Background

The California Health Incentives Improvement Project (CHIIP) was created in 2002, and is funded by a Medicaid Infrastructure Grant from the federal Centers for Medicare and Medicaid Services. Sonoma State University administered the grant from 2003 to 2008. In 2004, CHIIP successfully competed for a comprehensive employment opportunity award which provided a broader mandate and increased funding for the grant period, 2005-2008. In 2009 there was a competitive solicitation and CHIIP was again awarded the grant.

In 2005, the CHIIP worked closely with the California Governor's Committee on Employment of People with Disabilities to develop a Comprehensive Employment Strategy consistent with state law, the Workforce Inclusion Act (AB925, Aroner, Chapter 1088, Statutes of 2002). The Strategy, recently approved by the Committee, sets the course for project activities as well as coordinated efforts of state departments serving Californians with disabilities. With this intergovernmental structure in place, the Centers for Medicare & Medicaid Services approved a budget modification from the CHIIP to enhance the State's ability to advance its priorities for bringing the employment rate of people with disabilities as close as possible to that of the general population. California's Strategy addresses three central themes: Meeting the Needs of Business; Preparing and Supporting People with Disabilities; and Aligning Systems.

In 2006 and 2007 the California Health Incentives Improvement Project supported implementation of the Comprehensive Employment Strategy through core outreach & training activities, research, policy analysis/development & sustainability goals:

1. Build state and local intergovernmental infrastructure to remove healthcare and other barriers to employment for people with disabilities:

Extending local demonstration projects designed to inform statewide planning for services for youth with disabilities. This partnership with the California Workforce Investment Board ensures that outcomes and lessons-learned from three local intermediary pilots will benefit state planning even though U.S. DOL funding was eliminated;
Working with the Department of Health Services and local agencies to connect Medicaid Administrative Activity resources and community-based organizations that conduct Medi-Cal Working Disabled Program outreach and education;
Supporting existing local cross-program steering committees in education and public awareness activities around employment and healthcare access for people with disability.
Convening meetings for cross-program discussion of performance measurement.

2. Increase the number of participants utilizing the Medi-Cal Working Disabled and In-Home Supportive Services in the Workplace programs through outreach to people with disabilities, service providers, eligibility workers and employers:

Create and implement a public information campaign on work and access to healthcare and services. The campaign strategy will be designed in 2006 with local stakeholders in 2 counties and piloted in 2007. Adjustments will be made for statewide roll-out in 2008.
Conduct direct mail activities to people in other Medi-Cal eligibility categories. A series of 4 mailings are taking place in 2006. Informational materials on the Medi-Cal Working Disabled Program are being mailed to Medi-Cal recipients in Share of Cost, Blind and Disabled categories, and a follow-up mailing 2 months later is intended to boost response rates to an enclosed survey. Another direct mail outreach effort will support the use of Personal Assistance Services at Work among Medi-Cal recipients who are currently approved for In-Home Supportive Services and are within particular demographics. This effort will also include a brief survey and be repeated to increase likelihood of survey responses.

3. Strengthen labor force connections for people with disabilities by expanding and supporting the disability benefits counseling and training infrastructure of state and local program administrators, front line staff and community-based organizations who assist people with disabilities in achieving successful employment outcomes and economic self-sufficiency

Support user testing of the db101 Benefits Planning sessions developed by World Institute on Disability under contract through the Social Security Administration.
Host at least three additional Town Hall Forums on emerging issues in disability, employment and benefits planning subjects. Forums provide an opportunity for professionals to discuss breaking news and new resources in sessions across the state, and will especially benefit a network of benefits planners as new grants are awarded.
Conduct regional cross-program training series in 3 new areas. Enrollment in the Medi-Cal Working Disabled program increases in counties where this type of training has occurred and front-line workers become more informed and better-connected. By the end of 2007, 21 counties will have hosted this training supported by db101 web resources.

4. Improve employment and earnings levels of Medi-Cal Working Disabled participants by evaluating the adequacy and effectiveness of, and developing improvements in, health incentives and other supports for people with disabilities related to employment, including for the Medi-Cal Working Disabled and In-Home Supportive Services programs

Conduct evaluation of the Comprehensive Employment Strategy together with Governor's Committee on Employment of People with Disabilities subcommittees.
Study mechanisms for access to private Long Term Care plans for people with disabilities at high risk of using public systems upon retirement.
Analyze policies, laws and regulations that conflict with goals of employment and self-sufficiency of Californians with disabilities and make recommendations for change.

To help accomplish its mission, the CHIIP is overseen by a steering committee comprised of consumers, community-based organizations, and representatives from state and county government that help to guide the work of the project. This group has been meeting quarterly since 2002. The CHIIP Steering Committee also meets quarterly with the California Governor's Committee on Employment of People with Disabilities, as the two organizations share a common vision and goals.

Ticket to Work and Work Incentives Improvement Act

In-Home Supportive Services

The In-Home Supportive Services (IHSS) program is a federal, state and locally funded program designed to provide assistance to those eligible aged, blind and disabled individuals who, without this care would be unable to remain safely in their own homes. IHSS provides services according the client's needs, e.g., feeding, bathing, dressing, housekeeping, laundry, shopping errands, meal preparation and meal clean up, respiration, bowel and bladder care, moving in and out of bed, rubbing the skin (to prevent skin breakdown), accompaniment to medical appointments, paramedical services, and protective supervision.

County Social Workers determine eligibility for the IHSS program, assess a consumer's need for specific services, and identify the time to be allotted for the performance of these services.

The IHSS client is responsible for locating their own "individual provider", hiring and supervising the provider, and firing the individual if the services are not performed according to the consumer's specifications.
Eligibility Criteria:

The individual is Aged, blind, or disabled.
The individual is Unable to personally perform the services authorized.
Low income: The individual is receiving or eligible to receive SSI/SSP. If income exceeds SSI/SSP standards, eligibility may exist with a share of cost.
The individual has personal property valued at less than $2,000 for an individual or $3,000 for a couple.
Have a functional impairment expected to last 12 months or more.

Medi-Cal Working Disabled Program

Click here to find out information regarding history and eligibility.

To apply for 250% California Working Disabled (250% CWD) Program, it is recommended that you request an appointment with your local county coordinator who is authorized to work in the 250% CWD Program.

Click here to find a list of 250% Working Disabled Program County Coordinators

To contact your local Medi-Cal office call the Beneficiary Unit for Medi-Cal at (916) 636-1980. Medi-Cal provides applications in eleven languages. You can download an application online but you must submit your application in person or by U.S. mail.

If you are currently enrolled in another eligibility category of Medi-Cal, talk to your Medi-Cal eligibility worker and ask to be transferred to this program.

Updated 7/5/10