Form 8401, Employment First Uniform Assessment

Instructions

Updated: 6/2023

Purpose

The following programs under the 1915(c) and 1115 waiver programs must use this form to document information about individuals who express a desire to work: 

• Community Living Assistance and Support Services (CLASS)
• Deaf-Blind with Multiple Disabilities (DBMD) 
• Home and Community-Based Services (HCS)
• Texas Home Living (TxHmL)
• STAR+PLUS Home and Community-Based Services (STAR+PLUS HCBS)

Once an individual indicates a desire to work, the form must be completed.

Procedure

When to Complete or Update the Employment First Uniform Assessment

This form must be completed by the service coordinator or case manager for the waiver programs listed above during initial enrollment, the annual Person-Centered Plan (PCP) revision, or any other time the person indicates an interest in pursuing employment. The service coordinator or case manager must first document in the individual’s person-centered service plan if the person answered “yes” or “no” when asked about their desire to work. If the person answers “yes”, then the service coordinator or case manager must complete the Employment First Uniform Assessment and maintain it in the person’s records. If a person is not interested in working or is currently employed, then the form is not required.

Instructions

Community Living Assistance and Support Services (CLASS) – During the completion of the Individual Program Plan Addendum (Form 3629), the case manager should ask the person receiving services about their desire to work. Document the person’s response (Yes or No) on Form 3629.

If the person indicates a desire to work, the case manager must complete the Employment First Uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program where the person is enrolled.

Deaf-Blind with Multiple Disabilities (DBMD) – During the completion of the Individual Program Plan (Form 6501) to discuss, develop and identify the person’s strengths, preferences, support needs and desired outcomes, the case manager should ask the person receiving services about their desire to work. Document the person’s response (Yes or No) on Form 6501.

If the person indicates a desire to work, the case manager must complete the Employment First uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program where the person is enrolled.

Home and Community-Based Services (HCS) and Texas Home Living (TxHmL) – During the completion of Service Coordination Assessment (Form 8647), the service coordinator asks the person about their desire to work. Document the person’s response on Form 8647.

If the individual indicates a desire to work, the service coordinator must complete the Employment First Uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program where the person is enrolled. 

STAR+PLUS Home and Community-Based Services (STAR+PLUS HCBS) – During the completion of the Individual Service Plan (ISP) Addendum (form H1700-2), the service coordinator or case manager discusses individualized goals and action steps. The service coordinator or case manager must ask the individual receiving services about their desire to work. The person’s response (Yes or No) must be documented on Form H1700-2.

If the individual indicates a desire to work, the service coordinator or case manager must complete the Employment First Uniform Assessment and make a referral to Texas Workforce Commission or refer the person for employment services through the waiver program in which the individual is enrolled.

State Supported Living Centers (SSLC) – During the Community Living Discharge Planning process, if the person wants to work in the community, the Qualified Intellectual Disability Professional (QIDP) and Interdisciplinary Team members may complete the Employment First Uniform Assessment and give it to the community provider service coordinator or case manager. The service coordinator or case manager may use this information to complete and submit the assessment tool for referral.

Number of Copies

The original electronic Form 8401 must be maintained in the member's case record.

Form Retention

The Service Coordinator or Case Manager must keep Form 8401 according to the retention requirements found in all Medicaid managed care contracts and federal regulations. All original/electronic copies of this form must be kept in the member’s case record for five years after services are terminated.

Detailed Section-by-Section Instructions

Section A. Engage — Questions 1-6

The answers to questions 1-6 should identify a person’s core interests and develop a plan that informs future actions to help the person get employment. The service coordinator or case manager should guide the conversation to promote discussion about finding employment. If answers to questions 1 through 4 were already provided during the PDP process, the answers may be replicated in the Employment First Uniform Assessment.

Section B. Plan — Questions 7-12

The answers to questions 7-12 should define the person’s overall work goals that align with their strengths, interests, talents, and conditions for success. When completing these questions, the service coordinator or case manager should include any conditions needed to apply for or accept a job, including preferences and supports needed for the person to be successful. If answers to questions 7 through 12 were provided within the PDP process, answers may be replicated in the Employment First Uniform Assessment.

Section C. Finding Work — Questions 13-19

The answers to questions 13-19 should be the result of a conversation designed to help a person find and get settled into a job that meets their strengths, interests and conditions for employment. The service coordinator or case manager should focus on learning what the person is good at, what they like, what they want to accomplish and what’s needed to reach their goals. For those coming from plan phase, the employment portfolio will be used to inform this activity.

Section D. Creating an Individual’s Employment Plan — Questions 20-25

The answers to questions 20-26 should be the result of a plan that outlines a person's employment goals and the services needed to accomplish them. The service coordinator or case manager identifies current supports and sources for more supports, including employment services available through the Texas Workforce Commission (TWC) or the waiver program the person is enrolled in.