Persons with Intellectual Disabilities Receiving Services in the 1915(c) HCBS Waivers

Tennessee's programs and services for people with intellectual disabilities include three Section 1915(c) HCBS waiver programs and Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IIDs). These waivers are closed to new enrollment as of July 1, 2016. For individuals currently seeking services, please visit the Employment and Community First CHOICES page for more information.

TennCare’s Division of LTSS provides long-term care services for individuals with intellectual disabilities in two different types of settings as defined in federal law: 1) through Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) or 2) through home and community-based settings. If an individual meets the ICF/IID level of care qualifications, as determined by the state and federal governments, then that individual has the right to choose between institutional ICF/IID care and home and community based settings.

What is an ICF/IID?

An ICF/IID provides specialized services for individuals with an intellectual disability or related conditions. ICF/IIDs were created as part of the Social Security Act and are an optional Medicaid benefit. These facilities are required to provide active treatment. The primary purpose of an ICF/IID is to provide health and rehabilitative services.

All persons receiving ICF/IID services must meet the level of care criteria as defined in TennCare Rules. Many of the individuals who receive care have other disabilities, as well as intellectual challenges. Many individuals who reside at the facilities have transitioned out of large state institutions and have complex support needs, including physical challenges, seizure disorders, behavior problems, mental illness, are visually or hearing impaired, have eating or feeding disorders, or have a combination of these conditions that require a more intensive level of support.

HCBS Waiver Programs

Home and Community-Based Services (HCBS) are alternatives to institutional care, which include care in ICF/IIDs. HCBS are provided through three 1915(c) waiver programs approved by the federal government. TennCare’s Division of LTSS is responsible for the waiver programs. The Department of Intellectual and Developmental Disabilities (DIDD) is the state agency contracted by TennCare to operate the waiver programs. 

Comprehensive Aggregate Cap Waiver (Control #0357.R03)

Statewide Waiver Program (Control #0128.R05)

Self Determination Waiver Program (Control #0427.R02)