The Department of Health and Human Services recently announced two new initiatives to enable people with disabilities to become and stay competitively employed. One program will fund demonstrations that enable people with chronic, disabling conditions to get medical benefits without having to quit their jobs to obtain needed care. The other will assist states to increase services and supports to those who work, as well as help others return to work without the fear of losing health coverage.
Both projects help advance the goals of the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA), a law passed by Congress to encourage people with disabilities to work without fear of losing their Medicare, Medicaid or similar health benefits.
The second grant program will help 24 states and the District of Columbia in improving their ability to help people with disabilities hold down a job and maintain their health coverage. Congress approved the Medicaid Infrastructure Grants Program for 11 years with $150 million appropriated for the first five years of the program. States will share about $17 million for the first year. This program will help states build the needed systems to allow people with disabilities to purchase health care coverage through Medicaid. These funds will help enhance systems that provide personal assistance and supports, such as help with bathing, dressing and other activities at home or on the job. States can also use the funds to assist employers to gain better access to this underused pool of workers, conduct outreach to people with disabilities, train staff in new employment possibilities, and improve transportation or other supports upon which people with disabilities rely. States receiving this first round of awards include: Alabama, Alaska, Connecticut, District of Columbia, Georgia, Idaho, Illinois, Iowa, Kansas, Maine, Massachusetts, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, Oregon, Rhode Island, Utah, Vermont, Washington, West Virginia, and Wisconsin.
The Demonstration to Maintain Independence and Employment is a new approach for the Health Care Financing Administration (HCFA), which administers the Medicare and Medicaid programs. The demonstration will allow states to provide health care services and supports to working individuals that they need to manage the progression of their diseases. The program will help people remain competitively employed by preventing or delaying the deterioration or a relapse of their condition. Qualified enrollees will be those with conditions where individuals usually experience progressive deterioration or periodic setbacks in their health and their ability to work.
Rhode Island and Mississippi are the first recipients of TWWIIA grants for the Demonstration to Maintain Independence and Employment. All states are eligible to apply for the grants, a program Congress authorized for six years at a spending level of $250 million over the six years. Rhode Island will receive about $2 million over six years to provide health care to people with multiple sclerosis who are still able to work at least 40 hours a month. Other services included in that state’s package include case management, personal assistance services, copayments for medications, and other employment supports. Mississippi will use its $27.5 million grant award along with some state funds to cover 500 people with a diagnosis of HIV/AIDS who work or who PLAN to return to work. The state’s program will mirror the full Medicaid benefits and services. The project will be implemented in nine counties in the Mississippi Delta where there is a relatively high rate of HIV/AIDS and limited health care resources for people with this condition.