On April 22nd, the state legislature wrapped up the first year of the 114th Tennessee General Assembly session. This year’s session featured a special session on universal private school vouchers to kick things off, followed by an intense focus on the national immigration debate (among other debates) and concluded with a (sort-of) hard-top hurry-up near the end of session to accommodate a federal corruption trial featuring several current and former members of the Tennessee General Assembly. But overall, this year’s session was a pretty standard session featuring state, local and national policy debates, a little bit of protest, some wins, some losses, and ultimately, a promise to come back in January 2026 and pick up where they left off.
But, to the important stuff, the disability community did ok this year. As is the case every year, we won some, we lost some and others we continue to await their fate. But, as is also the case every year, disability advocates from across the state flexed their political muscles at Cordell Hull, beating back several bad bills, showing up in the hundreds for Disability Day on the Hill and securing legislative wins (and funding) for bills that prioritized our needs and interests. Of our 3-bill slate, TDC and advocates were able to pass one, with two more awaiting the possibility of funding in 2026.
This year was another great testament to the strength of the Tennessee disability community. Not only strength, but also the capacity to diagnose what ails the state and to come up with novel solutions to help address those needs. We know what we need, and we’re not afraid to ask (and sometimes demand) a solution. I take it as a badge of pride that all three of our bills this year were “flagged” by the state in opposition. To be flagged means that a bill is so opposed by a state department (like TennCare or the Department of Disability and Aging/DDA) that they ask the entirety of the Governor’s administration – other departments, lobbyists and legislative leadership – to also oppose. This makes it very difficult for these bills to pass, particularly when the fiscal review process is unhelpful, but it also means we’re getting at something. When those state departments oppose a bill to this degree, it’s because they don’t want to change. But change is what we do, and when it comes from the community, the change we demand is only meant to better serve the disability community.
This is not to dismiss any of the work we’ve collectively done over the last several years, including our many victories, but much of our recent legislative success has been narrowly tailored to the nuanced needs of disparate parts of our disability community. For example, our wheelchair bills (which remain Very Good Bills and greatly impactful) primarily serve those who use wheelchairs. This year, however, we took several swings at issues more universal to the full disability community, including access to care and support for caregivers. And it’s that universality that raised such opposition from the state, and that opposition means we’re getting at the heart of what we need. And aiming directly for the heart is what makes these bills more difficult to pass, but all the more worthwhile to pass. This fight is the long game, and we’re in it for the long game – this year was just the start, but we made our case, put the state on notice and let everybody know we’ll be back for another bite at this apple.
The Session
This year’s session was the first year in the 2-year 114th convening of the Tennessee General Assembly. The first year of a session tends to have a bit more pomp, a bit more flair and a bit more controversy, as legislators look to make their mark early and loudly. This year was no different, and that started with the Governor. Governor Lee called a special session early In January, shortly after the legislature convened, to discuss his proposal for a universal private school voucher bill (which I’ll get to later). This effort sort of upended the typical flow of a first year, which usually follows the convening, where legislators pat themselves on the back and switch offices, the Governor’s State of the State Address, and then a flurry of action to start. Throw in a “snow week” and a special session, and the session began abnormally in fits and starts.
The entirety of the House was up for reelection this year, as well as about half of the Senate, but not a ton changed. Of the 99 House Representatives, we saw 9 new faces, and of the 33 Senators, we saw 3 new ones. Of note, Chair of the House Finance, Ways and Means Committee, Patsy Hazelwood, was defeated in her primary, and long-serving controversial curmudgeon Rep. John Ragan likewise lost his primary. Senator Jon Lundberg, former chair of the Senate Education Committee, also lost his seat. There were a few other upsets, but some of the turnover was also due to retirement, including those of Good Friends Sam Whitson and Darren Jernigan. The speakers of each chamber – Rep Cameron Sexton and Senator Randy McNally retained their Speakership posts, as did most of the returning leadership in both chambers.
In a growing and concerning trend, for the second year in a row, the state is facing a revenue shortfall when compared to their enacted budget. Last year, the state came up $593 million short in revenue. This year, the state is currently running $11 million behind, which accounts for only about .1% of the budget expended so far. The state spent its budget surplus years lavishly, particularly on corporations like business tax refunds, Ford and the Titans, while cutting off several streams of revenue, such as the alternative business tax, Hall Tax and by creating one-off tax exemptions. It is unlikely that the state enacts many new taxes or other forms of revenue, so this budget circumstance might be typical of future sessions as well.
Unfortunately, this means that the scope of legislative ambition continues to narrow, and even ambitions bills with conceptual support will wither for lack of available funding. At least, for us advocates anyway – Governor Lee once again pushed for enactment of his extremely expensive universal school voucher plan, the General Assembly introduced a bill targeting undocumented students threatened over $1 billion in federal funds, and both the GA and the Gov agreed to $1.5 billion for road repairs. Of note, TennCare also had a bit over $300 million in “shared savings” (aka state and federal Medicaid funds that they failed to spend on the current Medicaid population). Of those funds, $100 million went to storm relief for communities impacted by Hurricane Helene, $78 million went to rural hospitals for uncompensated care and $4 million went to county health departments.
Despite these ostensible financial constraints, Governor Lee presented an ambitious agenda during his 2025 State of the State Address:
- Private School Vouchers: In 2019, the General Assembly passed a new voucher program that was limited in scope, offering a set amount of funding for families in Davidson, Hamilton and Shelby counties who met income and asset limits. The program was eventually expanded to Knox county as well.
- Lee’s new proposal was to expand the program to every county, and to eventually lift all income and asset caps, making all Tennesseans eligible for the program
- Last year, Governor Lee proposed a very similar bill, but ran into deep disagreement between is office and the General Assembly
- Who also had their own internal divisions between the House and Senate
- It was obvious that the Governor had done his homework this time and came to an agreement with the legislature in advance, smoothing the path to enactment
- His call for a special session also added additional pressure for votes – in theory, every vote for or against would be considered throughout the session, as well as budget/funding season
- So if a member voted against, and then wanted funding for their own bills later in the session (or votes/support), their vote could hang over their head and color those decisions
- And ultimately, the bill was indeed passed, and universal school vouchers will come to Tennessee
- But it was close! And not completely along partisan lines either.
- 54-44 in the House, 20-13 in the Senate
- But it was close! And not completely along partisan lines either.
- His call for a special session also added additional pressure for votes – in theory, every vote for or against would be considered throughout the session, as well as budget/funding season
- For us, this flatly doesn’t move the needle toward improving special education, and dedicates public funds to organizations that are legally empowered to discriminate against kids with disabilities
- Beyond that, universal school vouchers have proven to be a financial boondoggle for other states who earlier enacted these programs
- Arizona’s program was originally projected to cost $65 million, but cost the state $332 million in 2024, and is projected to cost $738 million this year, with further projections showing the program to approach a $1 billion per year price tag by 2026
- Now the state faces a $1.6 billion revenue shortfall, and when states come up short on funds, those cuts usually come from the most expensive program
- In which people with disabilities are often the primary beneficiary
- Similarly, Arizona schools on average lost about $300,000 from their public school systems
- Again, special ed is expensive, and when it comes time for cuts…
- Arizona’s program was originally projected to cost $65 million, but cost the state $332 million in 2024, and is projected to cost $738 million this year, with further projections showing the program to approach a $1 billion per year price tag by 2026
- There are many, many ways in which we could improve special ed in Tennessee, most of which require financial resources – this doesn’t do a thing to address that, while simultaneously making it much less likely that the state will invest in those improvements
- And just to note again, the law is explicit in permitting private schools from excluding kids with disabilities
- And if they do accept them, they are not on the hook for providing services (the local public school is)
- And the private school can kick them out at any time, for any reason, including because of their disability
- Beyond that, universal school vouchers have proven to be a financial boondoggle for other states who earlier enacted these programs
- Road Infrastructure: Governor Lee announced in his state of the state address a $1 billion investment toward the $40 billion road and infrastructure (bridges, etc.) repairs and improvement
- The General Assembly LOVED this one, so much so that they added another $500 million toward the fund, totaling $1.5 billion in the budget
- Yes, the roads in Tennessee are littered with potholes, and the bridges require a quick prayer before every cross
- But this doesn’t do much for the disability community, particularly when the need is so great
- No improvements to public transit, paratransit or individual funding for transportation services (like that in ECF or CHOICES)
- The General Assembly LOVED this one, so much so that they added another $500 million toward the fund, totaling $1.5 billion in the budget
- Starter Home Subsidy: Governor Lee also proposed a $60 million fund to offer 0% loans for the construction of new single family homes
- This didn’t get much of a sniff from the General Assembly, and didn’t get a dollar in the final budget
- Tennessee is indeed facing a housing shortage, and the shortage is particularly acute in the disability community
- We need both affordable AND accessible housing
- And sufficient home- and community-based services to permit individuals with disabilities to live in their communities, rather than at home or in institutions
- Which we don’t have
- Tennessee is indeed facing a housing shortage, and the shortage is particularly acute in the disability community
- It’s unclear if this, or any other housing initiatives, will continue to be a priority for Governor Lee
- This wasn’t a great solution in the first place, so I can see him (or the General Assembly) heading back to the drawing board for a better option
- This didn’t get much of a sniff from the General Assembly, and didn’t get a dollar in the final budget
- Freedom for Family Care Act – (aka Paid Family Caregiving: Part 1) this bill would prohibit TennCare for developing or implementing policies that discriminate against family caregivers in the employment of DSP’s
- **2024 Tennessee Disability Scorecard Homework**
- This was our big one this year, and one that’s been a long time coming
- For years, TennCare has used formal and informal means to prevent family caregivers from being compensated for the care they provide, even where the state fails to provide the care it promised
- To be transparent and clear, the bill doesn’t necessarily change the status quo, but lays the foundation for building a comprehensive, supportive and statewide paid family caregiving program
- Essentially, it’s a policy change, not a program
- But it does two things:
- Requires TennCare and DDA to produce a guidance document for providers so that they now feel free to hire, train and pay family caregivers
- It codifies that TennCare may not restrict providers from hiring family members based on a wide variety of statuses, including where the caregiver lives, the nature of the familial relationship or if they are receiving services from an outside provider already
- The goal here is to first knock down all the hurdles to care employment for family members, establish a base of provider agencies who are willing and capable of hiring family members, and set the stage to build a real program
- It may not seem like much, but the leveling of the field has eluded the disability community for ages
- There is one issue that has to be addressed – conservatorship within this new policy
- As a result of the DDA “flag” on this bill, we were forced to capitulate on access for guardians and conservators
- We initially wrote the bill to include conservators unless their conservatorship agreement explicitly prohibited being paid for care
- DDA rewrote that section to require conservators to have explicit permission to be paid
- Which we’re quite sure most existing agreements do not contain, given TennCare/DDA’s long-standing policy against paying family caregivers
- So, that is to say, we still have some work to do, but we’ll do it
- We’ve requested legal language from TennCare that would satisfy the requirement for explicit permission
- We’ve requested DDA reexamine the cap on “legal supports” offered in ECF to better fund these changes
- We’re also trying to spread the word, so that caregivers of those under 18 know that this language should be included in future agreements
- But this is just the start – now it’s back to the community and to the playbook while we design part 2 (and 3 and 4, etc.), to ensure that ALL Tennessee caregivers have support in caring for a loved one with a disability
- HB711/SB706 – TennCare Network Reporting Reform – this bill would require TennCare to collect and publish data about percent service utilization, appointment wait times and time between approval for a service and start of the service, broken down by county and waiver program
- **2024 Tennessee Disability Scorecard Homework**
- This one has not passed the General Assembly (yet) – we took it off notice in the House Insurance Committee to have the chance to try again next year
- The bill did, however, pass through the Senate no problem, and awaits a vote on the floor next year
- The issue here, which will prove to be a theme for the 2025 session, is that there was a large fiscal note placed on the bill
- Reminder: fiscal notes are estimates by the Office of Fiscal Review at the legislature about how much a bill would cost the state (and businesses) to implement
- Also reminder: fiscal notes are very often used as a political tool, with high estimates, faulty assumptions and questionable calculus
- And they are very effective at killing a bill
- Also reminder: fiscal notes are very often used as a political tool, with high estimates, faulty assumptions and questionable calculus
- The fiscal note claimed that TennCare and its MCO partners would need $4.5 million - $1.5M per MCO – to get this data and publish it in disaggregated form in an Excel file
- This is ridiculous – if TennCare and the MCO’s don’t already know this information, that’s a problem
- If they do already know this data, and threw up this fiscal note anyway, that means they’ve got something to hide
- I believe it’s a combination of both – collect no evidence of evil, see no evil, publish no evil
- Reminder: fiscal notes are estimates by the Office of Fiscal Review at the legislature about how much a bill would cost the state (and businesses) to implement
- This remains an important bill, and its intent was to get at one of those root causes/hearts of the issues that I alluded to in the intro
- To fix the issues of the lack of providers available to offer disability services, we need to demonstrate the problem – that was the goal here
- And I believe that this data would have demonstrated that problem, and been impetus to make changes
- To fix the issues of the lack of providers available to offer disability services, we need to demonstrate the problem – that was the goal here
- Which is why we’ll try again next year – either by building the support necessary to pay for the bill, or amending the bill to bring down the cost (without jeopardizing achievement of the goal)
- HB1158/SB1053 – Katie Beckett Part A Wraparound Improvement Act – this bill would permit Part A families to utilize HCBS wraparound services funds using an HRA, similar to that in Katie Beckett Part B
- This one also fell victim to the fiscal note trap
- TennCare, who received $25 million per year to serve up to 300 famillies in Part A, claimed they did not have enough money for 300 families to fully utilize the $15k HCBS funds benefit
- So, backing up, KB has two parts: A and B
- B serves those that are “at risk” of institutional care without these services
- Those in B get $10k in an HRA to help avoid institutional care
- A serves those who already qualify for institutional levels of care, meaning these kids have the most profound disabilities and the highest level of need
- They get enrolled in full TennCare Medicaid, and get $15k in HCBS funds to be spent through the procurement process of their MCO
- B serves those that are “at risk” of institutional care without these services
- That’s the problem – MCO’s make it so hard to use the HCBS funds benefit that families, by TennCare’s own estimation, are only able to use about 18% of the funds, or about $2,600
- We were absolutely outraged by this mismanagement of funds, and certainly made that clear to the legislature
- Who, in many instances, was also pretty upset by that fact
- If you’ve got the stomach to see TennCare defend this in committee, here’s a link (starts at 1:05:55)
- (It’s BS)
- If you’ve got the stomach to see TennCare defend this in committee, here’s a link (starts at 1:05:55)
- But our friends at the GA were just not outraged enough to pay the $541,000 fiscal note
- Who, in many instances, was also pretty upset by that fact
- We were absolutely outraged by this mismanagement of funds, and certainly made that clear to the legislature
- So, this bill achieved the same fate as the Network bill above – passed on merits, but not funded in the budget
- So that means that it will sit in the respective Finance committees next year, hoping to get paid for
- Similarly, we will again make every effort to get this bill its apparently necessary appropriation in the 2026 budget next year
- This one also fell victim to the fiscal note trap
- HB1314/SB1298 – Threats of Mass Violence Expansion – this bill would expand the types of facilities that would be subject to the enhanced felony penalty for a threat of mass violence
- While this bill was important in its own right, our interest in this legislation was the issue at hand, and the increasingly complicated solutions to the issue of threats of mass violence (TMV)
- We heard, all fall, that kids with disabilities were getting caught up in TMV investigations and prosecutions for “threats” they made at school
- Because these laws were overly broad and blunt, sometimes contradictory, and always without much discretion or capacity to consider nuance
- There are 3 primary TMV laws out there – the above one (which passed this year), one that applies to schools, and a zero-tolerance law that also applies to schools
- The above bill contains a bit of discretion and consideration, using the “valid” legal standard (one can reasonably believe the threat is made with intent to carry it out) and requiring one to actually take steps toward carry out the threat to incur a felony
- These are important considerations when evaluating a threat made by a person with a disability
- The school version does not have this nuance or permit this discretion – the only protection it has for a child with a disability is to exclude those with intellectual disabilities
- But this is not something that is established before a child with Autism is arrested at a family birthday party at the Longhorn Steakhouse and taken to jail
- The zero-tolerance version demands a student be expelled for a year if they commit a threat of mass violence, but only, again, if its valid
- The above bill contains a bit of discretion and consideration, using the “valid” legal standard (one can reasonably believe the threat is made with intent to carry it out) and requiring one to actually take steps toward carry out the threat to incur a felony
- So considering these differences, a child could be arrested and charged with a felony but the school would not be able to expel them
- And the first two contradict! Both apply to schools, but the new law that passed this year does not undo the existing one on the books!
- Anyway, the goal here was to begin to have a more rational discussion about how to address this very real issue as it applies to people with disabilities
- And to permit more discretion in investigating, arresting and/or charging an individual with a disability
- I think we made progress in this goal this year while we talked with legislators about the issue
- And I hope to see the GA begin to resolve the problems with these laws.
- HB793/SB836 – Plyler Challenge Bill – this bill would allow public schools in Tennessee to refuse to enroll undocumented immigrant students unless they pay tuition
- First things first, this bill stalled out in the Finance committees, failing to gain enough support for its cost and/or failing to get enough support for a sufficient vote count on the respective chamber floors
- Now, this bill may seem astray from our lane, but as is the case with most disability policy, we’ve got a tangential interest in the outcome
- And that’s because this bill could lead a school district to violate IDEA, the federal special education law (and, as such, the rights of kids with disabilities). It would have done so in two ways:
- First, the law says that schools are obligated to engage in “child find” which means the school has to go out into the community to evaluate kids suspected of having a disability and offer them services if they are found to qualify
- The plain text of the law says that this effort must include “migrant children” as well
- Second, the bill allows schools to charge tuition to undocumented students, which would violate IDEA’s “free and appropriate public education (FAPE)” clause
- First, the law says that schools are obligated to engage in “child find” which means the school has to go out into the community to evaluate kids suspected of having a disability and offer them services if they are found to qualify
- On top of those technical violations of IDEA specifically, the fiscal note of the bill also suggested that the state could lose ALL federal funding if it enacted this law
- That includes IDEA funds meant to serve and educate students with disabilities
- And that’s because this bill could lead a school district to violate IDEA, the federal special education law (and, as such, the rights of kids with disabilities). It would have done so in two ways:
- I think the key caveat here is that I can only accurately say “could”, in the sense that the law could lead schools to violate IDEA (and lose federal funds)
- And that’s because this bill represents a novel challenge to a Supreme Court precedent set in 1982, as much as it is an immigration or education bill
- This means that the purpose of the bill is for it to be challenged in court for its unconstitutionality with the purpose of arguing for the overturning of the 1982 Plyler vs Doe Supreme Court ruling and precedent
- So even if it passed, or passes next year, it’s unlikely to go into effect because it will be immediately challenged in court, and likely enjoined (prevented from going into effect), until it hit the Supreme Court
- And ultimately, rulemaking might have addressed these IDEA concerns, but nobody I spoke to could provide me any assurances for this, nor could they account for what would happen to an undocumented students with a disability
- But this discourse presented other concerns as well – Senator Watson, the prime sponsor of the bill, made the case that this bill was about the excess cost of educating undocumented students and the financial burden this imposed on districts
- Well, to frighteningly extend that logic a bit further, there’s this other population of students who cost even more to educate, and are much larger in number
- That’s right! Students with disabilities served under IDEA
- Again, this is extending his logic, and he did not make the case that he would extend his logic through future legislation, but it remains concerning nonetheless
- Well, to frighteningly extend that logic a bit further, there’s this other population of students who cost even more to educate, and are much larger in number
- Ultimately, the bill did not pass and remains in limbo until next year, when I would assume that the General Assembly takes another shot at passing the bill
- There was a lot of protest around this bill as well, and I’d expect that to return again next year as well
Other stuff we liked this year:
- HB498/SB321 – Reimbursement Rates Task Force – this bill would create a task force to make recommendations on the adequacy of reimbursement rates paid to health care providers
- Who doesn’t love a good task force?! The bill passed unanimously through each committee with very little opposition
- But this is a good idea – reimbursement rates for both health care services, as well as long-term supports and services (LTSS) are inadequate to support the need
- As long as we understand the limitations of a task force – they can’t make anybody do anything – this can’t hurt
- One unfortunate issue with the bill is that it calls for 6 legislators and some state commissioners – no providers, no provider agency, no doctors, no therapists, no consumers or advocates or self-advocates
- Which will limit the scope of their understanding
- Ultimately, they’ll make suggestions about what I assume will be increases to reimbursement rates – it’ll be on the funding state entities to make the call on their suggestions
- But at least they can’t feign ignorance at the inadequacy of reimbursement rates
- Who doesn’t love a good task force?! The bill passed unanimously through each committee with very little opposition
- HB870/SB420 – Pharmacy Financial Assistance Programs – this bill prohibits health insurance companies from exempting medication financial assistance from countable payments to a deductible or out-of-pocket expense limit
- This one is pretty complicated in the details – I’ll refer you to my fuller description from February – but nonetheless a good bill that gets at an important issue but also opens up a larger discussion about healthcare costs and incentives
- Very basically, it prevents private insurance companies (Blue Cross Blue Shield, Wellpoint, United HealthCare, etc.) from reserving consumer financial assistance for expensive drugs for themselves
- But I think the more interesting discussion is around the perverse incentives that drive the behavior of health care and insurance entities
- Insurance companies are (for the most part) for-profit entities, which means they have a profit incentive and a growth incentive
- And that means that the primary driver of decision-making are often those incentives
- Not the health or well-being of a consumer or the financial stability of a provider
- That’s not to say they are evil grubs, just that our system rewards this kind of decision-making
- And that means that the primary driver of decision-making are often those incentives
- In the larger health care discourse now, there is real anger about the behavior of insurance companies, including their tendencies to deny or limit care, to extract money and to generally treat consumers very poorly
- And a counter-argument that “somebody has to limit care in a resource-limited environment” as a defense for health-care decision-making
- But that argument doesn’t stand up in the face of things like the practice this bill is getting at – the hoarding of a benefit meant for the consumer
- This is profit-seeking pure and simple, and it comes at the expense of the consumer
- The GA, seemingly annually, has a bill trying to root out this behavior by prohibiting them, and they often pass!
- However, those motives, along with the ability to pay somebody very well to think of ways to get around those prohibitions and continue to extract from consumers
- It’s a really gross game of whack-a-mole
- Insurance companies are (for the most part) for-profit entities, which means they have a profit incentive and a growth incentive
- All in all, I’m glad the bill passed, but I’d expect the insurance folks to figure out a way around it, and I’d bet we’d see this issue raised again soon
- What that does allow us, however, is the opportunity to continue to take these opaque and extractionary practices to task, and highlight this as behavior that needs to get addressed by legislative action
- This one is pretty complicated in the details – I’ll refer you to my fuller description from February – but nonetheless a good bill that gets at an important issue but also opens up a larger discussion about healthcare costs and incentives
- HB1244/SB881 – PBM Reform – this bill establishes quality standards for the operations of Pharmacy Benefit Managers (PBMs)
- Like insurance companies, Pharmacy Benefit Managers (PBMs) likewise have a profit motive behind their work
- And they have tools at their disposal to extract that profit
- First though, a PBM typically plays the middle man between a drug manufacturer, an insurance company, a provider and a consumer in securing deals around drug costs and access
- Often times, this can be really helpful and good for the consumer!
- But as a mentioned about those “tools” above, they can also take a cut of that consumer benefit for themselves
- In this bill, the sponsors are trying to set standards regarding approval times, accurate rejection of claims and reimbursement times
- Which are tools used to extract those benefits – PBM’s will, say, delay reimbursement by requiring additional documentation in hopes that the provider may just give up or forget or something
- Essentially, they wrap up payments in red tape
- But this is a good bill, and, to bury the lede, one that passed!
- But, as is the case with those health care entities with those profit and growth motives, I’d guess we’ll be back at Cordell Hull again to address the newest iteration of this practice
- Like insurance companies, Pharmacy Benefit Managers (PBMs) likewise have a profit motive behind their work
- HB1330/SB1316 – Less is More Act – this bill establishes means by which members of a in governing body can participate in the proceedings virtually
- So, this was a big bill, one brought by House leadership, that was intended to “cut red tape and regulation” – and it passed!
- Our interest came around our desire to amend the Open Meetings Act here in Tennessee to permit accommodations for participation in state “governing bodies”
- Essentially, we wanted to see the state make more effort (and be legally allowed) to provide accommodations – specifically remote participation – for people with disabilities so they could more easily participate on state and local boards and councils and the like
- And this bill sort-of-without-trying-to got at that issue
- Now, people with disabilities (and others) may participate virtually, and their virtual participation counts towards a quorum and allows them to vote
- One drawback of the way this bill was constructed is that it only applies to “governing bodies” of state government agencies
- So, not local boards, councils or commissions
- One drawback of the way this bill was constructed is that it only applies to “governing bodies” of state government agencies
- It’s a good start – and thanks to leadership who, at no prompting from us, proposed and passed this bill
- It’ll be up to us to continue to build on this one to ensure that Tennesseans with disabilities have the same rights and access to participate in important local, regional and statewide decision-making bodies
- HB401/SB679 – TISA for Pre-K – this bill would apply some TISA formula weights to the state’s pre-kindergarten funding model
- This bill did not pass unfortunately, falling victim to its very large fiscal note ($161.7 million per year)
- And this is a bummer, because pre-k special education in the state of Tennessee is STRUGGLING with its current level of available resources
- We have heard of districts reducing their pre-k SPED offerings to only two days per week, districts that shut down altogether months before the school year ended, and a pending crisis for next year’s options
- And this really, truly is a resource issue – special education pre-k is expensive, and we do not dedicate nearly enough state funds for this
- Which seems to contradict our commitment to early childhood services for kids with disabilities
- Our early intervention system (TEIS) is the only one in the nation without a service gap from age 3 to Kindergarten
- And this required significant investment
- We have two tracks for pre-k disability school-based services, meaning families have options, which is good!
- The state knows, through the design of its TISA K-12 funding system, that SPED costs more to implement, we obviously care about pre-k disability services – let’s connect those dots and pass this one next year
- HB18/SB164 – Temporary Medicaid Expansion – this bill expands Medicaid eligibility to 138% of the poverty line with limits on how long individuals may be enrolled
- So I don’t get your hopes up, first things first: this one did not pass
- But it was fun while it lasted!
- Medicaid Expansion has been a taboo subject (outside of the Democrats) at the General Assembly for as long as it has existed
- Despite the capacity to draw down $1.2 billion in bonus Medicaid funding, the capacity to serve up to 800,000 currently uninsured Tennesseans and the downstream cost savings and health benefits demonstrated by nearly every other expansion state
- This bill was a novel approach by a smart guy (Rep. Baum)
- This aligned the qualifications and limitations in the state’s design of its SNAP program to this potential Medicaid expansion
- It would have made eligibility limited over the course of one’s lifetime (up to 120 months lifetime) and it would have limited consecutive months of enrollment (no more than 12 of each 24 month span)
- So, novel – not perfect or even sufficiently accessible, but novel nonetheless
- It would have made eligibility limited over the course of one’s lifetime (up to 120 months lifetime) and it would have limited consecutive months of enrollment (no more than 12 of each 24 month span)
- This aligned the qualifications and limitations in the state’s design of its SNAP program to this potential Medicaid expansion
- But alas, the cost ($102 million per year), the sponsors (a Senate Democrat) and the immovability of the GA Expansion Taboo doomed this one
- Where it failed in the House Insurance Committee (and wasn’t introduced in the Senate)
- But it was and is a good and necessary idea – I hope to see it back (and perhaps less temporary and more accessible)
- So I don’t get your hopes up, first things first: this one did not pass
- HB372/SB334 – Tennessee Medicaid Modernization and Access Act of 2025 – this bill would align Medicaid reimbursement for some services to Medicare or commercial reimbursement rates
- Like our Network bill mirrored some of the statutes in the new HCBS Access Rule, this bill mirrored a proposal that ultimately didn’t make the final rule, but was a good one nonetheless
- In general, Medicare pays higher rates for services than Medicaid does, for complicated reasons (and TN is extra weird in this respect)
- However, this leads to greater access for Medicare enrollees to receive services
- This bill would have required TennCare/Medicaid rates to match those Medicare (or commercial) rates for primary care, OB/GYB, outpatient mental health treatment and substance-use disorder services
- In general, Medicare pays higher rates for services than Medicaid does, for complicated reasons (and TN is extra weird in this respect)
- Parity is good! And this one is hard to achieve!
- Alas, its cost - $604 million per year – led to the bill’s demise
- It was taken off notice in Finance, so in theory, it could be back, but the cost obstacle remains
- Like our Network bill mirrored some of the statutes in the new HCBS Access Rule, this bill mirrored a proposal that ultimately didn’t make the final rule, but was a good one nonetheless
- OREA Report – this report is the response to a request by Chairman Mark White to study the use of informal removals in Tennessee schools
- This one wasn’t legislative, but it was part of our broader efforts to improve our state schools’ abilities to serve students with behavior needs
- We asked Rep Mark White, Chairman of the House Education Committee, to request the Office of Research and Educational Accountability (OREA) to study the use of informal removals in TN schools
- The goal of this request was two-fold: to get empirical information about the prevalence of informal removals in TN schools, and to begin the conversation by creating a tangible object through which we can discuss these issues
- Demonstrate the problem, then propose solutions to fix it
- Big takeaways from the report:
- We don’t know how much informal removal occurs in TN schools
- We know that they do occur, and now we know more about how and why they occur
- Conclusion: we should better record this information!
- To me, with that conclusion, a future bill on the subject writes itself
- This one wasn’t legislative, but it was part of our broader efforts to improve our state schools’ abilities to serve students with behavior needs
Stuff we didn’t like so much:
- HB932/SB897 – School Cell Phone Ban – this bill would prohibit students from accessing or using wireless communication devices during instructional time, unless related to instruction
- Personally, I’ve come around on schoolwide cell phone bans, and I’m now a believer (in strictly limiting their use)
- That said, it is important that a cell phone ban does not impede a student’s ability to use assistive technology
- Or access any other tech-related service found in their IEP
- That said, it is important that a cell phone ban does not impede a student’s ability to use assistive technology
- All that is to say, the bill passed, and the concept is good, but the protections for students with IEP’s are lacking
- Not altogether, just not comprehensive – it restricts use of tech outside of “instructional time”
- Which doesn’t include things like lunch or recess or any other time where a student may use a device (to communicate, for example)
- And it doesn’t include permission for their use during pre-evaluation interventions, during evaluations or if it is a commonly used tool, but not found in an IEP
- To the last point, IEP’s are typically only updated once per year – in theory, a teacher could implement an intervention using an assistive tech device and that accommodation not be found in the IEP – under this law, that would be prohibited
- Not altogether, just not comprehensive – it restricts use of tech outside of “instructional time”
- I hope that schools feel empowered to use some discretion as they roll this out and permit use for the purposes of accommodating disability where necessary
- It’s just a bummer that those protections aren’t equally codified in the legislative text
- Personally, I’ve come around on schoolwide cell phone bans, and I’m now a believer (in strictly limiting their use)
- HB522/SB386 – Early Warning Signs List – this bill requires schools to establish a system by which school personnel are mandated to report “early warning signs” from students indicating a concern about a wide variety of student issues
- This was an icky one, made ickier by the way the sausage was attempted to be made at the legislature
- Primarily, this one was icky because it required schools to create an opaque “list” of children who present “concerns” – mental health, bullying, etc.
- But it doesn’t do anything about that, like offer services or other interventions, just put them on a list
- Which feels like legally covering one’s behind, rather than trying to help a struggling student
- Plus, we have systems for this already! Counseling! Special Education evaluations! RTI!
- And to add an additional, perhaps overriding, option seems unnecessary at best, rights-defying at worst
- But it doesn’t do anything about that, like offer services or other interventions, just put them on a list
- But what was really ugly about it was who brought it: Raptor Technologies
- Who is a business that just happens to sell a software system that happens to make “early warning signs lists”
- And, it seems to me, this bill was trying to stir up a problem and then offer a “solution” that also offers themselves a big payday from the state
- That’s icky
- Ultimately, some heroic advocates called this out, and called out the concept in general, and were able to kill the bill in Senate Ed
- HB910/SB861 – Human Rights Commission Dissolution – this bill would transfer the responsibilities of the Tennessee Human Rights Commission (HRC) to the state Attorney General’s office
- This one, which effectively dissolves the Tennessee Human Rights Commission, passed
- Which is a bummer, because this is a Very Bad Bill (VBB)
- The Human Rights Commission was created in 1963, and then reorganized in 1978, to solicit and review complaints about Civil Rights violations, and to offer redress for violations when they find them
- They’ve operated independently since the start, which allows them the ability to fairly and neutrally adjudicate these claims
- But, some of those claims came against the state, and the state of Tennessee doesn’t like it when they are adjudicated as rights-violating
- So they hatched a plan to remove independence and roll these responsibilities into the Attorney General’s office
- Who spends most of his time challenging the very legal basis of many rights for marginalized people and groups
- The vast majority of complaints to the HRC were housing complaints, and the vast majority of those are disability rights violations
- There is no guarantee that the AG’s office will do better, let alone resolve these issues fairly
- Further, every current pending investigation will now be dropped, and each claimant is required to start over
- This is a bad bill for civil rights, for human rights, for the disability community and for democracy – including the ability to hold the state to account – writ large
- This one, which effectively dissolves the Tennessee Human Rights Commission, passed
- HB133/SB110 – Residential Pilot Programs – this bill would exempt an organization in East Tennessee from the state’s 4-person/500-yard anti-institutionalization rules
- This, as noted last year, is another of the same type to the bill last year that established the first exemption
- We oppose this bill, and others like it, because we believe fundamentally that people with disabilities should have the highest possible degree of choice in where they live and what they do, and that this choice is best facilitated in the community
- We also oppose this bill, and others like it, because it degrades the firewall protection that has for years prevented backsliding into institutionalization of people with disabilities
- And I believe this concern, based on the very existence of this bill, has been validated
- I won’t get too much into it, but it passed
- We had an agreement on amending the bill to add oversight and accountability that was initially accepted, passed through a committee, and then removed after some icky behind-the-scenes lobbying from an icky third party
- So no oversight, no accountability – these “pilot programs” will automatically become permanent programs in 2032 without demonstrating any evidence that they work
- That’s not a pilot program, and that puts the wellbeing of people with disabilities out of consideration for these programs’ continuation
- We had an agreement on amending the bill to add oversight and accountability that was initially accepted, passed through a committee, and then removed after some icky behind-the-scenes lobbying from an icky third party
- We’ll see another one again next year, and the year after that
- And it’ll only be a matter of time before a bad actor gets a whiff of these exorbitant costs for a spot at one of these places and comes to town asking for the same exemption
- This, as noted last year, is another of the same type to the bill last year that established the first exemption
And with that, we put a bow on the first year of 114th Tennessee General Assembly. It has certainly been an up and down year for the disability community at Cordell Hull, but as always, I’m perpetually impressed by (and indebted to) our community of advocacy. Disability Day on the Hill was again an incredible success with real impact, our disability advocacy groups flexed some muscle to kill some Very Bad Bills (VBB) and many individuals, advocates, self-advocates and families let it be known that we, the disability community, will have our say. That’s not to say we won all the time, but even when we don’t win, our voices are heard, and that’s because of the hard work y’all do every day.
These can be trying times, dear reader, and I understand the impulse to turn away in the face of such concern, uncertainty and peril. But as you show here in Tennessee, the only way to craft a life for yourself and your family is to roll up your sleeves and dig in. The disability community is a model for engagement, even as our plates overflow, because we know its importance, and we know its value. It’s certainly ok to feel a bit overwhelmed, but I encourage you, when you can, to keep digging. Not just for yourself; we are the canary in the coal mine, our needs are universal needs – so when you dig in, you are serving a broader, higher interest: that of everybody else.
Now we turn our eyes to 2026 where we’ve got work to do on paid family caregiving, work to do on special education, work to do on ECF and Katie Beckett – as Carol says, there are no shortage of targets. TDC will be out once again in the community talking about how things are working, soliciting opinions and ideas and working together to craft solutions. And then we’ll call on you all again in January to show Tennessee (and the country) how things get done.
Stay tuned for opportunities to work with us, and always feel free to reach out our way. Happy adjournment, TDC Family, catch you next time!