Employment FAQ

These services make the following three changes to Minnesota’s home and community-based services (HCBS) waivers:

• Separate community-based employment from the day training and habilitation (DT&H) and prevocational services. All community-based group work arrangements (such as work crews or enclave arrangements) will now be authorized, provided and billed as part of the employment support service. Center-based work activities remain a part of DT&H.
• Replace the current supported employment services support under the HCBS waivers with the new employment services (primarily with employment development and employment support)
• Add employment exploration as a new service to give people the experiences they need to make an informed choice about competitive, integrated employment

These services will allow us to:

• Provide new services and resources to support competitive, integrated employment for people with disabilities. We know many Minnesotans with disabilities choose to work in competitive jobs in the general workforce. We also know we must provide the necessary services and supports for people to be successful in their careers. These services provide new supports and additional resources.
• Create more individualized services. The new services allow us to tailor supports and services to each person’s needs, dreams and unique circumstances.
• Allow for more specific service planning. These services will give us all – the person, lead agencies, service providers and DHS – a better understanding of which services are authorized and being provided.

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:

• Lead agency staff should contact the employment services mentor for your agency or area. To find your primary mentor, see the list of primary mentors (XLS). (Mentors and liaisons who would like to update or add their information to the list should use this online form).
• Service providers who have questions about the new services should contact one of the service provider liaisons on the list of provider liaisons (XLS). (Mentors and liaisons who would like to update or add their information to the list should use this online form).
• People who receive services should contact their county or tribal case managers for information about work options and how to use the new employment services. You may also talk with the experts at Disability Hub MN. Visit www.disabilityhubmn.org or call 866-333-2466. You also might find New Waiver Services to Support your Choice at Work DHS-7654A-ENG (PDF) useful.

New employment service rates vary based on a person’s:

• County of residence
• Staffing ratio

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:

• For exploration, the ratio is between 1:1 and 1:5.
• For development, the ratio is 1:1.
• For support, the ratio is either individual (1:1) or a group ratio that is between 1:2 and 1:6.

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:

• Earns at least minimum wage but not less than the customary wage for the job.
• Has ordinary opportunities for interactions with co-workers without disabilities, customers and/or the public.
• Receives benefits from his or her employer that are the same or similar to workers without a disability.
• Receives his or her wages from an employer that is not his or her service provider. The person also may be self-employed.
• Works full or part time, with or without supports.

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:

• Higher quality of life, including increased earnings, better benefits, improved health and friendships.
• More choices and opportunities.
• Paths out of poverty.

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:

• Understands all of his or her options.
• Understands ways to overcome barriers.
• Knows the potential risks and benefits of decisions.
• Does not have his or her options limited.
• Is able to explore community resources. 

For a more information and resources, see the DB101 Informed Choice Toolkit (PDF).