2024 TDC State of the State Rapid Recap

The Tennessee State Capitol building lit up at night and behind a set of ascending stairs

Tonight, Governor Bill Lee gave his first State of the State Address of his second term in office. Governor Lee’s theme this year, “Fortify”, set the stage for his second term, where he stated that he intends to solidify the gains of his first term, and build off of those policies and programs going forward. This year, however, Governor Lee does not have the luxury of another multi-billion budget surplus, instead facing a revenue shortfall of about $280 million so far in the fiscal year. 

One of the most important and exciting announcements of the State of the State address was the introduction of a new Department of Disability and Aging. The proposal combines the Tennessee Commission on Aging and Disability (TCAD) and the Department of Intellectual and Developmental Disabilities (DIDD) into one comprehensive department that serves Tennesseans across the age span and disability spectrum. This has long been a goal of TDC, as well as the disability and aging community, and is a welcome (if not overdue) proposal. 

The benefits of such a department would be to streamline and facilitate collaboration across departments and to secure more resources for the needs of Tennesseans with disabilities, those who are aging and those who experience both. Keep in mind, this proposal is only in bill format, so it’s important that the disability community work to support its passage. You can find the text of the proposed bill at this link.

Governor Lee also highlighted what is likely to be his signature effort for the current legislative session in his proposal for a universal private school voucher program. Currently, the state offers ESA’s (Education Savings Accounts), often referred to as “vouchers”, in only Davidson, Shelby and Hamilton Counties, and only to children whose families meet the income restrictions. Governor Lee’s proposal expands the program over the next two years statewide, and without income restrictions. 

While public schools have certainly failed more than a few children with disabilities, access to private school is no surefire solution. It is important that parents and families are aware that private schools are not obligated by IDEA (the federal Individuals with Disabilities Education Act), meaning that there are fewer protections for students’ rights to special education services, and that the extent and quality of services that are offered are likely to be substantially diminished. School vouchers may work for some families of children with disabilities. However, Tennessee already has the Individualized Education Account (IEA) program, which offers education funds exclusively for students with disabilities. Of note, often the kids with disabilities who take part in the IEA program choose homeschooling, rather than attend a private school. We will be keeping watch on the text of the proposal with the interests of students with disabilities in mind. The text is not yet available, but when it is, you can find it here.

In the 2023 Tennessee Disability Scorecard, the state of Tennessee earned an F in the area of Housing, as only 5 counties in the state are affordable for a household with a disability to purchase a home. In his speech, Governor Lee announced statewide housing permitting reform, which he describes as intended to streamline the process for new construction of homes. We certainly need more housing in Tennessee, of all forms (especially accessible housing), and other cities and states have found success with permitting (more specifically zoning) reform. We’ll have to await details of said reform to fully evaluate, but to acknowledge the problem is a fantastic start.

Governor Lee also highlighted big investments in rural healthcare, citing the report from the Rural Health Care Task Force. Access to care in rural parts of the state is sorely lacking, especially for the disability community. We need investments to improve access to home- and community-based services, specialty care and home care. Again, we hope that as the details of this proposal emerge, the Governor’s office will prioritize the needs of rural Tennesseans with disabilities. 

Of note, the Governor highlighted the use of TennCare III “shared savings” to pay for these rural health care investments. TennCare III is the current state Medicaid waiver that outlines all of our TennCare programs. After much back and forth with the Centers for Medicare and Medicaid Services (CMS), TennCare III allows the state to split Medicaid funds that were not spent on the state’s enrolled population, and use those funds for new services or for reaching new populations. While it is important to continue to expand access to Medicaid, it is also concerning that the state was able to achieve over $300 million in “shared savings”, meaning they failed to spend those funds on our current programs and enrollees, likely to the detriment of the state’s disability community.  

While it is important to break down the Governor’s speech, of equal importance is the breakdown of/deep dive into his proposed budget. Here a couple highlights from the 545-page budget:

$273.7 million spending increase for TennCare/DIDD, proposed to:

  • Reduce the ECF CHOICES waitlist; increasing access to existing program offerings
  • Hire more enrollee-facing service positions (case managers)
  • Increase Direct Support Professional (DSP) wages from $15/hr to $15.37/hr
  • Provider rate increases for HCBS
  • Hire more Katie Beckett case managers
  • Add additional Katie Beckett part B slots
  • Fund Department of Children’s Services (DCS) specialized treatment for kids in foster care

$6.4 million for the Department of Mental Health and Substance Abuse Services


\While these funds proposed in the Governor’s budget are important, they are also reflective of the changed status of our state’s budget. Operating from a deficit rather than a surplus changes the types of investments the state is willing to make for the Tennessee disability community. The investments proposed by the Governor for disability services, as well as the establishment of a new Department of Disability and Aging, are indeed very welcome, however, we as a disability community should also not cease to advocate for our needs.

A budget proposal is also a statement of values. We are still waiting for Governor Bill Lee to elevate the priorities of the disability community to expand Medicaid, support family caregivers, fund special education programming, and create behavioral health services for Tennesseans with co-occurring diagnoses. These types of investment in 2024 would have gone a long way.

As we watch the General Assembly debate the final budget in the coming months, we must raise our voices together and demand a better state. This means that the state must consider the disability community – a full 1/3rd of the state’s residents – at every turn; this means “Nothing Without Us” at the Capitol. 

Please consider joining us on February 28th for Disability Day on the Hill to join us in challenging our elected officials to do better by our community– no proposal without the disability community – “Nothing Without Us”. Follow this link to RSVP.