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Supporting Families Community of Practice Evaluation

Tennessee State Data Brief

Evaluation Overview

In 2012, the Administration for Community Living (ACL), through the Administration on 

Disabilities (AoD)1, awarded the five-year National Supporting Families Community of Practice 

(CoP) grant to the National Association of State Directors of Developmental Disabilities Services 

(NASDDDS), which partnered with the University of Missouri-Kansas City Institute on Human 

Development (UMKC-IHD). In the first year of the grant, 15 states applied and five were selected 

to participate, including Connecticut, the District of Columbia, Oklahoma, Tennessee, and

Washington, with Missouri serving as the mentor state. Given growing interest in the work of the

CoP, NASDDDS and UMKC-IHD decided to expand and sustain the CoP outside of the initial 

grant. A second cohort, known as the expansion states, joined in 2016, including Alabama, 

Delaware, Hawaii, Indiana, Kansas, Maryland, Ohio, Oregon, Pennsylvania, and South Dakota. 

With interest continuing to grow around the nation, the CoP welcomed five new states—

Massachusetts, Michigan, Minnesota, Virginia, and New Jersey—in 2019 and created 

opportunities for participating states to adjust their level of participation.

Three project outcomes guide the work of the 

National Supporting Families CoP:

¡ State and national consensus on a national 

framework and agenda for improving supports

for families with children with I/DD

¡ Enhanced state policies, practices, and 

sustainable systems that result in improved 

supports to families

¡ Enhanced capacity of states to replicate and 

sustain exemplary practices to support 

families and systems

To examine progress toward federal project 

outcomes and identify which activities are leading 

to success, ACL funded the National Supporting 

Families CoP evaluation. The evaluation team 

gathered data that align with the three project 

outcomes to determine how the CoP is producing 

outcomes of interest to ACL, which reflect the 

five AoD priority areas (Exhibit 1). Findings will provide ACL with outcomes data and 

recommendations to improve supports to families of individuals with I/DD. They will also provide 

information on how the CoP and CtLC framework improve support and systems delivery of 

services to families and individuals with I/DD.

 

1 The Administration on Intellectual and Developmental Disabilities (AIDD) initiated the evaluation in 2017. The 

Administration on Disabilities (AoD) now oversees the evaluation.

Exhibit 1. AoD Priority Areas

The Five AoD Priority Areas

§ Ensure the continued protection of rights of 

individuals with I/DD and prevent their abuse, 

neglect, and exploitation

§ Improve and maintain effective and responsive 

management of responsibilities under 

Developmental Disabilities Assistance and Bill of 

Rights Act of 2000 (the DD Act)

§ Promote Employment First as a key strategy for 

individuals with I/DD to be contributing and 

productive members of society participating in 

the competitive integrated workforce

§ Empower individuals with I/DD and their families 

to access home and community based (HCBS) 

and supports that are self-directed and ensure 

opportunity for community participation

§ Support advocacy efforts of individuals with I/DD 

in order to ensure their participation in system 

and service delivery design
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The evaluation includes all 16 states that participated in the National Supporting Families CoP for 

at least two years between 2012 and 2018. For evaluation purposes, evaluators stratified states into 

three groups based on their stage of development, as described in Exhibit 2.

Exhibit 2. Evaluation Participants

Group One Group Two Group Three

The six original CoP states:

§ Connecticut

§ District of Columbia

§ Missouri (mentor state)

§ Oklahoma

§ Tennessee

§ Washington

States with previous exposure to 

the CoP and CtLC framework before 

joining the expansion state cohort:

§ Maryland

§ Ohio

§ Pennsylvania

§ South Dakota

States with little or no exposure to 

the CoP and CtLC framework before 

joining the expansion state cohort:

§ Alabama

§ Delaware

§ Hawaii

§ Indiana

§ Kansas

§ Oregon

Evaluators collected data from states using four tools:

¡ Reporting tools (one for each state grouping) gathered descriptive data about CoP structure, 

activities, and impact.

¡ Telephone interviews (informed by the reporting tools) collected contextual data about CoP 

activities and accomplishments specific to each state.

¡ Site visits (to select states) with CoP leadership and other stakeholders provided data on the

relationship between CoP activities, outputs, and outcomes.

¡ Materials review (on an ad-hoc basis) collected needed data on areas of interest.

Evaluators analyzed the collected data using a conceptual framework developed by Wenger, 

Trayner, and de Laat2(Exhibit 3), which assesses value creation in communities. Adapted for 

evaluation purposes, the framework considers five different cycles of value creation to capture the 

richness of value created by communities of practice. The following page describes the value 

generated from CoP activities and the CtLC framework within the Tennessee CoP.

 

2 Wenger, E., Trayner, B., and de Laat, M. (2011). Promoting and Assessing Value Creation in Communities and 

Networks: A Conceptual Framework. Rapport 18, Ruud de Moor Centrum, Open University of the Netherlands.

Exhibit 3. Value Cycle Framework
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A Look into Tennessee’s Community of Practice

Tennessee (TN) is one of the six original states to join the National Supporting Families CoP in 

2013. The TN CoP is a collaboration between the Developmental Disabilities (DD) Council and 

the Department of Intellectual and Developmental Disabilities (DIDD). The timeline below 

(Exhibit 4) provides detailed information about TN’s participation in the CoP over time.

Exhibit 4. Timeline of Tennessee’s CoP Participation

Using data from the most recent Residential Information Systems Project Report developed by the 

University of Minnesota, the number of people with I/DD known to or served by DIDD in 2016

was 25,159. Long-Term Services and Supports (LTSS) recipients include people with I/DD who 

receive Medicaid or State-funded supports and services. In 2016, 54% of 13,558 LTSS recipients

in TN lived at home with a family member. The report also shows annual Medicaid Waiver 

expenditures for recipients with I/DD, which amounted to $82,966 per recipient in 2016.3

Understanding the current state of I/DD services and supports in TN is important in better 

understanding how CoP activities and the CtLC framework impact families and individuals with 

I/DD. The evaluation team gathered valuable data from TN through administration of the reporting 

tool, telephone interview, and materials review. After careful analysis of the data using the value 

cycle framework, the evaluation team noted the following key achievements by TN’s CoP during 

evaluation year one:

¡ TN has a robust Employment First initiative spearheaded by TN’s DD Network and DIDD. 

Other valuable partnerships include the Governor's Children's Cabinet and the University 

Extension Network.

¡ TN developed a comprehensive rights assessment for ISCs and case managers to administer 

with people in DIDD services.

¡ In July 2018, the DD Council released a special edition focused on the TN CoP of their 

quarterly Breaking Grounds publication on innovative programs and practices, disability policy 

issues, and stories of Tennesseans with I/DD.

TN’s former participation in the National Supporting Families CoP shows their interest in the 

CtLC framework and advancing supports for families of individuals with I/DD. The following 

tables includes a more comprehensive list of TN’s achievements from evaluation year one.

 

3 Larson, S.A., Eschenbacher, H.J., Anderson, L.L., Taylor, B., Pettingell, S., Hewitt, A., Sowers, M., & Bourne, M.L. 

(in press, 2018). In-home and residential long-term supports and services for persons with intellectual or developmental 

disabilities: Status and trends through 2016. Minneapolis: University of Minnesota, Research and Training Center on 

Community Living, Institute on Community Integration.
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Exhibit 5. Tennessee’s Achievements in Evaluation Year One, 2018-2019

Value Cycle CoP Activities and Achievements

Cycle 1: Immediate Value

Value of Activities and 

Interactions Themselves

§ Partnerships previously facilitated by the National CoP continue to promote 

the sharing of information and best practices.

§ The TN CoP developed or strengthened partnerships with the University of 

Tennessee Extension program, the Governor’s Children’s Cabinet, Family 

Voices of TN, TN Adult Brothers and Sisters (TAB), and the Arc TN.

Cycle 2: Potential Value

Changes in Knowledge 

Capital

§ TN provides several state training opportunities that integrate the CtLC 

framework. They equip staff with family assistance tools as well as provide 

training opportunities for peers, self-advocates, stakeholders, and families.

§ TN’s two-day person-centered (PC) training embeds LifeCourse tools and 

occurs monthly in each region in addition to the PC Individualized Support Plan 

(ISP) training.

§ TN’s DD Council worked with the Department of Health to include information 

on disability resources and peer-to-peer support in the state “Welcome Baby” 

packet mailed to parents of all newborns.

§ The TN CoP created and disseminated over 5,000 copies of resource folders 

with information on agency and advocacy supports in the state.

Cycle 3: Applied Value

Changes in Practice

§ DIDD, TN's Employment Roundtable, and Employment First Task Force are 

measuring data surrounding employment for individuals with I/DD. The data 

collection incorporates measurements from the Council on Quality and 

Leadership (CQL) Accreditation process.

§ Trainings for DIDD individualized support coordinators (ISCs) incorporate the 

CtLC framework. In the pre-planning process, ISCs use LifeCourse tools.

§ The Employment and Community First CHOICES program incorporates the CtLC 

framework in contracts with managed care organizations (MCOs) and offers 

services in caregivers education, peer supports, and counseling.

§ The DD Council partnered with a human resources agency to create a Disability 

Leadership Academy focused on best practices.

§ The DD Council included a new “Need Services?” section of their website that 

provides life stage-specific guidance and resources to family members of 

individuals with I/DD.

Cycle 4: Realized Value

Performance 

Improvement

§ The CtLC framework provided TN with a common language to help guide 

conversations with individuals with I/DD and their families.

Cycle 5: Reframed Value

Redefining Success

§ The DD Council uses the CtLC framework within its everyday work, in addition 

to spreading these ideas to other organizations. They now measure success by 

how often new people join the conversation.