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Administrative Manual Section: General Administrative Procedures and Compliance Policy Manual Number: 200.010 Chapter: Rights and Responsibilities

February 1, 2024 Division of TennCare 4 a. Individuals with Disabilities

Under Section 504, Section 1557, and the ADA, effective communication is required except where TennCare can show that providing effective communication would fundamentally alter the nature of the service or program in question or would result in an undue financial and administrative burden. In order to be effective communication, auxiliary aids and services must be provided in accessible formats, in a timely manner, and in such a way as to protect the privacy and independence of the individual with a disability.

Remember, the type of auxiliary aid or services needed by an individual can change during a conversation or service encounter. During brief or simple face-to-face exchanges, very basic aids are usually appropriate. For example, exchanging written notes may be effective when an individual with a hearing disability asks for a copy of a form at a doctor’s office. Conversations that are more complex or lengthy may require more advanced aids and services. Consideration should be given to how important the communication is, how many people are involved, the length of the communication anticipated, and the context.

When an auxiliary aid or service is requested by someone with a disability, they must be provided an opportunity to request the auxiliary aids and services of their choice, and TennCare must give primary consideration to the individual’s choice. “Primary consideration” means that TennCare must honor the choice of the individual with a disability, with certain exceptions (see below for a list of the exceptions). The individual with a disability is in the best position to determine what type of aid or service will be effective.

The requirement for consultation and primary consideration of the individual’s choice applies to orally communicated information (i.e., information intended to be heard) as well as information provided in visual formats.

The requesting person’s choice does not have to be followed if:

i. TennCare can demonstrate that another equally effective means of communication is available; ii. Use of the means chosen would result in a fundamental alteration in the service, program or activity; or iii. The means chosen would result in an undue financial and administrative burden.

b. LEP Individuals

Similar steps are taken to ensure effective communication with individuals with LEP. It is important that LEP individuals understand their rights and the services, programs and activities that are available.