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Comprehensive Person-Centered State Work Incentive Initiatives:

A Resource Center for Developing & Implementing Medicaid Buy In Programs
Related Employment Initiatives for Persons with Disabilities


I. Overview of a State's Comprehensive Person-Centered Employment Initiatives


Connecticut's Medicaid Buy-In program legislation was signed into law in June 2000 and began operating on October 1, 2000. The Medicaid Buy-In program is part of a comprehensive work incentive approach that also includes benefits counseling and changes in personal assistance services. Connecticut includes both the Basic Insurance Group and the Medically Improved Group in its Medicaid Buy-In program.
The Connecticut Bureau of Rehabilitation Services has created the Connect to Work Center, which administers the Benefits, Planning, Assistance and Outreach grant from SSA and the Medicaid Infrastructure Grant from the Centers for Medicare and Medicaid Services. The Center uses a comprehensive approach to addressing employment needs of individuals with disabilities, combining benefits counseling, information about the Medicaid Buy-in, policy analysis, outreach and training in a single unit.

Link to Medicaid for the Employed Disabled Program Home page

New – Download file of two summary charts
State’s Medicaid Buy-In Program Design Features
- Income Eligibility Criteria
- Resource Limits and Exclusions
- Cost Sharing - Minimum Income Level and Premium or Cost Share Methods
- Work Related Policies and Protections
State’s SSI and Other Medicaid Income Standards for Adults with Disabilities

II. What's New and Persons to Contact

August 2003
Conecticut has joined with Wisconsin and Vermont in submitting, without solicitation, a proposal to the Social Security Administration to be one of the states which would be the site for a SSDI benefit offset demonstration project
( $1 for $2).

As of June 30, 2003 there were 2,663 enrollees in the Medicaid Buy In program in Connecticut

Persons to Contact

Amy Porter
Medicaid Infrastructure Grant Project
Department of Social Services
Bureau of Rehabilitation Services
25 Sigourney Street
Hartford, CT 06106
Phone: 860-424-4864
Fax: 860-424-4865

Larry Carlson
Public Assistance Consultant
Department of Social Services
25 Sigourney Street
Hartford, CT 06106
Phone: 860-424-5375
Fax: 860-424-4957

III. Program Development - Past and Present

  • Executive Branch Leadership, Cross Disability Coalition Leadership and Interagency Working Groups
    In the early 90s, the Work Incentives Committee of the Northwest Connecticut Regional Mental Health Planning Board, in cooperation with staff from the state Medicaid agency and state Vocational Rehabilitation agency, began working to increase the use of existing work incentives and advocate for improvements in them. One policy change occurred in 1994, when the state Medicaid agency extended SSI work incentives to persons who were receiving a state-administered SSI supplement, but were not receiving Federal SSI benefits. As a result of this policy, persons who lose their state SSI supplement because of earnings can remain eligible for Medicaid up to income thresholds specified in SSI law.

    In 1999, a cross-disability coalition of consumers and advocates with leadership from legal assistance groups began urging the adoption of the Medicaid Buy-In program. Building on their initiative, the Human Services Committee in the Connecticut House of Representatives established a Work Incentives Working Group in the fall of 1999. That group, whose members included legislators, legislative and executive branch staff, representatives from disability and legal assistance groups, and persons with disabilities, designed legislation to allow SSDI eligible people to work and retain their health care under Medicaid. The Governor endorsed the effort in January 2000, the legislature passed a bill in April 2000, and the Governor signed the bill in June 2000.
  • Initial Planning, Information Gathering and Program and Fiscal Estimates
    For a description of the development of the Connecticut program go to the Conneticut Case Study prepared by the George Washington University Work Incentives Project with support from ASPE at the Department of Health and Human Services and scroll down and click on to the Connectiuut study in the Table of Contents

    Or download a Word version of the Connecticut report


IV. State Legislation - Adopted and Pending

On May 3, 2000, the Connecticut General Assembly enacted legislation (HB 5778) to establish a Medicaid Buy In program. Governor Rowland signed the Medicaid Buy In legislation on June 1, 2000. The legislation also directs the Commissioner of the Connecticut Department of Social Services to:

  • Cooperate with the Social Security Administration on demonstration projects which provide additional work incentives for people eligible for Social Security Disability Insurance or Supplemental Security Income, as allowed under federal law.
  • Seek a Medicaid waiver to permit people participating in the new program to continue to receive Medicaid if they involuntarily stop working
  • To amend the federal Personal Care Assistance (PCA) waiver to enable people qualifying for the buy-in program to keep their PCA benefits even though their incomes exceed the waiver’s limits
For a copy of text of the legislative language that was adopted go to:


V. Current State Policies and Program Descriptions

  • State Policies: State Plans, Regulations and Waiver Requests to Federal Agencies - Pending and Adopted Programs

    Connecticut Medicaid Buy In Regulations Transmittal Letter -- Download file
    Connecticut Medicaid Buy In Regulations -- Download file

  • Ensuring Informed Choice and Person - Centered Programs: Benefits Counseling, Work Force Investment Act Implementation and Related Educational Services
  • Descriptions for Consumers and Staff Training Activities

VI. Program Data and Impact

  • Medicaid Buy-In Data
    As of June 30, 2003 there were 2,663 enrollees in the Medicaid Buy In program in Connecticut
  • Consumer Surveys and Evaluation Studies


VII. Comprehensive Employment Intiatives

Connecticul Personal Care Assistance program and the Medicaid Buy In program. See explanation in "Medicaid or the Employed Disabled" brochure.
Download Brochure

Link to Connecticut Medicaid Buy In Program page with Links to Brochures describing the program for consumers and State Vocational Rehabilitation Benefits Counseling program related to use of Medicaid Buy In program.
Fact Sheets and Brochures:
"Medicaid for the Employed Disabled"
"Medicaid and the Vocational Rehabilitation Program"

Center for the Study and Advancement of Disability Policy and Center for Health Services Research and Policy at George Washington University

Supported by a grant from the Robert Wood Johnson Foundation with additional support provided by NIDRR of the US Department of Education through the RRTC on Workforce Investment and Employment Policy at Community Options, Inc. (#H133B980042) 

Website created and maintained by the Law, Health Policy and Disability Center at the University of Iowa College of Law. The opinions and analyses set out in the articles on this website are those of the authors and do not necessarily reflect the positions of the Robert Wood Johnson Foundation, the US Department of Education, George Washington University or the University of Iowa.