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October 25, 2013

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October 25, 2013

This week’s edition includes important information I want to share with you:

Sunset Audit: As many of you have probably heard, the Comptroller released a Performance Audit on the department Tuesday morning. While I believe audits are an important management tool to help make sure DIDD is running efficiently and protecting the taxpayer’s money, the department disagreed with some of the findings. Actions have been taken to ensure measures are in place to protect those we serve.

I, along with former Commissioner Henry and other DIDD leaders, testified in front of the legislature’s Education, Health and General Welfare Joint Subcommittee of Government Operations about our audit findings. The subcommittee voted unanimously to recommend a 4-year extension of DIDD’s operations. We appreciate the opportunity to talk to lawmakers about the findings of the audit. Many of them are strong supporters of the work we and the providers do in the community to support people with intellectual and developmental disabilities.

Assistive Technology (AT) Clinic: Last Thursday, I had an opportunity to tour the AT Clinic in Middle Tennessee with representatives from the Bureau of TennCare, including Patti Killingsworth, Assistant Commissioner and Chief of Long Term Care Services; Vaughn Frigon, MD, Chief Medical Officer; David Collier, MD, Associate Medical Director; and Cy Huffman, MD, Medical Director for Blue Care of Tennessee.

clipThe department’s AT Clinics are an integral component of our service delivery system and comprised of experienced therapy staff including an Assistive Technology Practitioner (ATP) certified by the Rehabilitation Engineering & Assistive Technology Society of North America (RESNA), physical therapists, occupational therapists, occupational therapist assistants, and physical therapist assistants. Throughout the tour, Debbie Poirier, AT Clinic Director, and Karen Wills, State Therapeutic Services Director, discussed the benefits of custom seating and positioning for persons with severe physical disabilities, including how it helps to promote optimal health and prevent issues such as skin breakdown and aspiration.
Special thanks to our guests from the Bureau of TennCare for their time and interest, as well as the entire AT Clinic staff for such a thorough and informative visit.

Investigations Review Committee (IRC): This week, the department adopted a revised policy concerning the Investigations Review Committee (IRC). To enhance diversity in the membership, the committee now includes representatives from the Disability Law & Advocacy Center of Tennessee (DLAC), the Arc of Tennessee, the Tennessee Council on Developmental Disabilities, the Adult Protective Services unit of the Tennessee Department of Human Services and a provider representative. Department personnel on the committee are the Deputy Commissioner of Program Operations, the Director of Behavior and Psychological Services, the Director of Nursing, the Deputy Director of Quality Assurance, the ICF/IID Liaison and the Director of Person Centered Practices. Once the committee has rendered its decision, the matter is final. The conclusions of the committee may not be overturned or modified by any DIDD employee. A copy of the policy can be viewed on the DIDD website here.

Fiscal Impact of New DIDD Provider Manual: As many of you know, DIDD conducted an extensive review and revision of the DIDD Provider Manual, which has been condensed from 544 to 225 pages. The department’s approach to this process was to eliminate redundant information, clarify existing provider requirements, describe requirements associated with new waiver services, and describe new processes developed by the department in order to support providers.

In accordance with Tennessee Code Annotated (T.C.A.) 33-5-108, DIDD must assess the fiscal impact on licensees under chapter 2, part 4 of this title, of any change to any rule, regulation, policy or guideline relating to the staffing, physical plant or operating procedures of the licensees for rendering services pursuant to a contract, grant or agreement with the department. In order to accurately calculate the fiscal impacts resulting from changes in the new Provider Manual, the department needs input from every provider and is therefore requesting participation in a survey that can be accessed here. The deadline for survey completion is Friday, November 8 at 4:00 p.m. Please contact April Darby at or 615-253-2389 if you have any questions or issues accessing the link. Your valuable input and time in completing the survey is sincerely appreciated.

DIDD Training Update: The deadline for the final download of CDS historical training records is today. We appreciate everyone’s effort to get staff uploads completed and regret any inconvenience you may experience during the system update. As Relias strives to provide the most current, accurate and interactive content, existing courses will occasionally be retired and replaced with new ones. The Environmental Safety for Individuals with Developmental Disabilities (EL-ESIDD-DD-0) course has recently been replaced with the new Environmental Safety for Individuals with Developmental Disabilities (REL-ESIDD2013-DD-0) course. Please note this was done automatically within the curriculum for new DSP hires and no action is needed for assigning this new course, as it is already part of the existing DIDD curriculum. We suggest running reports on both course codes going forward in order to get completion data for your records, as some staff will have completed the old course and others, the new course. Any agencies who printed off the “Environmental Safety” course should reprint new material from the revised (REL-ESIDD2013-DD-0) course to update their course training materials.

On November 9, four (4) more courses will be archived and replaced with a revised version. No changes will be needed to TNDIDD curricula or any agency curriculum you may have already created which contain any of these courses.

Below, are the upcoming course changes:

  • Strategies for Teaching Individuals with Developmental Disabilities Part 1


  • Strategies for Teaching Individuals with Developmental Disabilities Part 2


  • Making Choices: Supporting Individuals with Developmental Disabilities


  • Signs and Symptoms of Illness and Injury for Individuals with Developmental Disabilities


Replacement courses from the list above are already in the system, so please review and suggest edits during the next two weeks. Please address your suggestions to or If you have any questions, please contact the help desk.

Family Model Residential Services: On September 27, DIDD announced the development of a stakeholder group to build effective strategies that will continue to refine the Family Model Residential Services (FMRS) programs. It is our aim to ensure that persons supported in this model are able to experience the full range of diversity and integration that is an expectation of all DIDD services. Additionally, we need to begin conversations about operationalizing proposed changes to the Provider Manual. If your agency currently provides FMRS programs or you have another intrinsic interest in this residential service model and wish to participate in these discussions, please contact Barbara DeBerry, Director of Provider Supports and Services at

Division of Rehabilitation Services: The Division of Rehabilitation Services Vocational Rehabilitation (VR) Program, will be introducing a new Letters of Agreement process designed to enhance service delivery and establish consistency in practices while promoting accountability and transparency. All vendors wishing to establish or continue a working relationship with the VR program are invited to learn about the changes that will be instituted.

Information on the new letters and procedures for applying to provide services to VR clients will be discussed in a series of meetings held across the state. A schedule of meetings and locations can be accessed here. It is strongly encouraged that all vendors attend at least one of the meetings. All current Letters of Understanding will expire on December 31, 2013.

Former Arlington Developmental Center Property: On Monday, the Executive Subcommittee of the State Building Commission approved a proposal by DIDD to dispose of 416 acres of real property through sale at the former Arlington Developmental Center property. This is another step forward in efforts to use the assets of DIDD to best serve the existing needs of the people we serve.

Johnson City/Greeneville Conservatorship Panel: The DIDD Office of Customer Focused Services in East TN is sponsoring an additional educational opportunity and Question & Answer (Q&A) session for families and DIDD stakeholders on Conservatorships at The Arc of Washington Co. in Johnson City at 11:00 a.m. and at the Greene Valley Developmental Center in Greeneville at 3:00 p.m. on November 5. A panel comprised of an attorney, conservator and advocates will explain the intricacies of conservatorships in the DIDD system.

Discussion topics will include:

  • What is Conservatorship?
  • How do I obtain Conservatorship?
  • Why should I consider Conservatorship?
  • Who can serve as a Conservator?
  • What do Conservators do? What can they not do?
  • What is the difference between a Conservator and Power-of-Attorney?
  • I am already the Conservator… Now what?
  • What are the new laws concerning Conservatorship?

Please contact Dr. Michael Mailahn at: (865) 588-0508, ext. 236 for more information.

Quality Improvement in Long-Term Services and Supports: QuILTSS community forums jointly hosted by TennCare and Lipscomb University, began across the state yesterday. QuILTSS stands for Quality Improvement in Long-Term Services and Supports. QuILTSS is a TennCare project to increase the quality of Long-Term Care Services and Supports (LTSS), provided to TennCare members. QuILTSS will help select ways to measure quality that are most important to people who receive LTSS and their families. These measures will be used to develop a new way to pay for nursing home services and for some kinds of Home and Community Based Services. The 90-minute QuiLTSS Community Forum will include an overview of QuILTSS, as well as other current national and state level quality efforts. Most of the time will be spent working in small groups. You can learn more about QuILTSS here. Dates, times and regions of the QuILTSS Community Forums are here, as well as an invitation to attend.

Be safe and have a great weekend!