Here, find answers to common questions about the work happening with the E1MN partnership.
To submit other questions or requests related to E1MN, use the E1MN request form.
Benefits planning is expected in every stage of employment. To engage in work conversations, plan for work, find work or keep work, the person needs to know how work would impact their benefits.
Benefits planning may look different in different situations and phases but it should always be based on the person's needs. Some people need a conversation and some questions answered, a benefits lookup or a DB101 "try-it" tool to see how work would impact a specific benefit. Some need a more thorough DB101 estimator session, while others might need a full benefit summary and analysis to be sure of what will happen with their benefits when they go to work.
Every professional working with people with disabilities (including case managers, providers and vocational rehabilitation staff) should know the basics of benefits and work. They should know enough to give the message that work and benefits can go together, and that benefits should not be the reason someone chooses not to work. Some professionals who work more directly with people on planning for and finding work need a deeper level of knowledge about benefits and work. The Hub offers three levels of training in the benefits planning toolkit.
So the answer is yes, benefits planning is expected as part of waiver employment exploration, waiver employment development services and waiver employment support services. Whatever benefits planning was done during waiver employment exploration and planning services should be shared in the referral from the provider to VRS/SSB. Benefits planning is also expected as part of VRS/SSB services.
Yes, Orientation to DB101 is available in the level 2 training in the benefits planning toolkit.
Helping people understand what happens to their benefits when they go to work (benefits planning) is crucial in helping a person move to competitive integrated employment. Many people with disabilities think they can't work, or limit the amount they work because they're afraid of what will happen to their benefits.
DB101 is a website that can help people plan for work and benefits. DB101 offers:
Benefits planning is a covered service and a required competency for providers in each of the waiver employment services: exploration, development and support. It's also a service paid for through Vocational Rehabilitation. To start learning about work and benefits, check out the level 1 training in the benefits planning toolkit.
If you need help navigating DB101 or more ideas about how to incorporate it into your work, chat with an options counselor or call 866-333-2466. The Hub also has community capacity builders who would be happy to work with groups of providers, lead agencies, schools and VR staff to build capacity within your area to provide benefits planning using DB101.
Great question! It is true that when people start working, their benefits often change, and many people worry about those changes. That's why benefits planning is so important!
When benefits change, including MA or other health care coverage, the person is sent a notice. Those notices are often hard to understand. People don't always read them and sometimes they get them too late to be proactive and plan for the change.
To help people be prepared for any changes, you can help people you work with use DB101. DB101 has estimators and "try-it" tools that can help people see what might happen to their benefits when they go to work. You can help the person request a benefits lookup from the Department of Human Services so they're sure which benefits they're getting. Then you can help them enter the benefit amounts and their earning goal in the estimator to see what will happen to their benefits when they go to work. This will help them be prepared, feel more comfortable with changes and be able to overcome their worry.
You can also check the benefits planning toolkit in the Hub for more information, training and resources on benefits planning, plus information on how to join the benefits planning learning community.
Use person-centered practices and motivational interviewing skills to understand where the person is at, to recognize the person's potential, and to ensure their choice is an informed choice.
MA-EPD is a work incentive that allows people with disabilities to get or keep their Medical Assistance when they work. To be eligible for MA-EPD, a person must be working, earn more than $65 a month and meet other eligibility criteria. This is often how MA-EPD is introduced to people, so their goal becomes "making more than $65 a month."
So, recognize their initial motivation. What got them engaged in thinking about work was the need to reduce healthcare costs or gain access to health care. They might not have fully considered what work could look like for them. Take the opportunity to help them step back and think more broadly about what they want in their life and how work can help. To open the conversation, consider using the Charting the LifeCourse tools. For instance, use the trajectory to capture the person's vision for their life. Then connect how work can be a strategy to not only reduce health care costs, but also help the person reach their vision in other ways. Listen for the person's fears and concerns so you can address barriers along the way.
This is also where Disability Benefits 101 and benefits planning are helpful. When you can show the person side by side what their income looks like today (often with minimal money coming in from SSI or SSDI and a lot going out in medical expenses) and then compare it to working and earning $66 a month (or more), the person might consider working more.
Explore jobs that will fit the person's needs, match their skills and get them started, even if it's just to earn enough to qualify for MA-EPD. As you look at jobs that meet the person's interests, it can be helpful to talk about the fact that there aren't a lot of jobs where you can earn just $66 a month. Keep checking to see if the person would be open to earning a little more and working a few more hours. Eventually the person may be ready to expand their thinking as they see the potential.
If the person truly wants or needs to limit their work to just an hour or two a week, then start there as you explore their options. Maybe they could be paid for a hobby or other things they're doing as a form of self-employment. If the person is on a waiver, waiver employment development plan services might be helpful. If you're with VRS/SSB, work with the person's waiver case manager and employment service provider (if they have one) to talk through the best service to help the person meet their goals.
Everyone starts somewhere. Just because a person wants to work only to get MA-EPD today doesn't mean that's where they'll be in a month, six months or a year.
Benefits planning is an essential part of employment services and should be done in each phase of employment. It's important to know what benefits a person is getting before talking about how work impacts those benefits. To be sure of a person's benefits, you can help a person request a benefits lookup through their My Vault account on DB101. Go to planning paths, click "What happens to my benefits when I work," then click "Get a benefits lookup." The request is routed to DHS and within two business days the information will be available in the person's My Vault account. They can click "Send a copy of my results to a counselor" and enter your email address so the results are also shared with you. Having the person request their own benefits allows them to have the information when they need it and choose who else to receive the information.
If the provider or the person has a question about a single benefit and doesn't need a full benefits lookup, they can call or chat with the Hub.
Providers are not allowed to request benefit lookups on someone's behalf unless they are the person's authorized representative in the DHS system or they have staff who spend more than 10 hours a week providing benefits planning services and have completed the training to become a benefit coach. See the benefits planning toolkit for more information on benefits planning training.
Assessors play an important role in helping people with disabilities get the information and supports they need to make an informed choice about working. Assessors are often the ones starting the conversation about employment, and addressing that need in the MnCHOICES assessment.
Much of what we talk about with this process is specific to people who are already on waivers. If the person is not on a waiver, or they do not want or need waiver employment services, and want a direct referral to VRS/SSB, the assessor can provide the person with the list of VRS/SSB office location most accessible to them.
Waiver employment service providers deliver engage and plan supports. Waiver case managers (including CADI case managers) assist people in identifying, accessing and navigating needed supports and services. This does not mean that case managers need to provide all of those services themselves.
In the engage and plan phases, case managers can authorize employment exploration services or the planning phase of employment development services so that the person can get the supports they need to make informed choices about employment and plan their career. Case managers meet with the person at least twice a year (or more often as needed) to monitor waiver services and review the person's needs and progress toward employment goals.
Consumer-directed community supports (CDCS) is a service option, available through all of the disability waivers, that gives people more choice. CDCS allows people to use their waiver funds to self-direct their own services, including waiver employment services. They get to choose or design the services and supports that fit their assessed needs, decide when they get them, and hire the people they want to deliver the services, including waiver employment exploration, development – plan phase and support services. How much money a person has to spend on their self-directed services, also known as the CDCS budget, is based on the person's needs (which are identified during their MnCHOICES assessment), annual reassessment or when the person lets their case manager know of a new need.
With the engage, plan, find, keep framework, people utilizing the CDCS option can use their CDCS budget to pay for employment supports they need to explore and plan for work.
If they are getting waiver services through CDCS and have new needs, for example, and they want to start exploring work, they may:
We are developing talking points related to E1MN geared toward people with disabilities and families. These will be available on the Hub. You can use them to help explain what E1MN is, but remember it's important to talk with the person and their family about the person's needs related to work (not necessarily E1MN, since that may confuse people). We will also have more information about how the CDCS option works and a waiver basics training video available soon.
Consumer-directed community supports (CDCS) is a service option available through all of the disability waivers to give people more choice. CDCS allows people to use their waiver funds to self-direct their own services. They get to choose or design the services and supports that fit their assessed needs, decide when they get them, and hire the people they want to deliver the services.
It is possible to complete a customized employment discovery profile that meets the standards required by VRS/SSB as part of employment development services – planning phase. Creating this profile would meet the service goals and expected outcomes of employment development services – planning phase, but it is not an expected or required component of the service.
There are important considerations to be aware of in this situation:
If you are working with someone receiving waiver services and believe they could benefit from customized employment, either referring to employment development services – planning phase or to VRS/SSB for customized employment may be appropriate. Employment development services – planning phase can provide an initial level of discovery that will inform the person's job search and help better understand if the person would benefit from customized employment. Customized employment through VRS/SSB includes a more defined and extensive discovery process as well as an individualized job placement strategy.
Customized employment can only be provided after VRS/SSB application and eligibility is completed and a need is identified by a VRS/SSB counselor.
The portfolio of outcome products developed during employment development services – planning phase is designed and expected to inform any customized employment discovery process through VRS/SSB. If the supports provided under employment development services – planning phase have equipped a person to start a job search, the person may begin with job placement services. If there is a need for additional discovery, the outcomes from the planning service will be used to inform a customized employment discovery process.
Yes, the person still needs to be referred to VRS/SSB and connected with a counselor to determine eligibility and priority for services according to federal regulations. Once someone is determined eligible, a VRS/SSB counselor works with the person to develop an employment plan and identify services that the VRS/SSB counselor will authorize for payment. In order to provide job search services (Find), an employment service provider must have a Professional/Technical (P/T) contract with VRS/SSB in order for VRS/SSB to pay a provider for services.
If the provider is dually enrolled with both 245D and VRS/SSB, there won't be a need for the person to switch providers. The funding source will switch, but the provider can stay the same. It will be seamless for the person, which is our goal!
If the provider is only 245D and not a VRS/SSB provider, we would encourage them to become dually enrolled. If they're not, the person will need to change to a provider who is a VRS/SSB provider when moving to the "Find" job search phase. Planning and good communication would be needed to help ensure a smooth transfer and not disrupt the momentum toward their employment goals.
Waiver case managers should also consider the person's needs and the best provider to meet their needs when planning and authorizing services. If the person is likely to need help finding a job from VRS/SSB, ensuring their waiver provider can support them through the whole process is important.
We encourage dual providers, which means providers that are both 245D licensed and have a P/T contract with VRS/SSB. If someone is working with a provider who is not a dual provider (has a P/T contract with VRS/SSB), then they will need to switch providers for their job search find service.
If the provider is dually enrolled with both 245D and VRS/SSB, there won't be a need for the person to switch providers. The funding source will switch, but the provider can stay the same. For the person it will be seamless, which is our goal!
If the provider is only 245D and not a VRS/SSB provider, we would encourage them to become dually enrolled. If they're not, when the person moves to the job search phase (find), they will need to change to a provider who is a VRS/SSB provider. Planning and good communication is needed to help ensure a smooth transfer. Waiver case managers should also consider the person's needs and the best provider to meet their needs when planning and authorizing services. If the person is likely to need help finding a job from VRS/SSB, ensuring their waiver provider can support them through the whole process is important.
VRS has two options for developing a P/T contract:
Engage | Plan | Find | Keep is the framework that describes how waiver and VRS/SSB services work together. VRS/SSB are the first and primary funders for job search (find) services. When someone is receiving waiver exploration and/or development planning (engage and plan) services and are ready to start their job search, they will be referred to VRS/SSB. VRS/SSB will work with the person to help them meet their CIE employment goals and fund services under find. If someone needs ongoing employment supports, waiver employment support services will be available to fund those services.
If you're an existing waiver employment service provider, you don't need to separately enroll to provide plan services. It's included as part of enrollment to provide employment services. Providers who aren't currently enrolled in either VRS, SSB or waiver employment services will need to enroll in each respective program to provide services through that program.
For more information on process and requirements for enrolling in each program, see the provider alignment webinar slides and recording under the provider training tab of the E1MN training and events page.
E1MN efforts are specifically for people who receive a waiver and are interested in competitive integrated employment. The engage, plan, find, keep framework outlines how our existing services will work together for people receiving a waiver who want to explore and pursue competitive integrated employment. One of E1MN's goals is to ensure a person receives the services they need, when they need it, as seamlessly as possible. Waiver employment exploration and development planning services will continue to be funded and provided by a waiver employment service provider under engage and plan. For job search services, a person will work with VRS/SSB who will fund job search services, funded by an E1 performance-based agreement (PBA) and provided by VRS/SSB employment service providers under find. Waiver employment support services will continue to fund those services, provided by a waiver employment provider for people who need long-term employment supports under keep.
For people who don't have a waiver, VRS/SSB will continue to serve those who apply and are determined eligible. This includes individualized counseling, training, job skills and job placement services to help people reach their employment goals.
Yes. All 245D licensed waiver employment service providers are listed in MinnesotaHelp.info and can be sorted by geographic area. For instructions on selecting a service provider (including a direct link to a MinnesotaHelp.info search that will return providers who are both waiver 245D licensed and enrolled as a VRS/SSB provider), check supporting people on waivers, plan in the work toolkit. Dually enrolled providers can offer a more seamless transition through the phases of employment.
VRS/SSB purchases job search (find) services through a performance-based agreement (PBA) structure with providers who have a contract with VRS/SSB. VRS/SSB make payments for services provided under a PBA after key outcome-based milestones are reached versus an hourly rate. As part of the MOU agreement between DHS and VRS/SSB, VRS agreed to develop a new PBA funding structure that would better meet the needs of people on waivers who may require more intensive levels of service and support for their job search. VRS has created the new E1 PBA to meet this need. The E1 PBA will only be for people on waivers. VRS will have two PBAs and SSB will continue to have one PBA. All three have milestone-outcome payments:
Information on the E1 PBA, including the payment framework, is available through DEED (PDF).
E1 PBA payments are as follows:
The general PBA remains the same:
Yes. If a partner has this on their PT contract, it can be added to the general PBA and the E1 PBA.
If you are an existing VRS/SSB provider, there will not be an amendment process to add the E1 PBA as long as you already have the PBA on your PT contract. The details on the PBA are referenced separately from the PT contract, allowing us to update and add to the details of the PBA and E1 PBA without having to amend the contract. If you want to dually enroll to provide waiver services, you would need to get a 245d license. If you are already dually enrolled to provide both VRS/SSB and waiver employment services, no further action is needed.
No. There will be no changes or retroactive E1 PBAs. If someone has a general PBA and a Medicaid waiver, they will stay in a general PBA. After July 1, 2021, people with Medicaid waivers who start job placement and follow-up services will be supported with an E1 PBA.
If a person on an E1 PBA loses or quits their job, the team should discuss next steps. If the job seeker wants support to secure another job with the same job goal, then the job seeker and the placement professional would resume the job search. In this case no new E1 PBA would be authorized and the partner would be eligible for the unpaid E1 PBA milestone payments.
Yes. A VRS/SSB provider can be paid for the E1 PBA when someone has a waiver even if they're not 245D licensed. If the person needs long-term supports funded by the waiver, they'll need to connect with a 245D licensed provider who can offer those supports.
We continue to encourage dual enrollment, when providers are enrolled with 245D and VRS/SSB. If someone is working with a provider who has only a P/T contract with VRS/SSB, the person will need to switch providers for their job search find service. If the provider is dually enrolled, the funding source will switch but the provider can stay the same. For the person it's a seamless switch, which is our goal!
Yes, as long as the conditions for placement as outlined in the E1 PBA are met.
Yes, as long as the position meets the definition of competitive integrated employment.
A 2011 CMS Bulletin directs that “When a state covers any category of supported employment services and/or prevocational services in a waiver, the waiver service definition of each service must specifically explain that the services do not include services that are available under section 110 of the Rehabilitation Act of 1973 or, in the case of youth, under the provisions of the Individuals with Disabilities Education Act (IDEA), as well as assure that such services are not available to the participant before authorizing their provision as a waiver service.”
There are other important components of federal guidance in this area (including Title XIX of the Social Security Act and Section 101 of the Rehabilitation Act). For more information on this guidance, see the III. Purpose of the MOU section of the September 2019 Memorandum of Understanding between DEED and DHS.
No. Federal guidance does not allow for VRS/SSB to be considered "unavailable" if the person would prefer to receive job search supports through HCBS waiver services.
DHS does not oversee county-funded services. Counties can choose how they administer those services. Counties may choose to administer their employment-related services following the E1MN model or not. It will be important to check with your local county to determine how county-funded employment services will be administered.
If people receiving waiver services need ongoing supports to maintain employment, waiver employment support services can provide these supports. The amount of support or number of units authorized will be included in the person's support plan. There are no time limits for employment support services. If a good job match has been achieved, it is anticipated that the amount of formal ongoing job supports will fade over time. To facilitate this, a person or their team should have a strategy to develop natural job supports, leverage assistive technology and further skill development.
First, it's important that you are identifying, providing and billing for all services the person needs and are available through waiver employment support. There is information about what services are billable under each waiver employment service in the work toolkit and in the community-based services manual (CBSM). Sometimes things the person needs, like benefits planning, are missed or providers do the service but don't realize they can bill for it.
If the person needs only a limited amount of support it may also be appropriate to level-down the services. Consider other options for support. Could coworkers or supervisors help the person with the supports they need to maintain their employment (such as tying an apron to get set up for work)?
If transportation associated with community employment will be provided through waiver services, the length of time between when the need is identified and when the transportation service is provided can depend on many factors. To make sure any needed services are in place following job placement with VRS/SSB, communication and coordination across a person's employment team is critical.
When the person begins job search services with VRS/SSB, the team should make sure the case manager is aware of the job search and understands any anticipated needs in ongoing job supports and transportation assistance. When the person first obtains the job, the team (including employment service provider) should make sure the case manager is aware of the placement and has the necessary details (job hours and location) to prepare necessary authorizations. While VRS/SSB is providing job stability services, the waiver case manager can then coordinate with the person on their choice of transportation support and organize authorizations for a timely transition to waiver supports after the person becomes stable in employment.
This is an area where continued focus is needed and where we invite the help of our partner organizations (including advocacy organizations, lead agencies and trade associations) in building connections and authentically engaging the diverse communities in our state.
Equity is a fundamental value of the E1MN partnership. Selections for the Interagency Employment First Advisory Committee membership were made based on geographic representation and representation of different disability types. The Professional Input Panel on Employment (PIPEin) also provides an agile way for people across Minnesota to provide feedback on our work. In our work to align and increase capacity of our provider networks, we are working right now to increase dual enrollment of employment services providers, but will also be engaging in work to increase capacity/access to service communities with culturally specific needs. If you have ideas or suggestions on how to do this work, let us know.
Businesses are an important factor in helping people get jobs! Our business engagement efforts are focused on meeting a business need and connecting our talented and qualified candidates to businesses. Our efforts are not focused on the human service aspects of this work. We also rely on and work closely with our community partners who we contract with for job search (find) services and we expect that they are also developing relationships with businesses.
Here are a few business engagement strategies:
VRS/SSB's contracts with providers don't address wages for direct support professionals, though VRS/SSB provides training and resources on contracted services.
For disability waiver services, the payment methodology for wage in the Disability Waiver Rate System rate-setting frameworks is per statute 256B.4914 HOME AND COMMUNITY-BASED SERVICES WAIVERS; RATE SETTING. The methodology determines how the rate is determined. Providers then determine staff wages out of the RMS rate. The College of Employment Services can be a good training resource with on-demand videos for organizations that provide employment services to people with disabilities.
See E1MN partnership for information regarding how these changes impact people receiving waiver services. People who are currently receiving employment development services may continue receiving those services. You may also consider using the engage, plan, find, keep framework to explain how services work together. If you are not already a dually enrolled provider, consider dual enrollment so you can continue to provide array of services to the person.
Yes. A commitment to align and streamline process and efforts is included in the MOU between DEED and DHS. We'll explore opportunities to better align and streamline each agency's business processes and requirements to create consistency and efficiencies for dually enrolled employment service providers.
It's important to note that each system is unique and has its own requirements. It'll take time to identify areas where alignment is possible and beneficial. We appreciate the question and the suggested areas for consideration.
People may look at credentialing or education needs at any phase in the Engage | Plan | Find | Keep framework. This can be especially important for transition-age youth or when people are making decisions about employment or career options. To help address this need, one of the available supports under employment exploration services is: Education about post-secondary educational opportunities that enhance employment, community employment resources and use of transportation services.
While young people are still in school, VRS/SSB and schools work together to provide pre-employment transition services, which allows students to explore career and postsecondary options. Credentials are an important factor to consider when exploring postsecondary education options since they provide proof of skills gained and can be a gateway for enhanced employment opportunities.
During job search (find) services with VRS/SSB, it may be determined by a VRS/SSB counselor that an adult (person out of school) needs training to meet their job goal. This can range from on-the-job training to more formal classroom education. VRS/SSB works individually with people to help them determine any training needs for a job goal.
For people on waivers who are in high school or ages 18 to 21, transition programming for the engage, plan and find phases of employment are provided through pre-employment transition services and school transition services. The E1MN Youth effort focuses on building resources and information for collaborating between programs.
It is important that waiver case managers participate in transition planning and aligning supports as students are graduating from school. If a student is requesting to participate in exclusively day or prevocational services, case managers need to ensure and document informed choice before authorizing services. Exploration is an excellent option to help make sure the student and family are making an informed choice and understand the risks and benefits of those decisions. Waiver case managers should support plans based on a person's needs and explain options and available supports (including employment exploration services, day support services and prevocational services) as part of this planning. If a young adult (age 24 or younger) is considering subminimum wage employment, they need to understand Workforce Innovation and Opportunities Act (WIOA) requirements, which includes applying for VR services. VRS and SSB will also engage the youth and their family in an informed choice process. If the youth and their family still choose prevocational services that includes a subminimum wage, their VR case will be closed and they will be able to receive the documentation that allows that to happen.
Through our E1MN Youth efforts, MDE, DEED and DHS are focusing on improving employment outcomes for transition-age youth.
Yes. Students can access employment support services to maintain employment as long as the support occurs outside of school hours. If the student's job is during school hours (like a school work experience), those supports are provided through school services.
Yes. A VRS counselor can keep a case open while a recent graduate works on prevocational skills or receives exploration services to make an informed choice about pursuing employment. For a youth age 24 or younger to receive subminimum wage through prevocational services, VRS would need to close the VR case file in order to provide the documentation that allows a youth to earn a subminimum wage. This is part of the limitations on the use of subminimum wages under WIOA. A youth whose case file has been closed can also choose to reapply for VR services at any time if they are ready to pursue competitive integrated employment.
We are not able to offer preapproved CEUs in association with the core trainings this summer given the overview nature of the training and timing and logistic constraints. You can create a record of the core training on your TrainLink transcript by adding a self-reported training. To do this, log in to TrainLink, click "My transcript" and then "Add self-reported training." If you need assistance, email firstname.lastname@example.org. For CESP, you then have to connect the training to one or more of the domains in the CESP content outline. You can self-report your trainings and submit them (using a CESP template) as part of your recertification application.
The College of Employment Services curriculum is preapproved by ACRE and free or low cost to everyone in Minnesota. It also follows the APSE/CESP competencies and DHS can provide an outline of how each course is connected to each domain.
To get low-cost DirectCourse trainings, registration must be conducted through DHS. To access free and low-cost DirectCourse College of Employment Services training options provided through DHS (expect low fees depending on organization size), see the College of Employment Services section of the Employment First webpage. You will need to submit a DirectCourse request form through the DHS Disability Services Division.
DHS offers on-demand waiver provider 101 provider training through TrainLink, where you can take the course on your own time. The waiver provider training 101 is for employees of organizations or agencies who want to enroll with Minnesota Health Care Programs (MHCP) to provide services to people who receive services through an HCBS waiver or the AC program or for other interested people.
People who take the training can learn basic information about MHCP and the HCBS waiver and AC program operations, policies and requirements. You can also find more information on the DHS Licensing for Home and Community-Based Services 245D providers page.
Support planning guidance related to E1MN will be published in July, but new authorizations are not required to specify planning or finding phase supports until September 1. Additionally, providers may use existing tools as long as they capture the information required in the service. The new HCPC codes associated with employment development services are T2019 U1 (plan) and T2019 U8 (find).
Training opportunities are ongoing.
The E1MN core training was presented to waiver case managers this spring, and the Support Planning Professional Learning Community (SPPLC) offered a series of presentations for case managers on the framework. Recordings are available in the work toolkit under E1MN trainings and events. Participation in ongoing monthly Coffee Chats is encouraged. Waiver case managers also have access to the frequently asked questions published here.
In addition, the DHS Disability Services Division published new waiver employment service guidance.
Additional training opportunities are in development and will be announced on the E1MN trainings and events page.
If you meet a waiver case manager who isn't aware of E1MN or the changes in waiver employment service guidance, offer the links shared here. It's important for lead agency and local VRS/SSB offices to start coordinating, addressing problems as they arise, and identifying where more training or information is needed from DHS or VRS/SSB.
Yes. The work toolkit provides details on the Engage | Plan | Find | Keep framework. The role of VRS/SSB in the find phase is outlined under supporting people on waivers, and working with VRS/SSB is covered in the plan phase section. DEED also offers information about VRS and SSB services.
A webinar training overviewing 245D licensing and enrollment was offered earlier this spring. This webinar was recorded and is available in the work toolkit under the provider training section of the E1MN training and events page. This webinar highlighted the requirements and process for both licensing and provider enrollment to become a 245D waiver provider.
We want to address this question in two parts. First, we want to talk about the term or concept of being "job ready." Both VRS/SSB and waiver services are person-centered and based on what the person needs and wants. We do not want to set a readiness standard that has historically placed barriers for people with disabilities in getting competitive integrated employment. Determining when to start a job search or when to refer to VRS/SSB is based on whether the person wants to start a job search versus any job-ready standard. Engage and plan services are available to help people plan their goals and build skills and understanding of work. They are not prerequisites for a job search. As a system, we need to move away from the term or idea of job readiness.
Second, if a person was referred to VRS/SSB for noncompetitive work services (like sheltered workshop or mobile work crew) these are not services VRS/SSB provides. The waiver case manager should help the person identify needs and services in this circumstance.
If a VRS/SSB counselor believes the person could benefit from engage or plan services under the waiver before starting a job search, they should discuss with the person and work closely with the waiver case manager and employment service provider to arrange or identify needed services. In this circumstance, great care needs to be taken to avoid bouncing the person between programs.
Avoiding these situations is why teamwork and collaboration is so important. Waiver employment service providers connecting early with VRS/SSB to consult on referral timing is an important strategy in avoiding confusion or bouncing of people. If a waiver case manager is making a direct referral to VRS/SSB, consulting is also important. We have created a VRS/SSB waiver liaison role to assist with this if your region does not already have good collaboration structures.
We know there may be times when there's not a provider or staff available to provide services. Though this may delay someone's ability to move forward, VRS/SSB will work with the person to explore other resources or services. We're encouraging a shared network of providers to improve access and smoother transitions.
To encourage new providers, VRS increased the amount of money that can be earned each year by limited use vendors, who are service providers not accredited with CARF. Limited use vendors may conduct business up to $100,000 a year (previously $20,000 a year).
We recognize that there might be shortages of VRS/SSB employment providers, so we need your help! If there are 245D licensed providers in your area who do not have a P/T contract with VRS/SSB, encourage them to develop a P/T contract so they can provide job search services.
Yes, VRS/SSB can help with a job search. If the person has never received services from VRS/SSB, they would need to apply for services and be determined eligible. It can take up to 60 to determine eligibility as part of our federal regulations. From there, the person will work with a VRS counselor on their employment goals and job search services. Services are individualized and person-centered.
If someone has previously worked with VRS/SSB and wants supports to start a new job search, VRS/SSB can open a new case for the person and provide supports. A previous case closure (successful or unsuccessful) does not preclude someone from applying for and receiving VRS/SSB services.
In the case of a previous unsuccessful closure, the VRS/SSB counselor will likely discuss with the person what has changed for them since they last worked with VRS/SSB. When a person is interested in re-engaging VRS/SSB in this instance, waiver case managers may also consider using the 4 +1 person-centered tool (PDF) to capture learnings from the past engagement and set the new job search up for success.
If a person is currently in a job search and a VRS/SSB counselor determines they can no longer benefit from services, waiver employment development services – find phase is available to continue job search.
The federal Rehabilitation Act provides the primary legislative authorization for VRS/SSB programs and services, along with several federal and state policies. Because these rules and regulations provide the governing structure for our work, we can't waive our requirement to determine eligibility for VR services. Eligibility is based mostly on whether a person has a physical or mental disability that makes it difficult to prepare for, get or keep work. VRS/SSB also considers how seriously someone's disability limits them and if a person could benefit from services. People who are eligible to receive Supplemental Security Income or Social Security Disability Insurance benefits based on their own disability and have not yet reached full retirement age are automatically eligible, unless they are too severely disabled to benefit from services.
While we must work within the bounds of our federal requirements, our E1MN work is about simplifying and clarifying these processes and aligning our systems (policies, programs, funding, providers, and roles) to better coordinate services and Employment First approaches.
No. VRS/SSB will continue to serve people who apply and are determined eligible. This includes people who receive a waiver and those who do not.
VRS determines eligibility based mostly on whether someone has a physical or mental disability that makes it difficult to prepare for, get or keep work. VRS also considers how seriously someone’s disability limits them, and if they can benefit from VRS services.
SSB determines eligibility based on whether someone has a significant vision loss that makes it hard for them to get and keep a job, then they may be eligible for a variety of counseling, training, job skills and job placement services.
As defined in DHS and DEED's memorandum of understanding (PDF), competitive integrated employment (CIE) is full-time, part-time or self-employment with or without supports in a competitive business or industry.
CIE is defined in Minnesota's Employment First Policy as well as governed by regulations under the Department of Education, 34 CFR Parts 361, 363, and 397, State Vocational Rehabilitation Services Program; State Supported Employment Services Program; Limitations on Use of Subminimum Wage; Final Rule 34 CFR §§361.5(c)(9)(ii) and 361.5(c)(32)(ii).
CIE must pay at least minimum wage but not less than the customary wage and level of benefits paid by the employer for the same or similar work performed by people without disabilities. If a person is self-employed, the work must yield a comparable income expected for someone without a disability doing the same work. The work must present opportunities to interact with people who don't have disabilities and opportunities for advancement.
People who have a disability but don't have a waiver can apply for VRS/SSB services. Additionally, DEED provides a range of resources for job seekers, including information on MN CareerForce Centers and a job search guide, which includes a section on preparing for the job search and career planning. The work toolkit also offers a variety of resources for any job seeker.
VRS/SSB will identify the need for long-term supports (available through waiver employment support services) when developing the person's employment plan. The authorized amount of support or number of units will be included in the person's support plan. There are no time limits for employment support services. If the person has a good job match, the amount of formal ongoing support is expected to fade over time. To facilitate this, a person or their team should have a strategy to develop natural job supports, leverage assistive technology and promote further skill development.
No. Employment development services will continue to be available under waiver services, but the service will be authorized and provided as two separate phases: plan and find.
We are maintaining a service code and option for the find phase of employment development services so that we can provide job search through waiver services when VRS/SSB is not available (for example, if someone isn't eligible for VRS/SSB or in the event someone doesn't meet priority of services for VRS/SSB and is placed on a waitlist maintained by the state VRS/SSB program).
DHS is defining and case managers will be separately authorizing plan and find phases for waiver employment development services. Find phase supports (to help people in a job search for competitive integrated employment) are primarily provided through VRS/SSB.
As intensive support services, employment exploration services has a one-year timeline and the planning phase of development should not exceed 120 days of service delivery. These timelines support rapid engagement in employment supports, as well as make services progress toward obtaining competitive employment. The timelines are based on national standards and best practices in the delivery of customized employment (discovery).
If people need more time in these services than the identified timelines, there are conditions where a case manager may reauthorize the service. For more information, see the service pages in the CBSM.
Prevocational services under the waivers are intended to help people gain essential work skills and strengthen their work capacity. If a person is interested in competitive integrated employment and would benefit from gaining essential work skills and strengthening their work capacity, prevocational services could be the support they need. It is important to know that prevocational services may include center-based work skills training and people may receive subminimum wages as part of that service. People who are new to prevocational services on or after January 11, 2021, can receive prevocational services for three years.
Yes. When providers become 245D licensed and want to provide waiver employment services, they enroll under an employment services record, which includes employment exploration, development and support services. A provider can choose which of these services they actively deliver as long as they're clear to potential recipients that they don't have related development or support service programming. Being able to provide a full continuum of employment supports has many benefits for the person and provider, including reducing logistical work, creating continuity of service for the person served, and providing expertise across employment supports.
A person who has a defined work goal or wants to start a job search immediately should be referred to VRS/SSB directly. Someone who needs to learn more about competitive employment to make an informed choice or needs help discovering their strengths or creating work goals may benefit from engage and plan services prior to a referral. This determination is made by the case manager in consultation with the person.
A person can receive a variety of waiver services (such as day, independent living or case management services) while receiving supports for a job search from VRS/SSB. If needed, waiver employment support services to maintain a current job can also be provided while the person is looking for a new job. The person shouldn't be receiving plan or exploration services at this time, however, since these are completed before a job search.
This time limit ensures rapid engagement and progression in the person's path to competitive employment. It's based on the existing waiver amendment language for employment development services, which states that the individualized, strengths-based assessments and employment opportunity discoveries component of the service shouldn't exceed 120 days of service delivery.
The 120-day timeframe is based on the Essential Elements of Customized Employment for Universal Application from the Workforce Innovation Technical Assistance Center (WINTAC) and the Department of Education's Rehabilitation Services Administration (RSA), which states:
Facilitators and funders should strive to balance the need to spend more time to better get to know the individual with the need to keep the customized employment process moving forward. Current evidence-based data indicate that the average timeframe for discovery is 35 hours over five to seven weeks.
There are conditions (outlined in the limitations section of the employment development services CBSM page) when the plan phase of employment development services can be reauthorized. These include when the person has a life event that interrupts delivery of the service or for up to 60 days when the person has submitted an application to VRS/SSB and is waiting for a determination of eligibility or priority status.
As of early July 2021, case managers should be using the guidance for employment services authorization CBSM page for employment support planning. This includes referring to VRS/SSB when a person needs supports to find a job as well as authorizing employment exploration services and the plan phase of employment development services.
People currently receiving waiver employment development services (T2019 U3) to support a job search can continue to receive supports uninterrupted. There's no requirement to stop services and transition to VR. If a person needs to modify their current authorization, the old T2019 U3 code remains available for use until September 1, 2021. After that date, the guidance for employment services authorization CBSM page has a condition allowing the find phase of employment development services (T2019 U8) to be used to extend or add units to an authorization for job search supports under the old employment development services code.
No. If someone has previously worked with VRS/SSB and wants supports to start a new job search, VRS/SSB can open a new case for the person and provide supports. A previous case closure (successful or unsuccessful) does not preclude someone from applying for and receiving VRS/SSB services.
The intent of the "VRS/SSB services exhausted" condition for authorizing the find phase under waiver services is to allow people to continue a current job search if VRS/SSB ends their services because they determine the person can no longer benefit from them. The intent is not to set up a situation where someone who was unsuccessful in getting a job in the past is excluded from participating in supports to find a job in the future. Similar logic applies to a determination of ineligibility or priority of service. The intent is for a recent determination, not one occurring in the past. If in doubt about eligibility for VRS/SSB, the person can submit an application or you can consult with a waiver liaison.
No. A service provider waitlist is not a condition that federal guidance or CBSM guidance allows for VRS/SSB to be considered unavailable. If you anticipate issues with VRS/SSB provider capacity but have existing waiver employment service providers with capacity, encourage them to become dually enrolled as a VRS/SSB and waiver provider.
The employment development services CBSM page provides conditions for when services can be reauthorized, including when a person experiences a debilitating health condition or life event or changes service providers. If a person wasn't able to meet the outcomes of the service during the given timeframe, waiver case managers could consider finding a new provider to deliver the plan phase of employment development services.
We didn't identify any needed changes to the Briefcase resource document: Transportation and day and employment services related to E1MN. The resource continues to be available. In the "collaborating and referring across programs" tab on the FAQ page, there are two FAQs related to coordinating transportation supports across VRS/SSB and waiver programs that may be helpful.
No, the intake for services are not billable under the waivers. Minnesota Health Care Programs (MHCP) providers must follow MHCP billing policies outlined in the MHCP Provider Manual for billing services.
MHCP providers who deliver services are responsible for claims submitted to MHCP:
Providers that have a 245D license should use the MN-ITS Direct Data Entry Eligibility Request to verify the person’s waiver eligibility.
Providers that do not have a 245D license should help the person request a benefit lookup, using their own My Vault account. See Disability Hub MN - Using My Vault to support people for more information.
Help the person create a My Vault account. If you try to create a new account when the person already has an account with their email address, you will get a message: “That email is already taken. Please sign in instead.” If you get that message, help them log on to their My Vault account with their email address. If they don’t remember their password, it’s easy to reset it using the “forgot password” link. There are great resources to help – see Disability Hub MN – Using My Vault to support people for more information like resetting a password.
If you’re still unsure, or need more help, you can chat or call the Disability Hub MN.
It’s important the person’s whole employment team knows they have a My Vault account. When you help a person create their My Vault account, encourage and help them share the information with the rest of their team members.
No, not necessarily. EE providers are responsible for ensuring they are providing supports according to EE program rules. During the annual EE plan, reviews, and check-in meetings are a good time to discuss any changes or updates to a person’s services.
Collaboration across a person’s support team is important. Hopefully, the person or their team will let you know of a change.
You can help the person request a benefit lookup, using their own My Vault account. This will include contact information for their case manager. See Disability Hub MN - Using My Vault to support people for more information. Call your local human service agency's social services agency, you can see a list here. If you are still having difficulty getting a hold of the case manager, consider reaching out to the Employment Liaison in their lead agency for assistance.
The first step is letting their waiver case manager know they have an interest in employment. Collaboration between the person’s employment team members is important. If the person wants help, you can help them let their case manager know about their interest in employment.
When a waiver case manager is made aware of the person’s interest in employment and potential new service need, they will talk with the person about their specific needs and preferences and discuss the available employment supports (through the waiver, or other sources) to meet those needs. They will help the person make an informed choice about their options and work with the person to develop the support plan. If waiver employment services are the best fit for the person’s needs and are what the person chooses, the case manager will help them find a service provider, and authorize the waiver employment service.
The services available to people on waivers are based on their individual needs. While waiver “budgets” are typically based on the person’s level of need, lead agencies have flexibility and control of the budget at a local level to plan for and meet the needs of people they serve.
The waiver case manager and the person work together to discuss the person’s assessed needs and preferences. They also discuss each service and the scope and purpose of those services so the person can make an informed choice about available employment support options to meet their needs. When a person’s needs change, their case manager works with them to update their assessment to better reflect their current needs.
Consumer-directed community supports (CDCS) is a service option available through all disability waivers to give people more choice. CDCS allows people to use their waiver funds to self-direct their own services. They get to choose or design the services and supports that fit their assessed needs, decide when they get them, and hire the people they want to deliver the services.
People on waivers have the right to appeal any denial, termination or reduction in services. The waiver case manager must provide a Notice of Action to the person to ensure they are aware of the denial and their right to appeal. You can find more information on the Community Based Services Manual (CBSM) - Notice of Action page.
Minnesota is an Employment First state and Minnesota’s HCBS waiver provide ongoing supports for people to maintain employment. While the appeal is in process, if possible, work with the person and the waiver case manager to resolve the issue. The services available to people on waivers are based on their individual, assessed needs. If the person requests ongoing employment supports to maintain their job, the lead agency must review the request to determine if it fits in with the person’s needs and preferences and determine if waiver employment support is the right service.
If a person has a need for employment supports and their case manager refuses to coordinate the needed supports, contact the Employment Liaison at that county. If you are still not able to resolve, submit an E1MN Request Form.
If the person is receiving VRS services, the E1 PBA would provide initial supports. As part of E1MN, we have provided guidance on making the transition from find to keep as smooth as possible. Authorizing waiver employment support services can take up to 30 days, so it’s important to start the process immediately. If a person gets a job and needs supports, you should help the person notify their case manager and provide the following information: job title, hourly wage, average weekly hours worked, hire & start dates, and name of business. The waiver case manager will use this information to authorize and coordinate waiver employment support services.
If an individual has a Medicaid waiver and obtains a job without the support of VRS, the Extended Employment program can fund employment supports while waiver Employment Support Services are authorized and put in place (this can take up to 30 days). Once waiver funding is in place, the individual should be moved from Extended Employment to waiver funding. If a service provider funds employment supports through the Extended Employment program and does not have a 245D license, the individual will need to move to a 245D provider.
We encourage current EE providers who do not have a 245d license to obtain a license and become enrolled to provide Medicaid waiver employment services alongside EE supports. As a dually enrolled provider, you will be able to provide a more seamless experience across funding streams for the people you support. From a business perspective: People, case managers, and VRS counselors will be considering dual enrollment when selecting providers to support the employment goals of people on waivers.
EE providers who are not dually enrolled should take advantage of the transition year ahead to explore and pursue dual enrollment.
Disability Waiver Rate System (DWRS) rates can only be adjusted by legislative action and requires CMS approval. The DWRS is a centralized system that calculates rates for home and community- based services provided under the disability waivers. The system is based on research completed on the average costs to deliver home and community-based services in Minnesota. DHS is dedicated to ongoing research and analysis on DWRS in order to ensure: the Disability Waiver Rate System accurately reflects the cost of providing services, the system is implemented fairly and consistently throughout the state, and people continue to have access to the services they need. You can read more about the evaluation process and results on the Disability Waiver Rates System ongoing evaluation webpage. For further questions, on DWRS or rates for employment services, reach out to email@example.com.
If the supports a person is authorized to receive are not sufficient to meet their employment support needs, the provider should work with the lead agency case manager, as the case manager will understand the assessed needs of the person as well as the supports available to them. When considering these supports, for people with minimal needs, consider options like informal or remote supports – does the person truly need continued formal supports provided in a traditional manner?
If this question more broadly refers to the rates and reimbursement under Employment Support Services, changing DWRS rates requires legislative action and CMS approval.