10701.1 Supported employment services for individuals with serious mental illness shall:

(a) Provide ongoing work-based vocational assessment, job development, job coaching, treatment team coordination, and vocational and therapeutic follow-along supports;

(b) Involve community-based employment, consistent with the strengths, resources, priorities, concerns, abilities, capabilities, interests, and informed choice of the consumer;

(c) Provide services at various work sites; and

(d) Provide part-time and full-time job options that:

(1) Are competitive, and integrated with co-workers without disabilities;

(2) Provide diverse job opportunities;

(3) Are based in business or employment settings that have permanent employment status rather than temporary or time-limited status; and,

(4) Pay at least minimum wage of the jurisdiction in which the job is located.

10701.2 Effective July 1, 2022, Medicaid reimbursable vocational supported employment services shall be billed in fifteen (15) minute increments and include the following, as defined in Chapter 37 of Title 22-A DCMR:

(a) Intake;

(b) Vocational Assessment;

(c) Individualized Work Plan Development;

(d) Treatment Team Coordination;

(e) Disclosure Counseling;

1. (f) Job Development;
2. (g) Job Coaching;
3. (h) Vocational Follow-Along Supports for the beneficiary and employer;
4. (i) Therapeutic Follow-Along Supports; and,
5. (j) Benefits Counseling

10701.3 In accordance with the eligibility requirements set forth in Chapter 37 of Title 22-A of the DCMR, individuals eligible for vocational supported employment services shall:

1. (a) Be a Medicaid beneficiary at least eighteen (18) years of age;
2. (b) Indicate an interest in employment;
3. (c) Have supported employment identified as a needed service on a current, person-centered plan of care that has been reviewed by DBH;
4. (d) Not be concurrently receiving Assertive Community Treatment (ACT) services, as defined in Chapter 34 of Title 22-A of the DCMR; and
5. (e) Be determined by DBH as meeting the needs-based criteria set forth in Chapter 37 of Title 22-A DCMR.

10701.4 Individuals shall be assessed for supported employment services by DBH.

10701.5 DBH shall conduct the needs-based assessment in accordance with the requirements set forth in Chapter 37 of Title 22-A DCMR and shall conduct a reassessment at least once every twelve (12) months, and as appropriate, based on changes in need.

10701.6 DBH shall be responsible for developing the person-centered plan of care, as identified in § 10701.3(c), in accordance with federal regulations under 42 CFR § 441.725 and requirements set forth in Chapter 37 of Title 22-A of the DCMR.

10701.7 DBH shall also assist the Medicaid beneficiary in identification and selection of a supported employment provider.

10701.8 Following review and approval of the assessment information and person-centered plan of care, DBH shall issue an authorization for the initiation of supported employment services by the beneficiary-selected supported

employment provider, in accordance with the requirements set forth in Chapter 37 of Title 22-A DCMR.

10701.9 DBH shall inform the beneficiary of his or her eligibility for supported employment services.

10701.10 Supported employment providers shall be certified in accordance with the requirements set forth in Chapter 37 of Title 22-A DCMR.

10701.11 A supported employment provider shall develop an Individualized Work Plan for each Medicaid beneficiary receiving supported employment services, in accordance with the requirements set forth in Chapter 37 of Title 22-A DCMR.

10701.12 Medicaid reimbursement shall not be made available for supported employment services provided to a Medicaid beneficiary residing in an institutional setting or any setting that is not in compliance with the Home and Community-Based Services (HCBS) setting requirements consistent with 42 CFR § 441.301.

SOURCE: Final Rulemaking published at 69 DCR 012102 (October 7, 2022).