These services make the following three changes to Minnesota’s home and community-based services (HCBS) waivers:
These services will allow us to:
No. We designed the new employment services to help us better support competitive, integrated employment. They are about adding, not taking away options. Sheltered workshops and subminimum wages will remain an option. Work crews or enclaves will, however, have a maximum staffing ratio of 1:6.
Minnesota must meet the requirements of the federal HCBS Final Rule to ensure that people with disabilities are not isolated in the settings where services are provided. This means that in future revisions of services (i.e, DT&H and prevocational services) DHS must decide how we can ensure that these settings meet the integration requirements of the HCBS Final Rule. We will have these conversations and make these changes separately from the implementation of the employment services.
The Employment First website contains the most up-to-date information about and resources for the new employment services. The Community-Based Services Manual (CBSM) contains policy guidance about employment-related HCBS waiver services. You'll find links to the policy pages for the new services in the What’s new in the CBSM section of the CBSM homepage. If you would like to speak to someone about the new services, please refer to the resources below:
New employment service rates vary based on a person’s:
You will find the rates for the employment services on the DWRS frameworks website.
To help with business-planning, consider using the projected weekly revenue calculator (XLS) to look at what the projected weekly revenue might be for service delivery, depending on the number of service units authorized and staffing ratios.
Yes. DT&H day services, structured day services and adult day services must be authorized and reimbursed on a 15-minute unit basis when agencies provide the employment services during the same day as these new services. So, all Tuesday units of DT&H would need to be in 15-minute units. On other days (when agencies do not provide employment services) the person might receive full-day or partial-day DT&H units.
DHS advises lead agencies to approve the transition to the new employment services, even if the result is an increased service cost for a person. If lead agencies have difficulty managing their budgets, they may contact DHS for assistance.
The lead agency determines the service-delivery ratio for each service based on level of need and the given employment activity. Lead agencies authorize a single ratio for service delivery under each service:
To determine what average ratio to authorize and how many weekly units to authorize for each service, consider using the Employment and Day Services Individual Planning Tool (XLS) to find an average ratio based on a person’s weekly activities and supports.
Exploration and development may be provided at a location that also provides DT&H services, but we expect you to provide these services primarily in the community. You must provide employment support services in integrated community settings.
The new employment services will be available for people who receive waiver services starting July 1, 2018. People’s current employment-related waiver services will move to the new services during their annual reviews, unless they request access sooner. If a person asks to use the new employment services sooner and the person’s case manager approves, then the lead agency should start the service planning.
The requirements in Minn. Stat. 245D.071 that apply when a person begins to receive services (including the 45-day meeting) are not required when a person moves to or between any employment service (i.e., employment exploration, development, support, day service, DT&H and prevocational services). A provider must meet the 245D.071 requirements, however, when a person is new to the license-holder’s program and has not previously received an employment or day service from the license-holder. The license-holder must complete a service-plan review and evaluation according to the timelines in the person's coordinated service and support plan or addendum. The license-holder must complete these reviews at least annually or within 30 days of a written request from the person, his or her legal representative or case manager.
Employment First is a national movement supported by the federal government and Minnesota agencies. It means competitive, integrated employment is the first and preferred outcome for all working-age people with disabilities, including people with complex and significant disabilities. Minnesota adopted an Employment First policy (PDF) as part of our Olmstead Plan in September 2014.
Competitive, integrated employment means a person:
Many people with disabilities want to work. A recent report published by the National Core Indicators© (PDF) showed the majority of Minnesotans with disabilities who are unemployed want a job but lacked a job goal in their service plans. Research, such as the NCI report, shows people with disabilities can be employed successfully in the general workforce given the right job match and supports. Employment offers people:
No. Each person’s decision to work is personal. It should be an informed choice, based on accurate information and experiences. Informed choice means people with disabilities are fully able to explore employment as an option.
The Minnesota Olmstead Plan includes activities our state must accomplish to ensure people with disabilities live, learn, work and enjoy life in the most integrated setting. The Olmstead Plan requires the state to create opportunities to work, but it does not force people with disabilities to work. The Employment First approach to provide choice is consistent with Olmstead principles. We will use this strategy to meet Olmstead priorities.
The Minnesota Association of People Supporting Employment First published “Myths and Realities of Employment First and Olmstead (PDF)” to address misconceptions and questions about what the Olmstead Plan and Employment First policy mean for people with disabilities.
Informed choice about employment means that a person:
For a more information and resources, see the DB101 Informed Choice Toolkit (PDF).