Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-559 - Foundational community supports program
Section 182-559-350 - Eligibility for supported employment services
Universal Citation: WA Admin Code 182-559-350
Current through Register Vol. 24-18, September 15, 2024
To be eligible for supported employment services, a client must:
(1) Be age sixteen or older;
(2) Be eligible for apple health (medicaid);
(3) Desire to obtain employment;
(4) Meet at least one of the following health criteria and is expected to benefit from supported employment services:
(a) Clients
assessed by a licensed behavioral health agency, under chapter 246-341 WAC, to
have a behavioral health need, which is defined as one or both of the following
criteria:
(i) Mental health needs, including a
need for improvement, stabilization, or prevention of deterioration of
functioning (including ability to live independently without support) resulting
from the presence of a mental illness; or
(ii) Substance use needs determined by an
assessment using the American Society of Addiction Medicine (ASAM) criteria
indicates that the client meets at least ASAM level 1.0, indicating the need
for outpatient substance use disorder (SUD) treatment. The ASAM is a
multi-dimensional assessment approach for determining a client's need for SUD
treatment.
(b) Clients
assessed via a CARE assessment, per WAC
388-106-0050,
to have a need for assistance demonstrated by:
(i) The need for assistance with at least
three activities of daily living (ADLs) defined in WAC
388-106-0010,
one of which may be body care; or
(ii) The need for hands-on assistance with at
least one ADL which may include body care.
(c) There is objective evidence, as defined
by the sequential evaluation process in chapter 388-449 WAC or the progressive
evaluation process in chapter 388-447 WAC, of physical or mental impairments
because of which the client needs assistance with basic work-related
activities, including one or more of the following: Sitting, standing, walking,
lifting, carrying, handling, manipulative or postural functions (pushing,
pulling, reaching, handling, stooping or crouching), seeing, hearing,
communicating, remembering, understanding and following instructions,
responding appropriately to supervisors and coworkers, tolerating the pressures
of a work setting, maintaining appropriate behavior, using judgment, and
adapting to changes in a routine work setting.
(5) Exhibit at least one of the following risk factors:
(a) Unable to be gainfully
employed for at least ninety consecutive days due to a mental or physical
impairment, as demonstrated by eligibility for the aged, blind, or disabled
program as defined in WAC
388-449-0001,
or the housing and essential needs program as defined in WAC
388-447-0001;
(b) More than one instance of treatment for a
substance use disorder within the past two years;
(c) At risk of deterioration of mental
illness and substance use disorder, or both, including one or more of the
following:
(i) Persistent or chronic risk
factors such as social isolation due to a lack of family or social supports,
poverty, criminal justice involvement, or homelessness;
(ii) Care for mental illness and substance
use disorder, or both, requires multiple provider types, including behavioral
health, primary care, long-term services and supports, or other supportive
services; or
(iii) Past psychiatric
history, with no significant functional improvement that can be maintained
without treatment and/or supports.
(d) Dysfunction in role performance due to a
behavioral health condition, including one or more of the following:
(i) Behaviors that disrupt employment or
schooling, or put employment at risk of termination or schooling
suspension;
(ii) A history of
multiple terminations from work or suspensions/expulsions from
school;
(iii) Cannot succeed in a
structured work or school setting without additional support or accommodations;
or
(iv) Performance significantly
below expectations for cognitive/developmental level.
(e) An inability to obtain or maintain
employment resulting from age, physical disability, or traumatic brain
injury.
Disclaimer: These regulations may not be the most recent version. Washington may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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