The Rollout of the New Employment and Community First CHOICES Waiver Program

/ July 12, 2016

About the Author

Janet Shouse is a parent of a young adult with autism, and she is passionate about inclusion, employment of people with disabilities, medical issues related to developmental disabilities, supports and services, public policy, legislative initiatives, advocacy, and the intersection of faith and disability. She wears many hats at the Vanderbilt Kennedy Center, including one as a disability employment specialist for TennesseeWorks.

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 me at janet.shouse@vumc.org.

By Janet Shouse

As many of you know, Tennessee launched a new Medicaid waiver program called Employment and Community First CHOICES on July 1. This home- and community-based services program is geared toward promoting integrated, competitive employment and independent living as the preferred option for all individuals with intellectual and developmental disabilities.

Many of us in the disability community have waited a long time for a waiver program that would offer people with developmental disabilities who do not have an intellectual disability a chance to receive waiver services in Tennessee.

So on Friday, I checked with TennCare to see how many referrals the agency had received in the first week. The answer: more than 300.

Quite honestly, I was rather surprised. I had expected that number to be higher. I knew several families had initially planned to stay up late on June 30 in order to complete the online self-referral form right at midnight, so I knew there were feelings of urgency to get a loved one’s application in as soon as possible. (But we learned shortly before July 1 that the self-referral form wouldn’t be available until 8 a.m., so those families got to have a full night’s sleep.)

And just to clarify, a referral (or application) does not mean enrollment into the waiver program. There are eligibility guidelines and priority groups, and there is funding available to enroll up to 1,700 individuals in the first year.

TennCare says that those who have completed the self-referral form should receive a letter within two weeks of filing the form. If you filed and don’t hear within two weeks, you can call 877-224-0219.

For those who have been on the DIDD Medicaid waiver waiting list for services, they are no longer on the DIDD waiting list. They will be moved to the new referral list for Employment and Community First CHOICES. Please read the list below and let TennCare know if you or your loved one is in one of these groups when you complete the referral form.

Those who will get the first chance to see if they qualify (first priority) for the new program are those who:

Have an intellectual disability and their primary caregiver (the person who provides most of your unpaid support) is age 75 or older.
Have a job in the community (not a sheltered workshop) and need help to keep that job.
Are age 18-22, and about to finish school. And, the person has found a job in the community that he or she can start when the person finishes school if the right help is in place.
Recently lost a job and need help to get and keep a new job.
Their primary caregiver recently passed away or is permanently incapacitated, and there is no other caregiver available to support the individual.
Are being abused, neglected or exploited where they live now, and the individual must move to prevent more abuse, neglect or exploitation. And the person has no other place to live.
Need these services to move out of a nursing home or an intermediate care facility for individuals with intellectual disabilities (ICF/IID) into a home in the community.
Are in immediate and ongoing risk of serious harm or danger to themselves or others. Other things have been tried but didn’t help reduce the risk of serious harm. And, you need these services to help keep you and others safe.
Have two or more complex health problems that keep the person from being able to work. And, the person is in urgent need of supports in order to keep living where he or she does now.

Other groups that may open up (if there is still room to enroll new people) include:

Those who age 18 to 22 who are about to finish school. They don’t have a job yet, but want to work and need help to find and keep a job in the community.
People of any age who don’t have a job yet, but want to work and need help to find and keep a job in the community.
Children age 14-21 who are planning to work when they leave school and need supports to get ready for work that they can’t get from their school or Vocational Rehabilitation.

Individuals who have been on the waiting list and who don’t meet that “first chance” qualifications will still be on the referral list for the Employment and Community First CHOICES program. The category on the referral list will depend on what category the person has been in on the waiting list for the DIDD waivers.

If the person’s status has been listed as “deferred” on the waiting list, this means the person doesn’t need services right away. The intent is just to keep the person’s name on the list. (If the person doesn’t complete a self-referral, he or she will also be listed as “deferred” on the list for Employment and Community First CHOICES.)
If the person has been listed as “active,” “urgent” or “crisis” on the waiting list and does not complete a self-referral form, the person will be listed as “other active” on the referral list for Employment and Community First CHOICES. This means the person wants services now, but does fit in any of the groups (in the list above) that qualify to enroll first.

If you are interested in completing the referral form, you can do so here.

If you need assistance in completing the self-referral form, here are the places to contact for help:

1. If an individual has Medicaid/TennCare, and is enrolled with Amerigroup or BlueCare should contact the Managed Care Organization. The information about how to call the MCO is on the insurance card. Or call the numbers listed below:

Amerigroup- 866-840-4991
BlueCare- 888-747-8955

2. If an individual has Medicaid/TennCare and is enrolled with United HealthCare Community Plan, he or she should contact DIDD Regional Intake Offices.

West Tennessee Regional Office 866-372-5709
Middle Tennessee Regional Office 800-654-4839
East Tennessee Regional Office 888-531-9876

3. If the individual does not have Medicaid/TennCare, contact DIDD Regional Intake Offices with questions or for assistance applying for both ECF CHOICES and Medicaid. (See numbers directly above.)

4. If the individual has Medicaid/TennCare but is not sure which is his/her MCO, call the Tennessee Health Connection line at 1-855-259-0701.

The only glitches that I’ve heard about were some concerns about whether the online self-referral form was secure. The response I receive from TennCare was: “Some public users received a certification error from newer browsers. This was very limited. We are working to correct the certification issue.”