8607 PROGRAM SERVICES: SUPPORTED EMPLOYMENT SERVICES FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESS

8607.1 Supported employment is an evidence-based practice that:

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

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

(c) Provides services at various work sites; and

(d) Provides part-time and full-time job options that: are diverse, competitive, and integrated with co-workers without disabilities; are based in business or employment settings that have permanent status rather than temporary or time-limited status; and which pay at least minimum wage of the jurisdiction in which the job is located.

8607.2 Effective February 1, 2020, Medicaid reimbursable vocational supported employment services shall 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;

(f) Job Development;

(g) Job Coaching; and

(h) Vocational Follow-Along Supports for the beneficiary and employer.

8607.3 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:

(a) Be a Medicaid beneficiary at least eighteen (18) years of age;

(b) Indicate an interest in employment;

(c) Have supported employment identified as a needed service on a current, person-centered plan of care that has been reviewed by DBH;

(d) Not be concurrently receiving Assertive Community Treatment (ACT) services, as defined in Chapter 34 of Title 22-A of the DCMR; and

(e) Be determined by DBH as meeting the needs-based criteria set forth in Chapter 37 of Title 22-A DCMR.

8607.4 Individuals shall be assessed for supported employment services by an entity designated by DBH.

8607.5 The designated assessment entity 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 every one hundred and eighty (180) days or upon significant change in the beneficiary's condition.

8607.6 The designated assessment entity shall also be responsible for developing the person-centered plan of care, as identified in § 8607.3(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.

8607.7 The person-centered plan of care must be reviewed and revised by the designated assessment entity in accordance with the requirements set forth in Chapter 37 of Title 22-A of the DCMR.

8607.8 The designated assessment entity shall also assist the Medicaid beneficiary in identification and selection of a supported employment provider.

8607.9 The assessment and the person-centered plan of care shall be reviewed by DBH, consistent with the requirements set forth in Chapter 37 of Title 22-A of the DCMR prior to initiation of supported employment services.

8607.10 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.

8607.11 The designated assessment entity shall inform the beneficiary of his or her eligibility for supported employment services.

8607.12 Supported employment providers shall be certified in accordance with the requirements set forth in Chapter 37 of Title 22-A DCMR.

8607.13 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.

8607.14 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 68 DCR 5406 (May 21, 2021).