How Tennessee Fails a Child in Crisis

For Kim Battinelli, life changed drastically in the fall of 2020. Just a year after losing her father to cancer, her husband of nearly 15 years was diagnosed with stage 4 colon cancer. As he began treatment, their son Caden—who is autistic and nonverbal—began showing signs of escalating behavioral challenges. At the time, Kim couldn’t fully grasp how the next few years would unravel. 

Now, in 2025, Kim is at risk of losing custody of Caden to the Department of Children's Services—not because of abuse or neglect, but because Tennessee lacks adequate support systems for families like hers. 

“It’s been a long road,” Kim shares. “A lot of time has been spent trying to get the help Caden needs, and I still only probably have about half of what I need. There’s nowhere left to turn,” she says. 

The Battinellis have called Tennessee home for 15 years, settling into their current house in Spring Hill a decade ago. Kim lives with her two sons, Caden and Brody, and their dog, Buster. Her oldest son, Brody, has been her anchor: “He’s been my rock through all of this,” she says. 

In February of 2023, after 14 rounds of chemotherapy and a clinical trial, her husband passed away. “Once my husband passed, I realized how much help I really needed,” Kim says. 

That realization came after years of trying —and failing— to get Caden the support he needs. Diagnosed with autism spectrum disorder, Caden is nonverbal and requires 24/7 supervision. He requires intense behavioral support to keep him safe.  

“Caden’s smile is contagious, he’s adorable,” Kim says. He loves to swim, even at 6 a.m. before school, and paddleboard with his mom. But he needs eyes on him constantly. 

Kim has spent over a decade trying to get services for her son, especially Applied Behavior Analysis (ABA) therapy, which she sees as the most comprehensive form of support. “ABA encompasses speech, Occupational Therapy, his whole life,” she explains. “Once we moved into this house 10 years ago, I started looking for ABA, and I realized I wasn’t able to find it. I couldn't get anyone out here. And I thought – gosh – maybe I’m doing something wrong." 

Even though Caden now qualifies for 35 hours of in-home ABA per week, getting to that point has been a ten-year uphill battle. 

“Filling out ABA paperwork is worse than a mortgage. And then, it still falls through,” she says. “There are organizations, but no providers. Nobody to actually come out and help.” 

Emily Jenkins, a staff attorney at the Tennessee Justice Center (TJC) who has worked closely with the Battinelli family, says Kim’s experience is heartbreakingly common. 

Jenkins explains that there’s more to getting care for a child with complex disabilities than just securing TennCare: “Even once they have coverage, their children’s needs are so complex, and they require such specialized services, that finding someone who can meet those needs is really a battle,” Jenkins explains. “It can be months – and in cases like this even years – to try to find a provider who is set up to provide for their needs.”  

She points to the compounding barriers families face. Even if one service needs get met, such as behavior support, then the next challenge arises. “Where do you go get dental care with someone who understands children who may not react well to the stress of a dental environment?” Jenkins questions. “It’s one upward hill after another.” 

Indeed, Tennesseans with intellectual and developmental disabilities (IDD) often require a coordinated, holistic approach to care. Yet in Tennessee, families are left navigating a fragmented and insufficient system. In Spring Hill, there are currently no ABA clinics. A new one recently opened in Thompson’s Station, but it only serves children under 12. Caden had just turned 13. 

And the options continue to shrink.  

In early September 2025—the very day of Caden’s first scheduled appointment—Kramer Davis, a well-regarded clinic in Hermitage that served patients with IDD, closed its doors due to a funding shortfall. The clinic had become a lifeline for nearly 650 patients and their families. Its closure sent shockwaves through a system already on the brink.  

“Even when we had it, it was just one clinic across the entire state. There’s a real hole in the services that meet the full spectrum of needs for people with complex disabilities,” Jenkins remarks.  

Kim kept a spreadsheet—over 180 entries long—tracking the dozens of companies and clinics she contacted for help. The answer was almost always no. 

Sometimes it was the family’s location or insurance. Other times, Caden's age or his need for specialized behavioral supports. Or simply the fact that he is nonverbal. “There was always an excuse for why a company would say no to us,” she says. “I’d hang up the phone and just cry. How can nobody help us?” 

Caden also receives about an hour of speech and occupational therapy per week through the school system; “definitely not enough,” Kim says. Finding psychiatric care for a nonverbal child has also been nearly impossible. 

Kim’s financial situation only adds to the challenge. After her husband’s passing, she lost access to the Katie Beckett waiver but now qualifies for Medicaid. Still, the family’s modest assets—like a second car— have disqualified them from certain state programs like Employment and Community First (ECF) CHOICES.    

“It’s absurd to think we can’t get in-home help [from ECF CHOICES] because my family has two cars,” Kim says. For a family caring for a child with intense needs, shared transportation is unrealistic. “My oldest can drive now, but that doesn’t matter to [TennCare],” she adds. With Caden’s care schedule, and Brody trying to live a normal teenage life, a second vehicle is far from a luxury.  

Her fear now is what will happen if Caden can’t stay at home. Kim has already looked into residential placements, both for when he turns 18 and in case something ever happens to her. But so far, none seem viable. 

“I called everywhere in the state. There were two places that would take him, and I’d never send him there again,” she says. The last time Caden was placed at one of those facilities, he lost thirty pounds and came back with bruises. “Finding a place that has good reviews and will take care of him if something happens to me is impossible to find. I’m still looking to this day,” she explains. 

Kim is quick to point out that she’s not asking for special treatment—just fair access to services to which her son is legally entitled. “There really wasn’t anything for [the state] to do for us. And there’s nothing else—for nonverbal kids especially.” 

She says providers often don’t know how to handle nonverbal children, and services for them should be treated as their own category. 

“Everything about working with nonverbal kids is different. It makes a difference in who you can go to for help, in every field,” she says. “A lot of times, Caden is the first nonverbal child they’ve ever worked with.” 

Her message to lawmakers is simple and urgent: families like hers cannot do this alone. “They say it takes a village, and it really does to raise these kids. I’m grateful for my neighbors, but I think the government has let us down a little bit.” 

Kim credits organizations like TJC and attorney advocates like Emily Jenkins for giving her a glimmer of hope. “She helped me get ABA. She’s looked into residential options. She’s been amazing. You can tell how much she cares.” 

It was Emily who eventually got Kim on the phone with the Vice President of Behavioral Health Services at UnitedHealthcare—a connection that finally led to her being matched with the company that now provides Caden’s in-home ABA therapy. 

But the emotional and physical toll remains heavy. 

“My body is really hurting over the stress from the past five years. It’s hard for me to take care of him - it takes everything out of me.” 

Still, Kim refuses to give up. 

“At some point every day, I lose hope,” she says. “But then I get back up again. You got to keep going. I’m not one to give up or give in easily.” 

For all the frustration and heartbreak, Kim still speaks with a deep sense of gratitude. 

“There are a lot of people out there that want to help, they just aren’t able to get it to me. And so, I just want to thank all those people that have tried.”  

Above all, she remains proud of her kids. And she continues to do everything in her power to give Caden the care he needs to navigate the world safely. 

Watch Kim Battinelli's story HERE.