Facilitating Independence and Employment for Persons with Disabilities: A Review of Findings from the Demonstration to Maintain Independence and Employment (DMIE)

The Demonstration to Maintain Independence and Employment (DMIE) was authorized under the Ticket to Work and Work Incentives Improvement Act of 1999 to fund state efforts to keep workers employed who may have functional limitations but whose disabilities may not have been severe enough to warrant applying for SSI or SSDI. Only six states (or districts) received funding under this initiative, which encouraged use of more comprehensive health insurance coverage and employment supports to maintain workers' health, independence, and community participation. The demonstrations ended in September 2009. Data from Kansas, Minnesota and Texas will be reviewed in this presentation as part of a panel devoted to rolling out DMIE findings in these three states. A literature review that summarizes the background and context for DMIE will be presented. A brief summary of major findings from the three states will be interpreted inductively for their public health relevance and bearing on recent health reform. In DMIE states, interventions which sought to increase the ability of participants to maintain employment and avoid SSDI or SSI status appeared to have been largely successful. Enhanced access to supportive services that retain working status for persons with disabilities appears to be an effective public health strategy for maintaining the health of segments of the disability population whose disability may not yet be severe.