Supported Employment

(A) Service Limitations. When supported employment services are provided at a work site where persons without disabilities are employed, MassHealth payment is made only for the adaptations, supervision, and training required by participants as a result of their disabilities. (B) Nonpayable Services. (1) Payment for supported employment does not include incentive payments, subsidies, or unrelated vocational training expenses, including but not limited to the following exclusions: (a) incentive payments made to an employer to encourage or subsidize the employer's participation in a supported employment program; (b) payments that are passed through to users of supported employment programs; or (c) payments for training that is not directly related to a participant's supported employment needs. (2) Supervisory activities performed as a normal part of the business setting are not covered. (3) Supported employment services are not covered when provided in settings that are solely comprised of individuals with disabilities, also known as sheltered workshops. (4) Supported employment services will not be covered on the same day as waiver per diem day services are covered, but are allowable on the same day as partial per diem day services. (5) Day services, community-based day supports, supported employment, and prevocational services, in combination, are limited to no more than 156 hours per month, with each day of day services considered to be six hours. The MassHealth agency or its designee may grant individualized exceptions to the limit on a 30-day basis in order to maintain a participant’s tenure in the community, to facilitate transitions to a community setting, or to otherwise facilitate the participant’s successful engagement in community-based waiver services. Exceptions to the 156 hour per month limit must be included in the participant’s waiver plan of care. (C) Recordkeeping. In addition to the requirements of 130 CMR 630.441, each provider of supported employment services must maintain documentation in each participant’s file that the service is not available under a program funded under §110 of the Rehabilitation Act of 1973 or the Individuals with Disabilities Education Act (20 U.S.C. 1401). The provider must also maintain records that include detailed descriptions of supported employment services provided and documentation of all units of services.