Supported Employment (Waiver Funded)

Illinois Department of Human Services

Division of Developmental Disabilities

Information Bulletin

DD.20.027 FINAL

Purpose:

This Information Bulletin addresses guidance on the process to obtain, utilize and document the use of Division of Developmental Disabilities Supported Employment (DDD SEP) for Individual (39U) and Group (39G) services for all NEW funding requests effective upon the date this draft information bulletin is final.

The Division of Developmental Disabilities is in the process of formalizing a plan to address current 39U and 39G authorizations that may include a revalidation process. Any requirements for revalidation of current authorizations for 39U and 39G will be distributed under a separate correspondence and/or information bulletin.


Background:

A Memorandum of Understanding (MOU) was enacted on September 8, 2020 between the Division of Developmental Disabilities (DDD) and the Division of Rehabilitation Services (DRS) to fulfill a portion of CFR 361.24.

A key component of the DDD/DRS MOU is the process to access/activate DDD SEP for individuals who are funded through the Adults with Developmental Disabilities Waiver.

DDD SEP consists of:

  1. DDD SEP Individual (39U)
  2. DDD SEP Group (39G)


Role of DRS:

Per Federal rule, DRS VR is the first payor of Competitive Integrated Employment Services for individuals with disabilities in Illinois. Initial referrals for Vocational Rehabilitation can be made to the Division of Rehabilitation Services by submission of an online web referral: Visit the DRS referral page here.

The DRS referral will be processed by the DRS office in closest proximity to the individual's home address. Barring exceptional or unforeseen circumstances, an eligibility determination must be made within 60 days. See Referral Processing Guidelines here

History of DDD SEP:

Previously DDD SEP Individual (39U) and DDD SEP Group (39G) were "bundled" - that is, both Service Codes were activated upon approval from DDD. Due to the inherent differences in Individual versus Group employment and the need for uniquely personalized supports in each area, the Service Codes have been separated.

The primary difference being that DDD SEP Individual (39U) requires an individual to have secured and maintained Competitive Integrated Employment, with a successful closure from DRS. DDD SEP Group (39G) does not require successful DRS closure. Please refer to the "Authorization Process" area of the Information Bulletin for guidance specific to requirements for each code.


Eligibility:

Individuals approved for the Adults with Developmental Disabilities Waiver are able to access DDD SEP with prior approval.

All Individuals must:

  • Be enrolled in the Adults with Developmental Disabilities Waiver; and
  • Require supportive services to work in an integrated environment; and
  • Have a defined, related and ongoing/long term employment support need identified in his/her Personal Plan (Career and Income section).


 Individuals seeking DDD SEP Individual (39U) must be:

  • Successfully Closed and transitioning from supports provided through DRS VR
    • DDD SEP Individual (39U) requests will not be considered for individuals who have not achieved a successful DRS VR employment outcome or those who have been found ineligible for DRS VR services
    • The request for DDD SEP Individual (39U) must occur within 90 days following DRS VR Closure

And

  • Engaged in Competitive Integrated Employment (CIE)*

*CIE is work performed on a full-time or part-time basis for which an individual is:

  • Paid at or above minimum wage; and
  • Not paid less than what other employees without disabilities are paid for the same or similar work; and
  • Eligible for the level of benefits provided to other employees without disabilities; and
  • Provided opportunities for advancement similar to those employees without disabilities who have similar positions; and
  • At a location where the employee interacts with other employees without disabilities, as well as regular interaction with persons without disabilities who are not paid care givers or service providers.
    • Self-employment or CIE at a location at which there are typically no other employees working, besides the individual, is acceptable.


Individuals seeking DDD SEP Group (39G) must be:

  • Paid at or above minimum wage; and
  • In a group work crew/enclave of no more than six (6) persons at a time; and
  • Receiving supports and services in an integrated business, industry or community setting that:
    • Meets the requirements of the HCBS Settings rule;
    • Is not isolated from individuals who do not have disabilities; and
    • Allows ample opportunity for routine interactions with customers, co-workers and other individuals who do not have disabilities.
    • Group employment at an integrated location at which there are typically no other employees working besides the work crew, is acceptable.

DDD SEP Group (39G) services should support a successful transition to competitive integrated employment or self-employment, or to supplement such employment and/or self-employment when it is only part-time.


Billable Time:

DDD SEP billing (39U & 39G) shall not exceed the daily state maximum (7 hours); monthly state maximum (115 hours) or the annual fiscal year state maximum (1,100 hours) in combination with any and all billing for: Community Day Services (31U, 31C), Virtual Day Services (31V), Adult Day Services (35U) and At Home Day Services (37U).

Note: if multiple supports that utilize the 1100 hours are used, there must be Implementation Strategies that define exactly the hours billed for each type of service to ensure the 1,100 hours is divided appropriately. The ISC is responsible for ensuring all services are reflected and itemized appropriately.

Service time should be rounded to the nearest 15 minutes.

Service payments (billing):

  • DDD SEP Individual (39U) payments are made only for the adaptations, supervision and training required by individuals receiving waiver services, as a result of their disabilities, to sustain competitive integrated employment.
  • DDD Group (39G) are made only for the adaptations, supervision and training required by individuals receiving waiver services, as a result of their disabilities, to engage in small group employment. The ultimate goal of 39G is to support successful transition to individualized integrated employment or self-employment, or to supplement such employment and/or self-employment when it is only part-time.

Adaptations, supervision and training under both DDD SEP Individual (39U) and DDD SEP Group (39G) may include non person facing portions of time which support continued successful employment. However, a direct service benefiting the individual's employment outcomes must be provided in order to bill for the time.


Billing shall not be submitted for activities such as:

  • Individual employment that does not meet the standard of CIE.
  • Group employment that is paid below minimum wage.
  • Group employment in a non-integrated environment.
  • Group employment supports in excess of 6 individuals.
  • Group or Individual general soft skill employment curriculum delivery.
  • Non-paid, pre-vocational experiences (e.g. volunteerism or business informational tours).
  • Supervisory activities rendered as a normal part of the business setting.
  • Transportation time, unless the individual's service plan indicates a need for transportation training and the transportation training is being provided.
  • "Stand-by" time when employment support staff is not actively supporting the individual(s) receiving DDD SEP supports.
  • Time between arrival and the start of active DDD SEP support.

It is expected that, as employment skills are learned, honed and improved, an individual's need for DDD SEP supports, both Individual and Small Group, would diminish over time.


Documentation Requirements:

DDD SEP provider agency employment support staff shall maintain records of the duration, nature and case specifics of employment supports for all units of DDD SEP, Individual (39U) and/or Group (39G), which are billed.

Permanent records of all individuals served in DDD SEP shall include:

  • Name of individual served
  • Job title of individual served
  • Hourly wage or annual salary of individual served
  • Name & address of employer
  • Name of direct employer supervisor
  • Start and, if applicable, end dates of employment
  • Employer benefits (Paid time off, 401K, donation match, insurance)

Daily records, progress/case notes of all individuals served shall include:

  • Date of DDD SEP supports
  • Start and end time(s) of DDD SEP supports
  • Name of provider agency DDD SEP support staff
  • Activities and nature of support provided
  • Location(s) of such activities
  • Any progress towards outcomes identified in the Personal Plan and Implementation Strategy
  • Staff signature and date

Daily records shall be retained for a minimum of 5 years.


Authorization Process for DDD SEP Individual (39U)

Upon DRS VR case closure, a request can be made to activate DDD SEP Individual (39U) funding for long term employment services. When approved, the DDD will authorize SEP Individual (39U) effective the day after the DRS VR case closure date so long as the VR case closure includes the date of closure. Otherwise, DDD SEP Individual (39U) will be effective the first day of the month after receipt and processing of the request.

  1. When an individual in the Adults with Developmental Disabilities Waiver receives a "Notice of Closure" from DRS VR, indicating success in achieving and maintaining CIE he/she is able to apply for long term employment services and supports, DDD SEP - Individual (39U).
  2. The "Notice of Closure" must:
    1. be the approved DHS DRS Form: IL 488-0717W; and include
      1. Date of Closure
      2. Case Number
      3. Circumstances of Closure (i.e. successfully placed)
  3. The individual will work with a DDD SEP provider and the ISC to complete the request.
    1. The request for DDD SEP must occur within 90 days following DRS VR Closure
  4. The ISC shall submit the following to the DDD via Birdseye:
    1. Completed Alternative Day Program Request  (versión en español)
      1. Signed and dated DRS Closure Notification
      2. A narrative that includes:
        1. The employer name
        2. Employer address
        3. Direct supervisor (if known at the time of application)
        4. Position and job duties
        5. Rate of pay
        6. The ongoing and/or proposed job supports that will be provided


Authorization Process for DDD SEP Group (39G)

  1. The individual will work with a provider and the ISC to complete the request.
  2. The ISC shall submit the following to the Division via Birdseye:
    1. Completed Alternative Day Program Request  (versión en español)
      1. A narrative that includes:
        1. The employer name
        2. Employer address
        3. Direct supervisor (if known at time of application)
        4. Position and job duties
        5. Rate of pay
        6. The ongoing and/or proposed job supports that will be provided


For both DDD SEP Individual (39U) & DDD SEP Group (39G):

  1. The Division will authorize, if appropriate, and generate an updated rate sheet and response correspondence. The response/turn-around time can vary due to multiple circumstances but in general should take no more than 30 days.
  2. DDD communicates the addition of the rate sheet through a Change Memo and an Updated Rate Sheet to the provider.
  3. The specific SEP program/service code, applicable statewide rate, total hours per month which can be billed and monthly total should be included on the Service Agreement prior to billing for any individual in Adult Home Based Services.


The information contained herein should not be considered a substitute for the appropriate official statutes, rules, regulations, or the advice of legal counsel.


Effective Date:

January 1st, 2021