Greeneville Visit

On Monday, I traveled to Greeneville and had the opportunity to present Margi Story, East Tennessee Community Homes Director, with the DIDD Extraordinary Performance Award. Margi responded to an immediate need in the Middle Tennessee region for assistance in opening DIDD’s first four Middle Tennessee Community Homes.  As the department expert in these endeavors, she responded to a request for this assistance that was made on a Friday evening, requiring her presence and expertise immediately.  She did not hesitate and promptly drove nearly five hours to the Middle Tennessee region.  During this time, she facilitated all preparations, implementations, and finalization of licensure requirements for the first four Middle Tennessee Community Homes.  Due to her dedication and expertise, a successful licensure certification was achieved.  The first transition to a Middle Tennessee Community Home occurred on February 27th and was made possible because of her above and beyond work ethic. 

This week, as Margi opened the final three ETCH homes, her tireless work ethic was once again on display. 

During my trip, I also toured Rosewood, Pinewood and Newell homes at Greene Valley Developmental Center and had the opportunity to visit with some of people living there

Medication Administration Update

As the date to implement the revised Medication Administration Curriculum approaches, a weekly update will be included in Open Line. This week, we want to answer some of the questions that have been raised. The department will have a statewide kick-off meeting for all the trainers on November 3rd and 4th at Fall Creek Falls State Park. This is the required annual update meeting for existing trainers, and our way to recognize the invaluable role they fulfill in ensuring the people we support receive medications safely. Thus far, about 90% of the trainers have indicated they will be attending. Therefore, there may be no classes on these two days and trainers may have changed some previously scheduled class dates. Once the trainers have the curriculum, Dr. Cheetham will be attending the Regional Provider Meetings to present more details than contained in the presentation to the Board of Nursing, which is on our website, and to answer questions.

For agencies that have people who are not yet trainers but require the instruction to become trainers, the existing process has not changed. Contact your Regional Nurse Educator to schedule this. As has always been the case, educating new trainers involves more than what is included at the annual update meeting. Naturally, training new people will be with the revised curriculum. The revised Rules are working their way through the required process.  

Employment First Conference

On Wednesday, DIDD held its Employment First conference at the Millennium Maxwell House Hotel in Nashville.  The conference focused on strategies to increase disability employment and DIDD’s progress on the Employment First initiative.  ODEP Subject Matter Experts Lisa Mills and Nancy Gurney discussed recent changes in federal policies designed to increase employment outcomes for people with disabilities.   In addition, a panel of state agencies discussed how their departments are working to advance Employment First.  Families and persons supported also shared with the crowd their experiences transitioning from a sheltered workshop to supported employment, and AutoZone’s Memphis Distribution Center manager shared the company’s perspectives on hiring people with disabilities through its “Persons With Abilities” program (click here to see the video).   Finally, DIDD honored SRVS for being a trailblazer on the state’s path to integrated employment with its first annual Madelieine Will Employment First Excellence Achievement Award.  Perhaps the best way to sum up the lessons and takeaways from the conference are with the quote DIDD Employment and Day Services Director Amy Gonzalez shared from John Maynard Keynes: “The difficulty lies not so much in developing new ideas as in escaping from old ones.” 

Thanks to everyone who participated in the conference who will help make Employment First a success in Tennessee!

Active Treatment Takes Off

I’m very excited to share with you the launch of the Harold Jordan Center’s Active Treatment Series. These sessions, being offered to all persons receiving treatment at the Center, focus on topics relevant to living life more fully, safely and healthfully.  The curriculum, developed and  presented by the Clinical team at the Jordan Center, represents a core body of knowledge indispensable to making competent decisions and taking appropriate actions within a specific life context, ranging from human sexuality and abuse prevention to wellness and money management.  This session is taught by Lahoma Ayers and Linda Hunt, and is designed to help the individuals identify and manage four basic or core emotions (sadness, anger, fear, and happiness) upon which all other emotions are based. With all three programs at the Harold Jordan Center now operational (Behavior Stabilization Unit, Forensic Unit and the Day One ICF program), we anticipate a continued and significant impact for some of the most vulnerable and challenging persons within our services system. Parities interested in accessing supports should contact Dr. Bruce Davis for consultation. 

(photo: one of the Active Treatment sessions)

A Serious Infectious Disease

With the attention to Ebola Virus Disease (EBV) over the past few weeks, there is a risk of forgetting a far more common and highly infectious virus – influenza. Unlike EBV, we already have effective vaccines that prevent contracting influenza (the ‘flu’) and in those who get it, decreases the severity and complications. We forget that people die each year from influenza. Depending on the particular flu season, the Centers for Disease Control and Prevention (CDC) estimates between 3,000 and almost 40,000 Americans die. Those at highest risk are the young, particularly under 5 years of age, the elderly, pregnant women and people with underlying diseases such as asthma and other lung disease, diabetes, and heart disease. Of particular concern to us is another high risk category of people who have neurological and neurodevelopmental conditions — such as intellectual disability, epilepsy (seizure disorder), and developmental disabilities, like cerebral palsy. Research has found a significantly higher risk of hospitalization, requiring a ventilator and death in the people we support.

Influenza is spread by large respiratory droplets, which means when someone with influenza coughs or sneezes near a susceptible person, the virus particles can get on the face or hands. Also, if a person touches a surface where the virus particles are, the infection is picked up on the hands and then can enter the body by touching the nose, eyes, mouth, etc. This explains why the single most important thing to prevent infection is washing the hands or using alcohol hand sanitizer.

Signs and symptoms of the flu include fever, cough, sore threat, runny nose, muscle aches, headaches and fatigue. It may be difficult for some of the people to report these, so if a person has a fever and a cough, it can be helpful to consider influenza.

The two things you can do to protect yourself, your family and the people we serve are to get a flu shot, and wash your hands.

The CDC website has a considerable amount of useful information including ongoing reports and graphs of influenza activity, prevention and treatment. The link is:   A poster that summarizes preventive actions is at:  

Conversations That Matter: Knoxville and Greeneville

Employment expectations for people with intellectual disabilities (ID) are changing and so are the services that support them. Sheltered employment options will decrease. Changes must be made thoughtfully so that “unintended consequences” are minimized. We invite you to this forum to learn about the changes impacting employment options for people with ID, to share your thoughts on what works for you in the current system, and to share what needs to be in place for you to consider other employment options.

When: Tuesday, October 21, 2014

1pm – 3pm or 5:30pm – 7:30pm

Where: The Arc Knox County/Sunshine Industries

3000 N. Central Street

Knoxville, TN 37917

When: Thursday, October 30, 2014

1pm – 3pm or 5:30pm – 7:30pm

Where: Greene County Skills

130 Bob Smith Blvd

Greeneville, TN 37745

Home Care Final Rule Update

The U.S. Department of Labor has announced a time-limited non-enforcement policy toward the Home Care Final Rule. From January 1, 2015 to June 30, 2015, DOL will not bring enforcement actions against any employer. From July 1, 2015 to December 31, 2015, the Department “will exercise prosecutorial discretion” in determining whether to bring enforcement actions, with particular consideration given to the extent to which States and other entities have made good faith efforts to come into compliance. For more details, and links to the Federal Register announcement, go to:

Ebola Virus Update

This is an update on the Ebola Virus Disease (EVD), which appeared in last week’s Open Line. Dr. Dreyzehner, Commissioner of the Department of Health, held a press conference earlier in the week at which he reported no cases in Tennessee. The most important points to remember are that Ebola is not spread in the air, as is influenza; there has to be direct contact with infected blood or body fluids from someone who is sick to get EBV. What’s interesting are the two specific examples Commissioner Dreyzehner gave in his statement, which showed how difficult it is to contract this infection.

The link to the video and his statement is here:

As with so many infections, the annual training we all take on Standard Precautions provides the necessary protection to keep us, our families, and the people we serve safe from infectious disease.

"Essentially Leadership" Series at MTRO

On Wednesday, MTRO welcomed Department of Human Resources Commissioner Rebecca Hunter as its guest speaker for its “Essentially Leadership” session.  The topic was “Leadership Integrity: Counting the Cost”.  Commissioner Hunter mentioned some key points of being good leader, including maintaining a positive attitude, encouraging innovation and maintaining grace under fire. The crowd at MTRO was thrilled to have such a distinguished guest speaker.  We would like to extend our thanks to Commissioner Hunter for her time and expertise. 

State of Tennessee Employment Consortium (STEC)

On October 9, the quarterly consortium meeting was held at One Cannon Way. Amy Gonzalez provided an overview of the Employment First State Leadership Mentoring Program grant and a brief overview of the Employment First Taskforce report that was shared with Governor Haslam on September 16, 2014. There were also updates regarding the Think Employment Summit that TennesseeWorks conducted. Lee Brown, Director of Supported Employment for Impact Centers, conducted a presentation of Impact’s transformation, which included details regarding how Impact Centers closed all four of its sheltered workshops. Employment and Day Service Coordinators also provided regional updates/.

If you are interested in attending the next quarterly STEC meeting, please contact Amy Gonzalez at