1. Supported Employment

2. Goals Service to persons with most severe disabilities Enable persons to obtain and retain competitive employment Succeed in an integrated setting Earn minimum wage or above Ongoing support to maintain competitive employment

3. Goals Providers can utilize Arkansas Rehabilitation Services (ARS) Supported Employment funding (be an ARS vendor) Provider ability to bill for job development and placement Provider ability to bill for personal care Provider ability to bill for waiver services

4. Supported Employment Providers AR Rehabilitation Services certifies vendors AR Rehabilitation Services Provides training for vendors Job coaches must be trained in supported employment techniques DDS supported employment providers must be certified by AR Rehabilitation Services

5. Referral Process Providers refer persons to ARS for supported employment services ARS refers appropriate supported employment individual to selected provider agencies Provider agency determines if they are capable of serving individual Provider agency sends ARS a letter accepting referral or explaining why they cannot meet the individual’s needs

6. Supported Employment Services Job development with placement in competitive and integrated employment Job Coach negotiates job accommodations and essential job duties to be performed Job Coach provides on-the-job training until person can perform all required job duties Job Coach fades as person uses natural supports Long term support for duration of employment via transition from ARS services to DDS services

7. Supported Employment Funding AR Rehabilitation Services $1000 for Referral $2,000 for Placement $1000 for Stabilization $2,000 for Closure DDS - $3.50 for 15 minute unit for supported employment

8. Personal Care/Assistance Personal Care services through Medicaid State Plan services or Independent Choices (concurrently as needed) Direct Support Professional (DSP) through Waiver for hands on help with cueing of personal care, behavior modification or communication (concurrently as needed)

9. Personal Care In the Workplace Section 213.540 of Personal Care Provider Manual regarding employment-related Personal Care Outside the Home notes the following among other things: Individual must be age 16 or older to receive personal care at work (under 21 requires prior authorization) Individual must meet Social Security/SSI disability criteria Individual must work at least 40 hours per month in an integrated setting or actively seeking employment for minimum of 40 hours per month in an integrated setting Individual must earn at least minimum wage or actively seeking employment that pays minimum wage

10. Personal Care in the Workplace (continued) Personal care aides may assist persons with personal care needs in the workplace or at employment related locations, such as human resource offices, employment agencies or job interview sites Aides may assist persons with transportation to/from work or during job-seeking (Medicaid does not cover mileage). Transportation is not included in 8 hour per month benefit limit that applies to transportation or shopping for personal care items but is included in the 64 hour per month personal care benefit limit for persons age 21 or older All employment related services including transportation must be included in detail in the service plan

11. Earnings Even though the ACS Waiver income limit is 300% of the SSI benefit ($,1911.00 per month) there is currently an earned income limit of $940.00 per month to be considered disabled for the waiver DDS has requested an amendment to the ACS Waiver to include the Working Disabled as an eligible category

12. Other Assistance Persons with SSI or SSDI can access benefits counseling through Project AWIN which will explain how their disability cash benefits will be affected Call the Employment Sources Hotline at 1- 866-283-7900 to request counseling from AWIN

13. ARS Closure Job coach fades Employee must be able to perform all job duties independently to satisfaction of employer At closure, staff cannot be physically performing person’s job duties but can cue person Can still receive personal assistance help Still receives long term support to maintain job via the waiver

14. Billing AR Rehabilitation Services until time of closure or notification of ARS funding exhausted DDS contract or waiver funding after closure for eligible persons Grandfather in persons currently in DDS Supported Employment

15. Supported Employment Process All referrals are handled through Arkansas Rehabilitation Services (ARS) If person qualifies for Supported Employment, ARS will make referral to selected Supported Employment provider Supported Employment provider will either accept referral or notify ARS they cannot accept referral

16. MAPS Process After acceptance of referral, provider submits MAPS revision Include Supported Employment with zero dollars Include any additional state plan personal care services required on the job Include any additional supported living services required on the job Attach copy of ARS Individual Placement Supported Employment Monthly Program Report form showing status 18 referral accepted

17. Job Placement After job placement is secured, submit copy of ARS Individual Placement Supported Employment Monthly Progress Report form showing status 20 for placement DDS will issue PA for additional supported living that was approved in previous revision

18. Closure After ARS closure, submit copy of ARS Individual Placement Supported Employment Monthly Progress Report form showing status 26 for closure Also submit budget page showing date of closure and dollar amount of supported employment services that will be needed DDS will issue PA for approved supported employment services

19. Additional Supported Living Services Note that the additional supported living services requested and current supported living services approved cannot exceed the maximum daily rate for the current service level of $356.32 for pervasive or $160.00 for extensive/limited