Background on Medicaid Infrastructure Grants
Section 203 of Ticket to Work and Work Incentives Act of 1999 directed the Secretary of the Department of Health and Human Services (DHHS) to establish a grant program to support State efforts to enhance employment options for people with disabilities. The Centers of Medicare and Medicaid Services (CMS) is the designated DHHS agency with administrative responsibility for this grant program. The Medicaid Infrastructure Grant program is authorized for 11 years, and $150 million in funding has been appropriated for the first five years of the program. The minimum grant award to an eligible State is $500,000 per fiscal year.
The goal of the Medicaid Infrastructure Grant program is to support people with disabilities in securing and sustaining competitive employment in an integrated setting. The grant program will achieve this goal by providing money to the States to develop and implement the core elements of the Ticket to Work and Work Incentives Improvement Act of 1999, so as to successfully modify their health care delivery systems to meet the needs of people with disabilities who want to work.
For the successful improvement of services to individuals with disabilities to take place, partnerships between public and private entities play a crucial role. State agencies, advocates, and educational entities such as the Department of Mental Health, Mental Retardation, and Substance Abuse Services, the Department for the Blind and Vision Impaired, the Department for the Deaf and Hard of Hearing, the Department of Rights of Virginians with Disabilities, the Department of Medical Assistance Services, the Department of Rehabilitative Services, the Virginia Board for People with Disabilities, the Department of Social Services, the Rehabilitation, Research, and Training Center on Workplace Supports affiliated with Virginia Commonwealth University, the Work Incentives Project affiliated with George Washington University, and the Statewide Independent Living Council have built such a partnership. The work group, which was established by the Disability Commission, has actively pursued and researched solutions to barriers to employment for persons with disabilities in Virginia. These partnerships enabled Virginia’s Department of Medical Assistance Services to submit an application for the Medicaid Infrastructure Grant in May of 2001. Centers for Medicare and Medicaid Services approved the grant in September of 2001 for $2,000,000 ($500,000 per fiscal year).
The Centers for Medicare and Medicaid Services continues to solicit proposals from States to develop infrastructures to support the competitive employment of people with disabilities by facilitating targeted improvements to States’ Medicaid programs. While each State’s proposal differs, there is the expectation that States participating in the grant program use the funds to remove the barriers to employment of persons with disabilities by creating health systems change through the Medicaid program. Thirty-seven states have received Medicaid Infrastructure Grants.