I

106TH CONGRESS

1ST SESSION H. R. 1091

To amend the Social Security Act to expand the availability of health care

coverage for working individuals with disabilities, to establish a Ticket

to Work and Self-Sufficiency Program in the Social Security Administration to provide beneficiaries with disabilities meaningful opportunities

to work, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

MARCH 11, 1999

Mr. HULSHOF introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Commerce, for a period to be subsequently determined by the Speaker, in

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned

A BILL

To amend the Social Security Act to expand the availability

of health care coverage for working individuals with disabilities, to establish a Ticket to Work and Self-Sufficiency Program in the Social Security Administration

to provide beneficiaries with disabilities meaningful opportunities to work, and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,
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1 SECTION 1. SHORT TITLE AND TABLE OF CONTENTS.

2 (a) SHORT TITLE.—This Act may be cited as the

3 ‘‘Ticket to Work and Self-Sufficiency Act of 1999’’.

4 (b) TABLE OF CONTENTS.—The table of contents is

5 as follows:

Sec. 1. Short title and table of contents.

TITLE I—EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

Sec. 101. Expanding State options under Medicaid for workers with disabilities.

Sec. 102. Extending Medicare coverage for OASDI disability benefit recipients

who are using tickets to work and self-sufficiency.

Sec. 103. Grants to develop and establish State infrastructures to support

working individuals with disabilities.

Sec. 104. Demonstration of coverage of workers with potentially severe disabilities.

TITLE II—TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM

Sec. 201. Establishment of the Ticket to Work and Self-Sufficiency Program.

Sec. 202. Effective date.

Sec. 203. Graduated implementation of Program.

Sec. 204. The Ticket to Work and Self-Sufficiency Advisory Panel.

Sec. 205. Demonstration projects and studies.

TITLE III—TECHNICAL AMENDMENTS

Sec. 301. Technical amendments relating to drug addicts and alcoholics.

Sec. 302. Treatment of prisoners.

Sec. 303. Revocation by members of the clergy of exemption from social security coverage.

Sec. 304. Additional technical amendment relating to cooperative research or

demonstration projects under titles II and XVI.

Sec. 305. Authorization for State to permit annual wage reports.

6 TITLE I—EXPANDED AVAILABIL7 ITY OF HEALTH CARE SERV8 ICES

9 SEC. 101. EXPANDING STATE OPTIONS UNDER MEDICAID

10 FOR WORKERS WITH DISABILITIES.

11 (a) STATE OPTION TO ELIMINATE INCOME, ASSETS,

12 AND RESOURCE LIMITATIONS FOR WORKERS WITH DIS13 ABILITIES BUYING INTO MEDICAID.—Section
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1 1902(a)(10)(A)(ii) of the Social Security Act (42 U.S.C.

2 1396a(a)(10)(A)(ii)) is amended—

3 (1) in subclause (XIII), by striking ‘‘or’’ at the

4 end;

5 (2) in subclause (XIV), by adding ‘‘or’’ at the

6 end; and

7 (3) by adding at the end the following:

8 ‘‘(XV) who, but for earnings in

9 excess of the limit established under

10 section 1905(q)(2)(B), and subject to

11 limitations on assets, resources, or un12 earned income that may be set by the

13 State, would be considered to be re14 ceiving supplemental security income

15 (subject, notwithstanding section

16 1916, to payment of premiums or

17 other cost-sharing charges (set on a

18 sliding scale based on income that the

19 State may determine and that may re20 quire an individual with income that

21 exceeds 250 percent of the income of22 ficial poverty line (as defined by the

23 Office of Management and Budget,

24 and revised annually in accordance

25 with section 673(2) of the Omnibus
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1 Budget Reconciliation Act of 1981)

2 applicable to a family of the size in3 volved to pay an amount equal to 100

4 percent of the premium cost for pro5 viding medical assistance to the indi6 vidual), so long as any such premiums

7 or other cost-sharing charges are the

8 same as any premiums or other cost9 sharing charges imposed for individ10 uals described in subclause (XVI));’’.

11 (b) STATE OPTION TO EXPAND OPPORTUNITIES FOR

12 WORKERS WITH DISABILITIES TO BUY INTO MEDIC13 AID.—

14 (1) ELIGIBILITY.—Section 1902(a)(10)(A)(ii)

15 of the Social Security Act (42 U.S.C.

16 1396a(a)(10)(A)(ii)), as amended by subsection (a),

17 is amended—

18 (A) in subclause (XIV), by striking ‘‘or’’ at

19 the end;

20 (B) in subclause (XV), by adding ‘‘or’’ at

21 the end; and

22 (C) by adding at the end the following:

23 ‘‘(XVI) who are working individ24 uals with disabilities described in sec25 tion 1905(v) (subject, notwithstanding
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1 section 1916, to payment of premiums

2 or other cost-sharing charges (set on

3 a sliding scale based on income) that

4 the State may determine so long as

5 any such premiums or other cost-shar6 ing charges are the same as any pre7 miums or other cost-sharing charges

8 imposed for individuals described in

9 subclause (XV)), but only if the State

10 provides medical assistance to individ11 uals described in subclause (XV);’’.

12 (2) DEFINITION OF WORKING INDIVIDUALS

13 WITH DISABILITIES.—Section 1905 of the Social Se14 curity Act (42 U.S.C. 1396d) is amended by adding

15 at the end the following:

16 ‘‘(v)(1) The term ‘working individuals with disabil17 ities’ means individuals ages 16 through 64 who—

18 ‘‘(A) by reason of medical improvement, cease

19 to be eligible for benefits under section 223(d) or

20 1614(a)(3) at the time of a regularly scheduled con21 tinuing disability review but who continue to have a

22 severe medically determinable impairment; and

23 ‘‘(B) are employed.

24 ‘‘(2) An individual is considered to be ‘employed’ if

25 the individual—
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1 ‘‘(A) is earning at least the applicable minimum

2 wage requirement under section 6 of the Fair Labor

3 Standards Act (29 U.S.C. 206) and working at least

4 40 hours per month; or

5 ‘‘(B) is engaged in a work effort that meets

6 substantial and reasonable threshold criteria for

7 hours of work, wages, or other measures, as defined

8 by the State and approved by the Secretary.’’.

9 (3) CONFORMING AMENDMENT.—Section

10 1905(a) of the Social Security Act (42 U.S.C.

11 1396d(a)) is amended in the matter preceding para12 graph (1)—

13 (A) in clause (x), by striking ‘‘or’’ at the

14 end;

15 (B) in clause (xi), by adding ‘‘or’’ at the

16 end; and

17 (C) by inserting after clause (xi), the fol18 lowing:

19 ‘‘(xii) individuals described in subsection (v),’’.

20 (c) PROHIBITION AGAINST SUPPLANTATION OF

21 STATE FUNDS; MAINTENANCE OF EFFORT REQUIRE22 MENT; CONDITION FOR APPROVAL OF STATE PLAN

23 AMENDMENT.—

24 (1) NO SUPPLANTATION OF STATE FUNDS.—

25 Federal funds paid to a State for medical assistance
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1 provided to an individual described in subclause

2 (XV) or (XVI) of section 1902(a)(10)(A)(ii) of the

3 Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii))

4 must be used to supplement but not supplant the

5 level of State funds expended as of October 1, 1998

6 for programs to enable working individuals with dis7 abilities to work.

8 (2) MAINTENANCE OF EFFORT.—With respect

9 to a fiscal year quarter, no Federal funds may be

10 paid to a State for medical assistance provided to an

11 individual described in subclause (XV) or (XVI) of

12 section 1902(a)(10)(A)(ii) of the Social Security Act

13 (42 U.S.C. 1396a(a)(10)(A)(ii)) for such fiscal year

14 quarter if the Secretary of Health and Human Serv15 ices determines that the total of the State expendi16 tures for programs to enable working individuals

17 with disabilities to work for the preceding fiscal year

18 quarter is less than the total of such expenditures

19 for the same fiscal year quarter of the preceding fis20 cal year.

21 (3) CONDITION FOR APPROVAL OF STATE PLAN

22 AMENDMENTS.—No State plan amendment that pro23 poses to provide medical assistance to an individual

24 described in subclause (XV) or (XVI) of section

25 1902(a)(10)(A)(ii) of the Social Security Act (42
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1 U.S.C. 1396a(a)(10)(A)(ii)) may be approved unless

2 the chief executive officer of the State certifies to

3 the Secretary of Health and Human Services that

4 the plan, as so amended, will satisfy the require5 ments of paragraphs (1) and (2) of this subsection.

6 (d) EFFECTIVE DATE.—

7 (1) IN GENERAL.—The amendments made by

8 this section shall apply on and after October 1,

9 1999.

10 (2) EXTENSION OF EFFECTIVE DATE FOR

11 STATE LAW AMENDMENT.—In the case of a State

12 plan under title XIX of the Social Security Act

13 which the Secretary of Health and Human Services

14 determines requires State legislation in order for the

15 plan to meet the additional requirements imposed by

16 the amendments made by this section, the State

17 plan shall not be regarded as failing to comply with

18 the requirements of this section solely on the basis

19 of its failure to meet these additional requirements

20 before the first day of the first calendar quarter be21 ginning after the close of the first regular session of

22 the State legislature that begins after the date of en23 actment of this Act. For purposes of the previous

24 sentence, in the case of a State that has a 2-year

25 legislative session, each year of the session is consid-
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1 ered to be a separate regular session of the State

2 legislature.

3 SEC. 102. EXTENDING MEDICARE COVERAGE FOR OASDI

4 DISABILITY BENEFIT RECIPIENTS WHO ARE

5 USING TICKETS TO WORK AND SELF-SUFFI6 CIENCY.

7 (a) IN GENERAL.—The next to last sentence of sec8 tion 226(b) of the Social Security Act (42 U.S.C. 426)

9 is amended—

10 (1) by striking ‘‘throughout all of which’’ and

11 inserting ‘‘throughout the first 24 months of which’’;

12 and

13 (2) by inserting after ‘‘but not in excess of 24

14 such months’’ the following: ‘‘(plus 24 additional

15 such months in the case of an individual who the

16 Commissioner determines is using a ticket to work

17 and self-sufficiency issued under section 1148, but

18 only for additional months that occur in the 7-year

19 period beginning on the date of the enactment of the

20 Ticket to Work and Self-Sufficiency Act of 1999)’’.

21 (b) REPORT.—Not later than 6 months prior to the

22 end of the 7-year period beginning on the date of the en23 actment of this Act, the Secretary of Health and Human

24 Services and the Commissioner of Social Security shall

25 submit in writing to each House of the Congress their rec-
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1 ommendations for further legislative action with respect

2 to the amendments made by subsection (a), taking into

3 account experience derived from efforts to achieve full im4 plementation of the Ticket to Work and Self Sufficiency

5 Program under section 1148 of the Social Security Act.

6 SEC. 103. GRANTS TO DEVELOP AND ESTABLISH STATE IN7 FRASTRUCTURES TO SUPPORT WORKING IN8 DIVIDUALS WITH DISABILITIES.

9 (a) ESTABLISHMENT.—

10 (1) IN GENERAL.—The Secretary of Health and

11 Human Services (in this section referred to as the

12 ‘‘Secretary’’) shall award grants described in sub13 section (b) to States to support the design, establish14 ment, and operation of State infrastructures that

15 provide items and services to support working indi16 viduals with disabilities. A State may submit an ap17 plication for a grant authorized under this section at

18 such time, in such manner, and containing such in19 formation as the Secretary may determine.

20 (2) DEFINITION OF STATE.—In this section,

21 the term ‘‘State’’ means each of the 50 States, the

22 District of Columbia, Puerto Rico, Guam, the

23 United States Virgin Islands, American Samoa, and

24 the Commonwealth of the Northern Mariana Is25 lands.
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1 (b) GRANTS FOR INFRASTRUCTURE AND OUT2 REACH.—

3 (1) IN GENERAL.—Out of the funds appro4 priated under subsection (e), the Secretary shall

5 award grants to States to—

6 (A) support the establishment, implemen7 tation, and operation of the State infrastruc8 tures described in subsection (a); and

9 (B) conduct outreach campaigns regarding

10 the existence of such infrastructures.

11 (2) ELIGIBILITY FOR GRANTS.—

12 (A) IN GENERAL.—No State may receive a

13 grant under this subsection unless—

14 (i) the State has an approved amend15 ment to the State plan under title XIX of

16 the Social Security Act (42 U.S.C. 1396 et

17 seq.) that—

18 (I) provides medical assistance

19 under such plan to individuals de20 scribed in section

21 1902(a)(10)(A)(ii)(XV) of the Social

22 Security Act (42 U.S.C.

23 1396a(a)(10)(A)(ii)(XV)); or

24 (II) provides medical assistance

25 under such plan to individuals de-
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1 scribed in subclauses (XV) and (XVI)

2 of section 1902(a)(10)(A)(ii) of the

3 Social Security Act (42 U.S.C.

4 1396a(a)(10)(A)(ii)); and

5 (ii) the State demonstrates to the sat6 isfaction of the Secretary that the State

7 makes personal assistance services avail8 able under the State plan under title XIX

9 of the Social Security Act (42 U.S.C. 1396

10 et seq.) to the extent necessary to enable

11 individuals described in subclause (I) or

12 (II) of clause (i) to remain employed (as

13 determined under section 1905(v)(2) of the

14 Social Security Act (42 U.S.C.

15 1396d(v)(2)).

16 (B) DEFINITION OF PERSONAL ASSIST17 ANCE SERVICES.—In this paragraph, the term

18 ‘‘personal assistance services’’ means a range of

19 services, provided by 1 or more persons, de20 signed to assist an individual with a disability

21 to perform daily activities on and off the job

22 that the individual would typically perform if

23 the individual did not have a disability. Such

24 services shall be designed to increase the indi-
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1 vidual’s control in life and ability to perform ev2 eryday activities on or off the job.

3 (3) DETERMINATION OF AWARDS.—

4 (A) IN GENERAL.—Subject to subpara5 graph (B), the Secretary shall determine a for6 mula for awarding grants to States under this

7 section that provides special consideration to

8 States that provide medical assistance under

9 title XIX of the Social Security Act to individ10 uals described in section

11 1902(a)(10)(A)(ii)(XVI) of that Act (42 U.S.C.

12 1396a(a)(10)(A)(ii)(XVI)).

13 (B) AWARD LIMITS.—

14 (i) MINIMUM AWARDS.—No State that

15 submits an approved application for fund16 ing under this section shall receive a grant

17 for a fiscal year that is less than $500,000.

18 (ii) MAXIMUM AWARDS.—No State

19 that submits an approved application for

20 funding under this section shall receive a

21 grant for a fiscal year that exceeds 15 per22 cent of the total expenditures by the State

23 (including the reimbursed Federal share of

24 such expenditures) for medical assistance

25 for individuals eligible under subclause
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1 (XV) or (XVI) of section

2 1902(a)(10)(A)(ii), whichever is greater, as

3 estimated by the State and approved by

4 the Secretary.

5 (c) AVAILABILITY OF FUNDS.—

6 (1) FUNDS ALLOCATED TO STATES.—Funds al7 located to a State under a grant made under this

8 section for a fiscal year shall remain available until

9 expended.

10 (2) FUNDS NOT ALLOCATED TO STATES.—

11 Funds not allocated to States in the fiscal year for

12 which they are appropriated shall remain available

13 in succeeding fiscal years for allocation by the Sec14 retary using the allocation formula established by

15 the Secretary under subsection (c)(3)(A).

16 (d) ANNUAL REPORT.—A State that receives a grant

17 under this section shall submit an annual report to the

18 Secretary on the use of funds provided under the grant.

19 Each report shall include the percentage increase in the

20 number of title II disability beneficiaries, as defined in sec21 tion 1148(k)(2) of the Social Security Act (as amended

22 by section 201) in the State, and title XVI disability bene23 ficiaries, as defined in section 1148(k)(3) of the Social Se24 curity Act (as so amended) in the State who return to

25 work.
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1 (e) APPROPRIATION.—Out of any funds in the Treas2 ury not otherwise appropriated, there is authorized to be

3 appropriated and there is appropriated to make grants

4 under this section—

5 (1) for fiscal year 2000, $20,000,000;

6 (2) for fiscal year 2001, $25,000,000;

7 (3) for fiscal year 2002, $30,000,000;

8 (4) for fiscal year 2003, $35,000,000;

9 (5) for fiscal year 2004, $40,000,000; and

10 (6) for fiscal years 2005 through 2010, the

11 amount appropriated for the preceding fiscal year

12 increased by the percentage increase (if any) in the

13 Consumer Price Index for All Urban Consumers

14 (United States city average) for the preceding fiscal

15 year.

16 (f) RECOMMENDATION.—Not later than October 1,

17 2009, the Secretary of Health and Human Services, in

18 consultation with the Ticket to Work and Self-Sufficiency

19 Advisory Panel established under section 202, shall submit

20 a recommendation to the Committee on Commerce and the

21 Committee on Ways and Means of the House of Rep22 resentatives and the Committee on Finance of the Senate

23 regarding whether the grant program established under

24 this section should be continued after fiscal year 2010.
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1 SEC. 104. DEMONSTRATION OF COVERAGE OF WORKERS

2 WITH POTENTIALLY SEVERE DISABILITIES.

3 (a) STATE APPLICATION.—A State may apply to the

4 Secretary of Health and Human Services (in this section

5 referred to as the ‘‘Secretary’’) for approval of a dem6 onstration project (in this section referred to as a ‘‘dem7 onstration project’’) under which up to a specified maxi8 mum number of individuals who are workers with a poten9 tially severe disability (as defined in subsection (b)(1)) are

10 provided medical assistance equal to that provided under

11 section 1905(a) of the Social Security Act (42 U.S.C.

12 1396d(a)) to individuals described in section

13 1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C.

14 1396a(a)(10)(A)(ii)(XV)).

15 (b) WORKER WITH A POTENTIALLY SEVERE DIS16 ABILITY DEFINED.—For purposes of this section—

17 (1) IN GENERAL.—The term ‘‘worker with a

18 potentially severe disability’’ means, with respect to

19 a demonstration project, an individual who—

20 (A) is at least 16, but less than 65, years

21 of age;

22 (B) has a specific physical or mental im23 pairment that, as defined by the State under

24 the demonstration project, is reasonably ex25 pected, but for the receipt of items and services

26 described in section 1905(a) of the Social Secu-
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1 rity Act, to become blind or disabled (as defined

2 under section 1614(a) of the Social Security

3 Act); and

4 (C) is employed (as defined in paragraph

5 (2)).

6 (2) DEFINITION OF EMPLOYED.—An individual

7 is considered to be ‘‘employed’’ if the individual—

8 (A) is earning at least the applicable mini9 mum wage requirement under section 6 of the

10 Fair Labor Standards Act (29 U.S.C. 206) and

11 working at least 40 hours per month; or

12 (B) is engaged in a work effort that meets

13 substantial and reasonable threshold criteria for

14 hours of work, wages, or other measures, as de15 fined under the demonstration project and ap16 proved by the Secretary.

17 (c) APPROVAL OF DEMONSTRATION PROJECTS.—

18 (1) IN GENERAL.—Subject to paragraph (3),

19 the Secretary shall approve applications under sub20 section (a) that meet the requirements of paragraph

21 (2) and such additional terms and conditions as the

22 Secretary may require. The Secretary may waive the

23 requirement of section 1902(a)(1) of the Social Se24 curity Act (42 U.S.C. 1396a(a)(1)) to allow for sub25 State demonstrations.
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1 (2) TERMS AND CONDITIONS OF DEMONSTRA2 TION PROJECTS.—The Secretary may not approve a

3 demonstration project under this section unless the

4 State provides assurances satisfactory to the Sec5 retary that the following conditions are or will be

6 met:

7 (A) ELECTION OF OPTIONAL CATEGORY.—

8 The State has elected to provide coverage under

9 its plan under title XIX of the Social Security

10 Act of individuals described in section

11 1902(a)(10)(A)(ii)(XV) of the Social Security

12 Act.

13 (B) MAINTENANCE OF STATE EFFORT.—

14 Federal funds paid to a State pursuant to this

15 section must be used to supplement, but not

16 supplant, the level of State funds expended for

17 workers with potentially severe disabilities

18 under programs in effect for such individuals at

19 the time the demonstration project is approved

20 under this section.

21 (C) INDEPENDENT EVALUATION.—The

22 State provides for an independent evaluation of

23 the project.

24 (3) LIMITATIONS ON FEDERAL FUNDING.—
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1 (A) APPROPRIATION.—Out of any funds in

2 the Treasury not otherwise appropriated, there

3 is authorized to be appropriated and there is

4 appropriated to carry out this section—

5 (i) for fiscal year 2000, $70,000,000;

6 (ii) for fiscal year 2001, $73,000,000;

7 (iii) for fiscal year 2002, $77,000,000;

8 and

9 (iv) for fiscal year 2003, $80,000,000.

10 (B) LIMITATION ON PAYMENTS.—In no

11 case may—

12 (i) the aggregate amount of payment

13 made by the Secretary to States under this

14 section exceed $300,000,000; or

15 (ii) payment be provided by the Sec16 retary for a fiscal year after fiscal year

17 2005.

18 (C) FUNDS ALLOCATED TO STATES.—The

19 Secretary shall allocate funds to States based

20 on their applications and the availability of

21 funds. Funds allocated to a State under a grant

22 made under this section for a fiscal year shall

23 remain available until expended.

24 (D) FUNDS NOT ALLOCATED TO STATES.—

25 Funds not allocated to States in the fiscal year
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1 for which they are appropriated shall remain

2 available in succeeding fiscal years for alloca3 tion by the Secretary using the allocation for4 mula established under this section.

5 (E) PAYMENTS TO STATES.—Subject to

6 the succeeding provisions of this section, the

7 Secretary shall pay to each State with a dem8 onstration project approved under this section,

9 from its allocation under subparagraph (C), an

10 amount for each quarter equal to the Federal

11 medical assistance percentage (as defined in

12 section 1905(b) of the Social Security Act (42

13 U.S.C. 1395d(b)) of expenditures in the quarter

14 for medical assistance provided to workers with

15 a potentially severe disability.

16 (d) STATE DEFINED.—In this section, the term

17 ‘‘State’’ has the meaning given such term for purposes of

18 title XIX of the Social Security Act.

19 TITLE II—TICKET TO WORK AND

20 SELF-SUFFICIENCY PROGRAM

21 SEC. 201. ESTABLISHMENT OF THE TICKET TO WORK AND

22 SELF-SUFFICIENCY PROGRAM.

23 (a) IN GENERAL.—Part A of title XI of the Social

24 Security Act (42 U.S.C. 1301 et seq.) is amended by add25 ing at the end the following new section:
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1 ‘‘THE TICKET TO WORK AND SELF-SUFFICIENCY

2 PROGRAM

3 ‘‘SEC. 1148. (a) IN GENERAL.—The Commissioner

4 of Social Security shall establish a Ticket to Work and

5 Self-Sufficiency Program, under which a disabled bene6 ficiary may use a ticket to work and self-sufficiency issued

7 by the Commissioner in accordance with this section to

8 obtain employment services, vocational rehabilitation serv9 ices, or other support services from an employment net10 work which is of the beneficiary’s choice and which is will11 ing to provide such services to such beneficiary.

12 ‘‘(b) TICKET SYSTEM.—

13 ‘‘(1) DISTRIBUTION OF TICKETS.—The Com14 missioner of Social Security may issue a ticket to

15 work and self-sufficiency to disabled beneficiaries for

16 participation in the Program.

17 ‘‘(2) ASSIGNMENT OF TICKETS.—A disabled

18 beneficiary holding a ticket to work and self-suffi19 ciency may assign the ticket to any employment net20 work of the beneficiary’s choice which is serving

21 under the Program and is willing to accept the as22 signment.

23 ‘‘(3) TICKET TERMS.—A ticket issued under

24 paragraph (1) shall consist of a document which evi25 dences the Commissioner’s agreement to pay (as
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1 provided in paragraph (4)) an employment network,

2 which is serving under the Program and to which

3 such ticket is assigned by the beneficiary, for such

4 employment services, vocational rehabilitation serv5 ices, and other support services as the employment

6 network may provide to the beneficiary.

7 ‘‘(4) PAYMENTS TO EMPLOYMENT NET8 WORKS.—The Commissioner shall pay an employ9 ment network under the Program in accordance with

10 the outcome payment system under subsection

11 (h)(2) or under the outcome-milestone payment sys12 tem under subsection (h)(3) (whichever is elected

13 pursuant to subsection (h)(1)). An employment net14 work may not request or receive compensation for

15 such services from the beneficiary.

16 ‘‘(c) STATE PARTICIPATION.—

17 ‘‘(1) PERIODIC ELECTIONS.—Each State agen18 cy administering or supervising the administration

19 of the State plan approved under title I of the Reha20 bilitation act of 1973 may elect to participate in the

21 Program (or to revoke any such election) as an em22 ployment network. The Commissioner shall provide

23 for periodic opportunities for exercising such elec24 tions (and revocations).
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1 ‘‘(2) TREATMENT OF STATE AGENCIES.—Any

2 such election (or revocation) by a State agency de3 scribed in paragraph (1) taking effect during any

4 period for which an individual residing in the State

5 is a disabled beneficiary and a client of the State

6 agency shall not be effective with respect to such in7 dividual to the extent that such election (or revoca8 tion) would result in any change in the method of

9 payment to the State agency with respect to the in10 dividual from the method of payment to the State

11 agency with respect to the individual in effect imme12 diately before such election (or revocation).

13 ‘‘(3) EFFECT OF PARTICIPATION BY STATE

14 AGENCY.—

15 ‘‘(A) STATE AGENCIES PARTICIPATING.—

16 In any case in which a State agency described

17 in paragraph (1) elects under paragraph (1) to

18 participate in the Program—

19 ‘‘(i) the employment services, voca20 tional rehabilitation services, and other

21 support services which, upon assignment of

22 tickets to work and self-sufficiency, are

23 provided to disabled beneficiaries by the

24 State agency acting as an employment net25 work shall be governed by plans for voca-
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1 tional rehabilitation services approved

2 under title I of the Rehabilitation Act of

3 1973; and

4 ‘‘(ii) the provisions of section 222(d)

5 and the provisions of subsections (d) and

6 (e) of section 1615 shall not apply with re7 spect to such State.

8 ‘‘(B) STATE AGENCIES ADMINISTERING

9 MATERNAL AND CHILD HEALTH SERVICES PRO10 GRAMS.—Subparagraph (A) shall not apply

11 with respect to any State agency administering

12 a program under title V of this Act.

13 ‘‘(4) SPECIAL REQUIREMENTS APPLICABLE TO

14 CROSS-REFERRAL TO CERTAIN STATE AGENCIES.—

15 ‘‘(A) IN GENERAL.—In any case in which

16 an employment network has been assigned a

17 ticket to work and self-sufficiency by a disabled

18 beneficiary, no State agency shall be deemed re19 quired, under this section, title I of the Reha20 bilitation Act of 1973, or a State plan approved

21 under such title, to accept any referral of such

22 disabled beneficiary from such employment net23 work unless such employment network and such

24 State agency have entered into a written agree-
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1 ment that meets the requirements of subpara2 graph (B).

3 ‘‘(B) TERMS OF AGREEMENT.—An agree4 ment required by subparagraph (A) shall speci5 fy, in accordance with regulations prescribed

6 pursuant to subparagraph (C)—

7 ‘‘(i) the extent (if any) to which the

8 employment network holding the ticket will

9 provide to the State agency—

10 ‘‘(I) reimbursement for costs in11 curred in providing services described

12 in subparagraph (A) to the disabled

13 beneficiary; and

14 ‘‘(II) other amounts from pay15 ments made by the Commissioner to

16 the employment network pursuant to

17 subsection (h); and

18 ‘‘(ii) any other conditions that may be

19 required by such regulations.

20 ‘‘(C) REGULATIONS.—The Commissioner

21 of Social Security and the Secretary of Edu22 cation shall jointly prescribe regulations specify23 ing the terms of agreements required by sub24 paragraph (A) and otherwise necessary to carry

25 out the provisions of this paragraph.
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1 ‘‘(D) PENALTY.—No payment may be

2 made to an employment network pursuant to

3 subsection (h) in connection with services pro4 vided to any disabled beneficiary if such em5 ployment network makes referrals described in

6 subparagraph (A) in violation of the terms of

7 the contract required under subparagraph (A)

8 or without having entered into such a contract.

9 ‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF

10 SOCIAL SECURITY.—

11 ‘‘(1) SELECTION AND QUALIFICATIONS OF PRO12 GRAM MANAGERS.—The Commissioner of Social Se13 curity shall enter into agreements with one or more

14 organizations in the private or public sector for serv15 ice as a program manager to assist the Commis16 sioner in administering the Program. Any such pro17 gram manager shall be selected by means of a com18 petitive bidding process, from among organizations

19 in the private or public sector with available exper20 tise and experience in the field of vocational rehabili21 tation or employment services.

22 ‘‘(2) TENURE, RENEWAL, AND EARLY TERMI23 NATION.—Each agreement entered into under para24 graph (1) shall provide for early termination upon

25 failure to meet performance standards which shall be
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•HR 1091 IH

1 specified in the agreement and which shall be

2 weighted to take into account any performance in

3 prior terms. Such performance standards shall in4 clude (but are not limited to)—

5 ‘‘(A) measures for ease of access by bene6 ficiaries to services; and

7 ‘‘(B) measures for determining the extent

8 to which failures in obtaining services for bene9 ficiaries fall within acceptable parameters, as

10 determined by the Commissioner.

11 ‘‘(3) PRECLUSION FROM DIRECT PARTICIPA12 TION IN DELIVERY OF SERVICES IN OWN SERVICE

13 AREA.—Agreements under paragraph (1) shall

14 preclude—

15 ‘‘(A) direct participation by a program

16 manager in the delivery of employment services,

17 vocational rehabilitation services, or other sup18 port services to beneficiaries in the service area

19 covered by the program manager’s agreement;

20 and

21 ‘‘(B) the holding by a program manager of

22 a financial interest in an employment network

23 or service provider which provides services in a

24 geographic area covered under the program

25 manager’s agreement.
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•HR 1091 IH

1 ‘‘(4) SELECTION OF EMPLOYMENT NET2 WORKS.—The Commissioner shall select and enter

3 into agreements with employment networks for serv4 ice under the Program. Such employment networks

5 shall be in addition to State agencies serving as em6 ployment networks pursuant to elections under sub7 section (c).

8 ‘‘(5) TERMINATION OF AGREEMENTS WITH EM9 PLOYMENT NETWORKS.—The Commissioner shall

10 terminate agreements with employment networks for

11 inadequate performance, as determined by the Com12 missioner.

13 ‘‘(6) QUALITY ASSURANCE.—The Commissioner

14 shall provide for such periodic reviews as are nec15 essary to provide for effective quality assurance in

16 the provision of services by employment networks.

17 The Commissioner shall take into account the views

18 of consumers and the program manager under which

19 the employment networks serve and shall consult

20 with providers of services to develop performance

21 measurements. The Commissioner shall ensure that

22 the results of the periodic reviews are made available

23 to beneficiaries who are prospective service recipients

24 as they select employment networks. The Commis25 sioner shall ensure the performance of periodic sur-
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•HR 1091 IH

1 veys of beneficiaries receiving services under the

2 Program designed to measure customer service satis3 faction.

4 ‘‘(7) DISPUTE RESOLUTION.—The Commis5 sioner shall provide for a mechanism for resolving

6 disputes between beneficiaries and employment net7 works and between program managers and employ8 ment networks. The Commissioner shall afford a

9 party to such a dispute a reasonable opportunity for

10 a full and fair review of the matter in dispute.

11 ‘‘(e) PROGRAM MANAGERS.—

12 ‘‘(1) IN GENERAL.—A program manager shall

13 conduct tasks appropriate to assist the Commis14 sioner in carrying out the Commissioner’s duties in

15 administering the Program.

16 ‘‘(2) RECRUITMENT OF EMPLOYMENT NET17 WORKS.—A program manager shall recruit, and rec18 ommend for selection by the Commissioner, employ19 ment networks for service under the Program. The

20 program manager shall carry out such recruitment

21 and provide such recommendations, and shall mon22 itor all employment networks serving in the Program

23 in the geographic area covered under the program

24 manager’s agreement, to the extent necessary and

25 appropriate to ensure that adequate choices of serv-
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•HR 1091 IH

1 ices are made available to beneficiaries. Employment

2 networks may serve under the Program only pursu3 ant to an agreement entered into with the Commis4 sioner under the Program incorporating the applica5 ble provisions of this section and regulations there6 under, and the program manager shall provide and

7 maintain assurances to the Commissioner that pay8 ment by the Commissioner to employment networks

9 pursuant to this section is warranted based on com10 pliance by such employment networks with the terms

11 of such agreement and this section. The program

12 manager shall not impose numerical limits on the

13 number of employment networks to be recommended

14 pursuant to this paragraph.

15 ‘‘(3) FACILITATION OF ACCESS BY BENE16 FICIARIES TO EMPLOYMENT NETWORKS.—A pro17 gram manager shall facilitate access by beneficiaries

18 to employment networks. The program manager

19 shall ensure that each beneficiary is allowed changes

20 in employment networks for good cause, as deter21 mined by the Commissioner, without being deemed

22 to have rejected services under the Program. The

23 program manager shall establish and maintain lists

24 of employment networks available to beneficiaries

25 and shall make such lists generally available to the
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•HR 1091 IH

1 public. The program manager shall ensure that all

2 information provided to disabled beneficiaries pursu3 ant to this paragraph is provided in accessible for4 mat.

5 ‘‘(4) ENSURING AVAILABILITY OF ADEQUATE

6 SERVICES.—The program manager shall ensure that

7 employment services, vocational rehabilitation serv8 ices, and other support services are provided to

9 beneficiaries throughout the geographic area covered

10 under the program manager’s agreement, including

11 rural areas.

12 ‘‘(5) REASONABLE ACCESS TO SERVICES.—The

13 program manager shall take such measures as are

14 necessary to ensure that sufficient employment net15 works are available and that each beneficiary receiv16 ing services under the Program has reasonable ac17 cess to employment services, vocational rehabilitation

18 services, and other support services. Such services

19 may include case management, benefits counseling,

20 supported employment, career planning, career plan

21 development, vocational assessment, job training,

22 placement, follow-up services, and such other serv23 ices as may be specified by the Commissioner under

24 the Program. The program manager shall ensure

25 that such services are coordinated.
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•HR 1091 IH

1 ‘‘(f) EMPLOYMENT NETWORKS.—

2 ‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET3 WORKS.—Each employment network serving under

4 the Program shall consist of an agency or instru5 mentality of a State (or a political subdivision there6 of) or a private entity, which assumes responsibility

7 for the coordination and delivery of services under

8 the Program to individuals assigning to the employ9 ment network tickets to work and self-sufficiency

10 issued under subsection (b). No employment network

11 may serve under the Program unless it demonstrates

12 to the Commissioner substantial expertise and expe13 rience in the field of employment services, vocational

14 rehabilitation services, or other support services for

15 individuals with disabilities and provides an array of

16 such services. An employment network shall consist

17 of either a single provider of such services or of an

18 association of such providers organized so as to com19 bine their resources into a single entity. An employ20 ment network may meet the requirements of sub21 section (e)(4) by providing services directly, or by

22 entering into agreements with other individuals or

23 entities providing appropriate employment services,

24 vocational rehabilitation services, or other support

25 services.
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•HR 1091 IH

1 ‘‘(2) REQUIREMENTS RELATING TO PROVISION

2 OF SERVICES.—Each employment network serving

3 under the Program shall be required under the

4 terms of its agreement with the Commissioner to—

5 ‘‘(A) serve prescribed service areas;

6 ‘‘(B) meet, and maintain compliance with,

7 both general selection criteria (such as profes8 sional and governmental certification and edu9 cational credentials) and specific selection cri10 teria (such as the extent of work experience by

11 the provider with specific populations); and

12 ‘‘(C) take such measures as are necessary

13 to ensure that employment services, vocational

14 rehabilitation services, and other support serv15 ices provided under the Program by, or under

16 agreements entered into with, the employment

17 network are provided under appropriate individ18 ual work plans meeting the requirements of

19 subsection (g).

20 ‘‘(3) ANNUAL FINANCIAL REPORTING.—Each

21 employment network shall meet financial reporting

22 requirements as prescribed by the Commissioner.

23 ‘‘(4) PERIODIC OUTCOMES REPORTING.—Each

24 employment network shall prepare periodic reports,

25 on at least an annual basis, itemizing for the covered
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•HR 1091 IH

1 period specific outcomes achieved with respect to

2 specific services provided by the employment net3 work. Such reports shall conform to a national

4 model prescribed under this section. Each employ5 ment network shall provide a copy of the latest re6 port issued by the employment network pursuant to

7 this paragraph to each beneficiary upon enrollment

8 under the Program for services to be received

9 through such employment network. Upon issuance of

10 each report to each beneficiary, a copy of the report

11 shall be maintained in the files of the employment

12 network pertaining to the beneficiary. The program

13 manager shall ensure that copies of all such reports

14 issued under this paragraph are made available to

15 the public under reasonable terms.

16 ‘‘(g) INDIVIDUAL WORK PLANS.—

17 ‘‘(1) IN GENERAL.—Each employment network

18 shall—

19 ‘‘(A) take such measures as are necessary

20 to ensure that employment services, vocational

21 rehabilitation services, and other support serv22 ices provided under the Program by, or under

23 agreements entered into with, the employment

24 network are provided under appropriate individ-
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•HR 1091 IH

1 ual work plans as defined by the Commissioner;

2 and

3 ‘‘(B) develop and implement each such in4 dividual work plan, in the case of each bene5 ficiary receiving such services, in a manner that

6 affords such beneficiary the opportunity to ex7 ercise informed choice in selecting an employ8 ment goal and specific services needed to

9 achieve that employment goal.

10 A beneficiary’s individual work plan shall take effect

11 upon approval by the beneficiary.

12 ‘‘(2) VOCATIONAL EVALUATION.—In devising

13 the work plan, the employment network shall under14 take a vocational evaluation with respect to the ben15 eficiary. Each vocational evaluation shall set forth in

16 writing such elements and shall be in such format as

17 the Commissioner shall prescribe. The Commissioner

18 may provide for waiver by the beneficiary of such a

19 vocational evaluation, subject to regulations which

20 shall be prescribed by the Commissioner providing

21 for the permissible timing of, and the circumstances

22 permitting, such a waiver.

23 ‘‘(h) EMPLOYMENT NETWORK PAYMENT SYSTEMS.—

24 ‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM25 PLOYMENT NETWORKS.—
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•HR 1091 IH

1 ‘‘(A) IN GENERAL.—The Program shall

2 provide for payment authorized by the Commis3 sioner to employment networks under either an

4 outcome payment system or an outcome-mile5 stone payment system. Each employment net6 work shall elect which payment system will be

7 utilized by the employment network, and, for

8 such period of time as such election remains in

9 effect, the payment system so elected shall be

10 utilized exclusively in connection with such em11 ployment network (except as provided in sub12 paragraph (B)).

13 ‘‘(B) METHOD OF PAYMENT TO EMPLOY14 MENT NETWORKS.—Any such election by an

15 employment network taking effect during any

16 period for which a disabled beneficiary is receiv17 ing services from such employment network

18 shall not be effective with respect to such bene19 ficiary to the extent that such election would re20 sult in any change in the method of payment to

21 the employment network with respect to serv22 ices provided to such beneficiary from the meth23 od of payment to the employment network with

24 respect to services provided to such beneficiary

25 as of immediately before such election.
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•HR 1091 IH

1 ‘‘(2) OUTCOME PAYMENT SYSTEM.—

2 ‘‘(A) IN GENERAL.—The outcome payment

3 system shall consist of a payment structure gov4 erning employment networks electing such sys5 tem under paragraph (1)(A) which meets the

6 requirements of this paragraph.

7 ‘‘(B) PAYMENTS MADE DURING OUTCOME

8 PAYMENT PERIOD.—The outcome payment sys9 tem shall provide for a schedule of payments to

10 an employment network, in connection with

11 each individual who is a beneficiary, for each

12 month, during the individual’s outcome pay13 ment period, for which benefits (described in

14 paragraphs (2) and (3) of subsection (k)) are

15 not payable to such individual.

16 ‘‘(C) COMPUTATION OF PAYMENTS TO EM17 PLOYMENT NETWORK.—The payment schedule

18 of the outcome payment system shall be de19 signed so that—

20 ‘‘(i) the payment for each of the 60

21 months during the outcome payment pe22 riod for which benefits (described in para23 graphs (2) and (3) of subsection (k)) are

24 not payable is equal to a fixed percentage

25 of the payment calculation base for the cal-
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•HR 1091 IH

1 endar year in which such month occurs;

2 and

3 ‘‘(ii) such fixed percentage is set at a

4 percentage which does not exceed 40 per5 cent.

6 ‘‘(3) OUTCOME-MILESTONE PAYMENT SYS7 TEM.—

8 ‘‘(A) IN GENERAL.—The outcome-mile9 stone payment system shall consist of a pay10 ment structure governing employment networks

11 electing such system under paragraph (1)(A)

12 which meets the requirements of this para13 graph.

14 ‘‘(B) EARLY PAYMENTS UPON ATTAIN15 MENT OF MILESTONES IN ADVANCE OF OUT16 COME PAYMENT PERIODS.—The outcome-mile17 stone payment system shall provide for one or

18 more milestones, with respect to beneficiaries

19 receiving services from an employment network

20 under the Program, which are directed toward

21 the goal of permanent employment. Such mile22 stones shall form a part of a payment structure

23 which provides, in addition to payments made

24 during outcome payment periods, payments

25 made prior to outcome payment periods in
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•HR 1091 IH

1 amounts based on the attainment of such mile2 stones.

3 ‘‘(C) LIMITATION ON TOTAL PAYMENTS TO

4 EMPLOYMENT NETWORK.—The payment sched5 ule of the outcome milestone payment system

6 shall be designed so that the total of the pay7 ments to the employment network with respect

8 to each beneficiary is less than, on a net

9 present value basis (using an interest rate de10 termined by the Commissioner that appro11 priately reflects the cost of funds faced by pro12 viders), the total amount to which payments to

13 the employment network with respect to the

14 beneficiary would be limited if the employment

15 network were paid under the outcome payment

16 system.

17 ‘‘(4) DEFINITIONS.—For purposes of this

18 subsection—

19 ‘‘(A) PAYMENT CALCULATION BASE.—The

20 term ‘payment calculation base’ means, for any

21 calendar year—

22 ‘‘(i) in connection with a title II dis23 ability beneficiary, the average disability

24 insurance benefit payable under section
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•HR 1091 IH

1 223 for all beneficiaries for months during

2 the preceding calendar year; and

3 ‘‘(ii) in connection with a title XVI

4 disability beneficiary (who is not concur5 rently a title II disability beneficiary), the

6 average payment of supplemental security

7 income benefits based on disability payable

8 under title XVI (excluding State sup9 plementation) for months during the pre10 ceding calendar year to all beneficiaries

11 who have attained at least 18 years of age.

12 ‘‘(B) OUTCOME PAYMENT PERIOD.—The

13 term ‘outcome payment period’ means, in con14 nection with any individual who had assigned a

15 ticket to work and self-sufficiency to an employ16 ment network under the Program, a period—

17 ‘‘(i) beginning with the first month,

18 ending after the date on which such ticket

19 was assigned to the employment network,

20 for which benefits (described in paragraphs

21 (2) and (3) of subsection (k)) are not pay22 able to such individual by reason of en23 gagement in work activity; and

24 ‘‘(ii) ending with the 60th month

25 (consecutive or otherwise), ending after
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•HR 1091 IH

1 such date, for which such benefits are not

2 payable to such individual by reason of en3 gagement in work activity.

4 ‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF

5 PRESCRIBED SCHEDULES.—

6 ‘‘(A) PERCENTAGES AND PERIODS.—The

7 Commissioner of Social Security shall periodi8 cally review the percentage specified in para9 graph (2)(C), the total payments permissible

10 under paragraph (3)(C), and the period of time

11 specified in paragraph (4)(B) to determine

12 whether such percentages, such permissible pay13 ments, and such period provide an adequate in14 centive for employment networks to assist bene15 ficiaries to enter the workforce, while providing

16 for appropriate economies. The Commissioner

17 may alter such percentage, such total permis18 sible payments, or such period of time to the

19 extent that the Commissioner determines, on

20 the basis of the Commissioner’s review under

21 this paragraph, that such an alteration would

22 better provide the incentive and economies de23 scribed in the preceding sentence.

24 ‘‘(B) NUMBER AND AMOUNT OF MILE25 STONE PAYMENTS.—The Commissioner shall
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•HR 1091 IH

1 periodically review the number and amounts of

2 milestone payments established by the Commis3 sioner pursuant to this section to determine

4 whether they provide an adequate incentive for

5 employment networks to assist beneficiaries to

6 enter the workforce, taking into account infor7 mation provided to the Commissioner by pro8 gram managers, the Ticket to Work and Self9 Sufficiency Advisory Panel, and other reliable

10 sources. The Commissioner may from time to

11 time alter the number and amounts of mile12 stone payments initially established by the

13 Commissioner pursuant to this section to the

14 extent that the Commissioner determines that

15 such an alteration would allow an adequate in16 centive for employment networks to assist bene17 ficiaries to enter the workforce. Such alteration

18 shall be based on information provided to the

19 Commissioner by program managers, the Ticket

20 to Work and Self-Sufficiency Advisory Panel, or

21 other reliable sources.

22 ‘‘(i) SUSPENSION OF DISABILITY REVIEWS.—During

23 any period for which an individual is using a ticket to work

24 and self-sufficiency issued under this section, the Commis25 sioner (and any applicable State agency) may not initiate
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1 a continuing disability review or other review under section

2 221 of whether the individual is or is not under a disability

3 or a review under title XVI similar to any such review

4 under section 221.

5 ‘‘(j) AUTHORIZATIONS.—

6 ‘‘(1) TITLE II DISABILITY BENEFICIARIES.—

7 There are authorized to be transferred from the

8 Federal Old-Age and Survivors Insurance Trust

9 Fund and the Federal Disability Insurance Trust

10 Fund each fiscal year such sums as may be nec11 essary to carry out the provisions of this section

12 with respect to title II disability beneficiaries. Money

13 paid from the Trust Funds under this section with

14 respect to title II disability beneficiaries who are en15 titled to benefits under section 223 or who are enti16 tled to benefits under section 202(d) on the basis of

17 the wages and self-employment income of such bene18 ficiaries, shall be charged to the Federal Disability

19 Insurance Trust Fund, and all other money paid

20 from the Trust Funds under this section shall be

21 charged to the Federal Old-Age and Survivors Insur22 ance Trust Fund. The Commissioner of Social Secu23 rity shall determine according to such methods and

24 procedures as shall be prescribed under this

25 section—
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•HR 1091 IH

1 ‘‘(A) the total amount to be paid to pro2 gram managers and employment networks

3 under this section; and

4 ‘‘(B) subject to the provisions of the pre5 ceding sentence, the amount which should be

6 charged to each of the Trust Funds.

7 ‘‘(2) TITLE XVI DISABILITY BENEFICIARIES.—

8 Amounts authorized to be appropriated to the Social

9 Security Administration under section 1601 (as in

10 effect pursuant to the amendments made by section

11 301 of the Social Security Amendments of 1972)

12 shall include amounts necessary to carry out the

13 provisions of this section with respect to title XVI

14 disability beneficiaries.

15 ‘‘(k) DEFINITIONS.—For purposes of this section—

16 ‘‘(1) DISABLED BENEFICIARY.—The term ‘dis17 abled beneficiary’ means a title II disability bene18 ficiary or a title XVI disability beneficiary.

19 ‘‘(2) TITLE II DISABILITY BENEFICIARY.—The

20 term ‘title II disability beneficiary’ means an individ21 ual entitled to disability insurance benefits under

22 section 223 or to monthly insurance benefits under

23 section 202 based on such individual’s disability (as

24 defined in section 223(d)). An individual is a title II
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•HR 1091 IH

1 disability beneficiary for each month for which such

2 individual is entitled to such benefits.

3 ‘‘(3) TITLE XVI DISABILITY BENEFICIARY.—

4 The term ‘title XVI disability beneficiary’ means an

5 individual eligible for supplemental security income

6 benefits under title XVI on the basis of blindness

7 (within the meaning of section 1614(a)(2)) or dis8 ability (within the meaning of section 1614(a)(3)).

9 An individual is a title XVI disability beneficiary for

10 each month for which such individual is eligible for

11 such benefits.

12 ‘‘(4) SUPPLEMENTAL SECURITY INCOME BENE13 FIT.—The term ‘supplemental security income bene14 fit under title XVI’ means a cash benefit under sec15 tion 1611 or 1619(a), and does not include a State

16 supplementary payment, administered federally or

17 otherwise.

18 ‘‘(l) REGULATIONS.—The Commissioner of Social Se19 curity shall prescribe such regulations as are necessary to

20 carry out the provisions of this section.’’.

21 (b) CONFORMING AMENDMENTS.—

22 (1) AMENDMENTS TO TITLE II.—

23 (A) Section 221(c) of such Act (42 U.S.C.

24 421(c)) is amended by adding at the end the

25 following new paragraph:
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•HR 1091 IH

1 ‘‘(4) For suspension of reviews under this subsection

2 in the case of an individual using a ticket to work and

3 self-sufficiency, see section 1148(i).’’.

4 (B) Section 222(a) of such Act (42 U.S.C.

5 422(a)) is repealed.

6 (C) Section 222(b) of such Act (42 U.S.C.

7 422(b)) is repealed.

8 (D) Section 225(b)(1) of such Act (42

9 U.S.C. 425(b)(1)) is amended by striking ‘‘a

10 program of vocational rehabilitation services’’

11 and inserting ‘‘a program consisting of the

12 Ticket to Work and Self-Sufficiency Program

13 under section 1148 or another program of voca14 tional rehabilitation services, employment serv15 ices, or other support services’’.

16 (2) AMENDMENTS TO TITLE XVI.—

17 (A) Section 1615(a) of such Act (42

18 U.S.C. 1382d(a)) is amended to read as follows:

19 ‘‘SEC. 1615. (a) In the case of any blind or disabled

20 individual who—

21 ‘‘(1) has not attained age 16; and

22 ‘‘(2) with respect to whom benefits are paid

23 under this title,
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•HR 1091 IH

1 the Commissioner of Social Security shall make provision

2 for referral of such individual to the appropriate State

3 agency administering the State program under title V.’’.

4 (B) Section 1615(c) of such Act (42

5 U.S.C. 1382d(c)) is repealed.

6 (C) Section 1631(a)(6)(A) of such Act (42

7 U.S.C. 1383(a)(6)(A)) is amended by striking

8 ‘‘a program of vocational rehabilitation serv9 ices’’ and inserting ‘‘a program consisting of

10 the Ticket to Work and Self-Sufficiency Pro11 gram under section 1148 or another program of

12 vocational rehabilitation services, employment

13 services, or other support services’’.

14 (D) Section 1633(c) of such Act (42

15 U.S.C. 1383b(c)) is amended—

16 (i) by inserting ‘‘(1)’’ after ‘‘(c)’’; and

17 (ii) by adding at the end the following

18 new paragraph:

19 ‘‘(2) For suspension of continuing disability reviews

20 and other reviews under this title similar to reviews under

21 section 221 in the case of an individual using a ticket to

22 work and self-sufficiency, see section 1148(i).’’.

23 (c) SPECIFIC REGULATIONS REQUIRED.—

24 (1) IN GENERAL.—The Commissioner of Social

25 Security shall prescribe such regulations as are nec-
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1 essary to implement the amendments made by this

2 section.

3 (2) SPECIFIC MATTERS TO BE INCLUDED IN

4 REGULATIONS.—The matters which shall be ad5 dressed in such regulations shall include (but are not

6 limited to)—

7 (A) the form and manner in which tickets

8 to work and self-sufficiency may be distributed

9 to beneficiaries pursuant to section 1148(b)(1)

10 of such Act;

11 (B) the format and wording of such tick12 ets, which shall incorporate by reference any

13 contractual terms governing service by employ14 ment networks under the Program;

15 (C) the form and manner in which State

16 agencies may elect participation in the Ticket to

17 Work and Self-Sufficiency Program (and revoke

18 such an election) pursuant to section

19 1148(c)(1) of such Act and provision for peri20 odic opportunities for exercising such elections

21 (and revocations);

22 (D) the status of State agencies under sec23 tion 1148(c)(2) at the time that State agencies

24 exercise elections (and revocations) under such

25 section 1148(c)(1);
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1 (E) the terms of agreements to be entered

2 into with program managers pursuant to sec3 tion 1148(d) of such Act, including (but not

4 limited to)—

5 (i) the terms by which program man6 agers are precluded from direct participa7 tion in the delivery of services pursuant to

8 section 1148(d)(3) of such Act;

9 (ii) standards which must be met by

10 quality assurance measures referred to in

11 paragraph (6) of section 1148(d) and

12 methods of recruitment of employment net13 works utilized pursuant to paragraph (2)

14 of section 1148(e); and

15 (iii) the format under which dispute

16 resolution will operate under section

17 1148(d)(7).

18 (F) the terms of agreements to be entered

19 into with employment networks pursuant to sec20 tion 1148(d)(4) of such Act, including (but not

21 limited to)—

22 (i) the manner in which service areas

23 are specified pursuant to section

24 1148(f)(2)(A) of such Act;
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1 (ii) the general selection criteria and

2 the specific selection criteria which are ap3 plicable to employment networks under

4 section 1148(f)(2)(B) of such Act in select5 ing service providers;

6 (iii) specific requirements relating to

7 annual financial reporting by employment

8 networks pursuant to section 1148(f)(3) of

9 such Act; and

10 (iv) the national model to which peri11 odic outcomes reporting by employment

12 networks must conform under section

13 1148(f)(4) of such Act;

14 (G) standards which must be met by indi15 vidual work plans pursuant to section 1148(g)

16 of such Act;

17 (H) standards which must be met by pay18 ment systems required under section 1148(h) of

19 such Act, including (but not limited to)—

20 (i) the form and manner in which

21 elections by employment networks of pay22 ment systems are to be exercised pursuant

23 to section 1148(h)(1)(A);
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1 (ii) the terms which must be met by

2 an outcome payment system under section

3 1148(h)(2);

4 (iii) the terms which must be met by

5 an outcome-milestone payment system

6 under section 1148(h)(3);

7 (iv) any revision of the percentage

8 specified in paragraph (2)(C) of section

9 1148(h) of such Act or the period of time

10 specified in paragraph (4)(B) of such sec11 tion 1148(h); and

12 (v) annual oversight procedures for

13 such systems; and

14 (I) procedures for effective oversight of the

15 Program by the Commissioner of Social Secu16 rity, including periodic reviews and reporting

17 requirements.

18 (d) WORK INCENTIVE SPECIALISTS.—The Commis19 sioner shall establish a corps of trained, accessible, and

20 responsive work incentive specialists to specialize in title

21 II and title XVI disability work incentives for the purpose

22 of disseminating accurate information to disabled bene23 ficiaries (as defined in section 1148(k)(1) of the Social

24 Security Act as amended by this section) with respect to

25 inquiries and issues relating to work incentives.
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1 SEC. 202. EFFECTIVE DATE.

2 Subject to section 203, the amendments made by sec3 tion 201 shall take effect with the first month following

4 one year after the date of the enactment of this Act.

5 SEC. 203. GRADUATED IMPLEMENTATION OF PROGRAM.

6 (a) IN GENERAL.—Not later than one year after the

7 date of the enactment of this Act, the Commissioner of

8 Social Security shall commence implementation of the

9 amendments made by section 201 (other than paragraphs

10 (1)(C) and (2)(B) of section 201(b)) in graduated phases

11 at phase-in sites selected by the Commissioner. Such

12 phase-in sites shall be selected so as to ensure, prior to

13 full implementation of the Ticket to Work and Self-Suffi14 ciency Program, the development and refinement of refer15 ral processes, payment systems, computer linkages, man16 agement information systems, and administrative proc17 esses necessary to provide for full implementation of such

18 amendments. Section 202 shall apply with respect to para19 graphs (1)(C) and (2)(B) of section 201(b) without regard

20 to this section.

21 (b) REQUIREMENTS.—Implementation of the Pro22 gram at each phase-in site shall be carried out on a wide

23 enough scale to permit a thorough evaluation of the alter24 native methods under consideration, so as to ensure that

25 the most efficacious methods are determined and in place

26 for full implementation of the Program on a timely basis.
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1 (c) FULL IMPLEMENTATION.—The Commissioner

2 shall ensure that the Program is fully implemented as

3 soon as practicable on or after the effective date specified

4 in section 202 but not later than six years after such date.

5 (d) ONGOING EVALUATION OF PROGRAM.—

6 (1) IN GENERAL.—The Commissioner shall de7 sign and conduct a series of evaluations to assess

8 the cost-effectiveness of activities carried out under

9 this title and the amendments made thereby, as well

10 as the effects of this title and the amendments made

11 thereby on work outcomes for beneficiaries receiving

12 tickets to work and self-sufficiency under the Pro13 gram.

14 (2) METHODOLOGY.—

15 (A) DESIGN AND IMPLEMENTATION.—The

16 Commissioner shall design the series of evalua17 tions after receiving relevant advice from ex18 perts in the fields of disability, vocational reha19 bilitation, and program evaluation and individ20 uals using tickets to work and self-sufficiency

21 under the Program. In designing and carrying

22 out such evaluations, the Commissioner shall

23 consult with the Comptroller General of the

24 United States and other agencies of the Federal

25 Government and with private organizations with
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1 appropriate expertise. Before provision of serv2 ices begins under any phase of Program imple3 mentation, the Commissioner shall ensure that

4 plans for such evaluations and data collection

5 methods are in place and ready for implementa6 tion.

7 (B) SPECIFIC MATTERS TO BE AD8 DRESSED.—Each such evaluation shall address

9 (but is not limited to):

10 (i) the annual cost (including net

11 cost) of the Program and the annual cost

12 (including net cost) that would have been

13 incurred in the absence of the Program;

14 (ii) the determinants of return to

15 work, including the characteristics of bene16 ficiaries in receipt of tickets under the Pro17 gram;

18 (iii) the types of employment services,

19 vocational rehabilitation services, and other

20 support services furnished to beneficiaries

21 in receipt of tickets under the Program

22 who return to work and to those who do

23 not return to work;

24 (iv) the duration of employment serv25 ices, vocational rehabilitation services, and
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1 other support services furnished to bene2 ficiaries in receipt of tickets under the Pro3 gram who return to work and the duration

4 of such services furnished to those who do

5 not return to work and the cost to employ6 ment networks of furnishing such services;

7 (v) the employment outcomes, includ8 ing wages, occupations, benefits, and hours

9 worked, of beneficiaries who return to work

10 after receiving tickets under the Program

11 and those who return to work without re12 ceiving such tickets;

13 (vi) the characteristics of providers

14 whose services are provided within an em15 ployment network under the Program;

16 (vii) the extent (if any) to which em17 ployment networks display a greater will18 ingness to provide services to disabled

19 beneficiaries;

20 (viii) the characteristics (including

21 employment outcomes) of those bene22 ficiaries who receive services under the out23 come payment system and of those bene24 ficiaries who receive services under the out25 come-milestone payment system;
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1 (ix) measures of satisfaction among

2 beneficiaries in receipt of tickets under the

3 Program; and

4 (x) reasons for (including comments

5 solicited from beneficiaries regarding) their

6 choice not to use their tickets or their in7 ability to return to work despite the use of

8 thier tickets.

9 (3) PERIODIC EVALUATION REPORTS.—Follow10 ing the close of the third and fifth fiscal years end11 ing after the effective date under section 202, and

12 prior to the close of the seventh fiscal year ending

13 after such date, the Commissioner shall transmit to

14 the Committee on Ways and Means of the House of

15 Representatives and the Committee on Finance of

16 the Senate a report containing the Commissioner’s

17 evaluation of the progress of activities conducted

18 under the provisions of this section and the amend19 ments made thereby. Each such report shall set

20 forth the Commissioner’s evaluation of the extent to

21 which the Program has been successful and the

22 Commissioner’s conclusions on whether or how the

23 Program should be modified. Each such report shall

24 include such data, findings, materials, and rec-
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1 ommendations as the Commissioner may consider

2 appropriate.

3 (e) EXTENT OF STATE’S RIGHT OF FIRST REFUSAL

4 IN ADVANCE OF FULL IMPLEMENTATION OF AMEND5 MENTS IN SUCH STATE.—

6 (1) IN GENERAL.—In the case of any State in

7 which the amendments made by section 201 have

8 not been fully implemented pursuant to this section,

9 the Commissioner shall determine by regulation the

10 extent to which—

11 (A) the requirement under section 222(a)

12 of the Social Security Act for prompt referrals

13 to a State agency; and

14 (B) the authority of the Commissioner

15 under section 222(d)(2) of such Act to provide

16 vocational rehabilitation services in such State

17 by agreement or contract with other public or

18 private agencies, organizations, institutions, or

19 individuals,

20 shall apply in such State.

21 (2) EXISTING AGREEMENTS.—Nothing in para22 graph (1) or the amendments made by section 201

23 shall be construed to limit, impede, or otherwise af24 fect any agreement entered into pursuant to section

25 222(d)(2) of the Social Security Act before the date
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•HR 1091 IH

1 of the enactment of this Act with respect to services

2 provided pursuant to such agreement to beneficiaries

3 receiving services under such agreement as of such

4 date, except with respect to services (if any) to be

5 provided after six years after the effective date pro6 vided in section 202.

7 SEC. 204. THE TICKET TO WORK AND SELF-SUFFICIENCY

8 ADVISORY PANEL.

9 (a) ESTABLISHMENT.—There is established in the ex10 ecutive branch a panel to be known as the ‘‘Ticket to Work

11 and Self-Sufficiency Advisory Panel’’ (in this section re12 ferred to as the ‘‘Panel’’).

13 (b) DUTIES OF PANEL.—It shall be the duty of the

14 Panel to—

15 (1) advise the Commissioner of Social Security

16 on establishing phase-in sites for the Ticket to Work

17 and Self-Sufficiency Program and on fully imple18 menting the Program thereafter;

19 (2) advise the Commissioner with respect to the

20 refinement of access of disabled beneficiaries to em21 ployment networks, payment systems, and manage22 ment information systems and advise the Commis23 sioner whether such measures are being taken to the

24 extent necessary to ensure the success of the Pro25 gram;
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1 (3) advise the Commissioner regarding the most

2 effective designs for research and demonstration

3 projects associated with the Program or conducted

4 pursuant to section 205(a);

5 (4) advise the Commissioner on the develop6 ment of performance measurements relating to qual7 ity assurance under section 1148(d)(6) of the Social

8 Security Act; and

9 (5) furnish progress reports on the Program to

10 the President and each House of the Congress.

11 (c) MEMBERSHIP.—

12 (1) NUMBER AND APPOINTMENT.—The Panel

13 shall be composed of six members as follows:

14 (A) one member appointed by the Chair15 man of the Committee on Ways and Means of

16 the House of Representatives;

17 (B) one member appointed by the ranking

18 minority member of the Committee on Ways

19 and Means of the House of Representatives;

20 (C) one member appointed by the Chair21 man of the Committee on Finance of the Sen22 ate;

23 (D) one member appointed by the ranking

24 minority member of the Committee on Finance

25 of the Senate; and
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1 (E) two members appointed by the Presi2 dent, who may not be of the same political

3 party.

4 (2) REPRESENTATION.—Of the members ap5 pointed under paragraph (1), at least four shall have

6 experience or expert knowledge as a recipient, pro7 vider, employer, or employee in the fields of, or re8 lated to, employment services, vocational rehabilita9 tion services, and other support services, of whom—

10 (A) at least one shall represent the inter11 ests of recipients of employment services, voca12 tional rehabilitation services, and other support

13 services;

14 (B) at least one shall represent the inter15 ests of providers of employment services, voca16 tional rehabilitation services, and other support

17 services;

18 (C) at least one shall represent the inter19 ests of private employers;

20 (D) at least one shall represent the inter21 ests of employees; and

22 (E) at least one shall be an individual who

23 is or has been a recipient of benefits under title

24 II or title XVI based on disability.

25 (3) TERMS.—
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1 (A) IN GENERAL.—Each member shall be

2 appointed for a term of 4 years (or, if less, for

3 the remaining life of the Panel), except as pro4 vided in subparagraphs (B) and (C). The initial

5 members shall be appointed not later than 90

6 days after the date of the enactment of this

7 Act.

8 (B) TERMS OF INITIAL APPOINTEES.—As

9 designated by the President at the time of ap10 pointment, of the members first appointed—

11 (i) three of the members appointed

12 under paragraph (1) shall be appointed for

13 a term of 2 years; and

14 (ii) three of the members appointed

15 under paragraph (1) shall be appointed for

16 a term of 4 years.

17 (C) VACANCIES.—Any member appointed

18 to fill a vacancy occurring before the expiration

19 of the term for which the member’s predecessor

20 was appointed shall be appointed only for the

21 remainder of that term. A member may serve

22 after the expiration of that member’s term until

23 a successor has taken office. A vacancy in the

24 Panel shall be filled in the manner in which the

25 original appointment was made.
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1 (4) BASIC PAY.—Members shall each be paid at

2 a rate equal to the daily equivalent of the rate of

3 basic pay for level 4 of the Senior Executive Service,

4 as in effect from time to time under section 5382 of

5 title 5, United States Code, for each day (including

6 travel time) during which they are engaged in the

7 actual performance of duties vested in the Panel.

8 (5) TRAVEL EXPENSES.—Each member shall

9 receive travel expenses, including per diem in lieu of

10 subsistence, in accordance with sections 5702 and

11 5703 of title 5, United States Code.

12 (6) QUORUM.—Four members of the Panel

13 shall constitute a quorum but a lesser number may

14 hold hearings.

15 (7) CHAIRPERSON.—The Chairperson of the

16 Panel shall be designated by the President. The

17 term of office of the Chairperson shall be 4 years.

18 (8) MEETINGS.—The Panel shall meet at least

19 quarterly and at other times at the call of the Chair20 person or a majority of its members.

21 (d) DIRECTOR AND STAFF OF PANEL; EXPERTS AND

22 CONSULTANTS.—

23 (1) DIRECTOR.—The Panel shall have a Direc24 tor who shall be appointed by the Panel. The Direc25 tor shall be paid at a rate not to exceed the maxi-
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1 mum rate of pay payable for GS–15 of the General

2 Schedule.

3 (2) STAFF.—Subject to rules prescribed by the

4 Panel, the Director may appoint and fix the pay of

5 additional personnel as the Director considers appro6 priate.

7 (3) EXPERTS AND CONSULTANTS.—Subject to

8 rules prescribed by the Panel, the Director may pro9 cure temporary and intermittent services under sec10 tion 3109(b) of title 5, United States Code.

11 (4) STAFF OF FEDERAL AGENCIES.—Upon re12 quest of the Panel, the head of any Federal depart13 ment or agency may detail, on a reimbursable basis,

14 any of the personnel of that department or agency

15 to the Panel to assist it in carrying out its duties

16 under this Act.

17 (e) POWERS OF PANEL.—

18 (1) HEARINGS AND SESSIONS.—The Panel may,

19 for the purpose of carrying out its duties under this

20 subsection, hold such hearings, sit and act at such

21 times and places, and take such testimony and evi22 dence as the Panel considers appropriate.

23 (2) POWERS OF MEMBERS AND AGENTS.—Any

24 member or agent of the Panel may, if authorized by
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1 the Panel, take any action which the Panel is au2 thorized to take by this section.

3 (3) MAILS.—The Panel may use the United

4 States mails in the same manner and under the

5 same conditions as other departments and agencies

6 of the United States.

7 (4) ADMINISTRATIVE SUPPORT SERVICES.—

8 Upon the request of the Panel, the Administrator of

9 General Services shall provide to the Panel, on a re10 imbursable basis, the administrative support services

11 necessary for the Panel to carry out its duties under

12 this subsection.

13 (f) REPORTS.—

14 (1) INTERIM REPORTS.—The Panel shall sub15 mit to the President and the Congress interim re16 ports at least annually.

17 (2) FINAL REPORT.—The Panel shall transmit

18 a final report to the President and the Congress not

19 later than eight years after the date of the enact20 ment of this Act. The final report shall contain a de21 tailed statement of the findings and conclusions of

22 the Panel, together with its recommendations for

23 legislation and administrative actions which the

24 Panel considers appropriate.
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1 (g) TERMINATION.—The Panel shall terminate 30

2 days after the date of the submission of its final report

3 under subsection (f)(2).

4 (h) AUTHORIZATION OF APPROPRIATIONS.—There

5 are authorized to be appropriated from the Federal Old6 Age and Survivors Insurance Trust Fund, the Federal

7 Disability Insurance Trust Fund, and the general fund of

8 the Treasury, as appropriate, such sums as are necessary

9 to carry out this section.

10 SEC. 205. DEMONSTRATION PROJECTS AND STUDIES.

11 (a) DEMONSTRATION PROJECTS PROVIDING FOR RE12 DUCTIONS IN DISABILITY INSURANCE BENEFITS BASED

13 ON EARNINGS. —

14 (1) AUTHORITY.—The Commissioner shall con15 duct demonstration projects for the purpose of eval16 uating, through the collection of data, a program for

17 title II disability beneficiaries (as defined in section

18 1148(k)(2) of the Social Security Act, as amended

19 by this Act) under which each $1 of benefits payable

20 under section 223, or under section 202 based on

21 the beneficiary’s disability, is reduced for each $2 of

22 such beneficiary’s earnings that is above a level to

23 be determined by the Commissioner. Such projects

24 shall be conducted at a number of localities which

25 the Commissioner shall determine is sufficient to
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1 adequately evaluate the appropriateness of national

2 implementation of such a program. Such projects

3 shall identify reductions in Federal expenditures

4 that may result from the permanent implementation

5 of such a program.

6 (2) SCOPE AND SCALE AND MATTERS TO BE

7 DETERMINED.—

8 (A) IN GENERAL.—The demonstration

9 projects developed under paragraph (1) shall be

10 of sufficient duration, shall be of sufficient

11 scope, and shall be carried out on a wide

12 enough scale to permit a thorough evaluation of

13 the project to determine—

14 (i) the effects, if any, of induced entry

15 and reduced exit;

16 (ii) the extent, if any, to which the

17 project being tested is affected by whether

18 it is in operation in a locality within an

19 area under the administration of the Tick20 et to Work and Self-Sufficiency Program;

21 and

22 (iii) the savings that accrue to the

23 Trust Funds and other Federal programs

24 under the project being tested.
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1 The Commissioner shall take into account ad2 vice provided by the Ticket to Work and Self3 Sufficiency Advisory Panel pursuant to sub4 section (e)(2)(C).

5 (B) ADDITIONAL MATTERS.—The Commis6 sioner shall also determine with respect to each

7 project—

8 (i) the annual cost (including net

9 cost) of the project and the annual cost

10 (including net cost) that would have been

11 incurred in the absence of the project;

12 (ii) the determinants of return to

13 work, including the characteristics of the

14 beneficiaries who participate in the project;

15 and

16 (iii) the employment outcomes, includ17 ing wages, occupations, benefits, and hours

18 worked, of beneficiaries who return to work

19 as a result of participation in the project.

20 The Commissioner may include within the mat21 ters evaluated under the project the merits of

22 trial work periods and periods of extended eligi23 bility.

24 (3) WAIVERS.—The Commissioner may waive

25 compliance with the benefit provisions of title II of
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1 the Social Security Act, and the Secretary of Health

2 and Human Services may waive compliance with the

3 benefit requirements of title XVIII of such Act, in

4 so far as is necessary for a thorough evaluation of

5 the alternative methods under consideration. No

6 such project shall be actually placed in operation un7 less at least 90 days prior thereto a written report,

8 prepared for purposes of notification and informa9 tion only and containing a full and complete descrip10 tion thereof, has been transmitted by the Commis11 sioner to the Committee on Ways and Means of the

12 House of Representatives and to the Committee on

13 Finance of the Senate. Periodic reports on the

14 progress of such projects shall be submitted by the

15 Commissioner to such committees. When appro16 priate, such reports shall include detailed rec17 ommendations for changes in administration or law,

18 or both, to carry out the objectives stated in para19 graph (1).

20 (4) INTERIM REPORTS.—On or before June 9

21 in 2001 and each of the succeeding years thereafter,

22 the Commissioner shall submit to the Congress an

23 interim report on the progress of the demonstration

24 projects carried out under this subsection together
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1 with any related data and materials which the Com2 missioner may consider appropriate.

3 (5) FINAL REPORT.—The Commissioner shall

4 submit to the Congress a final report with respect

5 to all demonstration projects carried out under this

6 section no later than one year after their completion.

7 (6) EXPENDITURES.—Expenditures made for

8 demonstration projects under this subsection shall

9 be made from the Federal Disability Insurance

10 Trust Fund and the Federal Old-Age and Survivors

11 Insurance Trust Fund, as determined appropriate by

12 the Commissioner, and from the Federal Hospital

13 Insurance Trust Fund and the Federal Supple14 mentary Medical Insurance Trust Fund, as deter15 mined appropriate by the Secretary of Health and

16 Human Services, to the extent provided in advance

17 in appropriation Acts.

18 (b) STUDY BY GENERAL ACCOUNTING OFFICE OF

19 EXISTING DISABILITY-RELATED EMPLOYMENT INCEN20 TIVES.—

21 (1) STUDY.—As soon as practicable after the

22 date of the enactment of this Act, the Comptroller

23 General of the United States shall undertake a study

24 to assess existing tax credits and other disability-re25 lated employment incentives under the Americans
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1 with Disabilities Act of 1990 and other Federal

2 laws. In such study, the Comptroller General shall

3 specifically address the extent to which such credits

4 and other incentives would encourage employers to

5 hire and retain individuals with disabilities under the

6 Ticket to Work and Self-Sufficiency Program.

7 (2) REPORT.—Not later than 3 years after the

8 date of the enactment of this Act, the Comptroller

9 General shall transmit to the Committee on Ways

10 and Means of the House of Representatives and the

11 Committee on Finance of the Senate a written re12 port presenting the results of the Comptroller Gen13 eral’s study conducted pursuant to this subsection,

14 together with such recommendations for legislative

15 or administrative changes as the Comptroller Gen16 eral may determine to be appropriate.

17 (c) STUDY BY GENERAL ACCOUNTING OFFICE OF

18 EXISTING COORDINATION OF THE DI AND SSI PROGRAMS

19 AS THEY RELATE TO INDIVIDUALS ENTERING OR LEAV20 ING CONCURRENT ENTITLEMENT.—

21 (1) STUDY.—As soon as practicable after the

22 date of the enactment of this Act, the Comptroller

23 General of the United States shall undertake a study

24 to evaluate the coordination under current law of the

25 disability insurance program under title II of the So-
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1 cial Security Act and the supplemental security in2 come program under title XVI of such Act, as such

3 programs relate to individuals entering or leaving

4 concurrent entitlement under such programs. In

5 such study, the Comptroller General shall specifically

6 address the effectiveness of work incentives under

7 such programs with respect to such individuals and

8 the effectiveness of coverage of such individuals

9 under titles XVIII and XIX of such Act.

10 (2) REPORT.—Not later than 18 months after

11 the date of the enactment of this Act, the Comptrol12 ler General shall transmit to the Committee on

13 Ways and Means of the House of Representatives

14 and the Committee on Finance of the Senate a writ15 ten report presenting the results of the Comptroller

16 General’s study conducted pursuant to this sub17 section, together with such recommendations for leg18 islative or administrative changes as the Comptroller

19 General may determine to be appropriate.

20 TITLE III—TECHNICAL

21 AMENDMENTS

22 SEC. 301. TECHNICAL AMENDMENTS RELATING TO DRUG

23 ADDICTS AND ALCOHOLICS.

24 (a) CLARIFICATION RELATING TO THE EFFECTIVE

25 DATE OF THE DENIAL OF SOCIAL SECURITY DISABILITY
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1 BENEFITS TO DRUG ADDICTS AND ALCOHOLICS.—Sec2 tion 105(a)(5) of the Contract with America Advancement

3 Act of 1996 (Public Law 104–121; 110 Stat. 853) is

4 amended—

5 (1) in subparagraph (A), by striking ‘‘by the

6 Commissioner of Social Security’’ and ‘‘by the Com7 missioner’’; and

8 (2) by adding at the end the following:

9 ‘‘(D) For purposes of this paragraph, an

10 individual’s claim, with respect to benefits

11 under title II of the Social Security Act based

12 on disability, which has been denied in whole

13 before the date of enactment of this Act, may

14 not be considered to be finally adjudicated be15 fore such date if, on or after such date—

16 ‘‘(i) there is pending a request for ei17 ther administrative or judicial review with

18 respect to such claim, or

19 ‘‘(ii) there is pending, with respect to

20 such claim, a readjudication by the Com21 missioner of Social Security pursuant to

22 relief in a class action or implementation

23 by the Commissioner of a court remand

24 order.
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1 ‘‘(E) Notwithstanding the provisions of

2 this paragraph, with respect to any individual

3 for whom the Commissioner of Social Security

4 does not perform the entitlement redetermina5 tion before the date prescribed in subparagraph

6 (C), the Commissioner shall perform such enti7 tlement redetermination in lieu of a continuing

8 disability review whenever the Commissioner de9 termines that the individual’s entitlement is

10 subject to redetermination based on the preced11 ing provisions of this paragraph, and the provi12 sions of section 223(f) of the Social Security

13 Act shall not apply to such redetermination.’’.

14 (b) CORRECTION TO EFFECTIVE DATE OF PROVI15 SIONS CONCERNING REPRESENTATIVE PAYEES AND

16 TREATMENT REFERRALS OF SOCIAL SECURITY BENE17 FICIARIES WHO ARE DRUG ADDICTS AND ALCOHOLICS.—

18 Section 105(a)(5)(B) of the Contract with America Ad19 vancement Act of 1996 (42 U.S.C. 405 note) is amended

20 to read as follows:

21 ‘‘(B) The amendments made by para22 graphs (2) and (3) shall take effect on July 1,

23 1996, with respect to any individual—
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1 ‘‘(i) whose claim for benefits is finally

2 adjudicated on or after the date of enact3 ment of this Act; or

4 ‘‘(ii) whose entitlement to benefits is

5 based on an entitlement redetermination

6 made pursuant to subparagraph (C).’’.

7 (c) EFFECTIVE DATES.—The amendments made by

8 this section shall take effect as if included in the enact9 ment of section 105 of the Contract with America Ad10 vancement Act of 1996 (Public Law 104–121; 110 Stat.

11 852 et seq.).

12 SEC. 302. TREATMENT OF PRISONERS.

13 (a) IMPLEMENTATION OF PROHIBITION AGAINST

14 PAYMENT OF TITLE II BENEFITS TO PRISONERS.—

15 (1) IN GENERAL.—Section 202(x)(3) of the So16 cial Security Act (42 U.S.C. 402(x)(3)) is

17 amended—

18 (A) by inserting ‘‘(A)’’ after ‘‘(3)’’; and

19 (B) by adding at the end the following:

20 ‘‘(B)(i) The Commissioner shall enter into an agree21 ment under this subparagraph with any interested State

22 or local institution comprising a jail, prison, penal institu23 tion, or correctional facility, or comprising any other insti24 tution a purpose of which is to confine individuals as de25 scribed in paragraph (1)(A)(ii). Under such agreement—
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1 ‘‘(I) the institution shall provide to the Com2 missioner, on a monthly basis and in a manner spec3 ified by the Commissioner, the names, Social Secu4 rity account numbers, dates of birth, confinement

5 commencement dates, and, to the extent available to

6 the institution, such other identifying information

7 concerning the individuals confined in the institution

8 as the Commissioner may require for the purpose of

9 carrying out paragraph (1); and

10 ‘‘(II) the Commissioner shall pay to the institu11 tion, with respect to information described in sub12 clause (I) concerning each individual who is confined

13 therein as described in paragraph (1)(A), who re14 ceives a benefit under this title for the month pre15 ceding the first month of such confinement, and

16 whose benefit under this title is determined by the

17 Commissioner to be not payable by reason of con18 finement based on the information provided by the

19 institution, $400 (subject to reduction under clause

20 (ii)) if the institution furnishes the information to

21 the Commissioner within 30 days after the date such

22 individual’s confinement in such institution begins,

23 or $200 (subject to reduction under clause (ii)) if

24 the institution furnishes the information after 30
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1 days after such date but within 90 days after such

2 date.

3 ‘‘(ii) The dollar amounts specified in clause (i)(II)

4 shall be reduced by 50 percent if the Commissioner is also

5 required to make a payment to the institution with respect

6 to the same individual under an agreement entered into

7 under section 1611(e)(1)(I).

8 ‘‘(iii) The provisions of section 552a of title 5, United

9 States Code, shall not apply to any agreement entered into

10 under clause (i) or to information exchanged pursuant to

11 such agreement.

12 ‘‘(iv) There is authorized to be transferred from the

13 Federal Old-Age and Survivors Insurance Trust Fund and

14 the Federal Disability Insurance Trust Fund, as appro15 priate, such sums as may be necessary to enable the Com16 missioner to make payments to institutions required by

17 clause (i)(II).

18 ‘‘(v) The Commissioner is authorized to provide, on

19 a reimbursable basis, information obtained pursuant to

20 agreements entered into under clause (i) to any agency

21 administering a Federal or federally assisted cash, food,

22 or medical assistance program for eligibility purposes.’’.

23 (2) EFFECTIVE DATE.—The amendments made

24 by this subsection shall apply to individuals whose

25 period of confinement in an institution commences
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1 on or after the first day of the fourth month begin2 ning after the month in which this Act is enacted.

3 (b) ELIMINATION OF TITLE II REQUIREMENT THAT

4 CONFINEMENT STEM FROM CRIME PUNISHABLE BY IM5 PRISONMENT FOR MORE THAN 1 YEAR.—

6 (1) IN GENERAL.—Section 202(x)(1)(A) of the

7 Social Security Act (42 U.S.C. 402(x)(1)(A)) is

8 amended—

9 (A) in the matter preceding clause (i), by

10 striking ‘‘during’’ and inserting ‘‘throughout’’;

11 (B) in clause (i), by striking ‘‘an offense

12 punishable by imprisonment for more than 1

13 year (regardless of the actual sentence im14 posed)’’ and inserting ‘‘a criminal offense’’; and

15 (C) in clause (ii)(I), by striking ‘‘an of16 fense punishable by imprisonment for more

17 than 1 year’’ and inserting ‘‘a criminal of18 fense’’.

19 (2) EFFECTIVE DATE.—The amendments made

20 by this subsection shall apply to individuals whose

21 period of confinement in an institution commences

22 on or after the first day of the fourth month begin23 ning after the month in which this Act is enacted.

24 (c) CONFORMING TITLE XVI AMENDMENTS.—
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1 (1) FIFTY PERCENT REDUCTION IN TITLE XVI

2 PAYMENT IN CASE INVOLVING COMPARABLE TITLE II

3 PAYMENT.—Section 1611(e)(1)(I) of the Social Se4 curity Act (42 U.S.C. 1382(e)(1)(I)) is amended—

5 (A) in clause (i)(II), by inserting ‘‘(subject

6 to reduction under clause (ii))’’ after ‘‘$400’’

7 and after ‘‘$200’’;

8 (B) by redesignating clauses (ii) and (iii)

9 as clauses (iii) and (iv), respectively; and

10 (C) by inserting after clause (i) the follow11 ing:

12 ‘‘(ii) The dollar amounts specified in clause (i)(II)

13 shall be reduced by 50 percent if the Commissioner is also

14 required to make a payment to the institution with respect

15 to the same individual under an agreement entered into

16 under section 202(x)(3)(B).’’.

17 (2) EXPANSION OF CATEGORIES OF INSTITU18 TIONS ELIGIBLE TO ENTER INTO AGREEMENTS WITH

19 THE COMMISSIONER.—Section 1611(e)(1)(I)(i) of

20 the Social Security Act (42 U.S.C. 1382(e)(1)(I)(i))

21 is amended in the matter preceding subclause (I) by

22 striking ‘‘institution’’ and all that follows through

23 ‘‘section 202(x)(1)(A),’’ and inserting ‘‘institution

24 comprising a jail, prison, penal institution, or correc25 tional facility, or with any other interested State or
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1 local institution a purpose of which is to confine in2 dividuals as described in section 202(x)(1)(A)(ii),’’.

3 (3) EFFECTIVE DATE.—The amendments made

4 by this subsection shall take effect as if included in

5 the enactment of section 203(a) of the Personal Re6 sponsibility and Work Opportunity Reconciliation

7 Act of 1996 (Public Law 104–193; 110 Stat. 2186).

8 The reference to section 202(x)(1)(A)(ii) of the So9 cial Security Act in section 1611(e)(1)(I)(i) of the

10 Social Security Act as amended by paragraph (2)

11 shall be deemed a reference to such section

12 202(x)(1)(A)(ii) as amended by subsection (b)(1)(C).

13 (d) CONTINUED DENIAL OF BENEFITS TO SEX OF14 FENDERS REMAINING CONFINED TO PUBLIC INSTITU15 TIONS UPON COMPLETION OF PRISON TERM.—

16 (1) IN GENERAL.—Section 202(x)(1)(A) of the

17 Social Security Act (42 U.S.C. 402(x)(1)(A)) is

18 amended—

19 (A) in clause (i), by striking ‘‘or’’ at the

20 end;

21 (B) in clause (ii)(IV), by striking the pe22 riod and inserting ‘‘, or’’; and

23 (C) by adding at the end the following:

24 ‘‘(iii) immediately upon completion of confine25 ment as described in clause (i) pursuant to convic-
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1 tion of a criminal offense an element of which is sex2 ual activity, is confined by court order in an institu3 tion at public expense pursuant to a finding that the

4 individual is a sexually dangerous person or a sexual

5 predator or a similar finding.’’.

6 (2) CONFORMING AMENDMENT.—Section

7 202(x)(1)(B)(ii) of the Social Security Act (42

8 U.S.C. 402(x)(1)(B)(ii)) is amended by striking

9 ‘‘clause (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’.

10 (3) EFFECTIVE DATE.—The amendments made

11 by this subsection shall apply with respect to bene12 fits for months ending after the date of enactment

13 of this Act.

14 SEC 303. REVOCATION BY MEMBERS OF THE CLERGY OF

15 EXEMPTION FROM SOCIAL SECURITY COV16 ERAGE.

17 (a) IN GENERAL.—Notwithstanding section

18 1402(e)(4) of the Internal Revenue Code of 1986, any ex19 emption which has been received under section 1402(e)(1)

20 of such Code by a duly ordained, commissioned, or li21 censed minister of a church, a member of a religious order,

22 or a Christian Science practitioner, and which is effective

23 for the taxable year in which this Act is enacted, may be

24 revoked by filing an application therefore (in such form

25 and manner, and with such official, as may be prescribed
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1 in regulations made under chapter 2 of such Code), if such

2 application is filed no later than the due date of the Fed3 eral income tax return (including any extension thereof)

4 for the applicant’s second taxable year beginning after De5 cember 31, 1999. Any such revocation shall be effective

6 (for purposes of chapter 2 of the Internal Revenue Code

7 of 1986 and title II of the Social Security Act), as speci8 fied in the application, either with respect to the appli9 cant’s first taxable year beginning after December 31,

10 1999, or with respect to the applicant’s second taxable

11 year beginning after such date, and for all succeeding tax12 able years; and the applicant for any such revocation may

13 not thereafter again file application for an exemption

14 under such section 1402(e)(1). If the application is filed

15 after the due date of the applicant’s Federal income tax

16 return for a taxable year and is effective with respect to

17 that taxable year, it shall include or be accompanied by

18 payment in full of an amount equal to the total of the

19 taxes that would have been imposed by section 1401 of

20 the Internal Revenue Code of 1986 with respect to all of

21 the applicant’s income derived in that taxable year which

22 would have constituted net earnings from self-employment

23 for purposes of chapter 2 of such Code (notwithstanding

24 paragraph (4) or (5) of section 1402(c) of such Code) ex-
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1 cept for the exemption under section 1402(e)(1) of such

2 Code.

3 (b) EFFECTIVE DATE.—Subsection (a) shall apply

4 with respect to service performed (to the extent specified

5 in such subsection) in taxable years beginning after De6 cember 31, 1999, and with respect to monthly insurance

7 benefits payable under title II of the Social Security Act

8 on the basis of the wages and self-employment income of

9 any individual for months in or after the calendar year

10 in which such individual’s application for revocation (as

11 described in such subsection) is effective (and lump-sum

12 death payments payable under such title on the basis of

13 such wages and self-employment income in the case of

14 deaths occurring in or after such calendar year).

15 SEC. 304. ADDITIONAL TECHNICAL AMENDMENT RELATING

16 TO COOPERATIVE RESEARCH OR DEM17 ONSTRATION PROJECTS UNDER TITLES II

18 AND XVI.

19 (a) IN GENERAL.—Section 1110(a)(3) of the Social

20 Security Act (42 U.S.C. 1310(a)(3)) is amended by strik21 ing ‘‘title XVI’’ and inserting ‘‘title II or XVI’’.

22 (b) EFFECTIVE DATE.—The amendment made by

23 subsection (a) shall take effect as if included in the enact24 ment of the Social Security Independence and Program
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1 Improvements Act of 1994 (Public Law 103–296; 108

2 Stat. 1464).

3 SEC. 305. AUTHORIZATION FOR STATE TO PERMIT ANNUAL

4 WAGE REPORTS.

5 (a) IN GENERAL.—Section 1137(a)(3) of the Social

6 Security Act (42 U.S.C. 1320b–7(a)(3)) is amended by

7 inserting before the semicolon the following: ‘‘, and except

8 that in the case of wage reports with respect to domestic

9 service employment, a State may permit employers (as so

10 defined) that make returns with respect to such employ11 ment on a calendar year basis pursuant to section 3510

12 of the Internal Revenue Code of 1986 to make such re13 ports on an annual basis’’.

14 (b) TECHNICAL AMENDMENTS.—Section 1137(a)(3)

15 of the Social Security Act (42 U.S.C. 1320b–7(a)(3)) is

16 amended—

17 (1) by striking ‘‘(as defined in section

18 453A(a)(2)(B)(iii))’’; and

19 (2) by inserting ‘‘(as defined in section

20 453A(a)(2)(B))’’ after ‘‘employers’’ .

21 (c) EFFECTIVE DATE.—The amendments made by

22 this section shall apply to wage reports required to be sub23 mitted on and after the date of enactment of this Act.

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