Online orientation
Within 30 calendar days of starting contracted services
Onboarding curriculum
Day-based 30-day and 60-day course lists (no single hour total)
CPR & First Aid
In-person hands-on skills test required — web-only not accepted
Medication administration
20-hour RN-Trainer course, 80% written + practical, recert every 3 years (0465-01-03)
Abuse reporting
Mandatory reporter — APS 1-888-277-8366 (T.C.A. §71-6-103)
Background checks
Aligned protocol: Abuse Registry + 5 more, plus TBI→FBI fingerprints
Tennessee delivers I/DD services through the Department of Disability and Aging (DDA, formerly DIDD) — the cabinet department created on July 1, 2024 when DIDD merged with the Commission on Aging and Disability — and its three regional offices (West, Middle, East). TennCare is the state Medicaid agency, and most I/DD services now flow through Employment and Community First (ECF) CHOICES, a managed-care program delivered through MCOs, with the legacy 1915(c) waivers (Statewide, CAC, Self-Determination) closed to new enrollment. Services are driven by each person’s Person-Centered Support Plan (PCSP).
Tennessee does not set a single training-hour total. Instead the DDA credentialing framework uses day-based windows: online orientation within 30 calendar days, a 30-day course list (Standard Precautions, HIPAA, Title VI, Reportable Event training, Supporting Individuals During Emergencies, Risk Management, Fire Safety, Individual Specific Training, and in-person CPR and First Aid), and a 60-day course list (Choice Making, Employment Support, Overview of Disabilities, DSP Federal HCBS Settings Requirements, Professionalism, Person-Centered Thinking, and Positive Behavior Support). Training is documented and tracked per Tenn. Comp. R. & Regs. 0465-02-06-.04.
Unlicensed staff may administer medications only after certification under Tenn. Comp. R. & Regs. 0465-01-03 (authorized by T.C.A. §68-1-904). A DDA RN Trainer delivers at least 20 hours of classroom instruction with an 80% written and 80% practical passing score, recertified every three years. This is a statutory exemption from the Nurse Practice Act — not nurse delegation. Certified staff may give oral, topical, eye, ear, nasal, rectal, and vaginal medications, pharmacy-pre-drawn routine subcutaneous insulin, and an epinephrine auto-injector; they may not give sliding-scale or drawn-up insulin, IM or IV injections, or tube-fed medications, or take verbal orders.
Every DSP is a mandatory reporter. Suspected abuse, neglect, or exploitation of an adult → Adult Protective Services, 1-888-277-8366, immediately (T.C.A. §71-6-103; failure is a Class A misdemeanor). Suspected child abuse → DCS, 1-877-237-0004 (T.C.A. §37-1-403). Separately, providers file a DDA Reportable Event — Tier 1 events (all sexual-abuse allegations, exploitation over $1,000, unexpected deaths) require a verbal call to the DDA Abuse Hotline, 1-888-633-1313, within 4 hours, plus a written Reportable Event Form the next business day (moving to the PERLSS online system in 2026). The DDA report never replaces the APS or DCS call. See our guide to becoming an ECF CHOICES provider in Tennessee.
DSPlife™ TrainingHub is built for Tennessee DDA, DES/DDD, DSHS/DDA, DDS, IDHS/DDD, OPWDD, MDHHS, DBHDD, APD, DODD, DMH/DD/SUS, ODP, HHSC, and DBHDS providers. Its Tennessee library ships with courses your staff can complete on their own schedule — the DDA/TennCare/ECF CHOICES system and the PCSP, Title 33 rights, Tennessee mandated reporting and reportable-event management, positive behavior supports, the medication-exemption model, and the full 30/60-day onboarding roadmap — logs completion, tracks the 30-day and 60-day windows and the three-year medication recert with automatic alerts, and generates audit-ready records. See the full compliance overview.
Effective July 1, 2024, the Department of Intellectual and Developmental Disabilities (DIDD) merged with the Commission on Aging and Disability to form the cabinet-level Department of Disability and Aging (DDA). DDA now oversees Tennessee’s I/DD services and provider licensure, while TennCare holds the Medicaid authority and most I/DD services are delivered through the Employment and Community First (ECF) CHOICES managed-care program. The name DIDD still appears in the rules chapter (0465), the medication-administration rule, and the DDA Abuse Hotline. (Note: Tennessee’s DDA is a different agency from Washington’s similarly abbreviated DDA.)
Tennessee uses a day-based onboarding framework rather than a single hour total. New staff complete online orientation within 30 calendar days, a set of courses due within 30 days (including Standard Precautions, HIPAA, Title VI, Reportable Event training, Fire Safety, Individual Specific Training, and in-person CPR and First Aid), and a further set due within 60 days (including Person-Centered Thinking, Choice Making, DSP Federal HCBS Settings Requirements, Positive Behavior Support, and Employment Support). Medication administration certification is required before a DSP passes any medications.
Yes, once certified. Under Tenn. Comp. R. & Regs. 0465-01-03 (authorized by T.C.A. §68-1-904), unlicensed personnel who complete an RN-Trainer-led course — at least 20 hours of classroom time with an 80% written and 80% practical passing score, recertified every three years — are statutorily exempt from the Nurse Practice Act for the medications they are trained on. This is a statutory exemption, not nurse delegation. Certified staff may give oral, topical, eye, ear, nasal, rectal, and vaginal medications, pharmacy-pre-drawn routine subcutaneous insulin, and an epinephrine auto-injector; they may not give sliding-scale or drawn-up insulin, IM or IV injections, or tube-fed medications, or take verbal orders.
Suspected abuse, neglect, or exploitation of an adult goes immediately to Adult Protective Services (in the Department of Human Services) at 1-888-277-8366 — under the Tennessee Adult Protection Act (T.C.A. §71-6-103), every person is a mandatory reporter and failing to report is a Class A misdemeanor. Suspected child abuse goes to the DCS hotline at 1-877-237-0004 (T.C.A. §37-1-403). Separately, providers file a DDA Reportable Event — Tier 1 events require a verbal call to the DDA Abuse Hotline at 1-888-633-1313 within 4 hours. The DDA report never replaces the statutory APS or DCS report.
Before any direct contact, providers run the TennCare/DDA Aligned Background Check Protocol: the Tennessee Abuse Registry (T.C.A. §68-11-1001 et seq.), the National Sex Offender Registry, SAM, the OIG exclusion list (LEIE), the TennCare Terminated Provider List, and the Felony Offender Information Lookup, plus TBI-to-FBI fingerprinting (T.C.A. §§33-2-1201/1202). A hit on any of the registries is an automatic disqualification; a criminal conviction triggers an individualized assessment rather than an automatic bar.
General information, not legal advice. DSPlife™ TrainingHub is not affiliated with the Tennessee Department of Disability and Aging or TennCare. Confirm current requirements at tn.gov/disability-and-aging, tn.gov/tenncare, and the Tennessee Code and rules at publications.tnsosfiles.com.
Assign the Tennessee DDA courses, log completion automatically, and get alerts before the 30-day, 60-day, or three-year medication-recert deadlines lapse. Free to start — no credit card required.
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