CLASS Supported Employment & Employment Assistance

As a Long-term Care program, CLASS did not originally include assistance related to education or employment.

But currently, we are able to address employment-related needs with 2 services:

  • Employment Assistance (EA) – which is assistance finding employment
    • CLASS can provide this assistance in 2 circumstance:
      • CLASS may provide EA to individuals who have applied for VR services until the VR Individual Plan for Employment (IPE) is signed and dated. 
      • CLASS may provide EA to individuals who are denied TWS-VRS services.
    • But if a person refuses to contact TWS-VRS, they may not receive CLASS EA.
  • Supported Employment (SE) – which is support to maintain employment
    • CLASS can provide SE to individuals who need assistance maintaining employment. (ie. who are already employed)
    • CLASS can provide SE to individuals who are denied TWS-VRS services.
    • Referred to as “Extended Services” by TWC.

Here are Resources that Support CLASS policies:

  • Reference to Employment Assistance and Supported Employment in the CLASS Provider Manual
    • Section 7000, Billing/Record Keeping Requirements
      • 7240 Supported Employment, Prevocational Services and Employment Assistance
        • 7241 Supported Employment
        • 7243 Employment Assistance
        • 7800 Service Delivery Record
          • if the individual requires supported employment services and is not already employed, written verification of HHSC determination of eligibility or denial of supported employment services;
          • if the individual requires employment assistance services, written verification of the HHSC determination of eligibility or denial of supported employment services unless CLASS employment assistance services are being provided while awaiting HHSC to develop an individual plan for employment (IPE) for the individual;
          • Evidence that employment assistance is not available to the individual under a program funded under §110 of the Rehabilitation Act of 1973 or under a program funded under the Individuals with Disabilities Education Act, must include documentation of the individual having applied for HHSC.
          • Individuals receiving educational services through a school system must seek to have employment assistance or supported employment services included in the Individual Education Plan, when appropriate.
  • Reference to CLASS in the HHS Guide – Employment for People with Disabilities
    • Pg 3: Table of contents
    • Pg 5: HHSC programs that include employment services:
    • Pg 6: Chart of HHSC programs that include employment services
    • Pg 15: Under “Help to Locate services.”
    • Pg 23: Attachment A: HHSC Employment-Related Policies
      • Service Planning: The service planning team is responsible for developing a program plan that is responsive to a person’s needs, including a request for employment.
      • Providing employment-related services and supports: The program provider is responsible for providing or arranging services and supports, including employment-related services and supports that are responsive to support and achieving goals identified in the person’s program plan.
      • Transportation: Transportation to and from potential job sites is included in the employment assistance rate. Transportation to and from a job site is included in the supported employment rate. Habilitation including transportation as an allowable activity, which may be used to get to and from a community location, including a job.
      • Other services that support employment: Habilitation may be provided at community locations, including the job site.
      • TWS-VRS referral: In accordance with 1915(c)(5)(C) of the Social Security Act, an HHSC consumer enrolled in a 1915(c) Medicaid waiver that offers employment assistance is required to seek TWS-VRS services before receiving HHSC-funded employment assistance.
      • TWC-VRS application: HHSC providers may provide employment assistance using HHSC funds and other funding such as TTW to HHSC consumers who have applied for TWC-VRS until TWS-VRS has developed the individual plan for employment (IPE). The HHSC representative must maintain communication with the TWS-VRS vocational rehabilitation counselor regarding services provided between the TWS-VRS VR application and the start date of TWS-VRS Services as defined in the person’s TWS-VRS VR IPE.
        • If a person is receiving services from a 1915(c) Medicaid waiver that offers employment assistance and the vocational rehabilitation counselor determine TWS-VRS is not the appropriate resource to meet the person’s needs and the person still requests assistance in locating competitive, integrated employment, the HHSC representative must document this in the person’s file and may begin to provide and bill HHSC for HHSC-funded employment assistance.
        • If a person is receiving services from a 1915(c) Medicaid waiver that offers employment assistance and the person refuses to contact tWS-VRS, they may not receive HHSC-funded employment assistance.
    • Pg 29: References: HHSC Employment-Related Policies
    • Pg 46: Here are some guidelines for how people in the following programs can work and keep their Medicaid benefits
  • DADS Information Letter 13-75 Addition of Employment Assistance and Expansion of the Consumer Directed Services Option to Supported Employment and Employment Assistance 
    • In accordance with §32.075 of the Texas Human Resources Code, the Department of Aging and Disability Services (DADS) began offering EA through the Community Living Assistance and Support Services (CLASS) Program effective February 1, 2014. Additionally, DADS added SE as a service that may be provided through the consumer directed services (CDS) option effective February 1, 2014. On December 1, 2014, DADS added EA as a service provided through the CDS option. 
    • EA is provided to an individual to help the individual locate competitive employment in the community. EA is provided by a direct service agency or by a provider hired by the CDS employer. 
    • SE is provided through the direct services agency or by a provider hired by the CDS employer. SE is provided, in order to sustain competitive employment, to an individual who, because of a disability, requires intensive, ongoing support to be self-employed, work from home, or perform in a work setting at which individuals without disabilities are employed. Individuals receiving supported employment earn at least minimum wage (if not self-employed). Supported employment includes employment adaptations, supervision, and training related to an individual’s assessed needs. 
  • DADS Information Letter 10-08 Supported Employment Transportation Requirements
    • The purpose of this letter is to announce the Texas Department of Aging and Disability Services (DADS) Employment Services Training and Technical Assistance Initiative and to provide CLASS, DBMD, and CWP providers with clarification in regard to the transportation requirements for Supported Employment (SE). 
    • The SE transportation requirements are as follows: 
    • CLASS:
      • Provider Manual (PM) 5319 Supported Employment Services 
      • Supported employment services must include any activity needed to sustain paid work, including supervision, training, and transportation. 

When CLASS does not have a tool or elaborate on a topic, I try to find descriptions in other HHS Programs.

  • TWC-VRS Manual refers to Supported Employment as Extended Services:
    • Examples of extended services include, but are not limited to, consulting with a customer’s job supervisor regarding areas of concern or training needs; creating supports and strategies to improve work performance through job coaching; providing services such as medication management or hygiene; and identifying and training on transportation options.
    • When HCBS services are coordinated in a VR customer’s case:
      • it is preferred and a best practice that the Extended Services, known as Supported Employment in the HCBS waiver, be identified before the VR counselor makes a referral for the VR Career Planning Assessment (CPA);
      • units for HCBS waiver Supported Employment (aka VR Extended Services), must be approved in customer’s HCBS waiver plan no later than the end of the final job retention benchmark in order for extended services to begin at job stability; and
      • see TWS-VRS & HHS Waiver Sequencing of Services document.
  • TWC-VRS Handbook for Providers states:
    • Some examples of Extended Services and supports include:
      • job performance monitoring;
      • job skill training (short-term) for new job tasks added to job duties or to improve performance;
      • setting up compensatory strategies;
      • earned income reporting to the Social Security Administration;
      • services such as medication management, attendant care, and counseling;
      • business venture supports such as bookkeeping, marketing, and managing data or inventories; and
      • transportation.
  • MDCP Handbook provides this narrative:
    • Supported employment (SE) services provide assistance to help a member receiving Medically Dependent Children Program (MDCP) services sustain competitive employment or self-employment. SE services include: assistance provided to a member to sustain competitive employment and who, because of a disability, requires intensive, ongoing support to be self-employed, work from home or perform in a work setting at which individuals without disabilities are employed; employment adaptations, supervision and training related to a member’s assessed need; and ensuring members earn at least minimum wage, if not self-employed.
  • HCS Form 4117 includes a list of Supported Employment tasks.
  • STAR+PLUS Handbook states:
    • Supported employment (SE) is assistance provided, in order to sustain competitive employment, to a member who, because of a disability, requires intensive, ongoing support to be self-employed, work from home, or perform in a work setting at which members without disabilities are employed. SE includes adaptations, supervision, training related to a member’s assessed needs and earning at least minimum wage (if not self-employed).