Having Issues with TennCare or Waivers? Call Tennessee Justice Center’s Client Advocate

By Sarah Connette

About the Author

Sarah Connette is the Tennessee Justice Center’s CHOICES Client Advocate. She has a B.A. in political science from Davidson College, and a Master of Divinity from Vanderbilt Divinity School. Sarah enjoys working hard to help vulnerable families get the care they need. Email her at sconnette@tnjustice.org

Our hope is that this weekly blog will offer information you want to know, so if you have a question you want answered about employment for people with disabilities or other mysteries of the world of work, please email janet.shouse@vumc.org.

The Tennessee Justice Center is a non-profit law firm that advocates for vulnerable Tennesseans who need access to health care. Our work has three primary areas:

  • We provide one-on-one assistance for clients across the state, free of charge. We help people get needed services through public programs that are supposed to provide medical care and support for vulnerable children and adults, such as TennCare, the “original” CHOICES, and Employment and Community First CHOICES.
  • We offer support and trainings to community partners. We help thousands of health care workers, professionals, and volunteers across Tennessee understand and use complex laws to assist their vulnerable clients.
  • We identify the problems that prevent public programs from working as they should, and we use those insights to fix those problems in a way that makes our health care system fair and just for all.

At the Tennessee Justice Center, our “Independence team” serves low-income people with disabilities as well as older adults. We have staff members who provide assistance with CHOICES and Employment and Community First CHOICES, elder abuse, neglect, and financial exploitation, and enrollment in five core benefit programs. Those five programs are Medicare Savings Programs, Extra Help with Medicare Prescription Drug Plan Costs, the Supplemental Nutrition Assistance Program (SNAP), the Low Income Home Energy Assistance Program (LIHEAP), and TennCare. All of our services come at no charge.

As a CHOICES Client Advocate, I work with families and people with disabilities, as well as older adults, who are interested in, applying for, or are on the CHOICES or Employment and Community First CHOICES program. ECF CHOICES is meant to serve people of all ages with intellectual and developmental disabilities. As many of you know, it is a relatively new program, beginning in July 2016, intended to help people live as independently as possible at home or in the community. Supports are designed to help people build relationships, be active in the community, and seek employment, if desired.

The “original” CHOICES program is TennCare’s long-term services and supports program for older adults and people with disabilities. CHOICES is intended to serve individuals with serious physical needs, rather than other types of needs. For more details on eligibility, application process, and further tips and resources, check out our CHOICES and ECF CHOICES pages on the Tennessee Justice Center’s website.

We help individuals and families across the state who contact us for assistance at various stages of the process—whether they:

  • Are exploring options and want to learn about eligibility requirements.
  • Are planning on applying and need information.
  • Have applied but haven’t heard anything.
  • Have been denied eligibility.
  • Are on ECF CHOICES or CHOICES and are experiencing service issues.

We try to help gather information, communicate between agencies, and resolve issues so that families can move forward in receiving the care they or their loved ones need. We primarily advocate for our clients if they are experiencing problems with TennCare or with their managed care organization. We also advocate for our clients if they are experiencing problems with a provider agency, but the advocacy looks a little different.

Folks are welcome to call us at any stage of the process, but historically our services are most often used when an individual is denied eligibility for a program or is denied services while in a program, and we then work with TennCare and/or appeal the issue.

One of my favorite clients was a 31-year old with IDD whose mother reached out to us. Together we were able to explore the Employment and Community First CHOICES groups and secure the services the family needed. The mother told us, “To know that somebody was gonna be standing there with me, that was the biggest blessing. Not everyone gets what you’re feeling and thinking, what we’re going through. I feel confident moving forward now.”

Thanks to working together, we were able to communicate with the managed care organization and with TennCare to address discrepancies and misinformation about the Family Caregiver Stipend (part of ECF CHOICES Group 4) at a systemic level.

When folks contact us with problems they’re experiencing, we’re grateful for the chance to identify issues that many are facing so that we can try and resolve the individual issue as well as address the systemic problem. We have learned so much from community partners and contacts in the disability advocacy community. We look forward to hearing from you!

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