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Advocate for TennCare to fix the CDTN Crisis

wide shot of government building

This spring, TennCare put out a Request for Proposals (RFP) for the contract to become the Fiscal Employer Agent (FEA) and Supports Broker for the state’s LTSS programs. FEA’s/Supports Brokers provides payroll and administrative services and customer service support to people using the consumer direction option in state long-term supports and services (LTSS) waiver programs.

After the RFP period closed, TennCare awarded the FEA/Supports Broker contract to an organization called Consumer Direct Tennessee (CDTN). Consumer Direct operates in a number of states around the country, and created the Tennessee branch upon receipt of the contract. The contract, worth a total of $36.5 million, runs from May 1st, 2023 through June 30th, 2026. 

Since the transition from the previous contract-holding organization to CDTN, members’ and families’ lives have been upended. Below is a short and incomplete list of the issues stemming from the transition:

  • Workers are not getting paid, and are thus quitting employment. Some of these DSP’s have years-long relationships with the members and families they serve, but they cannot afford to work and not be paid.
  • Workers have had their wage rate suddenly changed. There is mass confusion between TennCare, the MCO’s and CDTN about what wages workers should be making, leading to all sorts of unintended consequences.
  • People are running up against their budget caps. With sudden rate changes and incomplete data on PCSP’s/ISP's, people are running over budget in fulfilling the hours they are owed. 
  • People are paying out of pocket to make up for these issues. 
  • Workers and consumers cannot access the webpage or app to log hours, manage working time, monitor budget caps, etc. 
  • CDTN support brokers are unsure about how to help members and their families. The transfer of data from TennCare was incomplete, and so CDTN employees are attempting to backfill data and information that should have already been there. 
  • People are getting accidentally disenrolled from TennCare entirely. 
  • There is no public-facing manual for members and families to navigate apps/portals, the transition or CDTN as a whole. 

These issues have been occurring for months, with seemingly little progress towards resolving them at the systemic level. TennCare must act with greater urgency in fixing these problems, and they must ensure that families are held harmless for these circumstances beyond their control. TennCare must ultimately provide those affected with some degree of accountability. 

Tennessee Disability Coalition has sent a letter of concern to Deputy Commissioner Stephen Smith and his team in Gary Smith and Katie Evans-Moss, asking them to resolve this immediately. You can see the letter here at this link.

Accountability, however, may need to come from our collective advocacy. In order to maximize our advocacy, we are asking legislators to convey a sense of urgency to Deputy Commissioner Smith, his team and TennCare. You can join us by following this link to send a note to your state Representative and Senator, asking them for their support in fixing these problems immediately. Please consider supporting this advocacy!


Link to send a message to your state Representative and Senator