The Kansas Department of Social and Rehabilitation Services (SRS) is in the midst of implementing infrastructure changes to its Medicaid program allowing persons with disabilities who want to work, maintain vital health insurance coverage. The goal is to significantly increase the employment of individuals with disabilities.

At issue is the implementation of the Ticket to Work and Work Incentives Improvement Act, passed by Congress in 1999. The law, which will be phased in over three years, was designed to make it easier for states to assist people with disabilities maintain employment without losing necessary health care benefits. The act improves access to employment training and placement services, and offers states opportunities to eliminate barriers to employment for people with disabilities by improving access to health care coverage under Medicare and Medicaid.

The act directed the U.S. Department of Health and Human Services to establish a Medicaid Infrastructure Grant program for the design, establishment, and operation of state infrastructures to support working individuals with disabilities. States are expected to use the grant funds to create a program for Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) beneficiaries who enter gainful employment to retain their Medicaid coverage. Medicaid is a state/federal health insurance program for persons with low income or persons with low income and disabilities.

In October 2000, SRS received a Medicaid Infrastructure Grant in the amount of $529,000. Kansas is using the grant to design a Medicaid Buy-In program called "Working Healthy, Making Health Care Work," which will be initiated in January, 2002. The program, authorized by the 2001 Kansas Legislature, will allow Kansans with disabilities to maintain or initiate Medicaid coverage when they enter competitive employment. Before the Act went into effect, persons covered by Medicaid under SSI or SSDI could lose health insurance eligibility once they became employed.

Shannon Jones of the Statewide Independent Living Council of Kansas said that one thing she has heard over and over from individuals with disabilities is "I can work, I want to work, but without health care it is impossible for me to work." She is optimistic that the Medicaid Buy-In program will help open the door, giving them the chance to escape poverty and become economically self-sufficient.

It is important to note that over the past decade the number of people receiving disability benefits has increased substantially. Nationwide, more than 9 million people receive either SSI or SSDI. Yet fewer than one out of every 500 SSDI beneficiaries leaves this roll by returning to work. In addition, only 8.2 percent of SSI recipients had any earned income in 1996, with average earnings of $344 per month.

SRS Secretary Janet Schalansky said for people with disabilities who want to work, the Working Healthy program will provide the necessary health insurance supports, and "It will help people return to work and develop assets to reduce reliance on publicly-funded supports."

Schalansky recalled a statement from a "well-known labor priest, Msgr. George Higgins. ‘Work is an important way in which we exercise our humanity. In return, society offers us not only our daily bread, but a sense that we, ourselves, are honored for the contributions we make.’"