Employment and Community First CHOICES

What is Employment and Community First CHOICES?

Employment and Community First CHOICES is for people of all ages who have an intellectual or developmental disability (I/DD). This includes people who have significant disabilities.

Services help people with I/DD gain as much independence as possible. People are supported to live with their family or in the community, not in an institution. Residential services are available for adults with I/DD who do not live with family but need supports where they live.

Employment and Community First CHOICES can help the person with an I/DD explore the possibility of working. Services can also help people learn skills for work, find a job, and keep a job. This could be a part-time job, a full-time job, or self-employment. Working helps people earn money, learn new skills, meet new people, and play an important role in their communities. Work can also help people stay healthy and build self-confidence.

Other services help people learn and do things at home and in the community that help people achieve their goals. If a person lives at home with their family, the services help the family support the person to become as independent as possible. Services also help people get actively involved in their communities and include peer supports for the person and for their family.

To qualify for Employment and Community First CHOICES, a person must:

  • Provide proof that they have an intellectual disability or other developmental disability.
    • An intellectual disability must start before the age of 18.
    • A developmental disability must start before the age of 22.
  • Qualify financially to get TennCare. This means:
    • As of January 2024, the person’s income can’t be more than the following amount:
      • $2,829 per month if the person is approved with nursing facility level of care;
      • $1,883 per month if the person is not approved with nursing facility level of care, but is approved with at risk level of care; or
      • $3,138 per month if the person is working and has less than $943 in unearned income.
    • These amounts are subject to change each calendar year. If the person’s income is over the limit, they may be able to set up a Qualifying Income Trust. For children under age 18, the parent’s income and resources count too, unless the child is age 17 or older and qualifies for nursing home level of care, or the child is enrolling in or transitioning from Intensive Behavioral Family Supports (sometimes called “Group 7”).
    • The total value of things you own can't be more than $2,000 (The home where you live doesn't count); AND
    • You can't have given away or sold anything for less than what it's worth in the last five (5) years.
    • People in one of the groups on the green page may qualify to enroll in the program and get services now. These are people who need services right away because they have the most urgent needs.
    • People in one of the groups on the pink page may qualify to enroll in the program and get services when there is a slot. These slots are VERY limited right now.
    • If you are under 18 and do not qualify for Medicaid, you may qualify for Katie Beckett

There are 5 benefit groups in Employment and Community First CHOICES (Click each group to learn more):

Group 4 – Essential Family Supports

This group is for families caring for a child under the age of 21 who has an intellectual or developmental disability (I/DD). The child must live at home with their family (not a foster family). Adults age 21 with I/DD living at home with their family may also enroll in this group if they qualify.

Group 5 – Essential Supports for Employment and Independent Living

This group is for adults age 21 and older who have an I/DD. A person age 18-21 with I/DD may be enrolled in this group if they can’t live with their family anymore.

Group 6 – Comprehensive Supports for Employment and Community Living

These services are for people who need more services to help them live in the community and achieve their employment and community living goals. This group is for adults age 21 and older who have an I/DD. A person age 18-21 with I/DD may be enrolled in this group if they can’t live with their family anymore.

Group 7 – Intensive Behavioral Family Supports

This group is for a small number of children under age 21 who live with their family and have I/DD and severe behavior support needs that place the child or others at risk of serious harm. This group provides mental health treatment and other services in the home with the family. The family must be willing to be part of the child’s treatment. The services will train and support the family to support the child so they can keep living safely together. People are usually in this group short-term. Once the person is stable in the community, they will move to a different benefit group that can safely meet their needs.

Group 8 – Comprehensive Behavioral Support for Employment and Community Living

This group is for a small number of adults who have I/DD and severe behavior support needs and are moving into the community from a place with lots of structure and supervision. This could be coming from a mental health hospital, the foster care system, jail, or a nursing home. These services are mostly for adults age 21 or older. But sometimes, a person age 18-20 can get them too. They combine 24/7 residential services with mental health treatment and support. People are usually in this group short-term. Once the person is stable in the community, they will move to a different benefit group that can safely meet their needs.

Please view the Member Benefit Table for a complete list of services covered in each benefit group, how they can help, and any limits.

Joseph’s Story

JT’s Story

Brandon’s Story

April’s Story

Timothy's Story

Employment and Community First CHOICES Videos:


There is a limited amount of funding to serve people each year. This means that not everyone who applies and qualifies can enroll or get services right away. If openings are not available, qualified applicants are placed on a referral list. Qualified members on the referral list are enrolled based on priority groups and the availability of slot openings.

There are different ways to apply for the program. Individuals can apply on their own by completing the online Self-Referral Form. Be sure your web browser (used to access information on the web or internet) is Internet Explorer versions 8, 9, or 10, Google Chrome, or Firefox. TennCare’s Privacy Policies can be found here: Privacy Policies.

A list of possible information that may be needed to complete the financial eligibility part of the application can be found here: ECF CHOICES application items for financial eligibility.

Do you need help to complete the self-referral? We can help you fill out the form OR we can fill out the form for you with the facts you give us.

If you have TennCare and your health plan is Wellpoint (formerly known as Amerigroup), BlueCare, or United Health Care Community Plan, you can call them for free. Tell them you need help with a self-referral for Employment and Community First CHOICES. The number is on your TennCare card. The toll-free numbers are also listed below:​

Wellpoint (formerly known as Amerigroup) 833-731-2153

BlueCare 888-747-8955

United Health Care Community Plan 800-690-1606

If you do not have TennCare you can get help by calling your Department of Intellectual and Developmental Disabilities Regional Office for free. Tell them you need help with a self-referral for Employment and Community First CHOICES. The toll-free numbers are listed below.

West Tennessee Regional Office 800-308-2586

Middle Tennessee Regional Office 800-654-4839

East Tennessee Regional Office 888-531-9876

Additional questions can be directed to the TennCare Long-Term Services and Supports (LTSS) Help Desk at:

1-877-224-0219

Vocational Rehabilitation and TennCare work in partnership to provide employment related services to individuals with disabilities.

For more information or to make a self-referral, Vocational Rehabilitation can be contacted at:

  • Toll free: 833-751-0597

For assistance in getting connected with VR, current members can also contact their MCO:

  • Wellpoint (formerly known as Amerigroup) 833-731-2153
  • BlueCare 888-747-8955
  • United Health Care Community Plan 800-690-1606

For assistance for non-members, you may contact a DIDD Regional Office:

  • West Tennessee Regional Office 800-308-2586
  • Middle Tennessee Regional Office 800-654-4839
  • East Tennessee Regional Office 888-531-9876

Long-Term Services & Supports Help Desk: 1-877-224-0219

LTSS HELP Desk: 1-877-224-0219