What ECF CHOICES actually is
Employment and Community First (ECF) CHOICES is TennCare's program for Tennesseans with intellectual and developmental disabilities. Instead of paying for care in an institution, it funds support in the places people actually live and work — a home, a job, a community.
Support is organized into benefit groups. Group 6 covers people with the most complex medical and behavioral needs — the population DHS built its clinical model around.
Who qualifies
Broadly, ECF CHOICES is for people with an intellectual or developmental disability that began before age 22, who are TennCare-eligible and meet the level-of-care criteria for their benefit group. Some groups serve people 21 and older; others start earlier.
Eligibility is a determination, not a guess. If someone has been told 'no' before, circumstances change — diagnoses are documented differently, needs escalate, and reassessment is possible.
How enrollment works
1. Contact the DDA intake line or your TennCare Managed Care Organization to request an ECF CHOICES referral.
2. An assessment is scheduled to document medical, behavioral, and daily-living needs.
3. If approved, a support coordinator helps build a Person-Centered Support Plan (PCSP).
4. You choose the provider who will deliver those authorized services — that choice belongs to the family and the person, not the agency.
Where DHS fits in
Once services are authorized, DHS can deliver residential, employment, day, skills-training, personal-assistance, and transportation supports under one coordinated provider — so a change in need doesn't mean starting over with a stranger.
We also sit with families before enrollment is finished, because the paperwork is easier when someone who has done it before is reading it with you.
Not sure if you qualify for ECF CHOICES?
Our free eligibility consultation walks you through it — no obligation, no pressure.