WORKPATH: Planning for a "Comprehensive Employment Opportunities"

approach using the Medicaid Infrastructure Grant

The National Consortium for Health Systems Development (NCHSD) announces a new series of issue papers and topical teleconferences designed to support state efforts for building a comprehensive employment infrastructure.

As detailed in the RFP released by the Centers for Medicare and Medicaid Services (CMS) in 2004, "…a unique component of this solicitation is the opportunity for States to include in their application a new use of grant funding. States may propose to use funding to lessen or remove the primary barriers to employment for adults with disabilities through a comprehensive, coordinated approach between Medicaid and non-Medicaid programs. This use of funding will allow States with fairly advanced Medicaid systems to take the next step in employment efforts and bring the Medicaid components together with other non-Medicaid resources and programs." CMS calls this funding component "Comprehensive Employment Opportunities" (CEO).

CEO funding is structured around eight key elements represented by the acronym WORKPATH:

Work Pays

Opportunity Development through Employers and Job Connections


Key Services and Supports

Peer Worker Connections and Personal Commitments

Access to Information and Benefits Counseling

Total Program Design

Health Care and Long-term Supports and Services

CMS has indicated that it will use the CEO approach in future MIG solicitations. Because this RFP offers states funding to develop and coordinate key components of infrastructure in addition to Medicaid-funded services, NCHSD is planning technical assistance activities for the remainder of 2003 and 2004 to help states meet the challenge of developing a Comprehensive Employment Opportunities approach. Toward that end, NCHSD will offer assistance in:

understanding, developing and implementing key support services,

increasing coordination of programs and policies within a comprehensive approach designed to improve employment opportunities and outcomes for people with disabilities, and

protecting and enhancing existing health care programs.

States already possess a remarkable diversity of expertise in exploring and implementing a continuum of support for employed persons with disabilities. Through a new series of issue papers and topical teleconferences, NCHSD will facilitate additional opportunities for sharing this state-level expertise on a national scale around the WORKPATH components, and some key topical issues facing states in their comprehensive planning.

WORKPATH Series: Issue papers and topical teleconferences

The first teleconference will be scheduled for October 23, 2021 and subsequent calls will take place the first and third Thursdays of the month. Teleconferences will be supported by a brief issue paper, as well as other identified resources for each area.


Teleconference Schedule

October 23: W-What can states do to guarantee that work "pays"?

November 6: O-How can states improve public/private collaboration and employer involvement in work incentives for people with disabilities?

November 20: R-What research infrastructure is needed to monitor and evaluate work incentives?

December 4: K-What key supports and services are essential?

December 18: P-What kinds of peer supports help achieve better employment outcomes?

The schedule for January calls will be announced at a later date…

A: How can states ensure access to accurate benefits and financial information?

T: What sort of total program design will reduce fear and adverse consequences for people with disabilities who have increased earnings?

H: Are necessary health and long-term supports in place and functioning for people with disabilities who want to work?

Each supporting issue paper will provide: an overview of the issue, key policy challenges, information about current innovation and promising practices in the states, resources and key contacts for states to explore the issue further, and related activities sponsored by NCHSD and other TA providers.

The issue papers will be developed through a collaboration of NCHSD state partners and other experts in the disability and employment policy fields. NCHSD’s goal is to facilitate a continuous and informative dialogue on the issues among all stakeholders.

To conclude this series, NCHSD plans to develop a Comprehensive Employment Opportunities assessment tool for states to use as a framework for planning their applications for CEO or other infrastructure funding in 2004.

For more information, contact Melissa Wittman, Project Director, at (312) 925-3040 or


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