By: Jackie Kancir, Executive Director, National Council on Severe Autism
In Tennessee today, hundreds of families are at risk of losing access to the only clinic in our state designed specifically for adolescents and adults with severe autism and intellectual and developmental disabilities (IDD). Kramer Davis Health in Hermitage has announced it may be forced to close. The consequences would be devastating, not only for patients and families, but also for TennCare and taxpayers.
#AuthenticAwareness - Why We Cannot Afford to Lose Kramer Davis
In January 2020, before Kramer Davis existed, my daughter developed a severe abscessed tooth. Despite her minimal verbal communication abilities, her pleas for help were undeniable yet ignored. We went from dentist to dentist. It took taking her to three different dentists over a period of weeks before finding one to even prescribe an antibiotic. It wasn’t until the fourth provider that she finally received treatment. The delay was inhumane and dangerous. Back then, my dog’s pain was considered and managed better by my veterinarian than my daughter’s was by available providers.
This remains the reality for most adults with severe autism. Clinics like Kramer Davis are rare. NCSA’s New York State Chair, Steve Gonyea, reports that families are waiting three years to access dental care. “I know families who would book a flight and travel to Tennessee to access a clinic like that,” he told us when he heard the news of Kramer Davis’s closure announcement.
For the first 20 years of her life, my daughter, now 22, was required by dentists to undergo full sedation for anything beyond a simple cleaning or X-rays, but in the past two years at Kramer Davis, she has needed no sedation at all, not even for a filling. Instead of fear, she’s developed trust. She actually loves going there because the transdisciplinary, sensory-friendly approach makes care humane, safe, and positive.
Fast forward to last year: she walked out of her dental appointment at Kramer Davis smiling. She even took her own selfie with her iPad of her clean pearly teeth. She especially loves the special chair designed for patients like her when she attends the clinic for her medical needs. No sedation, no trauma, no being turned away. That transformation — from neglect to dignity — is what Kramer Davis represents.
These photos tell the story: from pain and rejection to dignity and joy. Kramer Davis gave my daughter back her smile and so much more.
More Than a Clinic
Kramer Davis is unique. It is Tennessee’s only transdisciplinary health clinic for people with severe autism and IDD, bringing together medical, dental, behavioral, and therapy services under one roof. This model closes the dangerous gaps that too often push patients into ERs or psychiatric wards when underlying medical issues go untreated.
Early data estimates the model has reduced
ER visits by 31%
Inpatient stays by 45%
Readmissions by 60%.
Kramer Davis also avoids general anesthesia in 93% of dental cases where it would otherwise be required, sparing patients significant risk and the healthcare system considerable cost. The clinic reduces the healthcare spend for its current 600 patients by more than $16 million annually. Critically, it is one of the only clinics in the nation with a no-expulsion policy: patients are never turned away for behaviors. For families who have been turned away everywhere else, it is literally the end of the line — a true safety net.
NCSA is presently running a nationwide survey for family caregivers of severe autism. Our latest preliminary data shows that 80% of families have been denied access to services being told their child was “too severe” or “not a good fit.” Of those who could find services, 54% had been discharged from a provider (e.g. therapy, clinic, school, etc) because of their behavioral challenges. Kramer Davis has developed a solution to a pervasive problem facing families all across the nation.
Beyond direct care, Kramer Davis also addresses a systemic crisis: physician training. Most doctors and dentists graduate with less than an hour of education on treating individuals in this special population. By functioning as a teaching clinic, Kramer Davis is preparing the next generation of providers and building the healthcare workforce Tennessee desperately needs.
If this clinic closes, patients from 52 counties, many of whom already travel long distances for care, will have nowhere to turn. TennCare will see higher costs as patients return to ERs and hospitals, and Tennessee will lose this innovative site for training doctors and dentists to care for people with severe autism and IDD.
Impact Beyond the Walls (and State)
“There’s no words that can adequately describe the relief I am feeling right now.” (One of the recipients in Colorado of the Rideshare Safety Partition partnership with NCSA.)
The innovation at Kramer Davis extends far beyond direct care. For example, I fought unsuccessfully for five years for safe transportation for my daughter. We had countless life-threatening situations trying to get her to appointments. Providers wrote letters, we sent videos, but nothing worked.
Then a Kramer Davis nurse practitioner stepped in with a dogged determination and got a vehicle safety partition approved under my daughter’s existing adaptive technology waiver benefits. That breakthrough spread to other families in Tennessee and even nationally, leading to a partnership between NCSA and Rideshare Safety Partition that distributed partitions for free to families across the country. Today, countless lives are safer because one provider at Kramer Davis refused to give up when the system had failed us.
“Just as ripples spread out when a single pebble is dropped into water, the actions of individuals can have far-reaching effects.”
Learn More
Watch the full webinar we hosted with Kramer Davis Health in 2024 to see inside the clinic and hear from founder Dr. Matt Holder.
“Part of our mission is not only to help solve this health care — I think of it as a crisis, but certainly a problem — whereby we have a lot of individuals who have these complex needs and not nearly enough health care providers who know how to work with people with these complex needs....It’s not just a clinic that provides these services, but it’s also a teaching clinic so we can help educate them and show them how it’s done. We take it up an extra step and really try to see ourselves as people who can help assist our patients in having a better quality of life, period.”
A Call to Action
Kramer Davis has announced it may be forced to close. The loss would be devastating for families and for Tennessee as a whole.
🔹 Tennessee Policymakers and Disability Organization Leaders: I invite you to join me in building a unified strategy to protect this clinic and create sustainable solutions. Please email me at policy@ncsautism.org to collaborate.
🔹 Families: Your stories are powerful and essential. Kramer Davis has created a form for families who want to be notified of ways to share your experiences. Please sign up and add your voice. Use #SaveKramerDavis on social media.
Kramer Davis has already proven what is possible: safer care, lower costs, and restored dignity for those too often left behind, but its future now depends on all of us. Advocates, leaders, and families must stand united to keep this lifeline open. Together, we can ensure that Kramer Davis not only survives but thrives as a model of care for Tennessee and beyond. Join us, share your story, and stand with us to #SaveKramerDavis.
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