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Coalition Urges Governor to Use Funds for Home-Based Services

NASHVILLE (June 28) – The Tennessee Coalition for Better Aging called on Gov. Bill Lee and the Bureau of TennCare last week to apply for $157 million in federal Medicaid funding to address critical gaps and challenges for Tennesseans who need home- and community-based services.

The funds are made available to states through the new American Rescue Plan Act (ARPR) however, state Medicaid programs must file an action plan with the Centers for Medicare and Medicaid Services (CSM) no later than July 12.

“This is free money to the state that can enhance home- and community-based services and address numerous challenges in long-term services and supports, including financial incentives for direct care workers, supports for families that care for aging or disabled family members and cost-effective services to maintain independence for aging and/or disabled Tennessee residents,” said James Powers, M.D., geriatrician at Vanderbilt Medical Center and co-chair of the coalition.

The ARPA requires states to maintain current home- and community-based services (HCBS), including funding and eligibility, and use the new federal funds to improve or expand services. The new federal dollars must be spent and services delivered by March 31, 2024.

“The need to invest in home- and community-based care and strengthen our long-term care system has never been greater. Issues that have lingered in recent years were magnified by the pandemic, and it’s time to reimagine long-term services and supports for Tennesseans,” said Grace Sutherland Smith, executive director of AgeWell Middle Tennessee and co-chair of the coalition. “We are encouraged that TennCare plans to take advantage of this opportunity to provide a better, more resilient system for long-term care, informed by stakeholder input and recommendations from our coalition.”

The coalition hosted three virtual meetings earlier this year to gather stakeholder feedback on improving long-term services and supports, and recently sent information to the governor and TennCare, outlining a series of recommendations to improve long-term care, using the federal dollars, including:

  • Addressing the direct-care workforce crisis by developing a pilot program with sign-on and retention bonuses and stipends for child and adult care and transportation, as well as incentives for students to pursue education and certifications and development of a career ladder.
  • Enhancing support for family caregivers who are often forced to choose between staying home to care for a loved one and working outside the home to support their families, including flexible financial support for caregivers to use as they choose, increasing investment in respite care and day programs, and providing assistive devices and home modifications to promote independence and safety.
  • Investing in preventive services to delay or avoid the need for nursing home placement, including restoring the TennCare CHOICES 3 program that is a cost-effective investment, enabling older adults to age in their own homes and be available at the same income limits as nursing home care.
  • Strengthening systems capacity by creating a No Wrong Door (NWD) network, and strengthening assessment and person-centered planning practices, to make it easier for older adults, adults with disabilities and their families to learn about available options and receive person-centered planning assistance that supports quality of life at home and in the community. No Wrong Door (NWD) Systems streamline access to long-term services and supports for all populations and are a key component of LTSS systems reform.

“We have an opportunity now, at no cost to the state, to make meaningful changes to enhance home- and community-based services that will benefit individuals and families for years to come. We cannot afford to maintain the status quo, and our coalition strongly urges the governor and TennCare to develop and submit an innovative plan for the federal funds to support older Tennesseans, adults with disabilities and caregivers across the state,” said Donna DeStefano, assistant executive director of the Tennessee Disability Coalition and secretary of the coalition.

About the Tennessee Coalition for Better Aging

The coalition serves to promote the general welfare of aging Tennesseans and their families, through partnerships that mobilize resources to educate and advocate for important policies and programs. Member organizations who have been leading the “Reimagining Long Term Services and Supports in TN” initiative include AgeWell Middle Tennessee (formerly the Council on Aging of Middle TN), Mental Health America of the Mid-South, Tennessee Association of Adult Day Services, Tennessee Disability Coalition, Tennessee Justice Center and the West End Home Foundation. For a list of member organizations and more information about the coalition, visit

1 Comment

  1. Laura Damon on July 31, 2021 at 12:39 pm

    How do we keep them accountable to this?

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