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210-RICR-40-15-1 TITLE 210 – EXECUTIVE OFFICE OF HEALTH AND HUMAN SERVICES CHAPTER 40 – MEDICAID FOR ELDERS AND ADULTS WITH DISABILITIES SUBCHAPTER 15 – WORKING ADULTS WITH DISABILITIES PART 1 – WORKING ADULTS WITH DISABILITIES 1.1 Scope and Applicability A. One of the principal objectives of health and human services policymakers is to support Medicaid-eligible adults with disabilities who work by enabling them to obtain or maintain the coverage they need to retain their independence and optimize their health. Toward this end, an array of State and Federal laws and Regulations have been adopted that establish special provisions for disregarding all or a portion of the earned income of adults with disabilities who work. The State also provides Medicaid coverage for an array of employment services and supports to assist beneficiaries with disabilities who are employed. This Part describes the eligibility pathways that are available to adults with disabilities who are working. B. In addition, the State has taken the options under Federal law to create two (2) eligibility pathways – known as the Sherlock Plan and the Ticket to Work Program – which enable working adults with disabilities who are otherwise Medicaid ineligible or unable to obtain needed employment supports to buy into the program at a low monthly cost. To qualify for the Medicaid special income provisions afforded by the Sherlock Plan or the Ticket to Work Program, a person must be determined to have a disability by a Federal or State government entity or appropriately designated contractual agent of the State in accordance with the standards set forth in Subchapter 05 Part 1 of this Chapter. Such entities include the U.S. Social Security Administration and the Medicaid Assessment and Review Team (MART) described in Subchapter 05 Part 1 of this Chapter. Adults with disabilities who work and are seeking initial or continuing eligibility for Medicaid long-term services and supports (LTSS) may be subject to distinct “clinical/functional disability” criteria, as set forth in § 1.8.1 of this Part. A beneficiary who meets these disability criteria and qualifies for these special income provisions is eligible for the full range of Medicaid covered employment services and supports. C. Employment services and supports may also be available to adults with disabilities over age nineteen (19) who are eligible for Medicaid in accordance with the provisions of Part 30-00-1 of this Title in one (1) of the Medicaid Affordable Care Coverage (MACC) groups based on the modified adjusted gross income (MAGI) standard. Although a disability determination is not required, the