Tennessee DD Services Application and Family Support Program

Where to Start the Application

Tennessee's developmental disability services are managed by the Department of Disability and Aging (DDA), formed in July 2024 through the merger of the Department of Intellectual and Developmental Disabilities (DIDD) and the Tennessee Commission on Aging and Disability. The DDA is the intake point for the state's primary disability support program: Employment and Community First (ECF) CHOICES.

There are three routes into the system depending on your family's current Medicaid status.

If your child is already enrolled in TennCare, contact your assigned Managed Care Organization (MCO) directly and request an ECF CHOICES assessment. The three MCOs are BlueCare Tennessee (1-888-747-8955), UnitedHealthcare Community Plan (1-800-690-1606), and Wellpoint (1-833-731-2153).

If your child is not enrolled in TennCare, contact a DDA Regional Office. They'll help with both the TennCare application and the ECF CHOICES self-referral. Regional contacts are West Tennessee (1-866-372-5709), Middle Tennessee (1-800-654-4839), and East Tennessee (1-888-531-9876).

Online self-referral is available through the TennCare PERLSS portal at perlss.tenncare.tn.gov/externalreferral. This option works regardless of current TennCare status and gets your child's name on the referral list.

Clinical Eligibility Requirements

ECF CHOICES requires documented proof of one of two conditions: an intellectual disability with onset before age 18, or a developmental disability with onset before age 22. The documentation typically comes from psychological evaluations, school records (IEP eligibility determinations), and medical diagnoses.

The self-referral starts the intake process. Have your child's most recent psychological evaluation, IEP, and any diagnostic reports organized and ready so the intake team can review the record and tell you what additional documentation is needed.

Financial Eligibility

Financial limits depend on which ECF CHOICES benefit group the individual qualifies for. For Group 6 (nursing facility level of care), the 2026 monthly income limit is $2,982. For Group 5 (employment and independent living supports), the limit is $1,995 per month.

Countable resources must not exceed $2,000, excluding the primary home. This is where an ABLE TN account becomes critical — up to $100,000 in an ABLE account is excluded from the SSI resource limit; if the balance exceeds $100,000 and combined countable resources exceed $2,000, SSI payments are suspended while Medicaid eligibility remains active.

If the individual's income exceeds the program limit, a Qualifying Income Trust (QIT) can hold the excess income and maintain eligibility. A QIT is a specific legal tool — talk to a disability planning attorney or contact the Tennessee Council on Developmental Disabilities for guidance on setting one up.

Family Supports Through ECF CHOICES

ECF CHOICES Group 4 — Essential Family Supports — is specifically designed for families who provide primary care for a person with an intellectual or developmental disability. It's available to children under 21 and adults 21 and older who live with family.

Group 4 services include respite care (temporary relief for family caregivers), supportive home care (assistance with activities of daily living in the family home), family caregiver stipends, community participation services, and assistive technology.

This group exists because the state recognizes that families provide the majority of direct support for people with disabilities, and without structured relief, that arrangement breaks down. Respite care alone can be the difference between a sustainable living situation and a family crisis.

The Referral List

ECF CHOICES enrollment is limited by available state funding. When there isn't an immediate opening, qualified applicants go on a referral list. Wait times depend on the benefit group, the region of the state, and available funding.

Qualified applicants on the referral list are enrolled based on priority groups and the availability of slot openings. Keep your contact information current and respond promptly to any letters, calls, or portal notifications so you do not miss follow-up about your referral.

For transition-aged students, the practical advice is to submit the self-referral by age 16. Even if your child doesn't need adult services for several years, getting on the referral list early is the only protection against the wait.

Other DD Services Outside ECF CHOICES

The DDA also connects families with services that don't require ECF CHOICES enrollment, including the Family Support Program, which provides small annual grants to eligible families, information and referral services through regional offices, family engagement and peer support programs, and connections to community organizations like The Arc Tennessee and the Tennessee Council on Developmental Disabilities.

Tennessee Vocational Rehabilitation operates independently from the DDA system and provides employment-focused services — job development, career coaching, assistive technology — to any eligible person with a disability, regardless of ECF CHOICES status.

The Tennessee IEP Transition to Adulthood Guide includes a DDA intake tracking sheet that helps you document every step of the application process — from initial self-referral through MCO assignment and Support Coordinator contact.

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