Narrative: d. 2. H. i.

Medical Assistance, the state’s Medicaid program, is administered by the Minnesota Department of Human Services (DHS). Vocational Rehabilitation Services (VRS) collaborates closely with DHS in the provision of a variety of Medicaid services.

Waiver Programs: Medicaid participants with disabilities who need a defined level of care and choose to live in the community may be eligible for one of the following waivers to help fund the cost of community living and supportive employment:

• Brain Injury Waiver: the person must have a traumatic, acquired or degenerative brain injury and require the level of care typically provided in a nursing facility or neurobehavioral hospital.

• Community Alternatives for Disabled Individuals (CADI) Waiver: the person must have a disability and require the level of care typically provided in a nursing facility.

Developmental Disability Waiver: the person must have a developmental disability or related condition and require the level of care typically provided in an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD).The Department of Human Services has submitted amendment language to the Centers for Medicare and Medicaid Services (CMS) for an employment services waiver. The waiver amendment would create three new employment services. CMS needs to approve the amendment language before the services can be implemented. Employment Exploration Services which are defined as community-based services that introduce and explore employment, such as work experiences, assists people in making an informed choice about working in competitive, integrated employment. Employment Development Services are defined as individualized services that help people find competitive, integrated employment or attain self-employment. Employment Support Services are defined as individualized services and supports that assist people with maintaining community employment in an individual or group arrangement.

VRS accesses Medicaid dollars to pay for durable medical supplies such as wheelchairs, hearing aids and communication boards. Medicaid has limits on what they will pay for specific items. If the rehabilitation counselor feels the consumer would benefit from an “upgrade” to the item, Vocational Rehabilitation can pay the difference between the Medicaid payment and the cost of the upgraded product. Medicaid will apply the VR payment to the consumer’s spenddown.

Minnesota’s Medicaid Infrastructure Grant was a joint project of the Department of Human Services, the Department of Employment and Economic Development (VRS and SSB) and the State Council on Disability. Collaborative efforts utilizing grant funding have been continued through the use of state appropriations, including:

• Disability Hub MN: The Disability Hub is a partnership between DHS and the Centers for Independent Living to provide disability related information and referral resources for Minnesotans with disabilities. Assistance is available in the areas of accessible housing, personal care services, transportation, employment, disability benefits, assistive technology, and other community resources. Services are available through a toll-free number or online at www.MinnesotaHelp.info. Where space is available, the Disability Hub staff are co-located with VRS staff. The most recent expansion of the Disability Hub has been in the area of benefits planning and benefits summary and analysis for beneficiaries of Social Security benefits.

• Disability Benefits 101: DB101 (www.db101.org) is a free online service operated by the Disability Hub that was initially developed using Medicaid Infrastructure grant funding. The program allows people to plan for their future by providing estimator sessions showing how income will impact benefits, explores effective use of work incentives, helps people establish work goals, and provides answers to questions through live chat, phone or email. The program includes short videos of success stories. Many of the Hub staff are certified Community Work Incentive Coordinators and can provide benefits analysis services if there are complex issues. Utilizing Department of Labor — Disability Employment Initiative funding and RSA demonstration grant funds a section on Work Benefits for Youth has been enhanced.