Medicaid Infrastructure Grants To Support the Competitive Employment of People with Disabilities
Published on AidPage by
IDILOGIC on Jun 24, 2005
Purpose of this program:
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.
Possible uses and use restrictions...
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.
Who is eligible to apply...
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.
Credentials/Documentation
Federal funds must go to a designated State Medicaid Agency or its partner agencies or instrumentalities. Individuals must meet State requirements. Administrative cost will be determined in accordance with OMB Circular No. A-87, "Cost Principles for State and Local Governments."
Note:This is a brief description of the credentials or documentation required prior to, or along with, an application for assistance.
About this section:
This section indicates who can apply to the Federal government for assistance and the criteria the potential applicant must satisfy.
For example, individuals may be eligible for research grants, and the criteria to be satisfied may be that they have a professional or scientific degree,
3 years of research experience, and be a citizen of the United States. Universities, medical schools, hospitals, or State and local governments may also be eligible.
Where State governments are eligible, the type of State agency will be indicated (State welfare agency or State agency on aging) and the criteria that they
must satisfy.
Certain federal programs (e.g., the Pell Grant program which provides grants to students) involve intermediate levels of application processing, i.e., applications
are transmitted through colleges or universities that are neither the direct applicant nor the ultimate beneficiary. For these programs,
the criteria that the intermediaries must satisfy are also indicated, along with intermediaries who are not eligible.
How to apply...
Application Procedure:
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. This program is subject to the provisions of OMB Circular No. A-102.
Note: Each program will indicate whether applications are to be submitted to the Federal headquarters, regional or local office, or to a State or local government office.
Award Procedure:
Official notice of approved applications is made through the issuance of a grant award.
Note: Grant payments may be made by a letter of credit, advance by Treasury check, or reimbursement by Treasury check.
Awards may be made by the headquarters office directly to the applicant, an agency field office, a regional office,
or by an authorized county office. The assistance may pass through the initial applicant for further distribution by
intermediate level applicants to groups or individuals in the private sector.
Deadlines and process...
Deadlines
Established when program announcements are published in the Federal Register or transmitted to States.
Note:
When available, this section indicates the deadlines for applications to the funding agency which will
be stated in terms of the date(s) or between what dates the application should be received.
When not available, applicants should contact the funding agency for deadline information.
Range of Approval/Disapproval Time
The range is from 100 to 150 days.
Preapplication Coordination
No preapplications are required. This program is excluded from coverage under E.O. 12372.
Note:
This section indicates whether any prior coordination or approval is required with governmental or nongovernmental units
prior to the submission of a formal application to the federal funding agency.
Appeals
There are no formal appeals procedures. If an application is disapproved, the reasons for disapproval will be fully stated.
Note:
In some cases, there are no provisions for appeal. Where applicable, this section discusses appeal procedures or allowable rework time for resubmission
of applications to be processed by the funding agency. Appeal procedures vary with individual programs and are either listed in this section or
applicants are referred to appeal procedures documented in the relevant Code of Federal Regulations (CFR).
Renewals
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.
Note:
In some instances, renewal procedures may be the same as for the application procedure, e.g., for projects of a non-continuing nature renewals will be treated as new, competing applications; for projects of an ongoing nature, renewals may be given annually.
Who can benefit...
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 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 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.
Beneficiaries
About this section:
This section lists the ultimate beneficiaries of a program, the criteria they must satisfy and who specifically is not eligible. The applicant and beneficiary will generally be the same for programs that provide assistance directly from a Federal agency. However, financial assistance that passes through State or local governments will have different applicants and beneficiaries since the assistance is transmitted to private sector beneficiaries who are not obligated to request or apply for the assistance.
What types of assistance...
Project Grants
The funding, for fixed or known periods, of specific projects. Project grants can include fellowships, scholarships, research grants, training grants, traineeships, experimental and demonstration grants, evaluation grants, planning grants, technical assistance grants, survey grants, and construction grants.
How much financial aid...
Range and Average of Financial Assistance
$500,000 to $2,750,000; $500,000.
Note:
This section lists the representative range (smallest to largest) of the amount of financial assistance available. These figures are based upon funds awarded in the past fiscal year and the current fiscal year to date. Also indicated is an approximate average amount of awards which were made in the past and current fiscal years.
Obligations
(Grants) FY 03 $19,727,000; FY 04 est $25,000,000; and FY 05 est $30,000,000.
Note:
The dollar amounts listed in this section represent obligations for the past fiscal year (PY), estimates for the current fiscal year (CY), and estimates for the budget fiscal year (BY) as reported by the Federal agencies. Obligations for non-financial assistance programs indicate the administrative expenses involved in the operation of a program.
Account Identification
75-0516-0-1-551.
Note:
Note: This 11-digit budget account identification code represents the account which funds a particular program.
This code should be consistent with the code given for the program area as specified in Appendix III of the Budget of the United States Government.
Examples of funded projects...
For a description of State specific projects funded under this grant program. Please see our website at www.cms.gov/twwiia/inf_dmap.asp.
About this section
This section indicates the different types of projects which have been funded in the past. Only projects funded under Project Grants or Direct Payments for Specified Use should be listed here. The examples give potential applicants an idea of the types of projects that may be accepted for funding. The agency should list at least five examples of the most recently funded projects.
Program accomplishments...
CMS awarded 37 grants in fiscal year 2002. CMS awarded 34 grants in fiscal year 2003. It is estimated that CMS will award 30 grants in fiscal year 2004. With this funding the grantees will make systematic changes that will help individuals with disabilities gain employment and retain their health coverage. These changes are designed to increase Medicaid-buy-in programs and enhance State personal assistance service programs.
Criteria for selecting proposals...
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; provide needed personal assistance and other supports, and/or remove 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.
Assistance considerations...
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.
Formula and Matching Requirements
No State or local matching funds are required for the infrastructure grants.
Note:
A formula may be based on population, per capita income, and other statistical factors. Applicants are informed whether there are any matching requirements to be met when participating in the cost of a project. In general, the matching share represents that portion of the project costs not borne by the Federal government. Attachment F of OMB Circular No. A-102 (Office of Management and Budget) sets forth the criteria and procedures for the evaluation of matching share requirements which may be cash or in-kind contributions made by State and local governments or other agencies, institutions, private organizations, or individuals to satisfy matching requirements of Federal grants or loans.
Cash contributions represent the grantees' cash outlay, including the outlay of money contributed to the grantee by other public agencies, institutions, private organizations, or individuals. When authorized by Federal regulation, Federal funds received from other grants may be considered as the grantees' cash contribution.
In-kind contributions represent the value of noncash contributions provided by the grantee, other public agencies and institutions, private organizations or individuals. In-kind contributions may consist of charges for real property and equipment, and value of goods and services directly benefiting and specifically identifiable to the grant program. When authorized by Federal legislation, property purchased with Federal funds may be considered as grantees' in-kind contribution.
Maintenance of effort (MOE) is a requirement contained in certain legislation, regulations, or administrative policies stating that a grantee must maintain a specified level of financial effort in a specific area in order to receive Federal grant funds, and that the Federal grant funds may be used only to supplement, not supplant, the level of grantee funds.
Post assistance requirements...
Reports
Progress and expenditure reports are required on all projects.
Note:
This section indicates whether program reports, expenditure reports, cash reports or performance monitoring are required by the Federal funding agency, and specifies at what time intervals (monthly, annually, etc.) this must be accomplished.
Audits
All fiscal transactions identifiable to Federal financial assistance are subject to audit by the DHHS audit agency.
Note:
This section discusses audits required by the Federal agency.
The procedures and requirements for State and local governments and nonprofit entities are set forth in OMB Circular No. A-133.
These requirements pertain to awards made within the respective State's fiscal year - not the Federal fiscal year,
as some State and local governments may use the calendar year or other variation of time span designated as the fiscal year period,
rather than that commonly known as the Federal fiscal year (from October 1st through September 30th).
Records
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.
Note:
This section indicates the record retention requirements and the type of records the Federal agency may require.
Not included are the normally imposed requirements of the General Accounting Office.
For programs falling under the purview of OMB Circular No. A-102, record retention is set forth in Attachment C.
For other programs, record retention is governed by the funding agency's requirements.
Regulations...
Authorization
Ticket-to-Work and Work Incentives Improvement Act of 1999, Section 203, Public Law 106-170.
Note:
This section lists the legal authority upon which a program is based (acts, amendments to acts, Public Law numbers, titles, sections, Statute Codes, citations to the U.S. Code, Executive Orders, Presidential Reorganization Plans, and Memoranda from an agency head).
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 & 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 http:www.cms.hhs.gov/twwiia/424forms.pdf.