SMDL #02-002 
 
February 20, 2002 
 
Dear State Medicaid Director: 
 
I am pleased to announce the Centers for Medicare &amp; Medicaid Services 
(CMS) is issuing the third round grant solicitation for both the Demonstration 
to Maintain Independence and Employment and the Medicaid Infrastructure Grant. 
As you know, these two programs were authorized by the &quot;Ticket to Work and 
Work Incentives Improvement Act (TWWIIA) of 1999.&quot; This letter provides 
background information and application procedures for these two programs. 
 
Regarding the Demonstration to Maintain Independence and Employment, this 
letter serves as the official document announcing the third round grant 
solicitation. Only state Medicaid agencies are eligible to apply for funding 
under this grant program. 
 
The Demonstration to Maintain Independence and Employment provides federal 
matching funds to extend regular Medicaid 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 program 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. The Demonstration to Maintain Independence and 
Employment is a six-year demonstration with $250 million authorized in federal 
funding. 
 
The grant solicitation inviting states to participate in the Demonstration 
to Maintain Independence and Employment is posted on the CMS web-site and is 
referenced below. 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 to be enrolled. The grant solicitation 
also provides information regarding general policy considerations, eligibility, 
review criteria and an application kit. As specified in the solicitation, the 
deadline for submitting an application is May 10, 2002. Proposals must be 
postmarked on or before this date. 
 
States that wish to apply for this demonstration should refer to the CMS 
web-site and download a copy of the Demonstration to Maintain Independence and 
Employment solicitation using the following address: 
www.hcfa.gov/medicaid/twwiia/twwiiahp.htm. 
 
With respect to the Medicaid Infrastructure Grant, a Federal Register Notice 
(2139-N) was published on January 25, 2002 announcing the third round grant  solicitation. The announcement was made through the Federal Register because 
any agency or instrumentality of the state in addition to the single state 
Medicaid agency may apply. 
 
The 11-year Medicaid Infrastructure Grant program authorized by TWWIIA 
expires in 2011. A total of $30 million has been authorized for this grant 
cycle for new and continuation grants. Infrastructure grant funds are available 
to encourage states to make lasting changes to their service delivery systems 
for working individuals who have disabling conditions. Grant funds may also be 
used to design and develop a demonstration project in conjunction with the 
Demonstration to Maintain Independence and Employment described above. 
 
The deadline for submitting a Medicaid Infrastructure Grant application, as 
mentioned in the solicitation, is June 7, 2002. The solicitation entitled 
&quot;Ticket to Work and Work Incentives Improvement Act of 1999 - Medicaid 
Infrastructure Grant&quot; can be downloaded in its entirety by accessing the 
CMS Ticket to Work web-site referenced above. 
 
If you have any questions regarding the Demonstration to Maintain 
Independence and Employment or the Medicaid Infrastructure Grant, please call 
Joe Razes on (410) 786-6126. 
 
We look forward to receiving your application. 
 
Sincerely, 
 
/s/ 
 
Dennis G. Smith 
 
 Director 
 
cc: 
 
CMS Regional Administrators 
 
CMS Associate Regional Administrators for Medicaid and State Operations 
 
Regional Ticket to Work Coordinators 
 
Lee Partridge 
 
Director, Health Policy Unit 
 
American Public Human Services Association 
  Joy Wilson 
 
Director, Health Committee 
 
National Conference of State Legislatures 
 
Matt Salo 
 
Director of Health Legislation 
 
National Governors Association 
 
Brent Ewig 
 
Senior Director, Access Policy 
 
Association of State and Territorial Officials 
 
Jennifer King 
 
Director, Health and Human Services Task Force 
 
American Legislative Exchange Council 
 
Trudi Matthews 
 
Senior Health Policy Analyst 
 
Council of State Governments