New Hampshire
 New Jersey
 New Mexico
 New York
 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

Pathways to Independence offers improved health care insurance options, specialized benefits consultants, vocational planning specialists, a individual team of employment advisors and a full range of Division of Vocational Rehabilitation services.

Direct link to program information page of the Pathways to Independence Project

Wisconsin Department of Health and Social Services Pathways to Independence Project Web Site

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 -
August 2003
Wisconsin has joined with Connecticut 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).

New -
4,655 Medicaid Buy-In enrollees as of June 30, 2003

New -
Wisonsin’s Proposal to CMS to establish a Comprehensive Employment Initiative – “Bridges to Work.”
Go to VII for a direct Link to Explanation

Persons to Contact
John Reisser
Bridges to Work/Pathways to Independence Projects
1 South Pinckney Street Suite 34
Madison, WI 53713
Phone: 608-266-3063
E-mail: Reiserj@dhfs.state.wi.us


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

    New -
    For a description of the development of the Wisconsin program go to the Wisconsin 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 Wisconsin study in the Table of Contents

    Or download a Word file of the Wisconsin Case Study


IV. State Legislations - Adopted and Pending

For the text of the Wisconsin law to establish the Medicaid Purchase Plan go to the Wisconsin law  - Section 49.472 at


V. Current State Policies and Program Descriptions


VI. Program Data and Impact

  • Medicaid Buy-In Data
    4,655 Medicaid Buy-In enrollees as of June 30, 2003
  • Consumer Surveys and Evaluation Studies
    Pathways to Independence Project includes a large-scale research effort to measure the effectiveness of strategies to overcome employment barriers. Research results will help inform policy makers and contribute to future program design.
    For a direct link to an explanation of the research effort go to

    Evaluation of the Wisconsin Medicaid Buy-In program
    Direct link to November 2003 Evaluation


VII. Comprehensive Employment Initiatives

New -
Wisconsin’s Proposal to CMS to establish a Comprehensive Employment Initiative – “Bridges to Work.”
For a direct Link to Explanation

Summary of Proposal:
The objective of the Bridges to Work project is to achieve the following:
* Improve Implementation of the Medicaid Purchase Plan by increasing the efficiency of the Medicaid eligibility process and evaluating the disability determination process.
*Create a Coordinated, Comprehensive Return-to-Work Approach to 1) develop programs and policies that work in concert with one another and 2) improve the understanding of all programs that may affect the employment successes of the consumer.
*Develop and Study a Personal Assistance Service Model to explore innovative means of providing attendant services by partnering with employers and others to support the competitive employment of people with disabilities.
*Build State-to-State Coalitions to enhance our own effectiveness through participation in a multi-state group that brings state policy makers together to share innovation, best practices and common issues

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 the Law, Health Policy and Disability Center at the University of Iowa. (#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.