Katie Beckett, split three ways in Tennessee

Quick read: Tennessee runs more than one school-choice account, including a brand-new universal one and an older disability-specific one. It is one of the states that DOES have a Katie Beckett program, with three parts (A, B, and C). Its main disability Medicaid program, ECF CHOICES, has very limited slots and a referral list.

Tennessee stacks a new account on an older one

1. Education Freedom Scholarship (EFS). New universal program, first year 2025 to 2026.

• 20,000 accounts in the first year. Half are set aside for families at or below 300% of the federal poverty level ($96,450 for a family of four), families eligible for other choice programs, or families of children with a state-recognized disability. The other half are open to any Tennessee family. [EdChoice]
• Maximum account value for 2025 to 2026 is $7,296. Unspent funds roll over. An escalator adds 5,000 accounts in any year that more than 75% of scholarships are awarded, with priority to lower-income students and students with disabilities. [EdChoice]

2. Individualized Education Account (IEA) Program. The older, disability-specific account. Serves students with certain qualifying disabilities. Autism is among the qualifying categories. Funds come from the student's state and local education dollars and can be used for tuition, therapies, and other approved expenses. [TN Dept of Education] UNVERIFIED: the exact 2025 to 2026 IEA deposit amount and whether the IEA is being folded into EFS were not confirmed from a primary source. Confirm at tn.gov/education.

How autism qualifies: for the IEA, autism is a qualifying disability category. For the EFS, a state-recognized disability qualifies a family for the reserved (priority) half of accounts.

ECF CHOICES has very few open slots

Employment and Community First (ECF) CHOICES. The current TennCare program for people of all ages with an intellectual or developmental disability (I/DD). It replaced Tennessee's older DD waivers, which are closed to new enrollment.

• An intellectual disability must have started before age 18; a developmental disability before age 22. [TennCare]
• Enrollment is not guaranteed. People with the most urgent needs ("green page" groups) may enroll and get services now. Others ("pink page" groups) wait for a slot, and TennCare states those slots are "VERY limited right now." Qualified applicants who cannot enroll are placed on a referral list, served by priority group and slot availability. [TennCare]

Tennessee's Katie Beckett has three parts

Tennessee runs a Katie Beckett Program for children under age 18 with significant disabilities or complex medical needs whose families do not qualify for regular Medicaid because of income or assets. It has three parts. [TennCare]

• Part A: for children whose level of care would qualify them for a hospital, nursing home, or ICF/IID, but who are cared for at home. Includes up to $15,000 per year in home and community-based services (respite, supportive home care, home and vehicle modifications), plus full Medicaid.
• Part B: for children who do not meet institutional level of care but are "at risk" of it. They are NOT enrolled in Medicaid and receive up to $10,000 per year in services.
• Part C: keeps Medicaid for a child who already had it but is losing it because parent income or assets went up, or who qualifies for Part A but no Part A slot is open. Part C is used only when no Part A openings remain.

Enrollment caps apply, set by available funding. Families must apply for and be found eligible for Part B before Part A can be considered. TennCare handles financial eligibility; the Department of Disability and Aging (DDA) handles medical (level of care) eligibility. [TennCare]

Tennessee Early Intervention reaches the youngest kids

Tennessee Early Intervention System (TEIS), under the Department of Disability and Aging, IDEA Part C, birth to age 3. Serves children with a developmental delay or an established condition. [TN.gov]

Tennessee's mandate stops at age 12

Tennessee Code Section 56-7-2367 (2006). Requires state-regulated plans that cover neurological disorders to cover treatment of children under age 12 with autism, which the law defines as a neurological disorder. [NCSL] This mandate is narrower than many states (it stops at age 12 and is framed through the neurological-disorder benefit). It does not reach self-funded employer (ERISA) plans.

The wait for a diagnosis across Tennessee

Tennessee has developmental clinics in Nashville, Memphis, Knoxville, and Chattanooga, but rural East and West Tennessee have thin coverage. UNVERIFIED: no current statewide wait-time figure was located from a primary source. TEIS (birth to 3) and school evaluations are common faster entry points.