Adult Day Services
Tennessee is an Employment First state.76 This means DIDD requires that Supported Employment be considered as the first option for each individual enrolling in day service and for each person over the age of fifteen (15) who receives either Day Services and or Personal Assistance Services. The cornerstones to successful work opportunities reside within the essential components of informed choice. In order to make informed choice about employment, there should be effort to ensure that the person supported has had education, experience and exposure to the same array of jobs as other people in their community.77
Day services shall occur in the least restrictive setting possible as appropriate to the person. Therapeutic objectives and action steps are outlined in the ISP during the person-centered planning process. Types of Day Services include, Community Based Day Services, Employment Services, Facility Based Day Services and In-Home Day Services.
The guiding strategy in pursuit of effective Day Services employs the principles of productivity, inclusion and independence. Day Services must be structured so each person has the opportunity to discover his or her skills, interests, and talents in his or her community.
Some examples of the implementation of effective Day Services objectives are:
1. Exploring Supported Employment.
2. Job shadowing.
3. Exploring volunteering opportunities or volunteering in their community.
4. Being an active member of their community (examples are being a member of a garden club, neighborhood organization, local gym, etc.).
5. Taking a class in the community to learn a new skill.
6. Participating in experiences that coincide with their interests.
7. Training in a specific skill.
In-Home Day Services, while available to meet specific and well-documented needs, are to be used only in exceptional circumstances. These circumstances may include limited provision of these supports due to behavioral or psychiatric destabilization, medical concerns/necessity, or other infrequent and exceptional circumstances. Extended in-home services related to medical concerns shall require a physician’s order and accompanying documentation in the ISP supporting the provision of in-home services as the most appropriate and viable option. The BSP for a person with extended in-home services related to behavioral concerns should be time-limited and include a plan to fade out in-home services with increasing community services. If the reason for the request for In-home Day Services is retirement then the information in the ISP should indicate that the person was employed and has chosen retirement. It is not