Working together to improve health care for adults with IDD in Tennessee

Doctor Speaking with Patient. Image by © Royalty-Free/Corbis

Two free, short online training series focused on improving health care for adults with intellectual and developmental disabilities have been created by the Vanderbilt Kennedy Center (VKC), in partnership with the Tennessee Department of Intellectual and Developmental Disabilities (DIDD) and TennCare.

In 2014, the VKC launched the IDD Toolkit, (, an online resource for health care providers to better serve adults with intellectual and developmental disabilities (IDD). The two training series are based on information in the Toolkit.

One series targets health care professionals, including physicians, nurses, pharmacists, and other health care professionals. Free CME/CPD credits are available.

The second training is intended for individuals with IDD, their families, conservators, and other caregivers, including direct support professionals.

While the IDD Toolkit team at the VKC had aimed to create related training opportunities, it was the State’s Exit Plan to end a longstanding federal lawsuit, People First et al. v. Clover Bottom et al., seeking to close one of Tennessee’s large institutions, which helped pave the way for training. In the Exit Plan, the State committed to provide training for prescribers, individuals, and families on appropriate use of psychotropic medications, using the IDD Toolkit. DIDD, TennCare, and the VKC teamed up to produce these two training series.

“The Vanderbilt Kennedy Center is happy to be a partner in this important initiative to increase the capacity of health care providers for people with intellectual and developmental disabilities in the community. One of our focuses is health care, and we know that too many people with disabilities and their families still don’t have access to quality health care in Tennessee,” said Elise McMillan, J.D., co-director of the VKC University Center for Excellence in Developmental Disabilities (UCEDD).

Although the training is entitled “Appropriate Use of Psychotropic Medications for People with IDD: Helping Individuals Get the Best Behavioral Health Care,” the video vignettes also include foundational information about communication barriers that may exist with people with IDD; physical health issues that are more prevalent in this population; and emotional, behavioral, and mental health concerns that may be more difficult to diagnose in this group.

The training for medical professionals can be accessed at:

Information on the enrollment process is available at:

The training program is designed to accommodate the busy schedules of practicing professionals by offering roughly 90 minutes of training in eight 10- to 15-minute modules, each of which can be completed independently. A brief competency-based test at the start and end of each module helps to ensure understanding of key concepts. Satisfactory completion of all modules, including competency checks, is required in order to receive free CME/CPD credits for the training (1.5 hours AAFP Prescribed credits, 1.5 AMA PRA Category 1 credits for physicians and advanced practice nurses with prescription authority, and 1.5 APA CE credits).

“This training is a great example of cooperation between multiple government agencies and private institutions that will greatly enhance care for these patients. There is something of benefit for all providers in these videos,” said Dr. Vaughn Frigon, chief medical officer for TennCare.

The version for individuals, families, other caregivers and conservators, which is approximately an hour, can be found at:

This training also is divided into eight 5- to 13-minute modules, which can be completed in any order. Pre-test and post-test questions are provided to help in the retention of the material. Participants in the family training receive a certificate at the end of each module.

Among the many health disparities that people with intellectual and developmental disabilities experience, research has found that often psychotropic medications are prescribed for people with IDD to try to address “challenging behavior,” despite little evidence that such medications are effective in treating such behaviors. In addition, many people with IDD end up receiving drugs from multiple classes of psychotropic medications, resulting in what is called polypharmacy. Frequently treatment plans do not include a strategy to taper or discontinue these medications.

“When looking at people with IDD, you have a population that can be extremely difficult to diagnose for a number of reasons,” said Dr. Tom Cheetham, deputy commissioner of Health Services for DIDD. “Combine that with practitioners who don’t receive much training on this specialized population and you end up with many patients taking too many unnecessary medications.”

The aim of the medical provider training is to empower health care professionals to have more knowledge and skills to feel more comfortable in treating adults with IDD.

The family/caregiver training aims to build the confidence of individuals, families, and caregivers to create a partnership with their health care provider. The videos encourage families and caregivers to ask questions and provide information to the health care provider about conditions and behaviors and other factors that can impact behaviors—when they occur, why they occur—that will help the doctor better identify the appropriate treatment, including interventions other than drugs when possible. Creating such a partnership can make a powerful difference in the health and well-being of the person with IDD.

The Vanderbilt University team that made these trainings possible included Janet Shouse, program coordinator for the IDD Toolkit; Elise McMillan, co-director of the VKC UCEDD; Jon Tapp, VKC director of information technology and webmaster; Dr. Tom Cheetham, DIDD deputy commissioner of Health Services; Dr. Beth Malow, professor of Neurology and Pediatrics; Dr. Elisabeth Dykens, VKC director and Annette Schaffer Eskind Chair; Don Moore, director of the Vanderbilt Office of Continuous Professional Development (OCPD); Nanette Bahlinger, assistant director for educational planning services for OCPD; Sarah Krentz, health informatics consultant; Cindy Franco, product manager for Education Informatics; Jan Rosemergy, VKC deputy director and director of Communications; Joanie Crowley, a member of the VKC Community Advisory Council; and several graduates of the Next Steps at Vanderbilt postsecondary education program.

For additional information about the health care training series or about the IDD Toolkit, please contact Janet Shouse at 615-875-8833 or email

Janet Shouse is a VKC UCEDD staff member working with the IDD Health Care Toolkit and related training, with Putting Faith to Work (Kessler Foundation funded), and with the TennesseeWorks Partnership (AIDD, ACL, HHS funding).

Pictured top of page: A doctor speaks with her patient. Image by © Royalty-Free/Corbis.

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