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Aged, Blind and Disabled Manual Policy Manual Number: 130.010 Section: CHOICES Chapter: Employment and Community First CHOICES August 01, 2024 Division of TennCare 4 b. Essential Supports for Employment and Community Living (ECF CHOICES Group 5) ECF CHOICES Group 5 is for adults age 21 or older with I/DD who, in the absence of HCBS, are at risk for institutionalization. Adults age 21 and older with I/DD who meet NF LOC may be enrolled in ECF CHOICES Group 5 if their needs can be safely and appropriately met in Group 5. c. Comprehensive Supports for Employment and Community Living (ECF CHOICES Group 6) ECF CHOICES Group 6 is for adults age 21 or older with I/DD who meet NF LOC and need specialized services for I/DD. d. Intensive Behavioral Family Supports (ECF CHOICES Group 7) ECF CHOICES Group 7 is for children under age 21 with I/DD who meet NF LOC, live with family caregivers, have severe behavioral health and/or psychiatric conditions that: i. Place the child or others at imminent and significant risk of serious physical harm (that does not rise to the level of inpatient treatment or for which such treatment would not be appropriate); ii. Significantly strain the family’s ability to adequately respond to the child’s needs; iii. Threaten the sustainability of the family living arrangement; and iv. Place the child at imminent and significant risk of placement outside the home. e. Comprehensive Behavioral Supports for Employment and Community Living (ECF CHOICES Group 8) ECF CHOICES Group 8 is for adults age 21 and older with I/DD who have severe behavioral and/or psychiatric conditions, are transitioning out of a highly structured and supervised environment (e.g., criminal justice system, foster care system, long-term institutional placement, psychiatric hospital), meet NF LOC, and need specialized services for I/DD. A person’s psychiatric symptoms or behaviors must: i. Place the person or others at imminent and significant risk of serious physical harm (that does not rise to the level of inpatient treatment or for which such treatment would not be appropriate); and ii. Necessitate continuous monitoring and supervision by 24-hour staff to ensure the person’s safety and/or the safety of others.