Employment and Community First Choices

What should I know about Employment and Community First CHOICES (ECF CHOICES)?

Many people with disabilities get their health care through TennCare, Tennessee’s Medicaid agency. Medicaid provides both medical and non-medical services. Non-medical services are called “long term services and supports.” People with intellectual or developmental disabilities can get long term services and supports. These supports are provided through waiver programs. Employment and Community First CHOICES (ECF CHOICES) is a waiver program that helps people with disabilities find jobs and live on their own. You need to be on Medicaid or be eligible for Medicaid to qualify for ECF CHOICES.

There is a referral list for this program, and people with urgent need will get into the program sooner. Those who do not meet more urgent criteria will be placed on the referral list until a slot becomes available. These slots become available when an individual in the program moves out of state, disenrolls, or when state funding is provided for more slots.

Common Terms/Acronyms

ECF CHOICES: Employment and Community First CHOICES program

DIDD: Department of Intellectual and Developmental Disabilities. This agency oversees the ECF CHOICES program.

MCO: Managed Care Organization, or health care provider, that administers ECF CHOICES program. BlueCare, Amerigroup, and United Health Care are the MCOs for ECF CHOICES

Waiver program: long-term services and supports for people with disabilities to help them participate fully in the community

What should students know about ECF CHOICES?

  • The ECF CHOICES program is for people with intellectual and developmental disabilities
  • Although employment is a focus and priority within the program, work is not a requirement for the program
  • Some examples of activities and supports provided by ECF CHOICES include:
    • Helping you decide if you want to work and the kinds of jobs you might like and be good at
    • A chance to try out certain jobs to see what they are like
    • A job coach to support you when you start your job
    • Learning new skills to live independently such as taking care of yourself, your home, or your money
    • Getting help to live independently
  • There is a referral list to get into the ECF CHOICES program.
  • People with more urgent needs are more likely to be accepted to the program first.
  • If you are on TennCare (or Medicaid) already, contact the number on the back of your insurance card to apply.
  • If you are not on TennCare (or Medicaid), contact the Department of Intellectual and Developmental Disabilities in your region and ask for help in applying: tn.gov/didd/about/contact-information.html.

How can I partner with Employment and Community First CHOICES on pre-ETS?

  • Invite an ECF CHOICES advocate to speak at a parent night about the program and walk through the application process.
  • Ask an ECF CHOICES advocate to suggest a success story of someone currently enrolled in the program. Invite that person to speak to your class about their experience.
  • Help students complete the online referral form.
  • For a student who is already enrolled in the program, contact their Support Coordinator and set up a meeting with them to discuss the student’s employment goals.


How do I contact ECF CHOICES?

The ECF CHOICES program is administered by three Managed Care Organizations (MCOs): BlueCare, United Health Care, and Amerigroup. Providers from these MCOs can collaborate on pre-ETS activities. Contact the MCOs individually to find an ECF CHOICES advocate in your area:

  • BlueCare: (888) 747-8955
  • Amerigroup: (866) 840-4991
  • United Health Care: (800) 690-1606

To help students apply to ECF CHOICES, figure out if they are on TennCare already. If so, contact the number on the back of their insurance card to get help applying. If a student is not on TennCare, call the Department of Intellectual and Developmental Disabilities (DIDD) regional office to get help applying:

  • West Tennessee Regional Office: (866) 372-5709
  • Middle Tennessee Regional Office: (800) 654-4839
  • East Tennessee Regional Office: (888) 531-9876

For general questions about long-term services and supports, contact the TennCare helpdesk at 1 (877) 224-0219.

Where do I find more information about ECF CHOICES?

  • Access this complete list of services and what benefits cover it
  • Access this list of who qualifies to enroll in the program
  • View videos about the ECF CHOICES programs and success stories
  • For other information, see the tn.gov website