How to support people with intellectual and developmental disabilities

• Opinion: Employment and Community First CHOICES is the first program of its kind in the nation.
• Amber Cambron is president and CEO of BlueCare Tennessee.

At age 3, doctors said Ryan Denton would never even walk, run or write his name. 

He’s diagnosed with mild intellectual disability, Apraxia and seizure disorder. When we met him last summer, he had already accomplished more than anyone expected. His mother, Kim, told us, “Ryan definitely has perseverance.”

She also recognized that Ryan still had potential to push even further. So when TennCare launched a new program called Employment and Community First CHOICES, Ryan was among the first people to sign up.

Our team at BlueCare Tennessee was just as eager to participate.

We’ve been a Medicaid managed care organization since 1994, and we have had the privilege of serving members with long-term service and support needs through the CHOICES program since 2010. 

CHOICES prioritizes home- and community-based services – rather than institutional living – for seniors and adults with physical disabilities. And members are grateful for the services and supports that are helping them remain connected to their communities.

In addition to improving quality of life, the CHOICES program is helping TennCare serve more people in a more cost-effective way. 

Now, the Employment and Community First CHOICES program is bringing similar benefits for Tennesseans with intellectual and developmental disabilities – helping them set and achieve their own goals for employment, independent living and community integration. 

Launched a year ago this month, Employment and Community First CHOICES is the first program of its kind in the nation. Together with TennCare, the provider community and the members we serve, we’re learning how to ensure people get the services and supports they need to thrive.

When Employment and Community First CHOICES launched, there were 6,000 individuals on the waitlist for home- and community-based services. That didn’t include people with other kinds of developmental disabilities who hadn’t previously been eligible for these services in Tennessee.

Those waiting for services face numerous challenges, like finding a job – even though many want to work and end up proving themselves as capable and reliable employees. Many people were living with a caregiver over the age of 60 and needed to make plans for the future.

When we met Ryan last summer, we paired him with a support coordinator, Kristen Calloway, who helped develop a person-centered plan based on his own goals: getting a promotion at work, learning how to drive and living on his own.

They may sound ambitious for a person with Ryan’s challenges; but his mom told us, “These are goals we’ve had for a long time – goals any parent would want for their children.”

As Kristen says, Employment and Community First CHOICES “is not about saying ‘no.’ It’s about saying ‘yes’ and then asking ‘How can we make this happen?’”

Now Ryan is getting the help he needs to make progress, and his is just one of many success stories.

One young woman who used to spend all her time stuck at home is working a restaurant job, managing her own medical appointments and visiting the library regularly. Another is taking a driving class her family couldn’t afford so she can build independence. 

One young man was frequently in and out of a psychiatric hospital, but now he’s able to have more social interaction and is in job training. He’s stabilized and happier. Another young man has been working since December and moved into his own apartment. 

Today our 29 support coordinators – who have nursing or social work backgrounds – are working with 953 Employment and Community First CHOICES members across the state. 

For those employees, the biggest reward is the hope and help they are delivering, and seeing members’ dreams become reality.

Amber Cambron is president and CEO of BlueCare Tennessee, a wholly owned subsidiary of BlueCross BlueShield of Tennessee.