Caregiver Tennessee’s Employment and Community First Program Supports Individuals with Disabilities

Caregiver Tennessee’s Employment and Community First Program Supports Individuals with Disabilities

ECF Supports Improve Outcomes as Caregiver Adds Employees, Revenues

After Hunter Lewis (pictured above, left) survived a severe illness and spent months in the hospital during 5th grade, his family knew they faced an uphill climb helping their previously bright, energetic 11-year-old son navigate a post-illness world with diminished intellectual capabilities and previously unimagined challenges to social interactions, among other residual effects.

Now 23, Hunter Lewis has a passion for model cars, bowling, and his job at a Kingsport, Tennessee Wendy’s.

That job is just one of Lewis’s achievements made possible, in part, by the work of Caregiver, Inc. Tennessee, an affiliate of Texas-based Caregiver, Inc., with over 3500 employees at the headquarters support group and in dozens of branded affiliate organizations throughout Texas, Indiana, Ohio and Tennessee. They provide care services to nearly 3000 individuals who qualify as developmentally or intellectually disabled (IDD) or are impacted by related conditions, including services like home living, family protective services, case coordination, nursing services, respite services, day habilitation, psychology services, dental treatment, specialized therapies, adaptive aids, minor home modifications, and within the past several years in Tennessee and soon in Texas, supported employment.

Caregiver Tennessee, often still referred to as Omni Support Services (Caregiver acquired Omni in 2017), designed a supported employment program in direct response to consumer demand fueled by the State of Tennessee’s 2018 Employment First (EF) program. EF aims, among other goals, to achieve a stronger shared community commitment to increasing the number of employers that hire people with disabilities. Tennessee is at the forefront of employment supports, one of only two states to receive Core State distinction for the eighth straight year.

William (Will) Blank, Caregiver’s Regional Director for Tennessee, joined the company a year ago and now leads Caregiver Tennessee’s own Employment and Community First (ECF) program.

Will Blank

“By making significant company investments over the past 18 months, we are enthusiastically meeting the state’s Employment First challenge,” he explained.

He said other providers were simply not offering the job support services in ways his company thought most effective.

“To help individuals find meaningful work and contribute in their local communities, Caregiver designed ECF to cover every step in the process,” Blank said. “Our program identifies employers willing to diversify their workforce with IDD employees, facilitates interviews, transports individuals to work, and provides guided instruction by professional job coaches at the workplace. Coaches shadow participants as long as necessary for real time education and skills supports.”

From their Tennessee corporate office in Nashville, Tennessee, Caregiver has recruited ideal staff members to fulfill positions in each area they serve in the state, as well as drawing from their own Direct Service Providers (DSPs) who met the criteria for job coach opportunities. After customized staff training, the resulting suite of employment support services addresses needs and furthers the tenets of Tennessee’s landmark initiative to move IDD individuals from sheltered workshop job settings into their communities to participate in what’s called in the industry competitive, community employment.

Among the most important of Caregiver’s program protocols and tools is professional job coaching. With a coach assigned to each employee candidate with intellectual or developmental disabilities, barriers to employment are greatly diminished.

Beth Landry

Beth Landry, President of Operations for Caregiver Tennessee, Indiana and Ohio, explained: “By pairing experienced, trained professionals with individuals seeking employment, Caregiver is seeing improved outcomes, expanded capabilities and positive responses from the individuals we’re supporting, our employment partners and their patrons.”

Closely supported by his Caregiver coach Craig Adkins, Hunter Lewis is a shining example of the impact of general workforce jobs and real wages — increased compensation from the sheltered workshop setting. According to Employment First’s website, the general workforce should be the first and preferred option for individuals with disabilities receiving assistance from publicly funded systems.

The situation also encourages greater understanding of diversity about individuals with developmental and intellectual disabilities. Work for IDD individuals has wide ranging benefits, not just for the employee, but for his or her co-workers. Each job coach helps teach and enlighten employers by highlighting ways to adapt equipment, develop new techniques, and create cues so that work can proceed seamlessly and effectively. There are more and more employers willing to hire IDD job candidates who can fulfill the roles. Work opportunity tax credits, hiring diversity goals, and the availability of employment supports mean increased opportunities every month.

“The fact is that just about everybody can work,” said Blank, whose healthcare career includes having operated nursing homes for 15 years with the final four years as a Regional Vice President supporting approximately 1,400 residents across Tennessee and Kentucky. He studied business at Tulane University and has an MBA from Auburn University.

Hunter Lewis & Craig Adkins

“The individuals we serve just need the opportunity and coaching. And that’s what we are doing at Caregiver,” he continued. “If barriers like hearing, language, or capabilities happen to exist, our coaches act as a one-on-one mentors available to be with the IDD employee throughout their workday to help them and their employers overcome such barriers.”

Caregiver Tennessee Direct Service Professional and coach Shon Jones serves as a mentor for Caregiver support recipient Rodney Darden (top, right), an employee of Greenwood Cemetery in Nashville, a 115-year-old non-profit corporation with three locations. Jones has observed growing self-confidence as Rodney meets and exceed his goals at Greenwood. He is with him each workday, on site, but it’s Rodney who is growing and succeeding.

Rodney Darden & Shon Jones

“He has gained the respect and admiration of his coworkers at Greenwood,” said Jones. “Rodney is welcomed just like everyone else.”

The current robust economy has helped, too. “Historically low unemployment means individuals who really want to work can have a job,” Blank adds. “Developing great job coaches who understand coaching and can nurture good relationships with employers in the community are critical.”

With coaches and employers in place and buy-in from the managed care organizations such as Blue Cross/Blue Shield, Amerigroup, and United Health Care that provide funding through the Medicare Waiver Program, the program is solidly grounded and ready for expansion.

“Caregiver is dedicated to continuing to partner with the DIDD, Amerigroup, Blue Cross and UHC to support the Employment First initiative so that more individuals like Rodney and Hunter can gain fully integrated competitive employment,” Beth Landry emphasized.

Caregiver Tennessee’s employment supports are just one of the company’s remarkable programs underway.

As Caregiver expands and achieves an even higher profile on the national industry landscape, Caregiver is driving performance outcomes, expanding service delivery, securing effective partnerships, and contributing substantially to the bottom line.

“We have made a significant investment in both time and people to address Tennessee’s Employment First initiative,” said Will Blank. “As a result of the investment, Caregiver has not only helped individuals find meaningful work and enjoy community integration, but also, on the business side, Caregiver Tennessee has doubled ancillary revenues over a six-month period.”


Caregiver Tennessee is based in Nashville, TN, at 301 S Perimeter Park Dr Ste 110, Nashville, 37211. Phone: (615) 832-5454. Caregiver Tennessee is a part of the Caregiver, Inc., family of companies. Caregiver, Inc., is a privately-held company with over 3500 employees within the headquarters support group and branded affiliate organizations in four states. The affiliates provide intermediate, home and community care services to nearly 2800 individuals who qualify as developmentally or intellectually disabled or are impacted by related conditions. Caregiver, Inc. was formed in 2015 and now includes these affiliates: Unified Care Group, Southern Concepts, River Gardens, Daybreak Community Services Inc., St. Giles Living Centers, DSA of Indiana, CG-HHC, All Care Services, T/R Residential, and Omni Support Services of Tennessee. All have similar service offerings and strong reputations in their local communities. Caregiver services include supported home living, family protective services, case coordination, nursing services, respite services, day habilitation, psychology services, dental treatment, specialized therapies, adaptive aids, minor home modifications, and supported employment. Caregiver president and CEO is Mark Lashley. Company headquarters are at 4800 Overton Plaza, Suite 440, Fort Worth, Texas 76109. Phone is (800) 299-5161. They are on the web at


Adapting to Hunter Lewis’ environmental and educational needs required numerous twists and turns in the school system, at home, in their Kingsport, Tennessee neighborhood and in health care settings. Lewis’s parents Hope (currently Kingsport’s city court clerk) and Hobart (now retired) realigned their lives. Lewis spent a decade in special education classes at schools that delivered both the best and the worst that the systems had to offer.

Caregiver’s Craig A. Adkins is Hunter Lewis’s Direct Service Professional (DSP), guide and job coach. Craig is a Certified Employment Support Professional (CESP™) and the Greeneville (East Tennessee) regional office program coordinator for Omni Support Services/Caregiver Tennessee’s Employment and Community First Program. With over 19 years working in the field and having had a personal experience with disability – an accident left him disabled for several years and an aunt has cerebral palsy – Adkins is comfortable, compassionate and adept providing daily care and assisting Lewis’s family as he finds new opportunities for the young man in the community and shadows him at his job at Wendy’s.


Craig & Hunter on an outing


Adkins also oversees the work of additional Caregiver Direct Support Professionals replicating services for other individuals in his region. He lives nearby with his wife and daughter and assists Lewis with life at home and in the community, as he has several times each week for nearly three years.

Beginning in the fall of 2017, Adkins accompanied Lewis to work at Wendy’s where Lewis greets customers, busses tables, and helps clean the restrooms. He also sweeps the dining room, refills the condiment station, and cleans the drink machine. Through his work, Lewis has built self-confidence and gotten a paycheck, some of which he uses to add to his model car collection displayed in his room at home.

“I see his abilities, not his disabilities,” said Adkins. Recently, Adkins has been able to step away one day each week, a huge positive step for Lewis and his family.

IDD employee prospects who contact Caregiver about community job options trigger the process.

  • The company assigns a mentor who works in the community to identify suitable opportunities to present to their clients.

  • If the individuals and their families or guardians think an opportunity could be a good fit, an interview follows.

  • If successful, next comes a job offer.

  • Employees grow in their positions, and coaches adapt their involvement accordingly.

  • Ongoing training and introduction of helpful techniques assure individuals and employers enjoy the accomplishments that follow.

“Work gives people context, meaning, fulfillment, and income,” emphasized Will Blank, Caregiver’s Regional Director for Tennessee.


Hunter working at Wendy’s

Community employment has been rewarding for every aspect of the equation: disabled workers can continually engage with the general public, contribute along with their coworkers, diversify the workforce and make more money. Importantly, these jobs also encourage greater understanding about individuals with developmental and intellectual disabilities by co-workers, customers, and the neighboring communities.


Rodney Darden at work

Rodney Darden goes to work at Nashville’s Greenwood Cemetery wearing his embroidered uniform and provides valuable assistance as he polices the area to pick up and discard trash left on the cemetery grounds. He and his team of co-workers care for the greenspace, share good humor, and deepen camaraderie. Jason Sinecki, Caregiver Tennessee’s Area Director for Middle Tennessee, coordinates efforts for Direct Service Providers like Shon Jones.

“The Greenwood employees interact in ways that workforces at other organizations might find admirable,” states Sinecki. That positive sense of achievement is both general and specific.

“I really like doing a good job,” Darden said. He values and appreciates his paycheck, too. “I keep my money in my billfold, but I like to spend it on food like burgers, fries, and a Sprite.”

Darden puts on his suit every other Sunday so Shon Jones can drive him to church where can sing with his choir, having memorized all the songs. Jones reports Darden eagerly listens to the van radio whenever he can, preferring the sounds of Motown.

In the past, Darden participated in local Taekwondo classes for several months. Once each year, Jones and Darden put on their tuxedos and go together to an annual banquet held by Greenwood in Nashville.

Jennifer Boals

Many individuals supported by Caregiver arrive by referral from independent support coordinators, according to Jennifer Boals, Caregiver’s Area Director for Western Tennessee, based in Jackson. Boals completed her undergraduate degree at the University of Tennessee Martin and earned a Master’s degree in counseling at Freed-Hardeman.

“Support coordinators are the professionals who help our IDD individuals secure a pathway to community-based day services for six hours every day,” she said. “It can be volunteer work, paid work, or school.”

To assure there is capacity for further placement, Boals tries to anticipate at least three months in advance what will be necessary. She then provides education for families and community, one of the most fulfilling aspects of her job.

“This works simply calls you,” she said. “I have such a sense of making a difference in the lives of our adults, and that yields so much satisfaction.”

All Caregiver clients in Jackson have the opportunity to receive community employment supports. Community employment makes a huge difference. Historically, individuals with intellectual and developmental disabilities were primarily employed in sheltered workshop situations. When a series of legal challenges to the sheltered workshop model resulted in increased competitive community employment opportunities, one consequence was a change in requirements. A different set of services would be necessary for individuals to make the transition, such as help developing suitable jobs, identifying ideal positions for specific candidates and, after hiring, supporting the IDD individuals in their new roles.

The transition has been rewarding for every aspect of the equation. Community jobs mean disabled workers can continually engage with the general public, contribute along with their coworkers, diversify the workforce and make more money. These jobs also encourage greater understanding of diversity in general and about individuals with developmental and intellectual disabilities.

Jason Sinecki

Clearly, work for IDD individuals has wide ranging benefits for the individuals, for their employers and for co-workers, customers, and community.

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