Skip to Content

August 23, 2013

Open Line

August 23, 2013

Quality Waiver Review: The Centers for Medicare & Medicaid Services (CMS) recently conducted a quality review of Tennessee’s three Home and Community Based Services (HCBS) Waivers. The overall report of the Statewide, Arlington, and Self-Determination Waivers was outstanding with no recommendations noted. Additionally, the State was found to be in compliance with all six of the review components. Below, is a letter excerpt from CMS addressed to the Bureau of TennCare:

We would like to recognize the exceptional aspects of your waiver program. Specifically, we commend your overall quality improvement strategy, which was designed in accordance with CMS’ expectations to promote discovery, remediation and improvement. By working with the National Quality Enterprise (NQE), hard work and dedication of state staff, Tennessee has turned its waiver programs around from being on the verge of disapproval to becoming a model of best practices for other States.

I am proud to be among so many dedicated people who continually remain committed to ensuring the HCBS Waivers align with CMS standards and protocols. This achievement could not have happened without collaboration and a collective mission to improve the quality of lives for all persons we support. Congratulations on a job well done!

New Employee: Please join me in welcoming Cara Kumari as the new DIDD Director of Communications and External Affairs. Cara has over a decade of experience in the Broadcast Journalism field. She spent the last six years as the state government reporter for WSMV-TV in Nashville, where she was awarded a Regional Emmy for coverage of the 2010 flood. Prior to joining WSMV, she worked for television stations in Wichita, Kansas and Fayetteville, Arkansas. She graduated from the University of Missouri-Columbia and is on the governing board of the local Mizzou alumni chapter. Cara and her husband welcomed a daughter, Scarlett, to their family in March. We are certain Cara’s knowledge and skills will be an asset to the department and are glad to have her.

Director of Provider Supports and Services: The department would like to announce that Barbara DeBerry has been named the new Director of Provider Supports and Services. Barbara has served as the department’s Director of Residential Services for seven years. Her leadership and competency have helped shape our residential service system into one of the most effective in the country. Among numerous other contributions to the department, Barbara has presided over the conversion from utilization of the ICAP assessment tool to the currently utilized SIS assessment tool, served as one of the Subject Matter Experts involved in the design and implementation of the forthcoming Titan System and is a member of several committees within the department. Prior to leading the State’s residential service system, Barbara worked as a member of the DIDD provider community for 18 years, where she led a residential program with a wide focus and admirable reputation for exemplary service delivery. It is this combination of programmatic experience and clear demonstration of State leadership qualities that make Barbara the perfect choice for this instrumental position. Her appointment is effective immediately.

Amended Grant Notice: Last week, the department informed providers of an Employment First grant opportunity for up to five (5) program participants. The purpose of the grant is to increase the number of people with disabilities in obtaining integrated employment. The deadlines for application and the State’s response to questions and comments have now been extended; please click here for further details.

Licensure Update: The department is actively engaged in updating licensure rules currently shared with the Department of Mental Health and Substance Abuse Services. As you are probably aware, most of these rules were last revised in the late 1990s and early 2000. Any recommendations from the provider community on how to improve the rules so they reflect current best practices will be greatly appreciated. Current rules are available here. Comments and feedback can be submitted directly to Lee Vestal, Director of Risk Management and Licensure. Lee can be contacted at 615-253-8733 or via e-mail at

Persons Supported and Health Issues: Nausea and vomiting are not diseases, but rather are symptoms of many different conditions, such as infection, food poisoning and gastroenteritis, motion sickness, overeating, bowel obstruction, concussion or brain injury, appendicitis, and migraines. Usually vomiting is harmless, but it can be a sign of more serious illnesses. Some examples of serious conditions that may cause vomiting include concussions, encephalitis, meningitis, bowel obstruction, heart attack, and brain tumors.

Another concern with vomiting is dehydration. Persons with intellectual and developmental disabilities (IDD) are at greater risk of becoming dehydrated, especially if vomiting occurs with diarrhea because they may often be unable to detect the symptoms of dehydration, such as increased thirst and dry lips or mouth. Persons caring for persons with IDD need to be aware of these visible signs of dehydration: dry lips and mouth, sunken eyes, rapid breathing or pulse, and decrease in urination.

Persons with IDD should see a doctor if vomiting lasts more than one day; diarrhea combined with vomiting lasts more than 24 hours; there are signs of dehydration; there is a fever higher than 102 degrees Fahrenheit; or no urination occurs for eight hours. If vomiting does not resolve 24 hours after evaluation, a doctor should be consulted. Immediate attention should be sought if the following signs or symptoms occur: blood in the vomit; severe headache or stiff neck; lethargy; confusion; decreased alertness; severe abdominal pain; vomiting and diarrhea are both present; and rapid breathing or pulse.

Customized Employment: On August 15 and 16, Michael Callahan conducted the third series of training on Customized Employment that was held at the Vanderbilt Kennedy Center. The sessions primarily focused on creating a Visual Resume that can be presented to employers when conducting Job Development. Participants also learned how the visual resume can be tailored to meet specific preferences. Agencies that participated in the training were DIDD, Department of Labor and Workforce Development, Department of Rehabilitation Services, a representative from Metro Public Schools, one representative from Williamson County Public Schools, representatives from Next Steps at Vanderbilt, Rochelle Center, SRVS, and one representative from Orange Grove Center. If your agency is interested in obtaining information regarding Customized Employment, please contact Amy Gonzalez at 615-532-6119 or

Employment Presentation: On September 30, Subject Matter Expert Nancy Gurney will conduct a presentation regarding Ticket to Work and applying to become an Employment Network. After the presentation, providers will have an opportunity to engage in a “Q&A” session with Nancy, SRVS, Rochelle Center and DIDD. Nancy will present at the Tennessee Department of Labor and Workforce Development (220 French Landing Drive, Nashville, 37243 in the Tennessee Conference Room side A from 1:15 p.m.-4:00 p.m.). For more information, please contact Amy Gonzalez.

Tennessee Leadership Government Council News: Governor Haslam has tasked our DIDD committee with creating suggestions to improve employee customer service. Please submit your creative ideas to Thomas.O’ or call him at 615-517-6088. Our goal is to develop either a new employee customer service training module or devise ways in which employees can improve customer service in their everyday interactions. If you are a graduate of Tennessee Government Executive Institute (TGEI), Lead TN or Tennessee Government Management Institute (TGMI), don’t miss the Tennessee Leadership Conference scheduled for October 30 at the Curb Event Center located at Belmont University. All invitees should have already received an e-mail with registration information and conference details.

New Jackson Focus Group: The first Jackson focus group meeting will be held from 12:00 p.m.-2:00 p.m. on August 28 at the STAR Center in Jackson (1119 Old Humboldt Rd). Please plan on attending and bring your own sack lunch and drink; other snacks will be provided. Please RSVP to Yolanda Beason at 901-745-7523.

clip2013 Tennessee Community Organizations (TNCO) Awards: SRVS has announced their award recipients for the 2013 TNCO Awards, held on August 14. SRVS staff won in several categories: Wendy Saulsberry, a direct support professional in SRVS Community Living Program, won the Outstanding Direct Support Professional; George Martin, who resides in a SRVS supported home, won the Individual Achievement Award; Director of SRVS Community Employment Services Donna Palmer, won for Outstanding Manager and SRVS Public Relations Department Communications Coordinator Amanda Chisholm and Speak Creative won the Community Outreach award for SRVS website. Pictured with me left to right are Wendy Saulsberry, George Martin, and Donna Palmer. Congratulations to this year’s honorees!

Correction: In last week’s edition, the Community Conversations date listed for Greeneville was incorrect. Please note the correct date is September 16 from 6:00 p.m.-8:00 p.m. at the Comfort Inn on 1790 E Andrew Johnson Hwy. Please contact Sarah Harvey at if you have any questions.

DIDD Training Update: Some providers have noticed that one Relias course is now notated with “Retired 20130814.” Relias Learning continues to upgrade and revise course content and when a course is updated, transcripts will display with the course name “retired” and the date it was retired. This does not mean a learner has to complete the new version of a course. Transcripts with a “retired” notation will still meet the training requirement if completed within the necessary timeframe.

Relias Learning is pleased to announce their annual Relias Learning User Conference in San Antonio, Texas that will be held September 24-26 at the Sheraton Gunter Hotel. The conference offers something for everyone from new customers to advanced users and everyone in between. Training will cover beginner to advanced Learning Management System (LMS) topics like curriculum building, reports and user management. Breakout sessions will cater to all users, present a greater knowledge of LMS, your industry, and the team that serves you at Relias Learning. Click here for registration information, the agenda, and keynote speakers. There is no registration charge for the conference.

Please access our website here which has a FAQ section, recorded webinars and information on Relias courses that will meet Commission on Accreditation of Rehabilitation Facilities (CARF) and other accreditation requirements. Relias, in partnership with CQL, also offers courses on Personal Outcome Measures. Additionally, webinars will be offered in September if providers have any topics they’d like covered. Please send suggestions to

Project Titan Regional Provider Meetings: Beginning in September, the department will be hosting a series of Regional Provider meetings to provide information related to Project Titan. The purpose is to solicit input and feedback from the provider community and share information regarding proposed changes to current business practices. We feel that collaboration with providers is essential to the successful implementation of the Titan solution. In order to maximize the time available for these meetings, DIDD will host a web conference on Tuesday, August 27 from 9:00 a.m. to 11:00 a.m. (CST). During this web conference, we will present an overview of Project Titan, including the project scope and proposed project schedule. We will also discuss the format of meetings that will take place in each region based on the schedule provided below. This web conference will be recorded and posted to the DIDD website for providers that are unable to attend due to the short meeting notice.

In order to attend the web conference, participants will need an internet connection and a computer equipped with either internal or external speakers. Meeting schedules are listed below and locations for each will be updated in next week’s edition:

  • East Region
  • Memphis
  • 9/4/2013
  • 1:00 PM – 5:00 PM (CST)
  • Jackson
  • 9/6/2013
  • 8:30 AM – 12:30 PM (CST)
  • Middle Region
  • Nashville
  • 9/9/2013
  • 8:00 AM – 12:00 PM (CST)
  • Nashville
  • 9/9/2013
  • 1:00 PM – 5:00 PM (CST)
  • West Region
  • Knoxville
  • 9/11/2013
  • 1:00 PM – 5:00 PM (EST)
  • Greeneville
  • 9/12/2013
  • 8:00 AM – 12:00 PM (EST)
  • Chattanooga
  • 9/13/2013
  • 8:00 AM – 12:00 PM (EST)

To join the web conference, participants should enter the link below in their web browser: Select the option to enter as guest, type in your agency’s name, and click on the option to enter the meeting room.

You may be prompted to install an Adobe Connect Add-In, which may take a few minutes to download and install. You may also need to temporarily disable your pop-up blocker. If you have never attended an Adobe Connect meeting before, you can test your connection before the meeting using the link here. We look forward to your participation in these meetings.

clipGreene Valley: Rev. Frankie Isley, Greene Valley’s longtime spiritual volunteer, had long dreamed of hosting a gospel concert on campus. He knows how much the people who live there enjoy the ole’ time southern gospel tunes because that is what they sing at his regular Tuesday night church services in Pinewood Cottage. Once Rev. Isley learned that the gymnasium was recently equipped with air conditioning, he set the wheels in motion. Rev. Isley invited the popular southern gospel group, The Foundations and the rest is history! Over 170 people including those from the East Tennessee Community Homes and the local community, filled Greene Valley’s gymnasium for an evening of spiritual inspiration. Some sang along with The Foundations and those that could not sing displayed their enthusiasm. It appeared the evening was a huge success and that another concert should happen in the near future.

Have a nice weekend!