New Rules Published for Supported Employment under the Medicaid Wavier Will Keep the Service Elusive as Ever for DC Residents
________________________________________________________ By Genni Sasnett, Chief Operating Officer, St. John's Community Services
Supported Employment, was developed in the early 1980s to afford individuals with disabilities an alternative to sheltered employment. Sheltered employment
is characterized by piece rate work, often resulting in sub-minimum wages for workers, and facilities with only workers with disabilities, or segregation. Sheltered employment held the promise of graduation into
community employment but workers found themselves languishing in the workshop for years with little opportunity, chronic poverty, isolation from their communities and social devaluation. In contrast, supported employment was designed to
promote competitive work, meaning work at or above minimum wage and social inclusion, meaning work sites at which people without disabilities are employed. DC citizens with disabilities have
waited for a funding stream that would allow them access to this critical service. The rules for supported employment under Medicaid published on March 7, 2003 are a major disappointment. These rules as written allow both pay at
sub-minimum wage, and work in segregated settings. The rules must be rewritten to define supported employment using the three essential elements of the definition in the Rehabilitation Act of 1973 as Amended, (1) competitive
work, (2) social integration and, (3) need for long-term support to ensure success. There are other significant problems with the rules, like reimbursement to providers as a daily rate rather than an hourly rate
. To meet the needs of many people with disabilities, it is critical to be able to provide several kinds of complementary services within a single day. Many individuals may benefit from several hours a day of supported work
with a complement of some hours of day habilitation. It is critical that this service be provided in hourly increments to make it accessible to the majority of eligible individuals This service is designed to support individuals with disabilities who require intense, on-going support. Many people will begin working less than 5 hours per day and will increase work hours over time. The rules
currently mandate five hours of work per day or nothing, eliminating vast numbers of people from participation. The rules must be amended to allow for reimbursement at an hourly rate with no minimum on hours worked. As a result
of these flaws and others in the rules, supported employment will remain as elusive to the District citizens with disabilities as ever. It is important for every advocate to make their concern known about the inadequacy of these
rules. Let your opinion be heard.
Send comments to: Wanda R Tucker, Interim Senior Deputy Director Medical Assistance Administration Department of Health 825 North Capitol St. NE 5th Floor Washington DC 20002
And copies to:
Dale Brown, Acting
Administrator
MRDDA
429 O Street
NW
Washington DC 20001 Honorable Sandy
Allen
Council of the District of
Columbia
Suite
408
1350 Pennsylvania Ave
NW
Washington DC 20004
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