Home and Community-Based Services (HCBS)

Home and Community-Based Services (HCBS), or “waiver programs” as they are sometimes called, allow people on Medical Assistance (MA), who would otherwise live in a nursing home, to live in their homes and communities. These are the 4 waiver programs that serve people with disabilities:

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 HCBS in DB101’s section on MA-Waiver Programs.

Supported Employment Services (SES)

If you are on any of these 4 waiver programs and aren’t able to independently work at a job, you may be eligible for Supported Employment Services (SES). These support services will help you learn and perform the skills that you need to keep your job. Some of the services offered are:

  • One-on-one and group counseling
  • Individualized work-related assessment
  • Individual job development and job placement to find a good job match for you and the employer
  • Mobility training
  • On-the-job training and learning work skills needed to perform your job duties
  • Ongoing feedback on your job performance
  • Long-term support services to help the you keep your job
  • Teaching of skills that you need to get and keep your job, such as knowing how to find and effectively use available community resources
  • Help with learning how to use break and lunch areas
  • Teaching how to access various transportation resources

You must have paid employment in order to receive SES services.

Day Training & Habilitation (DT&H)

If you are on the Developmental Disabilities (DD) HCBS 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 HCBS Waiver Programs can help support you in getting and keeping a job, Chat with a Hub expert