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April 12, 2013

Open Line

This edition of Open Line includes important information I want to share with you:

Statewide Waiver Reengineering: As the Statewide Waiver is due for renewal in December 2014, department staff are in the early stages of internal discussions on design, services, and innovation.  As part of the development process, research into the services, funding, and number of persons supported in other states is critical to the success of Tennessee’s reengineered waiver.  The department is looking forward to working with providers and all interested parties in developing a waiver that will benefit as many Tennesseans with intellectual disabilities as possible. 

Departmental Initiatives:  It is imperative that DIDD strives to enhance the quality of services and supports persons receive.  This week, I’ve asked my staff to reflect and share their thoughts on the department’s top ten initiatives that would help us succeed in our efforts.  Over the next year, we will place an increased emphasis on the following priorities:

1.  Statewide Waiver Reengineering
2.  Supported Employment
3.  Accreditation
4.  Project Titan
5.  Exit Plan Compliance with Arlington Lawsuit
6.  Optimal Health for Persons Supported
7.  Ending CBDC/GVDC Litigation
8.  Ensuring Good Communication
9.  Increasing Quality of our Provider Network
10. Customer Focused Government

Please note the above priorities are not listed in order of importance.  Your continued feedback as to how we can improve our service delivery system is extremely valuable.  We recognize this is a collaborative undertaking.  Moving forward, I will ensure everyone stays apprised of developments pertaining to these initiatives through periodic updates in Open Line.

Legislative Update:  Most of you may remember the story of Lynn Cameron, 19 years old, who was driven from her home in Illinois and abandoned by her mother at a small, windowless bar in Caryville, Tennesee.  Lynn’s story made local and national news.  As a result, legislation was proposed to keep vulnerable adult citizens safe by not allowing a person who has assumed responsibility and is knowledgeable of the person’s inability to care for him or herself, from abandoning the person.  Lynn’s Law (HB 0531/SB 0675) sponsored by Representative Powers and Senator Ken Yager, passed on the Senate Floor yesterday.  The bill is scheduled for House Calendar and Rules next week and is expected to be placed on the Regular Calendar for a vote next Tuesday or Wednesday.  We will continue to inform everyone of the bill’s progress.

Office Moves:  The department currently has several offices throughout the state scheduled for relocation in the near future.  The following is a tentative schedule of the office moves:

Central Office to the Citizens Plaza Building  (September 2013)
Jackson Office to the Lowell Thomas Building (August-September 2013)
Knoxville Office to the Chota Building (June 2013)
Greeneville Office to the Greene Valley Campus (June 2013)
Johnson City Office to the Greene Valley Campus (June 2013)
Chattanooga Office – no scheduled move to report

We will continue to share updates on the moves as more concrete information is available and known by DIDD.

TB Skin Tests:  Dr. Cheetham has advised me that currently there is a national shortage of the solution (called Tubersol) used to do skin testing to determine if a person has been exposed to tuberculosis (TB). This shortage is expected to last at least until the end of May 2013. Both the Centers for Disease Control and Prevention (CDC) and the Tennessee Department of Health have issued guidance on how to handle the shortage. Consistent with these recommendations, Dr. Cheetham has advised the following and I agree:

Continue assessing risk of a person being infected with TB by evaluating any symptoms (e.g., cough, weight loss, etc.) they may have but defer TB skin testing until further notice. Track anyone whose TB skin test was deferred for future testing when Tubersol supplies are adequate.

Quality Assurance surveys will take into account this suspension of TB skin testing.

Family Model Supports Workgroup Update:  The department continues to actively work on exploring the intricacies and best practices currently being utilized by many of our most accomplished Family Model Support providers. At the last workgroup meeting on April 3, we discussed recruitment, protection from harm, and program requirements with department staff and provider representation from all three regions. As we continue to explore the benefits and ever-expanding possibilities for this model of service, input from all stakeholders is essential. The work already accomplished is paving the way for further development and sustainability and I am greatly encouraged by this effort.  The next Family Model Supports workgroup meeting is yet to be scheduled, but I encourage any of you interested in participating to contact Barbara DeBerry at Barbara.DeBerry@tn.gov  for more information.

Quality Review Panel (QRP):  The QRP recently completed surveys of Greene Valley Developmental Center (GVDC) and the East Tennessee Community Homes (ETCH).  Official results from the surveys will later be issued in a formal report.  However, GVDC and ETCH seemed to perform exceptionally well.  Once the report is released, we will detail the results in Open Line.       

Person Centered Organizations:  Becoming a Person Centered Organizations Coaches and Leaders group met this week at Journeys in Community Living, Michael Dunn Center, and Orange Grove Center.  Once again, the sites reported very positive changes for people receiving services and for staff working at the organization, both direct support and management.  The ongoing Coaches Support meetings have been very popular with these sites.  During the Coaches Support, staff receive intensive training and support for each individual Person Centered Thinking tool, including reporting success stories for people using services achieved through the use of the tools. 

In addition, People Planning Together self-advocate trainers from Buffalo River Services worked with a great group of self-advocates at Emory Valley Centers earlier this spring.  For this training, people who use DIDD services are the trainer and work with other people using services to teach them how to speak up and advocate for themselves during planning meetings and in day-to-day interaction.  Emory Valley was delighted to share a story about a person who took the training to heart and came into their offices to speak up for himself.  Since this was the first time something like this ever happened for the gentleman, everyone was thrilled with the outcome for him.  This is a great example of how when supported to do so, people can really find value in their own voice and opinion.

Above all, the people who use our services know how they need to happen.  We just have to find a way to support them to tell us and learn how to listen.  The department would like to thank these providers and all those who have been involved with this project for their time and support in learning how to support people to have fulfilled lives.

Self-Advocate Mentors:  Becky Hanson, CQL Director of Accreditation, visited Nashville in late March to continue training the advocate mentors.  To refresh your memory, advocate mentors are key stakeholders in the accreditation process.  They are being trained to facilitate self-advocate focus groups across Tennessee for the purposes of gathering data for the accreditation plan to be developed in 2014.  It is an amazing experience to see people stand before a group of peers and professionally facilitate a focused conversation regarding satisfaction with services, providers, and their life in general.  If we expect amazing things for people, they do amazing things.  It’s all about expectations.

DIDD Accreditation Process-What to Expect :  For the remainder of 2013, the DIDD Accreditation Team will be spending the majority of time working across the state to train providers and other stakeholders regarding CQL Personal Outcome Measures (POM) and Basic Assurances expectations.  These expectations will guide the changes that will be made to DIDD system expectations as we continue our accreditation efforts.

Beginning in 2014, CQL will determine the official representative sample of people using services and a sample of providers for which POM interviews and Basic Assurances validation reviews will be conducted.  In addition, regional focus groups for people using services will be held with specific requirements to gather information.  The three Regional Offices will be reviewed by CQL to determine what expectations they have for the stakeholder system and how they communicate these expectations.  Finally, Central Office will be reviewed to determine what support and information is offered to the Regional Offices regarding system expectations.  All of the information will be analyzed and synthesized to determine what the DIDD accreditation plan will contain.  The plan will lead the department to obtain accreditation with CQL.  We have been really pleased with the feedback from all providers who have participated in the training and hands-on workshops statewide.  Please contact Laura Doutre at Laura.Doutre@tn.gov to schedule your Personal Outcome Measures workshop.

Tennessee Works:  Tennessee Works, produced by the Vanderbilt Kennedy Center, is a comprehensive website replete with information on employment of persons with disabilities. 

If interested, please visit  http://gadd.kc.vanderbilt.edu/tennesseeworks/ and bookmark this site as a resource.

Helpful Guide to Understanding Your Remittance Advice:  Some providers have expressed concerns about reading and/or understanding the Bureau of TennCare Provider Remittance Advice, now considered the document of record for payments made to the providers.  A remittance advice guide has been designed by TennCare to assist providers in understanding the TennCare remittance.

TennCare and DIDD want to provide as many tools as necessary to make it easy for you to reconcile your payment information. This guide will help you understand the data listed on the remittance and help you determine the adjudication of your claims.  The remittance advice guide is available for online viewing at:


If you have any questions regarding this guide, please send them by email to DIDD_Monthly.PRA@tn.gov. DIDD Training:  Online training changes are coming.  Our new training partner, Relias Learning, will present additional training at regional meetings the week of April 15. A copy of the agenda is available at:

Please remember the target audiences are your organization’s training administrator(s), as well as interested executives. Registration at each site below will begin at 9:00 a.m. and the meetings will run from 10:00 a.m. to 3:00 p.m. local time.  Refreshments and lunch will be available.  Pre-registration is not required.

Monday, April 15, 2013: West Region
DoubleTree by Hilton Hotel Memphis
5069 Sanderlin Avenue
Memphis, TN 38117
Phone: 901-767-6666

Wednesday, April 17, 2013: East Region
DoubleTree by Hilton Hotel Oak Ridge – Knoxville
215 S. Illinois Avenue
Oak Ridge, TN 37830
Phone: 865-481-2468

Thursday, April 18, 2013: Middle Region
DIDD Middle Tennessee Regional Office
275 Stewart's Ferry Bldg: One Cannon Way, Basement Conference Room
Nashville, TN 37214

Training Roll-Out Questionnaire:  The DIDD Office of Staff and Provider Development requests that all providers complete a brief questionnaire on their training experiences.  Please complete the questionnaire and bring to your regional roll-out meeting next week or e-mail the form to Joyce Munda at Joyce.Munda@tn.gov. The questionnaire can be accessed at:

 http://www.tn.gov/didd/vault/newsroom/OpenLine/resources/Training%20RollOut%20Questionnaire%20April%202013%20Rev.docx An Ounce of Prevention:  Last September, the Personal Funds Management policy (# 80.4.3) was updated to include “if applicable” in the clause regarding repayment plans.  The phrase “if applicable” was added because each conservatorship is specific to the person and their needs.  The conservatorship document must indicate that the conservator has authority to make decisions in financial matters and enter into an agreement on the person’s behalf.

This also applies to other financial transactions.  It is not uncommon for a person’s ISP to have statements to the effect that his or her conservator must be contacted before payments greater than a set amount are made from his or her account.  As with repayment plans, these types of statements should not be part of an ISP unless the conservatorship document indicates that the conservator has authority to make decisions in financial matters.

2013 Revolutionary Leaders Series:  A series of webinars will be held in May through July featuring speakers sharing their insight, knowledge, and best practices learned through their work in the disabilities field.  For registration information and a complete list of speakers, please visit:  http://www.tn.gov/didd/vault/newsroom/OpenLine/resources/2013%20Revolutionary%20Leadersflyerv2.pdf