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  • EMORY VALLEY CENTER
    MAXIMIZING HUMAN ABILITIES
  • Family Support
  • TN Department of
    Disability & Aging Program

  • Family Support 2026-2027 Intake

  • The Tennessee Family Support Program is a grant program, totally funded with state dollars and administered through the Tennessee Department of Disability and Aging (TDDA). This program offers a small amount of financial support to help people (of all ages) with a severe lifelong disability, and their families to remain together in their homes and communities, while living as independently as possible. These services are flexible and responsive to the families and their needs.
  • The 26-27 fiscal year runs from July 1, 2026-June 30, 2027.
    • Due to limited funding, it is possible that some applicants who are considered eligible will not receive a grant for the 26-27 fiscal year.
    • Applicants are not guaranteed to be awarded a grant, even if they have received one in previous years.
    • If the applicant is approved to receive a grant, the amount is not guaranteed to be the same amount it was in previous years.
    • Selection must be open to every person applying each year, as if they have never applied before.
    • Selection is based on priorities set by the local council, and applications are ranked according to these priorities.
    • We strive to notify families of their application status as quickly as possible. Our guidelines, which are set by the state, declare we must notify applicants of their application status no later than Sept. 30th. (If you apply after this date, we'll notify you of your application status asap).
    • Mental illness and aging related disabilities are not covered by the Family Support Program.

  • Individuals who are enrolled in the Katie Beckett Waiver, ECF Choices, DIDD Waiver, TennCare Choices or Pace programs are NOT eligible for the Family Support grant.

  • Once you begin the application, it must be completed in one session—you won’t be able to save it and return later. Please make sure you have all required documents ready before starting.

  • To apply for the 2026-2027 Family Support grant, you must submit the the following required documents.

    • Proof of Disability Clearly stated diagnosis list from a physician. For school age children with an IEP - please also provide a copy of their most recent, full IEP. For young children enrolled in TEIS - please also provide their most recent IFSP. We reserve the right to request further documentation when necessary.
    • Proof of Residency Current utility bill (water, gas, electric or internet) that shows the service address - we need this for the address on the intake form, even if the services are not in your name. Must be dated within the last 60 days of application date.
    • Proof of Citizenship Copy of legal birth certificate OR proof of qualified alien status/current USCIS documentation. (We cannot accept the hospital souvenir or the mother's copy). If the applicant has received the grant in previous years, we may have this on file.
    • Social Security Card If the applicant has received the grant in previous years, we may have this on file.
    • Proof of Custody If the applicant is not your biological child, or if the child was adopted. (If the child was adopted, all documents must be consistent with their adopted name on them). If the applicant has received the grant in previous years, we may have this on file.
    • Decision Making Paperwork (Conservatorship or Financial POA) If one is already in place. (Applicants 18 years or older are responsible for signing for themselves unless legal documentation is provided giving consent to someone else). If the applicant has received the grant in previous years, we may have this on file.
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  • We log intakes into our system in the order we receive them. Once your intake and all required documents are received and logged in, we'll send an email (or a letter if you don't have an email) letting you know everything has been received, and when you can expect to receive status of your grant application.

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  • EMORY VALLEY CENTER
    MAXIMIZING HUMAN ABILITIES
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  • TN Department of
    Disability & Aging Program

  • 2026 - 2027 Family Support Intake Form

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Are you applying for yourself?*

  • INFORMATION GOING FORWARD MUST BE ABOUT THE PERSON YOU ARE APPLYING FOR

  • Date of Birth:*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Do you rent or own your home?*
  • Is the applicant a:*
  • 1. Potential Support Services Needed/Requested (Check all that apply):
  • 2. Do you (the person you're applying for) receive any of the following? (Check all that apply):*
  • 3. What type of insurance do you (the person you're applying for) have? (Check all that apply):*
  • 4. Do you (the person you're applying for) currently receive any of the following? (Check all that apply)*
  • 5. Have you (the person you're applying for) applied for any of the following? (Check all that apply)*
  • Page 1 of 6

  • 2026-2027 Family Support Intake Form

  • To comply with Title VI, the following information is being requested (Check all that apply):
  • 1. GENDER:*
  • 2. RACE:*

  • DIAGNOSED DISABILITY - Check which of the following "major disability categories" is most relevant to the applicant's diagnosed condition(s). You must provide proof for each diagnosed disability that's checked:

  • Disability Categories*
  • Did the person's primary disability occur:*
  • 0/100
  • By signing and dating this intake form, I, the person applying for the Family Support grant, OR their legal representative, indicate that all information provided above is true and accurate. Furthermore, I understand that providing invalid, inaccurate, or incomplete information could be considered as fraud and may result in a criminal investigation and disqualification from the program which would prevent re-application in subsequent years.
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • If someone other than the family/applicant is making a referral:
  • Format: (000) 000-0000.
  • Page 2 of 6

  • Family Support 2026-2027 Intake Form - continued

  • 1. Has the applicant previously received Family Support Program Funding?*
  • 0/100
  • 0/50
  • Are there other individuals with disabilities residing in the home?*
  • 5. Does the applicant attend any regular medical appointments (physician, specialist, therapies, etc.)? If yes, check all that apply:*
  • 0/100

  • Written and Expressive Language

  • 6. Is the applicant's ability to communicate affected by their disability?*
  • 0/50
  • 8. Does the applicant have difficulty understanding verbal instructions?*
  • 9. Does the applicant have difficulty following along in conversations?*

  • Mobility

  • Is the applicants mobility affected by their disability?*
  • 13. Does the applicant need CONSTANT supervision, due to safety concerns that are related to their disability (NOT due to his/her age)?*

  • Cognitive

  • 0/100
  • The next few pages are for the age of the person applying. Look at pages 4 to 6 to find the page that matches the age of the person you're applying for. You'll see the age category at the top of each page.
    For applicants age infant to 5 years old, please answer the following questions:

  • Activities of Daily Living (ADLs)

  • 1. Does he/she drink from a:*
  • 2. Does he/she feed themselves?*
  • 3. Can he/she use utensils?*
  • 4. Does he/she have choking concerns?*
  • 5. Does he/she try to help with getting dressed and undressed?*
  • 0/50
  • 8. If 3 years old or older, is he/she potty trained?*

  • Self-Direction

  • 9. Is he/she able to do simple step tasks, as age appropriate (throw a tissue in the trash, put a toy in the closet, etc. if asked)?*
  • 10. Does he/she enjoy interacting with people?*
  • 0/50
  • For applicants age 6 years to 13 years old, please answer the following questions:

  • Activities of Daily Living (ADLs)

  • 1. Does he/she feed themselves?*
  • 2. Does he/she need their food prepared in a particular way?*
  • 3. Does he/she have choking concerns?*
  • 4. Can he/she open food items on their own (packages, drink tops, etc.)?*
  • 5. If age appropriate, does he/she cook food in the microwave?*
  • 6. Does he/she bathe on their own?*
  • If no, what type of assistance is required (check all that apply)
  • 7. Does he/she use the toilet on their own?*
  • 8. Is he/she able to dress/undress themselves (check all that apply)?*

  • Self Direction and Independent Living

  • 10. Is he/she able to do chores around the home. (Check all that apply):*
  • 11. Is he/she able to tell the time?*
  • 12. Can he/she manage time or know routines?*
  • 13. Would he/she be able to call 911, self-evacuate in an emergency:*
  • 14. Can he/she count and understand the value of money?*
  • Page 5 of 6
  • For applicants age 14 years and older please answer the following questions:

  • Activities of Daily Living (ADLs)

  • 1. Does he/she feed themselves?*
  • 2. Does he/she need their food prepared in a particular way?*
  • 3. Does he/she have choking concerns?*
  • 4. Can he/she open food items on their own (packages, drink tops, etc.)?*
  • 5. Can he/she cook food in the microwave, oven, or stove?*
  • 6. Does he/she bathe on their own?*
  • If No, do they need (check all that apply)?
  • 7. Does he/she use the toilet on their own?*
  • 8. Is he/she able to dress/undress themselves (check all that apply)?*

  • Self Direction and Independent Living

  • 10. Is he/she able to do chores around the home. (Check all that apply):*
  • 11. Is he/she able to tell the time?*
  • 12. Can he/she manage time or know routines?*
  • 13. Would he/she be able to call 911, self-evacuate in an emergency:*
  • 14. Can he/she count and understand the value of money?*
  • 15. If 16 or older, does he/she have a job?*

  • Thank you for your application. You should receive a response within 30 business days. If you have not heard from us after that time, please contact us for an update.
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