Demonstration to Maintain Independence and Employment

Published on AidPage by IDILOGIC on Jun 24, 2005

Administered by:

Purpose of this program:

To prevent the loss of employment and reliance on cash assistance by individuals at risk for disability. 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.

Possible uses and use restrictions...

These demonstration grants will enable States to assist working individuals by providing the necessary benefits and services required for people to manage the progression of their conditions and remain employed. Federal funds paid to the States under this demonstration must be used to supplement, but not supplant, State funds expended for workers with potentially severe disabilities at the time the demonstration project is approved.

Who is eligible to apply...

All States are eligible to apply.

Eligible Applicant Categories:
Eligible Functional Categories:

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."

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 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...


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

From 100 to 150 days.

Preapplication 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.

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.


There are 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).


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...

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.

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

$284,253 to $3,980,308; $2,132,280.

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.


(Grants) FY 03 $0; FY 04 est $8,000,000; and FY 05 est $10,000,000.

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


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...

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.

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...

It is estimated that CMS will award 5 demonstration grants in FY 2004. Since the programs inception in FY 2001, three States and the District of Columbia have participated. CMS anticipates an increase to a total of 9 participants by the end of FY 2004. The demonstration grant funding enables grantees to provide Medicaid-equivalent services to employees with potentially severe disabilities. The demonstrations will measure the effect of providing early intervention in the form of Medicaid-equivalent benefits and services on the ability of participants to retain competitive employment.

Criteria for selecting proposals...

The major elements in evaluating proposals include: The applicant's proposed strategy to achieve each of the outcomes identified by the applicant, including capability to identify a study population, conduct outreach and enroll individuals; whether the particular Medicaid equivalent benefits and services will be advantageous if provided to demonstration participants; the methodology for evaluation of its demonstration project that adequately measures its effectiveness; the adequacy of measures of the demonstration outcomes; and compliance with all reporting requirements.

Assistance considerations...

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.

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. Administrative expenses will be paid with 100 percent demonstration funding.

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 of progress and expenditures 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.


All fiscal transactions identifiable to Federal financial assistance are subject to audit by 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).


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.



Ticket-to-Work and Work Incentives Improvement Act of 1999; 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) 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 application forms are also available on the CMS website at

Contact information...

Web Sites
Regional Or Local Office

Contact the appropriate CMS Regional Administrator. (See Additional Contact Information - FMR Help for Regional Offices).

Note: This section lists the agency contact person, address and telephone number of the Federal Regional or Local Office(s) to be contacted for detailed information regarding a program such as: (1) current availability of funds and the likelihood of receiving assistance within a given period; (2) pre-application and application forms required; (3) whether a pre-application conference is recommended; (4) assistance available in preparation of applications; (5) whether funding decisions are made at the headquarters, regional or local level; (6) application renewal procedures (including continuations and supplementals) or appeal procedures for rejected applications; and (7) recently published program guidelines and material. However, for most federal programs, this section will instruct the reader to consult the so-called Appendix IV of the Catalog due to the large volume of Regional and Local Office Contacts for most agencies. This information is provided in Additional Contact Information (see below).

Headquarters Office

Dennis Smith, 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.

Note: This section lists names and addresses of the office at the headquarters level with direct operational responsibility for managing a program. A telephone number is provided in cases where a Regional or Local Office is not normally able to answer detailed inquiries concerning a program. Also listed are the name(s) and telephone number(s) of the information contact person(s) who can provide additional program information to applicants.

Additional Contact Information (Appendix IV)

Due to the large volume of regional and local office contacts for most agencies, full contact information is also provided separately here in a PDF format: