Introduction to DD Services
Approximately 84,000 people with developmental disabilities live in non-institutional settings in Tennessee. Conditions resulting in DD include mental retardation and severe, chronic disabilities such as cerebral palsy, spina bifida and autism. An estimated 44,000 people in Tennessee have mental retardation, while approximately 40,000 have severe, chronic disabilities other than mental retardation.
The Tennessee General Assembly responded to the needs of people with DD in 2000 by making substantial changes in mental health laws as recommended by the Title 33 Revision Commission. To create an agency home for people with DD, lawmakers renamed the Tennessee Department of Mental Health and Mental Retardation, the Tennessee Department of Mental Health (TDMH). The new law reaffirmed that people with mental retardation were eligible for services and required that people with DD other than mental retardation become eligible for services on March 1, 2002. Any service or support at state expense under this title is subject to the availability of funds appropriated for that purpose by the General Assembly, and unfortunately, funding thus far has not been appropriated to TDMH for this population.
The 2000 revision of Tennessee mental health laws (Title 33) defined terms critical for determining eligibility for DD direct services including developmental disability; serious, chronic disability; mental retardation; and severe disability. These definitions, based on federal definitions of developmental disability and the recommendations of the American Association on Mental Retardation, are shown in the chart below.
Title 33 Developmental Disability Definitions
| Term | Statutory Definition and Tennessee Code Annotated (TCA) Section (§) |
|---|---|
| Developmental Disability | "Developmental disability" means a condition based on having either a severe chronic disability or mental retardation. [TCA §33-1-101(10)] |
| Severe Chronic Disability up to Age Five (5) | "Severe, chronic disability" in a person up to five (5) years of age means a condition of substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disability as defined for persons over five years of age if services and supports are not provided. [TCA §33-1-101(22)] |
| Severe Chronic Disability over Age Five (5) | "Severe, chronic disability" in a person over five (5) years of age means a condition that: [TCA §33-1-101(22)] (A) Is attributable to a mental or physical impairment or combination of mental and physical impairments; (B) Is manifested before age twenty-two (22); (C) Is likely to continue indefinitely; (D) Results in substantial functional limitations in three (3) or more of the following major life activities:
(E) Reflects the person’s need for a combination and sequence of special, interdisciplinary, or generic services, supports, or other assistance that is likely to continue indefinitely and needs to be individually planned and coordinated. |
| Mental Retardation | "Mental retardation" means substantial limitations in functioning: [TCA §33-1-101(17)] (A) As shown by significantly sub-average intellectual functioning that exists concurrently with related limitations in two or more of the following adaptive skill areas: communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work, and (B) That is manifested before age eighteen (18). |
| Severe Disability | "Severe disability" means a disability that is functionally similar to a developmental disability but occurred after the person was twenty-two (22) years old. [TCA §33-5-201(5)] |
Eligibility Criteria
The 2000 revision of Tennessee’s mental health laws (Title 33) allowed people with developmental disabilities (DD) other than mental retardation to become eligible for services effective March 2002 and established a standard for determining eligibility for DD direct services. While people with mental retardation have historically received services in Tennessee, people with developmental disabilities have had more limited and uncoordinated access to state services.
Developmental Disability Eligibility Criteria
| Eligibility Criteria | Developmental Disability is a condition based on: | |
| Severe, Chronic Disability | Mental Retardation | |
| Residence | A person must reside in the State of Tennessee. | |
| The presence of an impairment | Is attributable to a mental or physical impairment or combination of mental and physical impairments | As shown by significantly sub-average intellectual functioning that exists concurrently with related limitations in adaptive skill areas |
| The age that the condition is manifested | Before age twenty-two (22) | Before age eighteen (18) |
| The impact of the disability on major life activities | Results in substantial functional limitations in three (3) or more of the following major life activities: a. Self-care |
Related limitations in two (2) or more of the following adaptive skill areas: a. Self-care |
| The need for lifelong services | The condition must result in the person’s need for a combination and sequence of special, interdisciplinary, or generic services, supports, or other assistance that is likely to continue indefinitely and need to be individually planned and coordinated. | |
| Persons up to age five (5) | In a person up to five (5) years of age, severe, chronic disability means a condition of substantial developmental delay or specific congenital or acquired conditions with a high probability of resulting in developmental disability as defined for persons over five (5) years of age if services and supports are not provided. | |
| Exclusion | If a person has a developmental disability solely on the basis of having a mental illness or serious emotional disturbance, the person is not eligible to have services or supports provided for the developmental disability primarily under this chapter. | |