Tennessee

The first in a series on a system change, this report is a collaborative with state developmental disability agencies. In each various location, the goal has been consistent, to create person centered systems that support person directed services. What follows is a brief overview of central ideas including: learning what is and is not working, using value-based skills to drive change, improve quality of life with skills, quality management and organizational development tools.

The Network consists of 10 regional centers funded by the National Institute on Disability and Rehabilitation Research (NIDRR), a division of the U.S. Department of Education. The mission is to provide information and Technical Assistance on the Americans with Disabilities Act (ADA) to individuals, organizations and employers. They provide training materials, referrals, and a searchable database of legal documents, fact sheets and checklists.

Nearly every state provides at least some funds for services for low-income older adults or people with disabilities who have too many assets to qualify for Medicaid. AARP reports on how much each state spends on both multiservice and single-service programs. It also compares funding sources, eligibility criteria, services, cost management strategies, consumer direction, and other characteristics.

Medicaid currently fills in the gaps in Medicare’s benefit package for 8.8 million enrollees with limited income and resources (dual eligibles). Shifting aspects of this financing to the Federal government could save states money and create opportunities for better care management and coordination. Data tables show how much each state could save if certain financing roles were shifted.

This spreadsheet provides a list of ADRC program sites and information about which organizations are operating the ADRC and the services and functions they provide. The list is organzied by state and then country.

Recognizing caregivers' needs, many federal and state lawmakers have spent the past several years introducing legislation to provide supports to caregiving families. Unfortunately, fiscal crises and other pressing social concerns have meant that few of these proposals have actually passed or been enacted. Trends in caregiver legislation introduced in 2007 and 2008 are summarized and those that have been successful are highlighted.

The study compares monthly income for people receiving Supplemental Security Income (SSI) to local median incomes and Fair Market Rent rates for modest units across the U.S. In 2008, there were 219 housing markets in 41 states where recipients of SSI, people with long-term disabilities and virtually no assets, would have to pay 100% of their income for a modest one-bedroom unit. Ten years ago there were 44 such markets in 13 states. Policy recommendations are given to reverse this trend.

Follow the link for a comprehensive listing of state statutes, regulations, policies, and procedures regarding the use of emergency or planned physical, chemical, mechanical, or other restraints. Additional documents offer information on positive behavior support guidelines, training manuals, and other policy-related materials. Many emphasize the use of positive or non-aversive interventions. Links are provided to access documents on many state DD agency websites.

Three key issues affecting the understanding of low rates of successful employment outcomes for people with mental illness are explored. These are: lack of a common definition of successful employment; lack of clear, objective, standardized data; and differences among states and programs in measuring client characteristics. Peer critiques to the data and analysis are provided along with tables comparing employment outcomes by state.

When states are unable to serve all those eligible for vocational rehabilitation services, they are obligated to use an “order of selection” and first serve people with the most significant disabilities. The paper informs policymakers, agencies, providers, and consumers about the frameworks used by the federal government and selected states to deal with this issue.