DIDD Helping Individuals Figure Out How to Return to ‘Regular’ Activities

/ June 8, 2021

(Editor’s note: This is a special edition of the Rise to Work blog, because I felt like this information was timely and needed to be share as quickly as possible. I hope you are looking forward to this “re-engagement” with our community as much as I am.)

By Cara Kumari

After a year of uncertainty, change, fear, anxiety, and embracing a “new normal,” Tennessee is now seeing promising signs of the “old normal.”  Restaurants are filling up, families and friends are gathering again, capacity limits have been lifted at many sporting events, and people (including us at the Department of Intellectual and Developmental Disabilities) have returned to their offices.  More than 2.5 million people across Tennessee have received at least one dose of a vaccine, with a large percentage of those fully vaccinated.

The Centers for Disease Control has now issued guidance that people who are fully vaccinated can return to many of their normal activities without the need to wear a mask.

In Tennessee and the nation, the number of positive cases continues to plummet. This is also true for those receiving home and community based or intermediate care facility services for people with intellectual and developmental disabilities in Tennessee. The positive cases for both people supported and their staff have dropped significantly, with only 17 positive cases among people supported in all of April.  One reason for this steep decline is that Tennessee prioritized vaccinations for people with intellectual and developmental disabilities and their staff.  Now, the spread is occurring primarily among people who have not been vaccinated.

We are also seeing the change in desires among people supported and families to get out and do things.  We have heard that people either have or are anxious to return to the community activities and jobs they love.  They are wanting to visit with their families and friends again.  This past year has disrupted many routines and kept people away from those they love the most.

It’s important to note that during the past year, people supported have had the choice to engage in activities outside their home.  Dozens of people supported maintained their jobs as essentials workers throughout the past year, even during the stay-at-home orders.  However, DIDD and TennCare submitted what’s called an Appendix K to the federal government, which gave us the ability to make service revisions to provide for people to stay at home and minimize their contact with others.  That’s been the reality for thousands of people with disabilities for the past year.  It’s understandable that people are ready for a change.

Many of the changes we are looking at are being driven by the desires of the people we support.  As the world has “opened up,” people are being supported to return to those activities.  To assist in making those decisions, we have provided a risk-benefit analysis tool to help folks weigh the pros and cons of returning to the community.  For those who aren’t ready to return, they have been supported to stay at home.  The tool can be found here.

We are also looking at some of the flexibility that we were given by the federal government and determining where it’s appropriate for our staff to return to face-to-face visits with people supported and with provider agencies. If a person in a residential placement requests in-person services, the residential provider cannot prevent the independent support coordinator, therapists, etc., from entering the home to provide the services.  Also, if a person requests a therapeutic service be provided in-person, then the therapeutic provider must honor that request.

In the Katie Beckett Program, the Tennessee Early Intervention System, and the Self-Determination Waiver, we are offering families the option of returning to face-to-face visits with their case managers and service coordinators.  However, understanding that some families aren’t ready to return to in-person visits, we are still offering virtual options for these visits.

As much as we are anxious to return to “normal,” there are some important lessons we learned through the pandemic that we hope to keep.  Dozens more people are using Enabling Technology today than prior to March 2020.  They are now experiencing a greater level of independence than some ever thought possible.  Even as these individuals return to their activities, we want to make sure the technology is there to continue to support their goals and their lives.

Also, we have a better understanding of how telehealth can support people with disabilities and address gaps in rural areas where clinical providers are hard to find.  While many people may choose to visit their doctors in person, DIDD envisions providing telehealth options for people supported in cases where it can be as effective or even more effective than an in-person visit.

Before I close, DIDD wants to thank all of its stakeholders for working together with us during the pandemic.  It was absolutely a team effort.  But there’s one group that I must single out: direct support professionals.  So many DSPs sacrificed, worked overtime, and did everything they could to make sure people had the staffing support they needed.  Even more, DSPs had to rise to the occasion and think outside the box to provide meaningful and entertaining activities in home.  They are the true heroes of the COVID pandemic inside the DIDD service system, and we cannot thank you enough.

In so many ways, for me at least, it feels like closing up shop and staying home was a lot easier process than opening back up. And we understand not everyone is ready to get out in the community or throw away the masks.  Also, the unemployment rate for people with disabilities is still much higher than it was pre-pandemic, even though so many businesses are seeking employees.  There is a lot of work to be done. Your support coordinator can help you explore your options.  As we look at services and supports, we are keeping all of this in mind so that we can honor the decisions of the people we serve and support them to live the lives they envision for themselves.


I appreciate Cara taking the time to write about this process of the people whom DIDD supports getting back to their regular activities and daily lives. I think for many of our loved ones, the last year has been difficult. We are delighted that our son can now go out and about, as he loves to do. And I echo the wonderful efforts of the direct support professionals who have worked tirelessly through this pandemic to see that the individuals they assist have gotten the supports and services they need to the greatest extent possible. DSPs are the backbone of this system of supports, and they don’t hear “thank you” often enough! If you have questions, please contact me at janet.shouse@vumc.org.

Cara Kumari is the assistant commissioner of Communications and External Affairs for DIDD.  In her role, she oversees DIDD’s internal and external communications efforts for the state’s HCBS waivers, Katie Beckett Program, and the Tennessee Early Intervention System.  Prior to joining DIDD eight years ago, she spent a more than a decade in TV news as a state government reporter in Nashville, Kansas, Arkansas, and Missouri.  She is a proud graduate of the University of Missouri School of Journalism.

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