Comprehensive Aggregate Cap Waiver Program

Comprehensive Aggregate Cap Waiver

The Comprehensive Aggregate Cap (CAC) Waiver (#0357.R04), formerly known as the Arlington Waiver, offers supports to individuals with intellectual disabilities who are former members of the certified class in the United States vs. the State of Tennessee, et al. (Arlington Developmental Center), former members of the certified class in the United States vs. the State of Tennessee, et al. (Clover Bottom Developmental Center), persons discharged from the Harold Jordan Center following a stay of at least 90 days, and individuals transitioned from the Statewide Waiver (#0128) upon its renewal on January 1, 2020, because they were identified by the state as receiving services in excess of the individual cost neutrality cap established for the Statewide Waiver. CAC Waiver participants, who had formerly been institutionalized in a public institution, are part of a certified class because they were determined to be at risk of placement in a public institution, or have significant services/support needs consistent with that of the population served in a public Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) and who qualify for and, absent the provision of services provided under the CAC waiver, would require placement in an ICF/IID.

The CAC Waiver offers a continuum of services that are selected by the person pursuant to a person-centered planning process and support each person’s independence and full integration into the community, including opportunities to seek employment, work in competitive integrated settings, and engage in community life. Services are delivered in a manner which ensures each individual’s rights of privacy, dignity, respect and freedom from coercion and restraint; optimizes individual initiative, autonomy, and independence in making life choices; and are delivered in a manner that comports fully with standards applicable to HCBS settings delivered under Section 1915(c) of the Social Security Act, including those requirements applicable to provider-owned or controlled homes, except as supported by the individual’s specific assessed need and set forth in the person-centered Individual Support Plan.

The Department of Intellectual and Developmental Disabilities (DIDD) serves as the Operational Administrative Agency for this waiver, which is administered under the administrative oversight of TennCare.

Consistent with the special terms and conditions of the State’s approved 1115 demonstration and the June 2015 guidance issued by CMS, Tennessee utilizes tiered standards in its HCBS programs, working to ensure minimum compliance across settings in its Section 1915(c) waivers while closing all new enrollment into these waivers and directing all new HCBS enrollment into the Employment and Community First CHOICES program. However, the Tennessee CAC Waiver remains available to Tennessee residents in the target population who:

a. Meet TennCare ICF/IID level of care criteria (TennCare Rule 1200-13-1-.15) and financial eligibility criteria and have a Pre-Admission Evaluation approved by TennCare;

b. Have been assessed and found to have an intellectual disability manifested before eighteen 18 years of age, as specified in Tennessee State law (Tennessee Code Annotated, Title 33-1-101); AND

c. Were enrolled prior to July 1, 2016 or have been identified by the state as a person discharged from the Harold Jordan Center following a stay of at least 90 days.

Accordingly, a person must need at least one waiver service in addition to independent support coordination on an ongoing basis—at a minimum, quarterly. If you qualify for care in an ICF/IID, you have the right to choose between receiving supports in home and community based settings (HCBS) or receiving supports in institutional ICF/IID care. If you choose to receive HCBS waiver program services, you will still be eligible to receive your regular TennCare benefits. The following waiver services are available based on assessed participant need:

  • Behavior Services
  • Behavioral Respite Services
  • Community Participation Supports
  • Dental Services
  • Environmental Accessibility Modifications
  • Facility-Based Day Supports
  • Family Model Residential Support
  • Individual Transportation Services
  • Intermittent Employment and Community Integration Wrap-Around Supports
  • Medical Residential Services
  • Non-Residential Homebound Support Services
  • Nursing Services
  • Nutrition Services
  • Occupational Therapy Services
  • Orientation and Mobility Services for Impaired Vision
  • Personal Assistance
  • Personal Emergency Response Systems
  • Physical Therapy Services
  • Residential Habilitation
  • Respite
  • Semi-Independent Living
  • Specialized Medical Equipment & Supplies & Assistive Technology
  • Speech, Language, & Hearing Services
  • Support Coordination
  • Supported Employment-Individual
    • Exploration
    • Discovery
    • Job Development
    • Job Coaching
  • Supported Employment-Small Group
  • Supported Living Services
  • Transitional Case Management