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TennCare CHOICES in Long-Term Services and Supports, abbreviated as CHOICES, caters to adults aged 21 and above who have physical disabilities and seniors aged 65 and older. CHOICES offers a range of services aimed at enabling individuals to reside either in their private homes or within the community. These services fall under the category of Home and Community Based Services (HCBS) and can be administered in various settings, including homes, workplaces, or community environments. They are designed to assist with daily living tasks, facilitating individuals' ability to work and actively participate in their local communities. Additionally, CHOICES ensures that nursing home care is available when necessary.

Call 1-866-836-6678 from anywhere in the state to be automatically directed to your nearest Area Agency.

LTSS Help Desk: 1-877-224-0219

What Home Care Services Does CHOICES Cover?

CHOICES provides a range of home care services to meet your needs. Your Managed Care Organization (MCO) will assist you in determining which services are suitable for you. Below are some of the home care services covered by CHOICES, along with brief descriptions:

Some of these services can be arranged through Consumer Direction, which grants you more control over the selection and management of your care providers. You can even hire people you know, but certain responsibilities come with this choice, like hiring, training, and scheduling workers.

For more information and to determine your eligibility for these services, please contact the LTSS Help Desk at 1-877-224-0219. We are here to support and complement the care already provided by your family and friends, not to replace it.

Choices Homes Care

What Does Employment and Community First (ECF) CHOICES Cover?

The Employment and Community First (ECF) CHOICES program is overseen by TennCare in partnership with contracted managed care organizations (MCOs). This program is designed to assist individuals of all ages who have intellectual or developmental disabilities, including those with significant disabilities. The program's main objective is to promote independence and community living rather than institutionalization. It offers various services, including residential support for adults with disabilities who don't live with family but require assistance in their living arrangements.

One key aspect of the program is its focus on employment. It helps individuals with disabilities explore job opportunities, acquire work-related skills, find employment, and maintain their jobs, whether part-time, full-time, or self-employment. Employment not only provides financial benefits but also fosters skill development, social interactions, and a sense of community engagement. Additionally, the program offers services to help individuals with disabilities achieve personal goals both at home and in their communities. These services include peer support and assistance to families when the individual lives with their family. Employment and Community First CHOICES provides a comprehensive array of employment-related services, such as career exploration, job preparation, job coaching, and guidance on managing earnings in relation to other benefits like Social Security and TennCare. All services are community-based, tailored to individual needs, and applicable to all working-age individuals, beginning at age 16. While some services have specific eligibility criteria and limitations, a complete list of services is available for reference.


Even if an individual or their family believes they can't work due to their disability, the program offers support in exploring various options, finding suitable employment, or creating customized job opportunities. For those not yet of working age, the program can help prepare them for future employment and community integration. If individuals are not interested in pursuing employment or have reached retirement age, the program offers alternatives like Community Integration Support Services, Independent Living Skills Training, Personal Assistance, Enabling Technology, and other supportive services tailored to the needs of people with disabilities. Importantly, participation in the program does not jeopardize other benefits like SSI (Supplemental Security Income). The program includes a Benefits Counseling service to help individuals understand how their income from employment may affect their other benefits, ensuring that they can make informed decisions about their financial well-being.

For more information and assistance, please contact the LTSS Help Desk at 1-877-224-0219.


It's essential to be aware that there is a limited annual budget allocated to serve individuals within this program. Consequently, not everyone who wishes to apply will be able to enroll or receive services immediately. To offer some clarity, we have provided a list of groups that may qualify for immediate access to services.

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