Tennessee
Tennessee is worst in the nation in supporting caregivers, but here’s how to change that
It’s time for Tennessee to acknowledge the tireless efforts these family caregivers provide and pay them for their work
Tennessee Voices: A conversation with Elizabeth Moss
Tennessean Opinion Editor David Plazas spoke to Elizabeth Moss, founder, Caregivers by WholeCare
Nashville Tennessean
Tennessee ranks last in all 50 states and D.C. in its treatment of family caregivers according to a 2023 AARP report.
This comes as no surprise to Tennessee families who must care for loved ones with disabilities and/or who are aging.
The expectations and stress related to family caregiving are too high and have become unsustainable.
Every day, families reach a breaking point, as one family caregiver explained, “I would like there to be 24/7 support for my son in the family home. He would get this support in any other residential setting, but since he lives with me, it’s expected that I will do everything over 40 hours a week for free. It’s just too much to expect of any person. It’s no wonder that family caregivers go into crisis. Can’t live on four hours of sleep indefinitely.”
During the COVID-19 public health emergency, many states paid family caregivers as a method of protecting medically frail individuals during the pandemic. This experiment helped states understand that paying family caregivers is not only a tool to keep vulnerable community members safe and out of an institutional setting. It also provides critical relief for the family caregiver. It’s time for Tennessee to join this trend and pay these unsung heroes for their work. We can do this through Medicaid Structured Family Caregiving.
Change the system so it works for Tennessee families
Compensating family caregivers is a strategic investment in healthcare. Studies consistently show that family care at home significantly decreases health care utilization such as ER use. Paying family caregivers also recognizes caregivers as integral members of the healthcare team for the person supported. Not only will this prevent the undervaluing of their work but will also promote equity as Black and Hispanic households are more likely to take on family caregiving roles.
Right now, our state’s Medicaid program, TennCare, only has the option of “Consumer Direction” as an indirect way for family caregivers to be compensated.
However, many families have found this option to be impossible to implement. The most impractical barrier for many families is that immediate family members or any person that lives with the person supported, or even lived with the person in the last five years, cannot be paid through Consumer Direction. This structure just doesn’t work for many families.
But we can change the system so that it does work for those who are aging, those that have disabilities, and their families. Implementing this policy requires thoughtful analysis of what Tennessee families experience today, the experience during COVID, and what other states are trying now.
One option that Tennessee can study is Georgia’s state agency, Health Force of Georgia, which manages hiring and paying family caregivers. Another option is the agency-directed model, where family members are hired by existing agencies, as seen in Oregon.
Care giving should not become a financial burden
It’s time to acknowledge the tireless efforts these family caregivers provide and pay them for their work.
They shouldn’t have to choose between caring for a loved one and financially supporting their family.
This not only helps value their work but also reaches the heart of what our TennCare program is about – providing healthcare to Tennesseans.
Vanessa Zapata is an attorney and the director of health policy and equity at the Tennessee Justice Center. She provides direct services to individuals having issues navigating public benefits programs like TennCare Medicaid. She advocates for policies that strengthen public benefits programs, remove access barriers to these programs, and promotes health equity.
Mark Green, a physician and retired U.S. Army surgeon, represented Tennessee’s 7th congressional district from 2019 until his resignation in 2025. A Republican, Green chaired the House Committee on Homeland Security from 2023 to 2025 before leaving Congress to enter the private sector.
A West Point graduate, Green served as an infantry officer before earning his medical degree at Wright State University. He became a flight surgeon with the Army’s elite 160th Special Operations Aviation Regiment, participating in missions in Afghanistan and Iraq, including Operation Red Dawn, which captured Saddam Hussein. He later authored a book about the experience.
After retiring from the military in 2006, Green founded Align MD, a hospital staffing company, and launched a medical foundation providing care to underserved communities. He entered politics in 2012, winning a Tennessee Senate seat, where he championed legislation to repeal the state’s Hall Income Tax and expand protections for veterans and small businesses.
Green was elected to Congress in 2018, succeeding Marsha Blackburn, and won reelection three times. His tenure included a brief bid for House Speaker in 2023 and leadership on homeland security issues. He announced his resignation in June 2025 after the passage of the “One Big Beautiful Bill Act,” ending his congressional career on July 20.
Tennessee
TN special election: Voters to decide between Republican Van Epps, Democrat Behn to fill vacant congressional seat
NASHVILLE, Tenn. (WSMV) – It all comes down to Tuesday, December 2, as voters will decide between Republican Matt Van Epps and Democrat Aftyn Behn to fill Tennessee’s 7th Congressional District seat left vacant by former Rep. Mark Green.
The 7th congressional seat was formerly filled by Green, a combat veteran, emergency room doctor and former state senator, who announced his retirement from politics twice to pursue a career in the private sector.
Results – Special Election: U.S. House of Representatives 7th Congressional District
District 7: The 7th Congressional District spans 14 Tennessee counties, including Benton, Cheatham, Davidson, Decatur, Dickson, Hickman, Houston, Humphreys, Montgomery, Perry, Robertson, Stewart, Wayne and Williamson.
Latest: Poll shows Republican Van Epps holding slight lead over Democrat Behn in Tennessee’s special congressional race
A new survey from Emerson College Polling/The Hill survey shows that 48% of voters support Van Epps and 46% support Behn. It also found that 2% plan to vote for one of three third-party candidates on the ballot, and 5% are undecided.
Here is the official list of candidates:
- Matt Van Epps – Republican
- Aftyn Behn – Democratic
- Teresa “Terri” Christie – Independent
- Bobby Dodge – Independent
- Robert James Sutherby – Independent
- Jon Thorp – Independent
Representative Aftyn Behn (D-Nashville): State representative elected in a 2023 special election who says she has “fought to keep our families safe, standing up to those who siphon wealth from our neighborhoods while stripping away our freedoms.”
Matt Van Epps: A combat veteran who worked in the Tennessee Department of General Services under Gov. Bill Lee, who says he “understands the values of hard work, personal responsibility, and service to community that define this great state.”
Previous: Trump-backed Van Epps and Democrat Behn win Tennessee primaries for US House special election
Here are when Special Election Day polls will open in each District 7 county:
- Benton County – 8 a.m.
- Cheatham County – 7 a.m.
- Davidson County – 7 a.m.
- Decatur County – 8 a.m.
- Dickson County – 7 a.m.
- Hickman County – 8 a.m.
- Houston County – 9 a.m.
- Humphreys County – 9 a.m.
- Montgomery County – 7 a.m.
- Perry County – 9 a.m.
- Robertson County – 7 a.m.
- Stewart County – 8 a.m.
- Wayne County – 8 a.m.
- Williamson County – 7 a.m.
All polls will close at 7 p.m. on Tuesday, December 2.
Only registered voters who live in the U.S. House District 7 are eligible to vote in this election. Voters can check which congressional district they live in and also find their polling locations here.
Copyright 2025 WSMV. All rights reserved.
The Tennessee Titans (1-11) took a massive step backward in their Week 13 matchup against the Jacksonville Jaguars, looking more like the undisciplined, unprepared team from earlier in the season than the unit that put up a fight against the Seattle Seahawks a week ago.
Tennessee struggled to get anything going, and between penalties, poor offensive line play, and allowing too many explosive plays, they had no chance against a Jaguars team that came to play and left with a share of the AFC South division lead.
The Titans will regroup and prepare for a trip to Cleveland to face Shedeur Sanders and the Cleveland Browns.
Before we move on, here’s a quick report card from Sunday’s action.
Offense
Cam Ward was not sharp, and he got little help from his perimeter receiving corps, who could not gain separation throughout the afternoon and had too many drops. Couple that with a dismal performance on third downs, and the unit got nothing going after the initial drive of the game.
The offense started with one of its best drives of the season, mixing run and pass, but after that, the issues that had plagued them early in the season came rushing back, and the unit looked completely overmatched by the Jaguars’ defense. It was a rough outing and a definite step back.
Grade: D
Defense
The defense was better than it was against the Seahawks, but the lack of cornerback depth without Jalyn Armour-Davis was noticeable. The unit is already thin and struggles to match up with the Jaguars’ receiving corps. When you couple the secondary struggles with an invisible pass rush, it makes for a long afternoon.
While they were better this week, the defense still gave up too many big plays, got almost zero help from the offense (or special teams), and wore down.
Grade: C
Special teams
The special teams were anything but special. Between turnovers and crushing penalties, they were unable to capitalize on some opportunities and, for the most part, had a rough day.
Chimere Dike did rip off another big return and made some other plays that made an impact, but his first-quarter fumble on a kickoff return changed the momentum of the game, and the Titans never recovered. Joey Slye made his only attempt for the Titans’ only points, but that was nowhere near enough.
Grade: C
Coaching
Yes, Tennessee entered the game with some injuries and roster questions, but after the first series, it appeared completely unprepared to take the field on Sunday. In a game that turned into a flagfest with 23 combined penalties, the Titans’ lack of discipline again came to light, and they got the worst end of the penalty stick with 13, including multiple that gave the Jaguars new life.
Tennessee has shown some improvement in recent weeks, but that was far from the case this week, with the team looking more like the Brian Callahan-led unit than those that took the field against the Houston Texans and Seattle Seahawks.
Grade: D
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