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Transition to Independence Act – Medicaid incentives to promote community options

Last week, U.S. Senator Chuck Grassley (R-Iowa) introduced legislation that would offer incentives to states for helping people with disabilities live and work in the community. The bill, S.1604, is known as the Transition to Independence Act.  It has the support of a bipartisan group of Senators being co-sponsored by Sen. Ron Wyden (D-Ore.) and Sen. Bob Casey (D-Pa.).

The proposed legislation would establish a new Medicaid demonstration program that would offer additional payments to states for encouraging community-based outcomes. The five-year pilot disabled at workprogram would be established in 10 selected states.  This proposed legislation brings national attention to some of the challenges faced by those with disabilities as they seek to engage in meaningful employment and at the same time, maintain their important Medicaid benefits.

It would allow disabled individuals in the selected states to buy in to their state Medicaid system to secure the critical supports offered by such programs. The five year demonstration program is designed to yield qualitative and quantitative data regarding the employment of individuals with disabilities, including identifying best practices from 10 different state models, which can be evaluated and considered in preparing permanent legislation.  While each state would create its own parameters and would organize its benefits and services accordingly, each state would be required to allow participants earning at least up to 400 percent of the poverty line to benefit from the Medicaid program.  The states would need to meet specific and measurable benchmarks in expanding employment for individuals with disabilities within the state.

Although it is in the infancy stage of legislation, the bill already has the support of a number of disability advocacy groups including the American Association of People with Disabilities, the National Association of State Directors of Developmental Disabilities Services, the National Down Syndrome Congress and Autism Speaks.

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