Tuesday, November 17, 2015

#Waiverwise: Supported Employment Follow Along

Waiver services should be person centered. You will create a Service Plan within the budget limit ( $16,545 annually for FSW). There is more information available on this process in the waiver manual.

More information, including service costs, available in the manual:
http://provider.indianamedicaid.com/ihcp/manuals/DDRS%20HCBS%20Waiver%20Provider%20Manual.pdf

Supported Employment Follow Along

Supported Employment Follow Along (SEFA) services are services and supports (time-limited to 18 months per employment setting), that enable a participant who is paid at or above the federal minimum wage to maintain employment in a competitive community employment setting. The 18-month clock begins with the start date of the SEFA service as it appears on the approved POC/CCB and Notice of Action (NOA). Note that the 18-month clock does not begin with the date the service is first rendered or with the date the service is first billed for this time-limited service, unless those dates correspond to the start date of the service as it appears on the POC/CCB and NOA. In each of the following situations (job in jeopardy, career advancement or job loss, as described below) requests for exceptions for SEFA beyond the approved 18 months will be reviewed. Although there is a suggested 18-month time limit, time can be extended when a POC/CCB is submitted. Depending on each participant's circumstances, the time limit may need to be extended or the participant may need to be referred to, or back to, Vocational Rehabilitation for services and reimbursement, in which case concurrent reimbursement for SEFA and Vocational Rehabilitation Services will not be allowed. Extensions are currently granted to anyone who is still making efforts toward employment. 

Definitions for job in jeopardy, career advancement, or job loss are as follows: 
 Job in jeopardy – The participant will lose his/her job without additional intervention, or 
 Career advancement – It is determined that the new job requires more complex, comprehensive, intensive supports than can be offered under the waiver, or 
 Job loss – The participant may need to be referred to, or back to, Vocational Rehabilitation for services and reimbursement, in which case concurrent reimbursement for SEFA and Vocational Rehabilitation Services will not be allowed 

Participants may utilize Workplace Assistance in conjunction with SEFA. Participants may also utilize Prevocational Services in conjunction with SEFA. 

Unless an exception is granted by the DDRS as described previously, reimbursement is not available under SEFA services for more than 18 months per employment setting, with the 18-month clock starting with the service start date as it appears on the POC/CCB and NOA.

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