HR built for Tennessee behavioral health
That is the Tennessee reality right now. We stop the churn and re-paper the files the state now asks for.
Three facts about working in Tennessee
Every figure below comes from a Tennessee state document or a federal dataset the state itself cites. Follow the link and read it yourself.
of everyone who leaves a Tennessee direct support job is gone within six months of being hired
A further 24 percent leave between six and twelve months. Caregiver and direct support vacancy runs 13 percent statewide. The problem is not attracting people. It is the first six months.
What your regulator actually wrote
We read the rule text, the provider manuals, and the bulletins so you do not have to. Each quote below is copied from the primary document and linked to it.
An employee on either the Abuse Registry or Sexual Offender Registry is ineligible to remain employed by or work as a volunteer or independent contractor with the licensee in any capacity.
Read the source document →
This description shall include whether this employee will be designated as an employee who can be assigned as an employee to assist individuals not capable of self-preservation.
Read the source document →
Facilities shall implement drug screenings for all persons providing direct services on behalf of the Facility regardless of whether persons are employed, contracted, or volunteering.
Read the source document →
What we would fix first in Tennessee
Three problems we hear from Tennessee operators, the published evidence behind each one, and the program we run against it.
Tennessee moved its shortage metric from 13.2 percent to 13.25 percent in five years.
This is not a criticism of the people who did the work. Tennessee built a scholarship program, added recurring rate money and stood up a new department. The pipeline grew. The gap did not close. Understanding why is worth more to an operator than another funding announcement.
Where Tennessee started
TDMHSAS and TennCare’s December 2021 Public Behavioral Health Workforce Workgroup report cited a psychiatrist percent of need met of 13.2 percent, using federal data as of September 30, 2020.
The same report projected shortfalls by 2030 of 1,270 mental health counselors, 890 psychologists, 830 substance abuse counselors and 780 psychiatrists.
Where Tennessee is now
As of December 31, 2025, Tennessee has 97 designated mental health professional shortage areas, 3,143,942 people living inside them, and a percent of need met of 13.25 percent. Eliminating the designations would take 252 additional psychiatrists.
In between, the state spent more than $10.3 million on the Behavioral Health Pathways Scholarship over two years and added an $18 million recurring provider rate pool.
Tennessee proves that a workforce strategy which stops at recruitment stops working. Whatever the state builds upstream, the retention happens inside your building.
Fifty eight percent turnover, thirteen percent vacancy
These come from Tennessee’s own commissioned instrument, not the national survey, which is why they are not directly comparable to the figures other states publish.
University of Minnesota Institute on Community Integration, Tennessee LTSS Workforce Quality Improvement Survey, Year Six Report, Tennessee state profile, 2023 survey year, administered for TennCare and DIDD. Read the source. Reported starting wage $14.55, average $15.01. This is Tennessee’s own instrument and not the National Core Indicators survey. Do not line these bars up against another state’s NCI figure. They are not measuring the same way.
Ten Tennessee metros, and the wage the scholarship graduate walks into
The pipeline puts a trained person at your door. This is what your offer looks like to them once they get there.
Direct care wage is the employment weighted median for front line direct care roles. The local wage floor is what the same worker can earn in retail and warehouse work in the same metro. Rent is the HUD Fair Market Rent for a one bedroom, FY2026. Full method and open data at the Direct Care Staffing Index.
The state’s public behavioral health system has significant challenges in recruiting and retaining an appropriate workforce.
Tennessee Department of Mental Health and Substance Abuse Services and TennCare, Public Behavioral Health Workforce Workgroup: Strategies for Meeting the Need in our Communities, December 2021, Executive Summary page 3. Read the source.
What changed in Tennessee, and one rule everyone still gets wrong
A new department, a live scholarship pipeline, and a background check rule that is routinely misquoted.
The Department of Disability and Aging launched
The Tennessee Disability and Aging Act merged DIDD with the Commission on Aging and Disability into a single department. Credentialing and provider standards documents are still being reissued under the new name, so check which agency letterhead your current policy references.
The ten day background check allowance was repealed
This is the one to fix today. Older guidance said a check could be completed within ten days of hire. That allowance was deleted by 2024 Tenn. Acts ch. 688. The current rule under T.C.A. 33-2-1202 is absolute: the check must be completed before allowing the person to have any direct contact with or direct responsibility for service recipients. If your onboarding still has a ten day window in it, close it.
The scholarship keeps producing candidates
TDMHSAS reopened the Behavioral Health Pathways Scholarship application portal in August 2025. Graduates are entering the market. Whether they stay is a question the state cannot answer for you.
Three things a Tennessee provider should do this month
Delete the ten day background check window
If any policy, offer letter or onboarding checklist you own still allows a person to start before the check clears, it is describing repealed law. The rule is now: no direct contact until the check is complete. This is a same day fix.
Rebuild the file to Rule 0940-05-06-.04(2)
The rule requires the background check evidence, status on the Tennessee Elderly and Vulnerable Abuse Registry, status on the Sexual Offender Registry, date of birth, social security number and records of any disciplinary action. Plus five years of work history and three references under the statute. Compliance Confidence™ builds it once.
Catch the scholarship graduates before someone else does
Tennessee is funding the pipeline. It is not assigning the graduates. The provider with a real onboarding experience and a supervisor who has been trained to keep people is the one who converts that public investment into their own staffing. Retention Reset™.
Start with the Workup
A full diagnostic of your workforce across eight dimensions, scored and mapped, with the gaps ranked. It credits toward any TWF Signature Program.
Built for the organizations others find too complex
Straight answers
Do you know the 0940 licensure rules?
Yes. We build to the current TDMHSAS Chapter 0940 rules, including the 0940-05-06 minimum program requirements effective May 25, 2026, and the opioid treatment and office based treatment chapters effective in September 2025.
Where does your Tennessee turnover figure come from?
The Tennessee LTSS Workforce Quality Improvement Survey, Year Seven Report, prepared by the Institute on Community Integration for TennCare and the managed care organizations. It reports 48 percent caregiver turnover for calendar year 2024.
How fast do you respond?
We respond to new inquiries within 2 hours.
What does the first step cost?
The Workup™ diagnostic starts at $1,750 and credits toward any TWF Signature Program.
Metro pages: Atlanta · Charlotte · Raleigh · Durham · Greenville NC · Nashville · Richmond · Jacksonville · Birmingham. Open workforce data for 90 metros lives at our public dataset.
The Tennessee advisory brief
Every rule on this page, quoted in full, dated, and linked to the state document it came from.
Read the Tennessee brief →Talk to an HR partner
Get a straight answer about your workforce.
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