Tennessee
Employment and Community First CHOICES
The Employment and Community First CHOICES (ECF) initiative, overseen by TennCare and its managed care partners, helps people with intellectual and developmental disabilities explore career opportunities — supporting skill development, job placement, and long-term employment, including self-employment. The program also funds services that build community skills and meaningful connections.
Who this service is for
- Adults with intellectual and developmental disabilities
- Individuals enrolled in or eligible for ECF CHOICES
- People pursuing competitive employment and community-based supports
What's included
- Pre-employment exploration and discovery
- Job development and job coaching
- Community living and independent living supports
- Family caregiver supports and respite
- Behavior supports and clinical services as part of the plan
What this supports
- A pathway to real, integrated employment
- Supports that adjust as life changes
- Stronger independence and community belonging
How ECF CHOICES works
ECF CHOICES is Tennessee's current program for helping people with intellectual and developmental disabilities build independence, pursue employment, and participate in community life. Services are organized into benefit groups based on a person's age, living situation, goals, and level of support.
- Employment exploration, job development, and support to keep a job
- Community living, independent living, and residential supports
- Family caregiver, respite, behavioral, and clinical supports when included in the plan
Eligibility, enrollment priorities, and available openings are determined by TennCare. Review current ECF CHOICES information from TennCare, or contact us for help finding the right starting point.
How to start
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Reach out.
Call us at (901) 383-9193 or use the contact form. Tell us a little about the person and what kind of support you're looking for.
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We'll help connect you with the right team.
Our team will help determine whether Employment and Community First CHOICES may fit, what funding pathways apply, and what information we'll need to move forward.
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Assessment and planning.
If the service is a good fit, we'll work with the person, family, and care team on assessment, intake documents, and a plan that reflects the person's goals.
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Begin support.
Once everything is in place, services begin. Plans are reviewed regularly so support can grow with the person.
Frequently asked questions
Am I eligible for ECF CHOICES?
ECF is for Tennesseans with intellectual and developmental disabilities who meet specific eligibility criteria. Contact us and we can help you understand how to apply or who to talk to.
How is ECF different from the older Waiver programs?
ECF was designed around employment and community participation as the primary goal, with a flexible benefit structure. Tennessee has been moving more individuals to ECF over time.
Can I keep my current supports if I move to ECF?
In most cases, yes. The transition is planned so existing support relationships continue. We help families navigate the process.
Not sure which service fits?