Supported Employment Follow Along /Extended services comparison

For the original publication, please click here. The following is a text version of the original publication.
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To: Case Managers and Service Providers
From: Cathy Robinson, Director, Bureau of Developmental Disabilities Services
Re: Supported Employment Follow Along /Extended services comparison
Date: September 29, 2015

The Centers for Medicare & Medicaid Services (CMS) have approved the Family Supports waiver (FSW) renewal and Community Integration & Habilitation waiver (CIH) amendment. Effective July 1, 2015, supported employment follow-along (SEFA) was replaced with extended services (ES).

Extended services are ongoing employment support services which enable a participant to maintain integrated, competitive employment in a community setting that pays at or above minimum wage.

Following is a comparison of SEFA and ES allowable and non-allowable core components. 

Core components	SEFA (Ended 6/30/15 for new participants)	Extended services (New service 7/1/15)
Allowable timeframe	Limited to 18 months with a provision for additional services that relate to advancement, job in jeopardy or job loss.	Not limited to a specific amount of time.
Employer training/Job development	N/A	Training for the participant’s employer(s) to promote inclusion at the worksite may be provided.
Group setting activities	N/A	The following reimbursable activities may be provided in a group setting: job-specific or job- related safety training; coaching work related personal care and social skills; self-advocacy; and training on the use of public transportation.
Group supports to participants utilizing different support options	N/A	Group supports may not be delivered to participants who are utilizing different support options.
Off-site monitoring	Off-site monitoring that is directly related to maintaining a job is allowable.	Off-site monitoring is not allowable.
Personal care/Social skills	N/A	Development or strengthening  of work-related personal care and social skills may be provided.
Public transportation	N/A	Training on the use of public transportation may be provided.
Safety training	N/A	Job-specific or job-related safety training is allowable.
Self-advocacy	Advocating, when necessary, at the work site on behalf of the participant is allowable.	Job-related, self-advocacy skills training may be provided.
Self-employed, working from home	N/A	Participants may be self- employed and/or working from home when the work is competitive and could be performed in an integrated environment.
Sheltered work settings	N/A	Services may not be delivered in facility based or sheltered work settings where participants are supervised for the primary purpose of producing goods or performing services.
Staff travel time	Staff time used in traveling to and from a work site is allowable.	Staff time used in traveling to and from a work site is not allowable.
Volunteer endeavors	N/A	Services may not be provided for volunteer endeavors.
Incentive payments	Incentive payments may not be made to an employer to subsidize their participation under SEFA or Extended services.
Job skills training	Coaching and training on job-related tasks such as computer skills or other job-specific tasks may be provided under both SEFA and Extended services.
Minor participants	Services may not be furnished to a minor participant by a parent or legal guardian under SEFA or Extended services.
Natural supports	Developing or strengthening new and existing work-related natural supports; transportation training, assistance with banking, or social support at the worksite is allowable under both SEFA and Extended services.
Observation/Supervision	Regular observation or supervision of the participant at the job-site is allowable under both SEFA and Extended services.
Public relations	Public relations are not allowable activities.
Rehabilitation Act of 1973,	No service that is otherwise available under the Rehabilitation Act of 1973 or Public Law 94-142 is allowable under SEFA or Extended services.
Sheltered work observation	Sheltered work observation is not allowable under SEFA or Extended services.
Supervisory activities	Supervisory activities rendered as a normal part of the business setting may not be provided under SEFA or Extended services.
Transportation	Transportation of a participant is not allowable under SEFA or Extended services.
Vocational training	Payment may not be made for vocational training that is not directly related to a participant’s supported employment needs outlined in the ISP under SEFA or Extended services.

Only those waiver participants engaged in competitive community employment and actively utilizing a combination of SEFA and prevocational services as of June 30, 2015, (as reflected in their ISP, approved CCB and NOA) may utilize the combination of ES and prevocational services on or after July 1, 2015.