Consumer Direct Care Network Tennessee: How CDTN Works for ECF CHOICES Families

What Consumer Direct Care Network Does in Tennessee

Consumer Direct Care Network Tennessee (CDTN) is the state-contracted Fiscal Employer Agent for ECF CHOICES. When a young adult with intellectual or developmental disabilities enrolls in consumer-directed services, CDTN handles the employment paperwork that lets families hire, pay, and manage their own support workers rather than relying on an agency.

CDTN processes payroll, withholds taxes, manages workers' compensation insurance, and files quarterly employment reports for every consumer-directed worker in the program. The young adult (or their representative) acts as the managing employer — they choose who to hire, set schedules, and direct the work — while CDTN handles the back-office compliance that would otherwise require a payroll accountant.

How Consumer Direction Fits Into ECF CHOICES

ECF CHOICES offers two service delivery models: agency-directed and consumer-directed. Under the agency model, a contracted provider sends staff on their schedule. Under consumer direction, the enrolled member picks their own workers, including family members in some cases, and manages them directly.

Consumer-directed services are available across ECF CHOICES Groups 4, 5, and 6. The services most commonly managed through CDTN include Supportive Home Care (personal assistance with daily living tasks), Community Integration Support, and Companion Care. Each service has an hourly rate set by TennCare, and the total cannot exceed the member's annual expenditure cap — $18,000 for Group 4, $36,000 for Group 5, or the tiered caps for Group 6.

The Family Caregiver Stipend in Group 4 is a separate benefit. Caregivers receiving the stipend are not registered as consumer-directed workers through CDTN and do not submit timesheets. The stipend is a flat monthly payment of up to $1,000, paid in place of hourly Supportive Home Care.

Setting Up a CDTN Account

Once the member's Person-Centered Support Plan authorizes consumer-directed services, their MCO (BlueCare, UnitedHealthcare, or Amerigroup/Wellpoint) sends enrollment paperwork to CDTN. The setup process requires:

• Worker enrollment forms — each worker completes a CDTN employment packet including W-4, I-9, and direct deposit authorization
• Background check clearance — complete any screening required for the worker before services begin
• Rate authorization — the MCO confirms the authorized service type, hourly rate, and total approved hours per week
• Timesheet training — CDTN provides training on their electronic timesheet system, which workers use to log hours by service type and date

Workers should not start billing until CDTN confirms that the enrollment paperwork has cleared. Most families report the process takes two to four weeks from the MCO's authorization to the first payroll-eligible shift.

Submitting Timesheets and Getting Paid

CDTN uses an electronic verification system for timesheets. Workers log their start and end times for each shift, and the managing employer (typically the enrolled member or their representative) approves the entries. CDTN processes payroll on a biweekly cycle.

Common issues that delay payments include missing timesheet approvals, hours logged that exceed the authorized weekly limit, and workers billing for a service type not listed in the support plan. CDTN's customer service line can help resolve discrepancies, but families should keep their own records of shifts worked in case a timesheet entry is rejected.

When Consumer Direction Makes Sense — and When It Does Not

Consumer direction works well for families who already have a trusted caregiver in mind and want scheduling flexibility. It gives the member control over who enters their home, when services happen, and how tasks are prioritized. For young adults transitioning out of school, this model lets families maintain continuity with support workers the young adult already knows and trusts.

It is a harder fit for families without a ready pool of workers. CDTN is a fiscal intermediary — they process payroll, but they do not recruit, screen, or supply workers. If the family cannot find and retain reliable caregivers on their own, agency-directed services may provide more stability, even at the cost of less scheduling control.

Families navigating ECF CHOICES enrollment, the referral list, and consumer-directed services for the first time can benefit from a structured planning tool. The Tennessee SSI at 18 & Adult Disability Benefits Guide walks through the ECF CHOICES application process, benefit group eligibility, and the consumer direction setup alongside SSI redetermination and legal decision-making steps — all in one sequenced plan.

Key Points for Families New to CDTN

CDTN does not set service rates or approve hours — that authority sits with TennCare and the member's MCO. If the family disagrees with the number of authorized hours or the service types approved, the appeal goes to the MCO, not to CDTN. CDTN's role is strictly payroll and compliance.

Workers paid through CDTN are W-2 employees, not independent contractors. CDTN withholds federal income tax, Social Security, and Medicare from each paycheck. This matters for SSI recipients who also work as consumer-directed caregivers for other members — those wages count as earned income and affect their own SSI calculation under the general income exclusion rules.

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