare I/DD Integration Letter

Person-Centered IDD Program Integration - Overview

I/DD Integration Family ECF Letter

Family Letter Regarding IDD Integration Waiver

1915c Waiver Amendments Plain Language Overview