Virginia Regulatory Town Hall
Department of Medical Assistance Services
Board of Medical Assistance Services
Previous Comment     Next Comment     Back to List of Comments
3/29/23  10:03 pm
Commenter: Karen Tefelski, VaACCSES

Barriers to Employment due to Workplace Assistance Policy

Appendix C: Participant Services, C-1/C-3: Service Specification, Workplace Assistance, Service Definition, page 170

Individuals have difficulty becoming or remaining employed due to the inability to access assistance for basic life functions such as eating, drinking and using the restroom. Four services can be used in an employment situation:

1. Individual Supported Employment that prohibits support with personal assistance.

2. Group Supported Employment that allows, “Personal care activities are not typically provided, but may be included.”

3. Personal assistant services reimbursed at a low provider rate virtually ensuring that no provider will commit to providing services in one-hour increments, leaving the work site, and returning later in the day for a one-hour service again. An individual could ask a co-worker to perform the personal care services, and then the co-worker take leave of their regular work duties to assist their co-worker with personal assistance. It is not typical in a professional working relationship for one employee to assist another with personal assistance such as using the restroom. This can become problematic for both co-workers.

4. Workplace Assistance is severely limited as an option for individuals who needs personal assistance due to restrictions in the draft Application including: “…nor may Workplace Assistance services be provided solely for the purpose of provision of assistance with ADLs.” The focus of Workplace Assistance is to “maintain stabilization” in employment. Workplace Assistance is one of the highest per hourly provider rate service. The assumption is that the service is not billed throughout the entire work day of the individual, but only when needed during certain parts of the day. The provider rate addresses the fact that this is an in-and-out service.

RECOMMENDATION:  A service is needed that can reasonably be expected to be available when needed so that an individual who needs assistance with ADLs can be competitively employed without being limited to group support employment.

CommentID: 215072