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Territory addendum · first edition, October 2026 Ready
Employment Services in Guam
Guam has no Medicaid waiver and no SSI. The territory's disability department funds supports by contract, and vocational rehabilitation carries the journey.
Guam at a glance
| Agency for employment services | Department of Integrated Services for Individuals with Disabilities (DISID), Division of Support Services |
|---|---|
| How employment is funded | No waiver; DISID contracts |
| Vocational rehabilitation | DISID Division of Vocational Rehabilitation |
| Medicaid agency | Department of Public Health and Social Services (capped Medicaid) |
| Minimum wage | $9.25, rising with any higher federal rate |
The three biggest differences
- No waiver, no SSI. Supports are bought by contract; the waiver chapters of the manual do not apply.
- One department, an open gap. Guam has no single provider of long-term supported employment — room for a program that carries people from Discovery to follow-along.
- The package keeps minimum wage. Local law still allows subminimum wages by licence; the program never uses them.
What the full addendum gives you
Twelve sections, filed directly behind Volume 0 and adopted by a single change request. Every rule cites its official source; anything not yet confirmed is marked for verification, never guessed.
- How to use the addendum, and the three biggest differences
- At a glance: every Maryland role and its local equivalent
- Crosswalk: each Maryland reference, its replacement, and where it is amended
- Waiver (or local) employment services: codes, units, rates, limits
- Vocational rehabilitation: becoming a vendor, fees, invoicing, fading
- Provider certification and staffing
- Incident reporting and protection from harm
- Billing, records and retention
- Local law that changes the package: wages, recording, false claims, safety, breach
- State-use purchasing and contract sites
- Volume-by-volume amendments, 0 to 15
- Open items to verify, and the official sources
The addendum is issued with the Adoption License. Ask for it here and the Adoption Office replies within one business day.