Opportunities for Medicaid funded job training and support services are opening up in the next few weeks. It is important for people to know how to get access to them. Community Supported Employment (CSE) is a Medicaid Home and Community Based Waiver service (HCBS). Adults who qualify for either the Developmental Disability (DD) waiver or the “Aged and Disabled” (A&D) waiver may be able to benefit from the service. CSE provides intense, usually one to one, on the job training and support from a “job coach”.

1.   The Court Decision:
The Idaho Federal District Court has certified a class action lawsuit and extended the benefits of a court order in that lawsuit to all adults on the Medicaid DD waiver. The order restores each person’s DD services budget to the highest level it has been since July 1, 2011. The Department of Health and Welfare has sent letters to everyone letting them know what their budget is for this year under the court order. For many people this budget is considerably higher than it was before the decision. People with higher budgets can now change their service plans to add services, including CSE. Because many people’s budgets were cut in 2011 and later years, some people lost CSE services or had to cut their hours of work. Some people may now have enough room in their budgets to access CSE for the first time. The restored budgets will allow them to use CSE services to get a job or increase the hours they are currently working. Participants, Service Coordinators, and Plan Developers should consider whether to take advantage of this opportunity.
2.   The State Law Change:
The Idaho Legislature passed a bill (H476) which will permit people with developmental disabilities to request an increase in their services budget if it is needed to obtain or retain employment. It has always been difficult to include CSE services in a DD services budget because the hourly cost of CSE is higher than many other DD services, and employment services have been left out of people’s plans to leave money for services more directly related to health or safety. Starting on July 1, 2014, participants can request an increase in their budget, if it is needed to pay for CSE. This is done through the “exception review process”. The new CSE rules will be available for public comment in June, 2014.  This exception review process is not necessary if your current DD service budget (which might be higher now due to the court decision) is large enough to pay for the CSE services you need. To take advantage of this opportunity, you will need to modify your plan to add the CSE service and to make adjustments to your other DD services, if needed.
3.   CSE services in the A&D Waiver:
Although very few people have used them, CSE services are also offered under the “Aged and Disabled” (A&D) waiver. CSE services are usually thought of as a service for people with developmental disabilities (DD). However, job coaching may be needed and helpful for people with other types of disabilities. If you participate in the A&D waiver and you want to get a job, consider whether CSE might be just what you need.
Waiver participants who want to add CSE services to their individual service plans should contact their Targeted Service Coordinator, or a CSE provider to start the process.

Most people with disabilities would welcome the opportunity to be employed, if only they could get the supports, specialized training and job accommodations they need. In the next few weeks there will be some new opportunities for people to get that kind of help.

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