Medicaid Infrastructure Grants To Support the Competitive Employment of People with Disabilities


To support State efforts to enhance employment options for people with disabilities by building Medicaid infrastructure. Funding may be used to develop a Medicaid buy-in, increase availability of Personal Assistance Services, or for State-to-State technical assistance. In addition, States may use funding to develop a comprehensive approach to bridge Medicaid services with other key supports and programs used by employed people with disabilities.

General information about this opportunity
Last Known Status
Deleted 02/05/2016 (Archived.)
Program Number
Federal Agency/Office
Agency: Department of Health and Human Services
Office: Centers for Medicare and Medicaid Services
Type(s) of Assistance Offered
Program Accomplishments
Not Applicable.
Ticket to Work and Work Incentives Improvement Act of 1999, Section 203, Public Law 106-170.
Who is eligible to apply/benefit from this assistance?
Applicant Eligibility
Either of the following may apply: (a) the single state medicaid agency; or (b) any other agency or instrumentality of a state(as determined under State law) in partnership, agreement and active participation with the single state medicaid agency, the State Legislature, or the office of the Governor.
Beneficiary Eligibility
There are two groups of potentially eligible beneficiaries, as defined by the Ticket to Work and Work Incentives Improvement Act of 1999. The first group consists of persons with disabilities between the ages of 16 and 65 years old, employed, and who meet income, asset, and resource standards established by the State. The second group of potential beneficiaries consists of persons between the ages of 16 and 65 years old, employed, and who cease to be eligible for Medical Assistance because of medical improvements determined at the time of a regularly scheduled disability review, but who also continue to have a severe medically determinable impairment.
Federal funds must go to a designated State Medicaid Agency or its partner agencies or instrumentality's. Individuals must meet State requirements. OMB Circular No. A-87 applies to this program.
What is the process for applying and being award this assistance?
Pre-Application Procedure
Preapplication coordination is not applicable. Environmental impact information is not required for this program. This program is eligible for coverage under E.O. 12372, "Intergovernmental Review of Federal Programs." An applicant should consult the office or official designated as the single point of contact in his or her State for more information on the process the State requires to be followed in applying for assistance, if the State has selected the program for review.
Application Procedure
OMB Circular No. A-102 applies to this program. This program is excluded from coverage under OMB Circular No. A-110. The standard application form SF-424 and related forms, as furnished by CMS, must be used for this program. Application forms are submitted to the Acquisition and Grants Group, CMS, C2-21-15 Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850.
Award Procedure
Official notice of approved applications is made through the issuance of a grant award.
Contact the headquarters or regional office, as appropriate, for application deadlines.
Approval/Disapproval Decision Time
The range is from 100 to 150 days.
There are no formal appeals procedures. If an application is disapproved, the reasons for disapproval will be fully stated.
Extensions and continuations of projects are available if formally applied for and approved. If a grant application is recommended for approval for 2 or more years, the awardee must annually submit a formal request for continuation accompanied by a progress report that will be evaluated prior to a recommendation of continuation.
How are proposals selected?
The major elements in evaluating proposals include: understanding the barriers that impede competitive employment of people with disabilities; the extent to which the proposed infrastructure development will offer enduring and significant improvement in the ability of the system to provide adequate health coverage for people with disabilities and are competitively employed; providing needed personal assistance and other supports, and/or removing other significant employment barriers; the appropriateness of the methods, work plan, budget, and timetable; the qualifications of key staff; and the State's plan for using its grant experiences to identify different or better ways to improve its buy-in or Medicaid services that support the competitive employment efforts of people with disabilities.
How may assistance be used?
While the proposals submitted by the States may vary, States participating in this grant program will use the funds to remove the barriers to employment of persons with disabilities, by creating health systems change through the Medicaid program. The development or enhancement of certain core Medicaid components in each State would enable people with disabilities not only to work, but to sustain adequate health coverage if they find they need to relocate to another State for employment purposes. An adequate personal assistance services benefit and a Medicaid buy-in for employed people with disabilities are significant components of the Ticket to Work and Work Incentives Improvement Act. The infrastructure grants program provides money to the States to develop these core elements. In addition, States may use funding to develop a comprehensive approach to bridge Medicaid services with other key supports and programs used by employed people with disabilities. Funds may not be used for the direct provision of services to people with disabilities except on a one-time, last resort, emergency basis for the purpose of sustaining the individual's competitive employment.
What are the requirements after being awarded this opportunity?
No program reports are required. No cash reports are required. Progress and expenditure reports are required on all projects. Progress and expenditure reports are required on all projects. No performance monitoring is required.
In accordance with the provisions of OMB Circular No. A-133 (Revised, June 27, 2003), "Audits of States, Local Governments, and Non-Profit Organizations," nonfederal entities that expend financial assistance of $500,000 or more in Federal awards will have a single or a program-specific audit conducted for that year. Nonfederal entities that expend less than $500,000 a year in Federal awards are exempt from Federal audit requirements for that year, except as noted in Circular No. A-133. All fiscal transactions identifiable to Federal financial assistance are subject to audit by the DHHS audit agency.
Proper accounting records, identifiable by project number and including all receipts and expenditures, must be maintained for 3 years. Subsequent to audit, they must be maintained until all questions are resolved.
Other Assistance Considerations
Formula and Matching Requirements
This program has no statutory formula.
This program has no matching requirements.
This program does not have MOE requirements.
Length and Time Phasing of Assistance
CMS announced the first round of infrastructure grant awards in October 2000. This grant program is authorized for 11 years beginning in fiscal year 2001. Method of awarding/releasing assistance: lump sum.
Who do I contact about this opportunity?
Regional or Local Office
See Regional Agency Offices. Contact the appropriate CMS Regional Administrator. (See Appendix IV for Regional Offices.).
Headquarters Office
Adrienne Delozier, 7500 Security Boulevard, Baltimore, Maryland 21244 Email: Phone: (410) 786-0278.
Website Address
Financial Information
Account Identification
(Formula Grants (Apportionments)) FY 13 Not Available; FY 14 est $0; and FY 15 est $0
Range and Average of Financial Assistance
$500,000 to $2,750,000; $500,000.
Regulations, Guidelines and Literature
Grants Administration policies (45 CFR 74 and 92) and application kits may be obtained from the Office of Acquisition and Grants Group, Centers for Medicare and Medicaid Services, Room C2-21-15, Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850. Grant applications forms are also available on the CMS website at
Examples of Funded Projects
Fiscal Year 2013: No Current Data Available Fiscal Year 2014: No Current Data Available Fiscal Year 2015: No Current Data Available


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