Resources for Navigating Adult Disability Services:

Medicaid Waiver

A row of nine different peoples faces in collage

For adults with intellectual and developmental disabilities (IDD), there is a primary Medicaid Waiver: ECF CHOICES (Employment & Community First CHOICES). Specifically, it is Tennessee’s Medicaid Home andCommunity-Based Services (HCBS) waiver for people of all ages with IDD who want to live, work, and thrive in the community. This program is grounded in person-centered planning and encourages individuals to make choices about their own lives.

Who is eligible for ECF CHOICES?

Eligibility varies by group; however, individuals may qualify if they:

  • Have an intellectual or developmental disability (I/DD)
  • Require support to live independently or participate in the community
  • Need assistance with employment, daily living skills, or personal supports
  • Meet TennCare’s functional and medical criteria

Age range: All Ages - infants through adults.

*Many students transition into ECF CHOICES right as they leave high school, making this a key program for educators and families during transition planning.

Video Resource  +

Watch this video to learn more:

Video thumbnail for the ASSIST series titled ‘Long-term Services and Supports and Medicaid Waiver Programs,’ featuring the program logo and a Watch Now button.

A version of this video is available in Spanish here.

ASSIST videos were supported by the National Institute of Mental Health (R01 MH116058, PI: Taylor). ASISTIR videos were supported by the National Institute of Mental Health (R03 MH129757, PI: Burke).

State and Local Level Resources  +

Below, we share some relevant resources in Tennessee. Click a resource title to visit its website. All resource descriptions are derived from the respective organizations.

Resource

Eligibility

Application

Contact

Employment and Community First (ECF) Choices
ECF Choices is a Medicaid waiver offering long-term employment supports, independent living skills training, transportation, and personal assistance.

Benefits of ECF: Supported employment, individualized integrated employment coaching, self-employment supports, and community-based skill-building.

Individuals with intellectual/developmental disabilities (IDD).

Apply through TennCare; providers must assist with planning.

*There are waitlists for ECF Choices*

Referral Form

(800) 535-9725
DDA.PublicAffairs@tn.gov

ECF FAQ
This page highlights common questions about ECF CHOICES.

Provide proof that they have an intellectual disability or other developmental disability.

Intellectual disability must start before the age of 18.

Developmental disability must start before the age of 22.

 Not applicable

MAPs
MAPs is a program that will set people with intellectual and developmental disabilities on a path to learn skills to help them work, live independently, learn about their neighborhoods, and find hobbies that interest them. MAPs service give people in the program the tools, technology, and support they need to meet the goal they set for themselves.

This program is available to anyone with an I/DD diagnosis who has graduated from high school or will graduate within three years. MAPs participants cannot be enrolled in another long-term services and supports program, including ECF CHOICES, the Katie Beckett Program, or 1915(c) Waivers.

How to apply

(866) 372-5709 – West TN
Carly.Bencivenga@tn.gov

(800) 654-4839 – Middle TN
brea.dormaier@tn.gov

(888) 531-9876 – East TN
Rachael.Goddard@tn.gov

Disability and Aging - Family Support Program
The primary purpose of the program is to support:

  • Families who have school-aged or younger children with severe disabilities
  • Adults with severedisabilities who choose to live with their families

Adults with severe disabilities are not supported by other residential programs funded by state or federal funds.

Persons with severe disabilities who meet eligibility criteria and who are residing in the community in an unsupported residential setting. Due to limited state funding and Local Council priorities, not all eligible individuals can be served.

There is a Family Support agency for every county in the state. Contact the Department of Disability & Aging Regional or Central Office to find out which agency has the Family Support contract for your county.

(800) 535-9725
DDA.PublicAffairs@tn.gov

Tennessee Technology Access Program (TTAP)
Provides assistive technology free or low cost, including: Communication devices, adaptive equipment, sensory items, loan programs for testing devices

Signal Centers Assistive Technology Services Referral Form

One DHS Contact Center
(833) 772-8347
TN.TTAP@tn.gov
(731) 668-3888
(800) 464-5619
info@star-center.org
www.star-center.org
(423) 629-4174
Deardra_McGee@signalcenters.org

Information last reviewed January 2026

To recommend other helpful resources, please send suggestions to ucedd@vumc.org.

Medicaid Waiver Tips  +

Waiting for a Medicaid waiver can feel overwhelming, but Tennessee offers many other resources that can support individuals with disabilities and families in the meantime. These programs help with respite, behavior supports, family training, assistive technology, insurance, school-based services, advocacy, and community supports.

Options to pursue while waiting for the Medicaid waiver:

  1. TennCare Medicaid (if eligible now)
  2. Family Support Program (Disability & Aging)
  3. Technology Access Program (TTAP)
  4. Insurance-Based Therapies
    • If the family has private insurance, they may still access:
      • ABA therapy
      • Speech therapy
      • OT/PT
      • Feeding therapy
      • Mental health counseling
    • Some programs offer a sliding scale or financial assistance
  5. Community & Nonprofit Supports
  6. Caregiver Training Programs
    • AutismTN trainings
    • Vanderbilt Kennedy Center workshops
    • Family Voices of TN
    • Parent education through school districts
  7. Apply for SSI or SSDI
    • While waiting for waiver services, families can apply for:
      • SSI (Supplemental Security Income) — critical for youth turning 18
      • SSDI (if eligible through a parent’s record)

TNPathfinder.org  +

Although Tennessee Disability Pathfinder does not have a Medicaid waiver-specific resource, it is an excellent resource for insurance, legal, respite, and many other services. Search topics of interest on the website.

Sometimes, it can be hard to know where to start in Pathfinder. If you are struggling to understand how to find resources, here are some step-by-step directions:

  1. Start at the main page and click the topic most relevant to your needs.
  2. Click next
  3. Select the stage of life - Transition/Young Adult
  4. Click next
  5. Select the diagnosis that you or the individual identifies with/has
  6. Click next
  7. Choose the appropriate payment option that fits your needs
  8. Click next
  9. Select the appropriate city or search by your city and/or address
  10. Take time and navigate the resulting resources to further find what fits your specific

Self-Reflection Guide (PDF)

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