Alexis D. Henry, ScD, OTR/L¹, Frederick H. Hooven, MMHS², Lobat Hashemi, MS³, and Jay Himmelstein, MD MPH². (1) Center for Health Policy and Research, University of Massachusetts Medical School, 222 Maple Ave, Shrewsbury, MA 01545, 508-856-8833, alexis.henry@umassmed.edu, (2) Center for Health Policy and Research, UMass Medical School, 222 Maple Ave, Shrewsbury, MA 01545, (3) UMass Medical School, Center for Health Policy and Research, 222 Maple Ave, Shrewsbury, MA 01545

People with disabilities are significantly less likely to work than those without disabilities. Many fear the loss of disability benefits, particularly health insurance, if they attempt work. Medicaid "buy-in" programs allow people with disabilities to work without fear of losing Medicaid benefits. Employment among buy-in programs participants is an indicator of program success.

We surveyed working-age adults with disabilities enrolled in the Medicaid program in Massachusetts, which has one of the oldest buy-in programs in the country. The survey gathered baseline data on work efforts among Medicaid enrollees, as well as data on disabling condition, health status, service use and work barriers. Surveys were administered to 3000 randomly selected enrollees in both the buy-in and the standard programs via mail and telephone interviews, yielding a 58% response rate.

Just over 39% of respondents reported being currently employed. Most worked part-time and earned less than $20,000 in the past year. Although the MA buy-in program has no income limit, earnings were low even among full-time, long-term workers. Over 35% of respondents reported co-occurring disabling conditions (e.g. psychiatric and physical disabilities). Other conditions included: psychiatric (28%), mobility or illness (21%), developmental (11%), and sensory (5%) disabilities. Those with co-occurring conditions were the least likely to work, and worked fewer hours per week. The strongest predictors of employment and work effort were overall health status, activity limitations, level of education and age. Implications of these findings for evaluating buy-in programs and for health and employment services for people with disabilities will be addressed.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify predictors of work effort among adults with disabilities in a Medicaid buy-in program
• Discuss the use of employment indicators to evaluate Medicaid buy-in programs
• Recognize health and other service needs of workers and potential workers with disabilities served by Medicaid programs

Keywords: Disability, Medicaid

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 103.0 kb)