What Were the Top Outcomes of State Medicaid Infrastructure (MIG) Grants?

Authorized by the Ticket to Work and Work Incentives Improvement Act (the “Ticket Act”) of 1999 and administered by the Centers for Medicare & Medicaid Services (CMS), the Medicaid Infrastructure Grant (MIG) program afforded states the opportunity to develop infrastructures and initiatives that promoted, supported, and facilitated the competitive employment of people with disabilities. Specifically, the MIG program aimed to increase the number of people with disabilities participating in competitive employment by (1) developing Medicaid infrastructure by facilitating targeted improvements to a state’s Medicaid program and/or developing a comprehensive employment infrastructure that coordinates disparate state service delivery systems; (2) removing barriers to employment of persons with disabilities by creating systemic change throughout the Medicaid program and coordinating with other programs to further remove barriers; and (3) developing infrastructure that offers sustainable and significant improvement in the ability of the system to provide adequate health coverage, personal assistance, and other supports for people with disabilities who are competitively employed. For the most part, CMS mandated that MIG funding was not to be used for the direct provision of services, but rather to change the systems surrounding and supporting the employment of individuals with disabilities. The one exception was that states could use up to 10 percent of MIG funding to provide benefits counseling services.