Alaska Administrative Code
Title 7 - Health and Social Services
Part 8 - Medicaid Coverage and Payment
Chapter 130 - Medicaid Coverage; Home and Community-Based Waiver Services
Article 2 - Home and Community-Based Waiver Services; Nursing Facility and ICF/MR Level of Care
7 AAC 130.270 - Employment services

Universal Citation: 7 AK Admin Code 130.270

Current through November 28, 2024

(a) The department will pay for employment services if they are

(1) provided in accordance with the department's Employment Services Conditions of Participation, adopted by reference in 7 AAC 160.900;

(2) provided to a recipient in one of the following recipient categories:

(A) children with complex medical conditions;

(B) adults with physical and developmental disabilities;

(3) are provided in person or using distance delivery that is justified and approved in a support plan to a recipient individually or as a member of a group; the units of service requested for distance delivery

(A) may not be more than 10 percent of the total units of employment services approved for a plan year; and

(B) must be justified and approved in the recipient's support plan;

(4) approved under 7 AAC 130.217 as part of the recipient's support plan; if a recipient is under 22 years of age, the support plan must document that the employment services do not duplicate or supplant educational services for which a recipient is eligible under 4 AAC 52;

(5) planned, if in the case of a recipient who is self-employed, to help the recipient earn an income that is comparable to the income received by other people who are not individuals with disabilities, who are self-employed in similar occupations or in similar tasks, and who have similar training, experience, and skills;

(6) in compliance with 29 U.S.C. 794g ( sec. 458, P.L. 113-128 (Workforce Innovation Opportunity Act)), that limits the use of a subminimum wage;

(7) provided to the recipient because the recipient's disability requires intensive support and training to perform in a work setting;

(8) based on the recipient's abilities, interests, priorities, and career goals, determined through a person-centered planning process that includes a review of the recipient's relevant medical, social, educational, and other records;

(9) provided in decreasing amounts over time, as the recipient meets the specific service outcomes and employment-related goals identified in the person-centered support plan;

(10) provided with the primary objective and expected outcome of the recipient becoming gainfully employed, as defined in AS 23.15.095,

(A) in an integrated workplace where recipients work with and alongside individuals without disabilities; and

(B) for compensation at or above the minimum wage and not less than the compensation paid by the employer for the same or similar work performed by an individual is not disabled;

(11) provided in a manner that protects the recipient's health, safety, and welfare; and

(12) services for which the department has given prior authorization.

(b) The department will consider employment services to be pre-employment services if they

(1) are provided to enable a recipient to become gainfully employed, as defined in AS 23.15.095;

(2) assist a recipient to develop general work readiness and non-job specific strengths and skills;

(3) assist a recipient to determine the recipient's individual strengths, interests, abilities, skills, experiences, support needs, and information about conditions and employment settings optimal for the success of the recipient;

(4) are provided in the most integrated setting appropriate to the recipient's needs, and support full access to the greater community;

(5) assist a recipient in becoming gainfully employed, as defined in AS 23.15.095, including services to help the recipient locate and secure that work;

(6) support recipients who desire to become self-employed if the services

(A) assist a recipient to determine the business concept and develop a business plan;

(B) provide appropriate referral to community resources for additional guidance in identifying potential sources of business financing and other assistance available in developing and launching a business.

(1) provide systematic, evidence-informed

(A) training and instruction for the recipient to learn and carry out the recipient's job duties, subject to limitations described in (d)(1) - (3) of this section;

(B) direct support to assist the recipient in remaining gainfully employed as defined in AS 23.15.095, preventing the recipient from losing a job, or stabilizing a recipient who had a change in job circumstances; or

(C) support for maximizing hours worked, pay, benefits, and opportunities for career advancement based on the recipient's abilities, interests, and priorities;

(2) assist the recipient to accomplish work-related goals identified in a person-centered support plan, and decrease over time as goals are achieved; and

(3) assist a recipient to become self-employed, for a recipient seeking self-employment, including subsistence activities, and the services

(A) identify the supports that are necessary for the recipient to operate the business; and

(B) provide ongoing assistance, counseling, and guidance after the recipient starts the business.

(d) The department will not pay for

(1) supervisory activities provided to all employees at the workplace;

(2) training provided to all employees at the workplace;

(3) accommodations commonly provided by the employer to employees;

(4) services described in (b) of this section if a recipient simultaneously receives services under (c) of this section;

(5) more than three months of services under (b) of this section during a recipient's lifetime unless the provider of employment services demonstrates that the recipient

(A) needs additional preparation for employment related to a medical event that caused a significant decline in the recipient's abilities;

(B) needs to prepare for a new job that requires additional skills to advance the recipient's career; or

(6) an expense associated with starting up or operating a business;

(7) transportation for a recipient, unless it is to or from an employment site, and no other transportation is available for the recipient;

(8) a service that is available under a program funded under 20 U.S.C. 1400- 1482 (Individuals with Disabilities Education Act) or 29 U.S.C. 730 (Rehabilitation Act);

(9) expenses that include

(A) incentive payments made to an employer to encourage or subsidize the employer's participation in supported employment; and

(B) payments that are passed through to recipients of supported employment services; or

(10) employment services that

(A) do not align with work-related goals identified in a recipient's person-centered support plan;

(B) are not planned to decrease over time;

(D) are provided in residential settings unless a recipient

(i) is operating a home-based business, including subsistence; or

(ii) has an agreement with the recipient's employer to work from home.

(e) In this section, "subsistence" means a form of self-employment in which individuals produce, using culturally relevant and traditional methods, goods or services that are predominantly consumed by their own household or used for noncommercial customary trade or barter and that constitute an important basis for the worker's livelihood. In this subsection, a form of self-employment that is "subsistence" and culturally relevant to American Indian or Alaska Native tribes may include the exchange of fish caught, or crops raised, by the individual with the disability for other goods produced by other members of the tribe that the individual needs to live and maintain the individual's home.

Authority:AS 47.05.010

AS 47.07.030

AS 47.07.040

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