Federal COVID Funds Will Help Add 2,000 ECF CHOICES Slots, Other Relief

/ January 4, 2022

By Cara Kumari

The COVID pandemic has significantly disrupted the lives of people across the world, including those with disabilities.  Many people with intellectual and developmental disabilities have felt both the physical and mental toll of this pandemic: some experienced illness due to COVID, many more lost connections with their jobs, friends and communities, and their families and caregivers faced additional stress.

As we continue to navigate the ongoing challenges, we have an opportunity to use millions of dollars of federal COVID relief funds to provide relief for thousands of people and their families. The state of Tennessee has pledged to use up to $400 million of American Rescue Plan funding to provide home and community-based services to people on the waiting list, support family caregivers, boost wages for direct support staff, and increase access to enabling technology to enhance opportunities for independence.

There are several different ways the funding will help families.  Here are some of the main ways they can benefit:

Enrolling up to 2,000 People in Employment and Community First CHOICES

Three years ago, TennCare and the Department of Intellectual and Developmental Disabilities created a shared strategic goal around eliminating the referral list for the Employment and Community First CHOICES Program.  Initial plans to reduce that referral list were deferred because of COVID-related budget impacts in 2020. Now, the federal American Rescue Plan funding will help eliminate a significant portion of that referral list, by providing for 2,000 new slots in the program.  Initially, we will target for enrollment those who are actively seeking services and have been waiting the longest to receive services.  DIDD and the state’s three managed care organizations have already started making contact to notify people about this option and begin the enrollment process. This represents the largest addition of persons into the Employment and Community First CHOICES Program since its inception in 2016.  While it will not completely eliminate the waiting list for the program, it will reduce it by more than half and most importantly, provide support to more Tennesseans to reach their employment and community living goals.

Family Caregiver Supports

During the pandemic, many people with intellectual and developmental disabilities who live at home have relied heavily on their family members to provide unpaid support.  This has caused additional strain on those family members, who many times are balancing their own jobs and managing the entire family’s health and safety.  To help sustain and support these family caregivers and support a person’s independence, up to $3,000 in additional supports are available for select services in the 1915(c) waivers operated by DIDD, Employment and Community First CHOICES and CHOICES for those who either live in the family home or rely heavily on unpaid family caregivers.  Funding for these additional services is available once a person has reached their maximum benefit level for the defined and qualifying service and must be used by March 31, 2024, even if a person exceeds the cap limit of the service or program. Each program has different services that are eligible, which are broken down in this plain language fact sheet about the benefit: https://www.tn.gov/content/dam/tn/tenncare/documents/FamilyCaregiverSupport112221.pdf

Enabling Technology

While enabling technology is not a new service for the 1915(c) waivers, this federal funding gives DIDD and TennCare the opportunity to increase access to this life-changing benefit to those in the CHOICES program.  This funding will support persons to use the up to $5,000 in enabling technology to increase their independence and safety in the community and improve a person’s overall quality of life. Individuals in all HCBS programs–CHOICES, Employment and Community First CHOICES, and 1915(c) waivers will now have access to a comparable enabling technology benefit.

Wage Increases for Frontline Workers

Over the past few years, the Tennessee General Assembly has made significant investments in the wages of direct support professionals in the 1915(c) waivers.  These increases have been vital as the entire nation confronts a direct care workforce crisis.  In order to ensure that frontline direct care workers across all long-term services and supports programs have access to an equitable wage, a portion of the federal funding will go towards targeted provider rate increases in the Employment and Community First CHOICES and CHOICES programs.  The sole purpose of these increases is to raise the wages of frontline staff.  While a specific rate is not prescribed, we expect that higher rates will account for wages of at least $12.50 per hour.  The goal is that this increase will help recruit and retain high-quality direct support professionals, who are the foundation of all home and community-based programs and make an impact daily on the lives of those they support.

All of these American Rescue Plan funds must be used by March 31, 2024. For the additional 2,000 slots and the frontline worker wage increase, we anticipate, but cannot guarantee, that we will be able to provide for ongoing funding after that date. TennCare has already requested recurring funds for the 2,000 slots and the wage increases as part of the fiscal year 2023 budget.  If approved by the General Assembly, there will be funding for these to continue once the American Rescue Plan funds expire.

How do I know if I or my loved one might be able to access these services?

Persons already enrolled in the 1915(c) waivers, Employment and Community First CHOICES or CHOICES program who may be eligible for these services have received a notice from TennCare and DIDD about the funding and the potential ways they may be able to access the services provided.  Those who have been identified for enrollment in the Employment and Community First CHOICES program will be notified by either their managed care organization if they already have Medicaid, or by a DIDD case manager if they don’t currently have Medicaid.

While this isn’t a complete list of ways the funding will be used to support people with disabilities, these are areas that we believe will have a direct impact on the quality of life for people supported and their families.  We are excited to be able to offer these benefits and provide relief to frontline workers and families and provide a better life experience for thousands of people with intellectual and developmental disabilities across Tennessee.

My thanks to Cara and the folks at TennCare for working during the holidays to put the finishing touches on this blog post. I know some of this information has been shared previously, I think it’s really important for people to know about these opportunities provided by the American Rescue Plan funds, and I hope you will share this information with individuals and families you know who could benefit. I hope everyone had a good holiday season, and I hope this year brings good things to each of you! Happy New Year! If you have questions or concerns, 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 home- and community-based waivers, the 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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