FEDERAL AGENCY:

CENTERS FOR MEDICARE AND MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES

AUTHORIZATION:

Ticket-to-Work and Work Incentives Improvement Act of 1999; Public Law 106-170.

To provide benefits equivalent to those provided by Medicaid to the categorically needy and to workers that have physical or mental impairments and without medical assistance, will result in a disability.

Project Grants. Place Cursor Here for Definition

Applicant Eligibility: All States are eligible to apply.

Beneficiary Eligibility: Eligible beneficiaries are workers with potentially severe disabilities that are: (a) At least 16 but less than 65 years of age, (b) have specific physical or mental impairments identified by the State that are reasonably expected to lead to blindness or disability (as defined under Section 1614(a) of the Social security Act, and (c) are employed.

Credentials/Documentation: Federal funds must go to a designated State Medicaid Agency or its partner agencies. Individuals must meet State requirements. Administrative costs will be determined in Accordance with OMB Circular No. A-87, "Cost Principles for State and Local Government."

Pre-application Coordination: This program is excluded from coverage under E.O. 12372. Demonstration proposals must be submitted by the Single State Medicaid Agency and funds will be distributed only to the Single State Medicaid Agency. States are limited to one overall demonstration proposal, but within the proposal the State may choose to cover up to three potentially severe physical or mental impairments. States may not be awarded funding for all three impairments based on budgetary concerns as well as the need to assure a distribution of covered impairments.

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, 2-21-15 Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850. This program is subject to the provisions of OMB Circular No. A-102.

Award Procedure: Official notice of approved applications is made through issuance of a Notice of Cooperative Agreement or Grant Award.

Deadlines: Established when program announcements are published in the Federal Register or transmitted to States.

Range of Approval/Disapproval Time: From 100 to 150 days.

Appeals: There are formal appeals procedures. If an application is disapproved, the reasons for disapproval will be fully stated.

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.

Formula and Matching Requirements: Funding will be distributed to the demonstration States as quarterly payments equal to the Federal medical assistance percentage of the expenditures of the States on medical assistance provided to workers with potentially severe disabilities at the normal service match rate. Likewise, administrative expenses will be matched at the normal Medicaid administration matching rate(s).

Length and Time Phasing of Assistance: While there are no restrictions precluding States from proposing demonstrations that operate for less than the total length of the demonstration, scoring preference will be given to States that propose to participate for the duration of the demonstration. Funding for the demonstration is available from fiscal year 2001 through fiscal year 2006. If any Federal funding remains available after 2006, payments may be made to the States until funding is depleted or through fiscal year 2009.

Reports: Reports of progress and expenditures are required on all projects.

Audits: All fiscal transactions identifiable to Federal financial assistance are subject to audit by DHHS audit agency.

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.

Account Identification: 75-0516-0-1-551.

Obligations: (Grants) FY 01 $4,811,750; FY 02 est $42,000,000; and FY 03 est $42,000,000.

Range and Average of Financial Assistance: In FY 2001, from $56,525 to $4,754,750. Average: $2,405,875. For FY 2002, est to be from $263,042 to $4,911,800. For FY 2003, est to be from $367,535 to $5,219,703.

Two States were awarded demonstration grants in fiscal year 2001. Four States were awarded demonstration grants in fiscal year 2002. It is estimated that at least six more States will receive demonstration grant awards in fiscal year 2003. This demonstration program requires State legislation in order to begin implementation.

Grants Administration policies (45 CFR 74 and 92) 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.

Regional or Local Office: Contact the appropriate CMS Regional Administrator. (See Appendix IV for Regional Offices).

Headquarters Office: Dennis Smith, Acting Director, Center for Medicaid and State Operations, Centers for Medicare & Medicaid Services, Department of Health and Human Services, Room C5-21-17, Central Building, 7500 Security Boulevard, Baltimore, MD 21244-1850. Telephone: (410) 786-3870. FTS is not available.

Web Site Address:  http://www.cms.hhs.gov/contracts/.

Projects approved so far will cover the HIV/AIDS, Multiple Sclerosis, and BiPolar/Schizophrenia populations. People enrolled in these demonstration programs will receive Medicaid equivalent services and will participate in an evaluation to determine if the provision of medical services delay the onset of disability and extends the duration for which a person can work.