Home and Community-Based Services

MA-Waiver Programs

MA-Waiver Programs, also called Home and Community-Based Services (HCBS), help people on Medical Assistance (MA), who would otherwise live in a nursing home, live in their homes and communities. These are the four waiver programs that serve people with disabilities:

• The Community Alternative Care (CAC) Waiver serves people who need the level of care normally given in a hospital.
• The Community Access for Disability Inclusion (CADI) Waiver serves people who need the level of care normally given in a nursing facility.
• The Developmental Disabilities (DD) Waiver serves people with developmental disabilities or related conditions who need the level of care normally given in an Intermediate Care Facility for Persons with Developmental Disabilities (ICF/DD).
• The Brain Injury (BI) Waiver offers services to people with a documented brain injury who need specialized neurobehavioral hospital or nursing facility level of care.

Each of the four disability waiver programs offers a wide range of services, including employment services. Here we will discuss a couple of specific types of job support provided by these programs. You can read more about other aspects of these programs in DB101’s section on MA-Waiver Programs.

Employment Services

You can get help exploring work options, finding a job, and keeping a job in the community through your MA-Waiver program:

• Exploration services (such as hands-on work experience) can help you learn about different jobs and make your own decisions about working in the community,
• Development services can help you find the right job or get started with self-employment,
• Support services (such as job coaching) can help you keep your job in the community.

The exact services you get depend on your needs. Talk to your waiver case manager about the employment services that are right for you.

The Minnesota Department of Human Services (DHS) has a brochure introducing these waiver services.

For more information about MA-Waiver services, Chat with a Hub expert.

Day Training & Habilitation (DT&H)

If you are on the Developmental Disabilities (DD) Waiver Program, you have an additional service option called Day Training & Habilitation (DT&H). DT&H services offers you supports to learn skills that help you develop and maintain life skills, participate in the community, and engage in activities of your choosing, which can include employment. The following services are covered by DT&H:

• Activities that help you become part of the community, including learning how to make the best of your nonwork time, supervision, training and help in the areas of self-care, communication, and interacting and getting along with others
• Ongoing support at work and work-related activities
• Learning survival skills, how to manage your money, doing therapeutic activities that help you gain more skills to adapt to living with your disability
• Transportation services for nonmedical purposes so you can participate in the above listed services

Based on your needs and desires, the employment portion of these services can be done in different settings:

• Center-based employment can be at the location of the DT&H provider. You are paid based on your work, which may be above or below minimum wage. In this setting, you don’t interact with coworkers without disabilities as part of your regular work.
• Community-based employment is in community settings and in groups. For instance, you and several people who get DT&H services may work together at a hotel. As with center-based employment, your wages may be above or below minimum wage. However, you do have some interaction with coworkers without disabilities.
• Individual employment is also in community settings, but not in groups. If you get DT&H services, you will work side-by-side with employees without disabilities at a job site, such as a restaurant, and you will earn wages at or above minimum wage. Support services are given as needed.

If you want more information about how MA-Waiver Programs can help support you in getting and keeping a job, Chat with a Hub expert