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PDFWAC 182-559-350

Eligibility for supported employment services.

To be eligible for supported employment services, a client must:
(1) Be age sixteen or older;
(2) Be eligible for apple health (medicaid);
(3) Desire to obtain employment;
(4) Meet at least one of the following health criteria and is expected to benefit from supported employment services:
(a) Clients assessed by a licensed behavioral health agency, under chapter 388-877 WAC, to have a behavioral health need, which is defined as one or both of the following criteria:
(i) Mental health needs, including a need for improvement, stabilization, or prevention of deterioration of functioning (including ability to live independently without support) resulting from the presence of a mental illness; or
(ii) Substance use needs determined by an assessment using the American Society of Addiction Medicine (ASAM) criteria indicates that the client meets at least ASAM level 1.0, indicating the need for outpatient substance use disorder (SUD) treatment. The ASAM is a multi-dimensional assessment approach for determining a client's need for SUD treatment.
(b) Clients assessed via a CARE assessment, per WAC 388-106-0050, to have a need for assistance demonstrated by:
(i) The need for assistance with at least three activities of daily living (ADLs) defined in WAC 388-106-0010, one of which may be body care; or
(ii) Hands-on assistance with at least one ADL which may include body care.
(c) There is objective evidence, as defined by the sequential evaluation process in chapter 388-449 WAC or the progressive evaluation process in chapter 388-447 WAC, of physical or mental impairments because of which the client needs assistance with basic work-related activities, including one or more of the following: Sitting, standing, walking, lifting, carrying, handling, manipulative or postural functions (pushing, pulling, reaching, handling, stooping or crouching), seeing, hearing, communicating, remembering, understanding and following instructions, responding appropriately to supervisors and coworkers, tolerating the pressures of a work setting, maintaining appropriate behavior, using judgment, and adapting to changes in a routine work setting.
(5) Exhibit at least one of the following risk factors:
(a) Unable to be gainfully employed for at least ninety consecutive days due to a mental or physical impairment, as demonstrated by eligibility for the aged, blind, or disabled program as defined in WAC 388-449-0001, or the housing and essential needs program as defined in WAC 388-447-0001;
(b) More than one instance of treatment for a substance use disorder within the past two years;
(c) At risk of deterioration of mental illness and substance use disorder, or both, including one or more of the following:
(i) Persistent or chronic risk factors such as social isolation due to a lack of family or social supports, poverty, criminal justice involvement, or homelessness;
(ii) Care for mental illness and substance use disorder, or both, requires multiple provider types, including behavioral health, primary care, long-term services and supports, or other supportive services; or
(iii) Past psychiatric history, with no significant functional improvement that can be maintained without treatment and/or supports.
(d) Dysfunction in role performance due to a behavioral health condition, including one or more of the following:
(i) Behaviors that disrupt employment or schooling, or put employment at risk of termination or schooling suspension;
(ii) A history of multiple terminations from work or suspensions/expulsions from school;
(iii) Cannot succeed in a structured work or school setting without additional support or accommodations; or
(iv) Performance significantly below expectations for cognitive/developmental level.
(e) An inability to obtain or maintain employment resulting from age, physical disability, or traumatic brain injury.
[Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-15-007, ยง 182-559-350, filed 7/6/18, effective 8/6/18.]
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