New Hampshire
 New Jersey
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 N. Carolina
 N. Dakota
 Rhode Island
 S. Carolina
 S. Dakota
 West Virginia

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

Medicaid Buy In Legislation enacted in 1999

NewDownload 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

New -
As of June 30, 2003, 5,496 persons were enrolled in the Iowa Medicaid Buy-In program

Persons to Contact:

Jennifer Steenblock
MIG Project Director
Division of Medical Services
Iowa Department of Human Services
Hoover State Office Building
5th Floor
Des Moines, IA 50319-0114
Phone (voice): 515/281-8839
Fax: 515/281-6230

Jim Overland
Buy-In Project Manager
Iowa SSA Project
Iowa Dept. Of Human Services
MH/DD Division
Hoover Bldg.
1305 East Walnut
Des Moines, IA 50319
Phone (voice): 515/281-8908
Fax: 515/281-8512

III. Program Development - Past and Present

  • Executive Branch Leadership, Cross Disability Coalition Leadership and Interagency Working Groups
  • Initial Planning, Information Gathering and Program and Fiscal Estimates

    For a description of the development of the Iowa program go to the Iowa 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 Iowa study in the Table of Contents

    Or download a Word file of the Iowa Case Study

IV. State Legislation - Adopted and Pending

For a copy of the Iowa Medicaid Buy In legislation enacted in 1999 go to:


V. Current State Policies and Program Descriptions

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

    Link to Iowa Explanation of Medicaid Buy-In program with Data
  • 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
New - (updated for 2003)
A brochure from the Iowa Department of Social Services describes the program:
File: Download a copy of the brochure

Iowa Medicaid Buy In Program Regulations
Link to portion of Iowa's Medicaid rules concerning "Working Persons with Disabilities" 75.1 (39)

VI. Program Data and Impact


VII. Comprehensive Employment Initiatives

A Report from the Medicaid Infrastructure Grant Working Group on Personal Assistance Services (PAS) submitted in September 2001.

Excerpt from the Report
“The Iowa Medicaid Infrastructure Grant Work Group respectfully submits the enclosed report as our final recommendations for Iowa to create a service system that enables people with disabilities to gain or maintain independence outside of institutional walls. To summarize: it is our strong recommendation that Iowa create a Medicaid Personal Assistance Service (PAS) State Plan Benefit.”

Download a copy of the report


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.