SMD Letter - Demonstration to Maintain Independence and Employment - Ticket to Work and Work Incentives Improvement Act of 1999 - June 7, 
2000  
Center for Medicaid and State Operations 7500 Security Boulevard Baltimore, MD 21244-1850  
June 7, 2000  
Dear State Medicaid Director:  
This is one in a series of letters that provides guidance on the implementation of the "Ticket to 
Work and Work Incentives Improvement Act of 1999." We invite you to participate in the 
Demonstration to Maintain Independence and Employment, established by that legislation.  
In October, 2000, the Health Care Financing Administration anticipates announcing awards to 
States that have successfully applied to participate in the Demonstration to Maintain Independence 
and Employment. This $250 million/6-year demonstration makes Federal matching funds available 
to extend Medicaid equivalent benefits and services to workers who are not yet disabled, but whose 
potentially severe physical or mental impairments are likely to lead to disability. The goal of the 
demonstration is to determine whether providing Medicaid coverage to people with progressive 
diseases or conditions earlier in the course of those diseases increases their ability to stay employed 
and self-sufficient, improves their health status, and delays the onset of disability.  
I enclose the grant solicitation inviting you to participate in the Demonstration to Maintain 
Independence and Employment. As explained in the solicitation, States determine which physical 
or mental impairment(s) will be the focus of the demonstration as well as the maximum number of 
participants they will enroll in their demonstration projects. The enclosed grant solicitation also 
provides information regarding general policy considerations, eligibility, application procedures 
and review criteria. As specified in the solicitation, the deadline for submitting an application is 
August 7, 2000. Proposals must be postmarked or received in the HCFA Grants Office on or 
before this date.  
(1)  
(1)The collection of information discussed in this grant solicitation is pending the Office of 
Management and Budget's (OMB) clearance under the Paperwork Burden Reduction Act. A Notice 
was published in the Federal Register on June 6, and comments are invited under that Notice 
through June 12, 2000. These paperwork requirements will not be legally binding until OMB 
clearance is received.  
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SMD Letter - Demonstration to Maintain Independence and Employment - Ticket to Work and Work Incentives Improvement Act of 1999 - June 7, 2000  
States that wish to participate in this demonstration should refer to the HCFA website and 
download a copy of the "Medicaid Infrastructure Grants" solicitation. Many States may be  
Page 2 - State Medicaid Director eligible to apply for funds under the Infrastructure Grants 
solicitation to design, develop and establish their demonstration project. See  www.hcfa.gov/medicaid/twwiia/twwiiahp.htm for more information. If you have any questions 
regarding this demonstration, please call Carey O'Connor at 202/690-7865.  
We look forward to receiving your application. 
Sincerely, 
/s/ 
Timothy M. Westmoreland  
 
Director 
 
Enclosure 
cc: All HCFA Regional Administrators All HCFA Associate Regional Administrators for Medicaid 
and State Operations Lee Partridge  
American Public Human Services Association  
Joy Wilson National Conference of State Legislatures Matt Salo  
National Governors' Association  
Jenifer E. Urff National Association of State Mental Health Program Directors Brent Ewig  
Association of State and Territorial Health Officers  
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SMD Letter - Demonstration to Maintain Independence and Employment - Ticket to Work and Work Incentives Improvement Act of 1999 - June 7, 2000  
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