CMS SOM App. J, Tag W132

efforts at prevailing wages and commensurate with their abilities;

Guidance §483.420(a)(8)

"Work", as used in the regulation, means any directed activity, or series of related activities

which results in a benefit to the economy of the facility or in a contribution to its maintenance,

or in the production of a salable product. In deciding whether a particular activity constitutes

"work" as defined above, the key determinant is whether the facility would be required to hire

additional full or part-time staff (or pay overtime to existing staff) to perform the service the

client is asked to perform.

Clients volunteering to do real work that benefits the facility should give informed consent for

such practices and understand that by providing employable services they are able to be

compensated. This does not preclude a client from helping out a friend or being kind to others.

Self-care activities related to the care of one's own person or property are not considered

"work" for purposes of compensation.

In general, participation in any household task which promotes greater independent functioning

and assists the client to prepare for less restrictive setting (and which the client has not yet

learned) is permitted as long as tasks are included in the IPP in written behavioral and

measurable terms. This participation must be supervised, and indices of performance should be

available. No task may be performed for the convenience of staff (e.g., supervising clients,

running personal errands).

"Compensated" means the client is provided with money or other forms of negotiable

compensation for work (including work performed in an occupational training program) and

such compensation is to be used at the client’s discretion.

Prevailing wage refers to the wage paid to non-disabled workers in nearby industry or the

surrounding community for essentially the same type, quality and quantity of work or work

requiring comparable skills. A client who works in the facility must be paid at least the

prevailing minimum wage, unless an appropriate certificate has been obtained by the facility in

accordance with current regulations and guidelines issued under the Fair Labor Standards Act,

as amended.

Any client performing “work”, as defined above, must be compensated in direct proportion to

his or her output. The facility should utilize Department of Labor and/or Department of

Vocational Rehabilitation formulas and techniques for determining rate of pay. A client's pay is

not dependent on the production of other clients when he or she works in a group.

When the client's active treatment program includes assignment to occupational or vocational

training or work, specific work objectives of anticipated progress should be included in the IPP

along with reasons for the assignments. If the training of clients on particular occupational

activities or functions involves "real work" to be accomplished for the facility, the clients must

be compensated based on ability. For example, if in the process of work training activities which

involve learning to clean a floor, the floor for a particular building is cleaned and does not

require further janitorial cleanup, then the client must be compensated for this activity at the

prevailing wage.