Tennessee has a “Katie Beckett”-like program as part of its TennCare Demonstration Waiver, which grants Medicaid coverage and additional services to a small number of children who do not otherwise qualify for Medicaid based on income. This program also provides home and community based services only (without Medicaid) to a second group of lower acuity children. These programs may require a parent fee and insurance coverage and unfortunately are not available to low-income or foster children who qualify for Medicaid categorically.

Tennessee also has a unified program for people of all ages with intellectual or developmental disabilities, the Employment and Community First CHOICES program, which is part of its 1115 demonstration waiver, TennCare.

Tennessee previously had three HCBS waivers that stopped enrolling participants in 2016. However, some individuals still remain in these programs, though they expect to be transitioned by 2024. These include: Comprehensive Aggregate Cap Home and Community Based Services, Self-Determination Waiver Program, and Statewide Home and Community Based Services Waiver.

Advocacy Organizations in Tennessee:

Last updated 10/25/23

Programs in Tennessee

  • Target Population: Children who would otherwise require care in an institution with any type of disability, including medical, developmental, intellectual, or psychiatric conditions.
  • Ages: 0-18
  • Levels of Care: Intermediate Care Facility, Nursing Facility, Hospital
  • Income Waiver: Yes, the program is based on the child’s income only. Parent income is not counted. Child must not be financially or categorically eligible for Medicaid. A parent fee may apply, as do insurance requirements.
  • Waiver Type: Part of an 1115 waiver
  • Spots: 300 in part A (full Medicaid plus HCBS); 2700 in part B (HCBS only)
  • Expiration Date: 12/31/2030
  • Description: Part A is a TEFRA-like program providing Medicaid coverage with additional home and community based services for those who do not financially qualify for Medicaid. Part B is an additional diversion program providing HCBS services only without Medicaid coverage.
  • Online State Information: Katie Beckett and Katie Beckett detailed info as well as this Katie Beckett information from Family Voices of TN
  • Official Federal Information
  • How to Apply: Apply through TennCare Connect. Additional application information is available here.
  • Waiting List: There are 4573 people with developmental disabilities on Tennessee’s waiting list. There will be a separate waiting list created for this program.
  • Target Population: Children and adults with developmental and intellectual disabilities.
  • Ages: all ages, however, families have reported that they are repeatedly being turned down by this program due to prioritization of adults
  • Levels of Care: Intermediate Care Facility
  • Income Waiver: Eligibility is based on the child’s income only if the child requires a nursing home level of institutional care.
  • Waiver Type: Processed through an 1115 waiver
  • Spots: unknown
  • Expiration Date: 12/31/2030
  • Description: Integrated Employment Path Services, Community Integration Support Services, Independent Living Skills Training, Community Transportation, Assistive Technology, Adaptive Equipment and Supplies, Minor Home Modifications, Respite, Supportive Home Care, Family Caregiver Stipend, Family Caregiver Education and Training
  • Online State Information: Employment and Community First CHOICES
  • Official Federal Information
  • How to Apply: Follow the instructions based on your program on this page.
  • Waiting List: There are 300 people with developmental disabilities on Tennessee’s waiting list.

Additional Information

  • A small group of individuals who receive services through the Employment and Community First CHOICES waiver can receive a small monthly stipend; however, this is not truly paid parent caregiving, but rather just a stipend more similar to SSI.