106TH CONGRESS

1ST SESSION S. 331

AN ACT

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 such individuals with 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,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

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

5 ‘‘Work Incentives Improvement Act of 1999’’.
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1 (b) TABLE OF CONTENTS.—The table of contents of

2 this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings and purposes.

TITLE I—EXPANDED AVAILABILITY OF HEALTH CARE SERVICES

Sec. 101. Expanding State options under the medicaid program for workers

with disabilities.

Sec. 102. Continuation of medicare coverage for working individuals with disabilities.

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

working individuals with disabilities.

Sec. 104. Demonstration of coverage under the medicaid program of workers

with potentially severe disabilities.

Sec. 105. Election by disabled beneficiaries to suspend medigap insurance when

covered under a group health plan.

TITLE II—TICKET TO WORK AND SELF-SUFFICIENCY AND

RELATED PROVISIONS

Subtitle A—Ticket to Work and Self-Sufficiency

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

Subtitle B—Elimination of Work Disincentives

Sec. 211. Work activity standard as a basis for review of an individual’s disabled status.

Sec. 212. Expedited reinstatement of disability benefits.

Subtitle C—Work Incentives Planning, Assistance, and Outreach

Sec. 221. Work incentives outreach program.

Sec. 222. State grants for work incentives assistance to disabled beneficiaries.

TITLE III—DEMONSTRATION PROJECTS AND STUDIES

Sec. 301. Permanent extension of disability insurance program demonstration

project authority.

Sec. 302. Demonstration projects providing for reductions in disability insurance benefits based on earnings.

Sec. 303. Studies and reports.

TITLE IV—MISCELLANEOUS AND TECHNICAL AMENDMENTS

Sec. 401. Technical amendments relating to drug addicts and alcoholics.

Sec. 402. Treatment of prisoners.

Sec. 403. Revocation by members of the clergy of exemption from Social Security coverage.

Sec. 404. Additional technical amendment relating to cooperative research or

demonstration projects under titles II and XVI.

Sec. 405. Authorization for State to permit annual wage reports.
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1 SEC. 2. FINDINGS AND PURPOSES.

2 (a) FINDINGS.—Congress makes the following find3 ings:

4 (1) Health care is important to all Americans.

5 (2) Health care is particularly important to in6 dividuals with disabilities and special health care

7 needs who often cannot afford the insurance avail8 able to them through the private market, are unin9 surable by the plans available in the private sector,

10 and are at great risk of incurring very high and eco11 nomically devastating health care costs.

12 (3) Americans with significant disabilities often

13 are unable to obtain health care insurance that pro14 vides coverage of the services and supports that en15 able them to live independently and enter or rejoin

16 the workforce. Personal assistance services (such as

17 attendant services, personal assistance with trans18 portation to and from work, reader services, job

19 coaches, and related assistance) remove many of the

20 barriers between significant disability and work.

21 Coverage for such services, as well as for prescrip22 tion drugs, durable medical equipment, and basic

23 health care are powerful and proven tools for indi24 viduals with significant disabilities to obtain and re25 tain employment.
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1 (4) For individuals with disabilities, the fear of

2 losing health care and related services is one of the

3 greatest barriers keeping the individuals from maxi4 mizing their employment, earning potential, and

5 independence.

6 (5) Individuals with disabilities who are bene7 ficiaries under title II or XVI of the Social Security

8 Act (42 U.S.C. 401 et seq., 1381 et seq.) risk losing

9 medicare or medicaid coverage that is linked to their

10 cash benefits, a risk that is an equal, or greater,

11 work disincentive than the loss of cash benefits asso12 ciated with working.

(6) Currently, less than 1 13 ⁄2 of 1 percent of so14 cial security disability insurance and supplemental

15 security income beneficiaries cease to receive benefits

16 as a result of employment.

17 (7) Beneficiaries have cited the lack of adequate

18 employment training and placement services as an

19 additional barrier to employment.

(8) If an additional 1 20 ⁄2 of 1 percent of the cur21 rent social security disability insurance (DI) and

22 supplemental security income (SSI) recipients were

23 to cease receiving benefits as a result of employ24 ment, the savings to the Social Security Trust
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1 Funds in cash assistance would total

2 $3,500,000,000 over the worklife of the individuals.

3 (b) PURPOSES.—The purposes of this Act are as fol4 lows:

5 (1) To provide health care and employment

6 preparation and placement services to individuals

7 with disabilities that will enable those individuals to

8 reduce their dependency on cash benefit programs.

9 (2) To encourage States to adopt the option of

10 allowing individuals with disabilities to purchase

11 medicaid coverage that is necessary to enable such

12 individuals to maintain employment.

13 (3) To provide individuals with disabilities the

14 option of maintaining medicare coverage while work15 ing.

16 (4) To establish a return to work ticket pro17 gram that will allow individuals with disabilities to

18 seek the services necessary to obtain and retain em19 ployment and reduce their dependency on cash ben20 efit programs.
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1 TITLE I—EXPANDED AVAIL2 ABILITY OF HEALTH CARE

3 SERVICES

4 SEC. 101. EXPANDING STATE OPTIONS UNDER THE MED5 ICAID PROGRAM FOR WORKERS WITH DIS6 ABILITIES.

7 (a) IN GENERAL.—

8 (1) STATE OPTION TO ELIMINATE INCOME, AS9 SETS, AND RESOURCE LIMITATIONS FOR WORKERS

10 WITH DISABILITIES BUYING INTO MEDICAID.—Sec11 tion 1902(a)(10)(A)(ii) of the Social Security Act

12 (42 U.S.C. 1396a(a)(10)(A)(ii)) is amended—

13 (A) in subclause (XIII), by striking ‘‘or’’

14 at the end;

15 (B) in subclause (XIV), by adding ‘‘or’’ at

16 the end; and

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

18 ‘‘(XV) who, but for earnings in

19 excess of the limit established under

20 section 1905(q)(2)(B), would be con21 sidered to be receiving supplemental

22 security income, who is at least 16,

23 but less than 65, years of age, and

24 whose assets, resources, and earned or

25 unearned income (or both) do not ex-
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1 ceed such limitations (if any) as the

2 State may establish;’’.

3 (2) STATE OPTION TO PROVIDE OPPORTUNITY

4 FOR EMPLOYED INDIVIDUALS WITH A MEDICALLY

5 IMPROVED DISABILITY TO BUY INTO MEDICAID.—

6 (A) ELIGIBILITY.—Section 1902(a)(10)

7 (A)(ii) of the Social Security Act (42 U.S.C.

8 1396a(a)(10)(A)(ii)), as amended by paragraph

9 (1), is amended—

10 (i) in subclause (XIV), by striking

11 ‘‘or’’ at the end;

12 (ii) in subclause (XV), by adding ‘‘or’’

13 at the end; and

14 (iii) by adding at the end the fol15 lowing:

16 ‘‘(XVI) who are employed indi17 viduals with a medically improved dis18 ability described in section 1905(v)(1)

19 and whose assets, resources, and

20 earned or unearned income (or both)

21 do not exceed such limitations (if any)

22 as the State may establish, but only if

23 the State provides medical assistance

24 to individuals described in subclause

25 (XV);’’.
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1 (B) DEFINITION OF EMPLOYED INDIVID2 UALS WITH A MEDICALLY IMPROVED DIS3 ABILITY.—Section 1905 of the Social Security

4 Act (42 U.S.C. 1396d) is amended by adding at

5 the end the following:

6 ‘‘(v)(1) The term ‘employed individual with a medi7 cally improved disability’ means an individual who—

8 ‘‘(A) is at least 16, but less than 65, years of

9 age;

10 ‘‘(B) is employed (as defined in paragraph (2));

11 ‘‘(C) ceases to be eligible for medical assistance

12 under section 1902(a)(10)(A)(ii)(XV) because the

13 individual, by reason of medical improvement, is de14 termined at the time of a regularly scheduled con15 tinuing disability review to no longer be eligible for

16 benefits under section 223(d) or 1614(a)(3); and

17 ‘‘(D) continues to have a severe medically deter18 minable impairment, as determined under regula19 tions of the Secretary.

20 ‘‘(2) For purposes of paragraph (1), an individual is

21 considered to be ‘employed’ if the individual—

22 ‘‘(A) is earning at least the applicable minimum

23 wage requirement under section 6 of the Fair Labor

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

25 40 hours per month; or
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1 ‘‘(B) is engaged in a work effort that meets

2 substantial and reasonable threshold criteria for

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

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

5 (C) CONFORMING AMENDMENT.—Section

6 1905(a) of such Act (42 U.S.C. 1396d(a)) is

7 amended in the matter preceding paragraph

8 (1)—

9 (i) in clause (x), by striking ‘‘or’’ at

10 the end;

11 (ii) in clause (xi), by adding ‘‘or’’ at

12 the end; and

13 (iii) by inserting after clause (xi), the

14 following:

15 ‘‘(xii) employed individuals with a medically im16 proved disability (as defined in subsection (v)),’’.

17 (3) STATE AUTHORITY TO IMPOSE INCOME-RE18 LATED PREMIUMS AND COST-SHARING.—Section

19 1916 of such Act (42 U.S.C. 1396o) is amended—

20 (A) in subsection (a), by striking ‘‘The

21 State plan’’ and inserting ‘‘Subject to sub22 section (g), the State plan’’; and

23 (B) by adding at the end the following:
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1 ‘‘(g) With respect to individuals provided medical as2 sistance only under subclause (XV) or (XVI) of section

3 1902(a)(10)(A)(ii)—

4 ‘‘(1) a State may (in a uniform manner for in5 dividuals described in either such subclause)—

6 ‘‘(A) require such individuals to pay pre7 miums or other cost-sharing charges set on a

8 sliding scale based on income that the State

9 may determine; and

10 ‘‘(B) require payment of 100 percent of

11 such premiums for such year in the case of

12 such an individual who has income for a year

13 that exceeds 250 percent of the income official

14 poverty line (referred to in subsection (c)(1))

15 applicable to a family of the size involved, ex16 cept that in the case of such an individual who

17 has income for a year that does not exceed 450

18 percent of such poverty line, such requirement

19 may only apply to the extent such premiums do

20 not exceed 7.5 percent of such income; and

21 ‘‘(2) such State shall require payment of 100

22 percent of such premiums for a year by such an in23 dividual whose adjusted gross income (as defined in

24 section 62 of the Internal Revenue Code of 1986)

25 for such year exceeds $75,000, except that a State
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1 may choose to subsidize such premiums by using

2 State funds which may not be federally matched

3 under this title.

4 In the case of any calendar year beginning after 2000,

5 the dollar amount specified in paragraph (2) shall be in6 creased in accordance with the provisions of section

7 215(i)(2)(A)(ii).’’.

8 (4) PROHIBITION AGAINST SUPPLANTATION OF

9 STATE FUNDS AND STATE FAILURE TO MAINTAIN

10 EFFORT.—Section 1903(i) of such Act (42 U.S.C.

11 1396b(i)) is amended—

12 (A) by striking the period at the end of

13 paragraph (18) and inserting ‘‘; or’’; and

14 (B) by inserting after such paragraph the

15 following:

16 ‘‘(19) with respect to amounts expended for

17 medical assistance provided to an individual de18 scribed in subclause (XV) or (XVI) of section

19 1902(a)(10)(A)(ii) for a fiscal year unless the State

20 demonstrates to the satisfaction of the Secretary

21 that the level of State funds expended for such fiscal

22 year for programs to enable working individuals with

23 disabilities to work (other than for such medical as24 sistance) is not less than the level expended for such

25 programs during the most recent State fiscal year
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1 ending before the date of enactment of this para2 graph.’’.

3 (b) CONFORMING AMENDMENTS.—

4 (1) Section 1903(f)(4) of the Social Security

5 Act (42 U.S.C. 1396b(f)(4) is amended in the mat6 ter preceding subparagraph (A) by inserting

7 ‘‘1902(a)(10)(A)(ii)(XV), 1902(a)(10)(A)(ii)(XVI)’’

8 after ‘‘1902(a)(10)(A)(ii)(X),’’.

9 (2) Section 1903(f)(4) of such Act, as amended

10 by paragraph (1), is amended by inserting

11 ‘‘1902(a)(10)(A)(ii)(XIII),’’ before

12 ‘‘1902(a)(10)(A)(ii)(XV)’’.

13 (c) GAO REPORT.—Not later than 3 years after the

14 date of the enactment of this Act, the Comptroller General

15 of the United States shall submit a report to Congress

16 regarding the amendments made by this section that

17 examines—

18 (1) the extent to which higher health care costs

19 for individuals with disabilities at higher income lev20 els deter employment or progress in employment;

21 (2) whether such individuals have health insur22 ance coverage or could benefit from the State option

23 established under such amendments to provide a

24 medicaid buy-in; and
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1 (3) how the States are exercising such option,

2 including—

3 (A) how such States are exercising the

4 flexibility afforded them with regard to income

5 disregards;

6 (B) what income and premium levels have

7 been set;

8 (C) the degree to which States are sub9 sidizing premiums above the dollar amount

10 specified in section 1916(g)(2) of the Social Se11 curity Act (42 U.S.C. 1396o(g)(2)); and

12 (D) the extent to which there exists any

13 crowd-out effect.

14 (d) EFFECTIVE DATE.—

15 (1) IN GENERAL.—Except as provided in para16 graph (2), the amendments made by this section

17 apply to medical assistance for items and services

18 furnished on or after October 1, 1999.

19 (2) RETROACTIVITY OF CONFORMING AMEND20 MENT.—The amendment made by subsection (b)(2)

21 takes effect as if included in the enactment of the

22 Balanced Budget Act of 1997.

23 SEC. 102. CONTINUATION OF MEDICARE COVERAGE FOR

24 WORKING INDIVIDUALS WITH DISABILITIES.

25 (a) CONTINUATION OF COVERAGE.—
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1 (1) IN GENERAL.—Section 226 of the Social

2 Security Act (42 U.S.C. 426) is amended—

3 (A) in the third sentence of subsection (b),

4 by inserting ‘‘, except as provided in subsection

5 (j)’’ after ‘‘but not in excess of 24 such

6 months’’; and

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

8 ‘‘(j) The 24-month limitation on deemed entitlement

9 under the third sentence of subsection (b) shall not

10 apply—

11 ‘‘(1) for months occurring during the 6-year pe12 riod beginning with the first month that begins after

13 the date of enactment of this subsection; and

14 ‘‘(2) for subsequent months, in the case of an

15 individual who was entitled to benefits under sub16 section (b) as of the last month of such 6-year pe17 riod and would continue (but for such 24-month lim18 itation) to be so entitled.’’.

19 (2) CONFORMING AMENDMENT.—Section

20 1818A(a)(2)(C) of the Social Security Act (42

21 U.S.C. 1395i–2a(a)(2)(C)) is amended—

22 (A) by striking ‘‘solely’’; and

23 (B) by inserting ‘‘or the expiration of the

24 last month of the 6-year period described in

25 section 226(j)’’ before the semicolon.
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1 (b) GAO REPORT.—Not later than 4 years after the

2 date of the enactment of this Act, the Comptroller General

3 of the United States shall submit a report to Congress

4 that—

5 (1) examines the effectiveness and cost of sub6 section (j) of section 226 of the Social Security Act

7 (42 U.S.C. 426);

8 (2) examines the necessity and effectiveness of

9 providing the continuation of medicare coverage

10 under that subsection to individuals whose annual

11 income exceeds the contribution and benefit base (as

12 determined under section 230 of the Social Security

13 Act);

14 (3) examines the viability of providing the con15 tinuation of medicare coverage under that subsection

16 based on a sliding scale premium for individuals

17 whose annual income exceeds such contribution and

18 benefit base;

19 (4) examines the interrelation between the use

20 of the continuation of medicare coverage under that

21 subsection and the use of private health insurance

22 coverage by individuals during the 6-year period;

23 and
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1 (5) recommends whether that subsection should

2 continue to be applied beyond the 6-year period de3 scribed in the subsection.

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

5 subsection (a) apply to months beginning with the first

6 month that begins after the date of the enactment of this

7 Act.

8 (d) TREATMENT OF CERTAIN INDIVIDUALS.—An in9 dividual enrolled under section 1818A of the Social Secu10 rity Act (42 U.S.C. 1395i–2a) shall be treated with re11 spect to premium payment obligations under such section

12 as though the individual had continued to be entitled to

13 benefits under section 226(b) of such Act for—

14 (1) months described in section 226(j)(1) of

15 such Act (42 U.S.C. 426(j)(1)) (as added by sub16 section (a)); and

17 (2) subsequent months, in the case of an indi18 vidual who was so enrolled as of the last month de19 scribed in section 226(j)(2) of such Act (42 U.S.C.

20 426(j)(2)) (as so added).

21 SEC. 103. GRANTS TO DEVELOP AND ESTABLISH STATE IN22 FRASTRUCTURES TO SUPPORT WORKING IN23 DIVIDUALS WITH DISABILITIES.

24 (a) ESTABLISHMENT.—
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1 (1) IN GENERAL.—The Secretary of Health and

2 Human Services (in this section referred to as the

3 ‘‘Secretary’’) shall award grants described in sub4 section (b) to States to support the design, establish5 ment, and operation of State infrastructures that

6 provide items and services to support working indi7 viduals with disabilities.

8 (2) APPLICATION.—In order to be eligible for

9 an award of a grant under this section, a State shall

10 submit an application to the Secretary at such time,

11 in such manner, and containing such information as

12 the Secretary shall require.

13 (3) DEFINITION OF STATE.—In this section,

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

15 District of Columbia, Puerto Rico, Guam, the

16 United States Virgin Islands, American Samoa, and

17 the Commonwealth of the Northern Mariana Is18 lands.

19 (b) GRANTS FOR INFRASTRUCTURE AND OUT20 REACH.—

21 (1) IN GENERAL.—Out of the funds appro22 priated under subsection (e), the Secretary shall

23 award grants to States to—
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1 (A) support the establishment, implemen2 tation, and operation of the State infrastruc3 tures described in subsection (a); and

4 (B) conduct outreach campaigns regarding

5 the existence of such infrastructures.

6 (2) ELIGIBILITY FOR GRANTS.—

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

8 grant under this subsection unless the State—

9 (i) has an approved amendment to the

10 State plan under title XIX of the Social

11 Security Act (42 U.S.C. 1396 et seq.) that

12 provides medical assistance under such

13 plan to individuals described in section

14 1902(a)(10)(A)(ii)(XV) of the Social Secu15 rity Act (42 U.S.C.

16 1396a(a)(10)(A)(ii)(XV)); and

17 (ii) demonstrates to the satisfaction of

18 the Secretary that the State makes per19 sonal assistance services available under

20 the State plan under title XIX of the So21 cial Security Act (42 U.S.C. 1396 et seq.)

22 to the extent necessary to enable individ23 uals described in clause (i) to remain em24 ployed (as determined under section
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1 1905(v)(2) of the Social Security Act (42

2 U.S.C. 1396d(v)(2))).

3 (B) DEFINITION OF PERSONAL ASSIST4 ANCE SERVICES.—In this paragraph, the term

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

6 services, provided by 1 or more persons, de7 signed to assist an individual with a disability

8 to perform daily activities on and off the job

9 that the individual would typically perform if

10 the individual did not have a disability. Such

11 services shall be designed to increase the indi12 vidual’s control in life and ability to perform ev13 eryday activities on or off the job.

14 (3) DETERMINATION OF AWARDS.—

15 (A) IN GENERAL.—Subject to subpara16 graph (B), the Secretary shall determine a for17 mula for awarding grants to States under this

18 section that provides special consideration to

19 States that provide medical assistance under

20 title XIX of the Social Security Act to individ21 uals described in section

22 1902(a)(10)(A)(ii)(XVI) of that Act (42 U.S.C.

23 1396a(a)(10)(A)(ii)(XVI)).

24 (B) AWARD LIMITS.—

25 (i) MINIMUM AWARDS.—
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1 (I) IN GENERAL.—Subject to

2 subclause (II), no State with an ap3 proved application under this section

4 shall receive a grant for a fiscal year

5 that is less than $500,000.

6 (II) PRO RATA REDUCTIONS.—If

7 the funds appropriated under sub8 section (e) for a fiscal year are not

9 sufficient to pay each State with an

10 application approved under this sec11 tion the minimum amount described

12 in subclause (I), the Secretary shall

13 pay each such State an amount equal

14 to the pro rata share of the amount

15 made available.

16 (ii) MAXIMUM AWARDS.—No State

17 with an application that has been approved

18 under this section shall receive a grant for

19 a fiscal year that exceeds 15 percent of the

20 total expenditures by the State (including

21 the reimbursed Federal share of such ex22 penditures) for medical assistance for indi23 viduals eligible under subclause (XV) and

24 (XVI) of section 1902(a)(10)(A)(ii) of the

25 Social Security Act (42 U.S.C.
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1 1396a(a)(10)(A)(ii)), as estimated by the

2 State and approved by the Secretary.

3 (c) AVAILABILITY OF FUNDS.—

4 (1) FUNDS AWARDED TO STATES.—Funds

5 awarded to a State under a grant made under this

6 section for a fiscal year shall remain available until

7 expended.

8 (2) FUNDS NOT AWARDED TO STATES.—Funds

9 not awarded to States in the fiscal year for which

10 they are appropriated shall remain available in suc11 ceeding fiscal years for awarding by the Secretary.

12 (d) ANNUAL REPORT.—A State that is awarded a

13 grant under this section shall submit an annual report to

14 the Secretary on the use of funds provided under the

15 grant. Each report shall include the percentage increase

16 in the number of title II disability beneficiaries, as defined

17 in section 1148(k)(3) of the Social Security Act (as

18 amended by section 201) in the State, and title XVI dis19 ability beneficiaries, as defined in section 1148(k)(4) of

20 the Social Security Act (as so amended) in the State who

21 return to work.

22 (e) APPROPRIATION.—

23 (1) IN GENERAL.—Out of any funds in the

24 Treasury not otherwise appropriated, there is appro25 priated to make grants under this section—
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1 (A) for fiscal year 2000, $20,000,000;

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

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

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

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

6 (F) for each of fiscal years 2005 through

7 2010, the amount appropriated for the pre8 ceding fiscal year increased by the percentage

9 increase (if any) in the Consumer Price Index

10 for All Urban Consumers (United States city

11 average) for the preceding fiscal year.

12 (2) BUDGET AUTHORITY.—This subsection con13 stitutes budget authority in advance of appropria14 tions Acts and represents the obligation of the Fed15 eral Government to provide for the payment of the

16 amounts appropriated under paragraph (1).

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

18 2009, the Secretary, in consultation with the Work Incen19 tives Advisory Panel established under section 201(f),

20 shall submit a recommendation to the Committee on Com21 merce of the House of Representatives and the Committee

22 on Finance of the Senate regarding whether the grant pro23 gram established under this section should be continued

24 after fiscal year 2010.
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1 SEC. 104. DEMONSTRATION OF COVERAGE UNDER THE

2 MEDICAID PROGRAM OF WORKERS WITH PO3 TENTIALLY SEVERE DISABILITIES.

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

5 Secretary of Health and Human Services (in this section

6 referred to as the ‘‘Secretary’’) for approval of a dem7 onstration project (in this section referred to as a ‘‘dem8 onstration project’’) under which up to a specified max9 imum number of individuals who are workers with a po10 tentially severe disability (as defined in subsection (b)(1))

11 are provided medical assistance equal to that provided

12 under section 1905(a) of the Social Security Act (42

13 U.S.C. 1396d(a)) to individuals described in section

14 1902(a)(10)(A)(ii)(XV) of that Act (42 U.S.C.

15 1396a(a)(10)(A)(ii)(XV)).

16 (b) WORKER WITH A POTENTIALLY SEVERE DIS17 ABILITY DEFINED.—For purposes of this section—

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

19 potentially severe disability’’ means, with respect to

20 a demonstration project, an individual who—

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

22 of age;

23 (B) has a specific physical or mental im24 pairment that, as defined by the State under

25 the demonstration project, is reasonably ex26 pected, but for the receipt of items and services
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1 described in section 1905(a) of the Social Secu2 rity Act (42 U.S.C. 1396d(a)), to become blind

3 or disabled (as defined under section 1614(a) of

4 the Social Security Act (42 U.S.C. 1382c(a)));

5 and

6 (C) is employed (as defined in paragraph

7 (2)).

8 (2) DEFINITION OF EMPLOYED.—An individual

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

10 (A) is earning at least the applicable min11 imum wage requirement under section 6 of the

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

13 working at least 40 hours per month; or

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

15 substantial and reasonable threshold criteria for

16 hours of work, wages, or other measures, as de17 fined under the demonstration project and ap18 proved by the Secretary.

19 (c) APPROVAL OF DEMONSTRATION PROJECTS.—

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

21 the Secretary shall approve applications under sub22 section (a) that meet the requirements of paragraph

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

24 Secretary may require. The Secretary may waive the

25 requirement of section 1902(a)(1) of the Social Se-
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1 curity Act (42 U.S.C. 1396a(a)(1)) to allow for sub2 State demonstrations.

3 (2) TERMS AND CONDITIONS OF DEMONSTRA4 TION PROJECTS.—The Secretary may not approve a

5 demonstration project under this section unless the

6 State provides assurances satisfactory to the Sec7 retary that the following conditions are or will be

8 met:

9 (A) ELECTION OF OPTIONAL CATEGORY.—

10 The State has elected to provide coverage under

11 its plan under title XIX of the Social Security

12 Act of individuals described in section

13 1902(a)(10)(A)(ii)(XV) of the Social Security

14 Act (42 U.S.C. 1396a(a)(10)(A)(ii)(XV)).

15 (B) MAINTENANCE OF STATE EFFORT.—

16 Federal funds paid to a State pursuant to this

17 section must be used to supplement, but not

18 supplant, the level of State funds expended for

19 workers with potentially severe disabilities

20 under programs in effect for such individuals at

21 the time the demonstration project is approved

22 under this section.

23 (C) INDEPENDENT EVALUATION.—The

24 State provides for an independent evaluation of

25 the project.
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1 (3) LIMITATIONS ON FEDERAL FUNDING.—

2 (A) APPROPRIATION.—

3 (i) IN GENERAL.—Out of any funds in

4 the Treasury not otherwise appropriated,

5 there is appropriated to carry out this

6 section—

7 (I) for fiscal year 2000,

8 $72,000,000;

9 (II) for fiscal year 2001,

10 $74,000,000;

11 (III) for fiscal year 2002,

12 $78,000,000; and

13 (IV) for fiscal year 2003,

14 $81,000,000.

15 (ii) BUDGET AUTHORITY.—Clause (i)

16 constitutes budget authority in advance of

17 appropriations Acts and represents the ob18 ligation of the Federal Government to pro19 vide for the payment of the amounts ap20 propriated under clause (i).

21 (B) LIMITATION ON PAYMENTS.—In no

22 case may—

23 (i) except as provided in clause (ii),

24 the aggregate amount of payments made
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1 by the Secretary to States under this sec2 tion exceed $300,000,000;

3 (ii) the aggregate amount of payments

4 made by the Secretary to States for ad5 ministrative expenses relating to annual re6 ports required under subsection (d) exceed

7 $5,000,000; or

8 (iii) payments be provided by the Sec9 retary for a fiscal year after fiscal year

10 2005.

11 (C) FUNDS ALLOCATED TO STATES.—The

12 Secretary shall allocate funds to States based

13 on their applications and the availability of

14 funds. Funds allocated to a State under a grant

15 made under this section for a fiscal year shall

16 remain available until expended.

17 (D) FUNDS NOT ALLOCATED TO STATES.—

18 Funds not allocated to States in the fiscal year

19 for which they are appropriated shall remain

20 available in succeeding fiscal years for alloca21 tion by the Secretary using the allocation for22 mula established under this section.

23 (E) PAYMENTS TO STATES.—The Sec24 retary shall pay to each State with a dem25 onstration project approved under this section,
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1 from its allocation under subparagraph (C), an

2 amount for each quarter equal to the Federal

3 medical assistance percentage (as defined in

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

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

6 for medical assistance provided to workers with

7 a potentially severe disability.

8 (d) ANNUAL REPORT.—A State with a demonstration

9 project approved under this section shall submit an annual

10 report to the Secretary on the use of funds provided under

11 the grant. Each report shall include enrollment and finan12 cial statistics on—

13 (1) the total population of workers with poten14 tially severe disabilities served by the demonstration

15 project; and

16 (2) each population of such workers with a spe17 cific physical or mental impairment described in sub18 section (b)(1)(B) served by such project.

19 (e) RECOMMENDATION.—Not later than October 1,

20 2002, the Secretary shall submit a recommendation to the

21 Committee on Commerce of the House of Representatives

22 and the Committee on Finance of the Senate regarding

23 whether the demonstration project established under this

24 section should be continued after fiscal year 2003.
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1 (f) STATE DEFINED.—In this section, the term

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

3 title XIX of the Social Security Act (42 U.S.C. 1396 et

4 seq.).

5 SEC. 105. ELECTION BY DISABLED BENEFICIARIES TO SUS6 PEND MEDIGAP INSURANCE WHEN COVERED

7 UNDER A GROUP HEALTH PLAN.

8 (a) IN GENERAL.—Section 1882(q) of the Social Se9 curity Act (42 U.S.C. 1395ss(q)) is amended—

10 (1) in paragraph (5)(C), by inserting ‘‘or para11 graph (6)’’ after ‘‘this paragraph’’; and

12 (2) by adding at the end the following new

13 paragraph:

14 ‘‘(6) Each medicare supplemental policy shall

15 provide that benefits and premiums under the policy

16 shall be suspended at the request of the policyholder

17 if the policyholder is entitled to benefits under sec18 tion 226(b) and is covered under a group health

19 plan (as defined in section 1862(b)(1)(A)(v)). If

20 such suspension occurs and if the policyholder or

21 certificate holder loses coverage under the group

22 health plan, such policy shall be automatically re23 instituted (effective as of the date of such loss of

24 coverage) under terms described in subsection

25 (n)(6)(A)(ii) as of the loss of such coverage if the
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1 policyholder provides notice of loss of such coverage

2 within 90 days after the date of such loss.’’.

3 (b) EFFECTIVE DATE.—The amendments made by

4 subsection (a) apply with respect to requests made after

5 the date of the enactment of this Act.

6 TITLE II—TICKET TO WORK AND

7 SELF-SUFFICIENCY AND RE8 LATED PROVISIONS

9 Subtitle A—Ticket to Work and

10 Self-Sufficiency

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

12 SELF-SUFFICIENCY PROGRAM.

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

14 Security Act (42 U.S.C. 1301 et seq.) is amended by add15 ing after section 1147 (as added by section 8 of the Non16 citizen Benefit Clarification and Other Technical Amend17 ments Act of 1998 (Public Law 105–306; 112 Stat.

18 2928)) the following:

19 ‘‘TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM

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

21 shall establish a Ticket to Work and Self-Sufficiency Pro22 gram, under which a disabled beneficiary may use a ticket

23 to work and self-sufficiency issued by the Commissioner

24 in accordance with this section to obtain employment serv25 ices, vocational rehabilitation services, or other support

26 services from an employment network which is of the bene-
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1 ficiary’s choice and which is willing to provide such serv2 ices to the beneficiary.

3 ‘‘(b) TICKET SYSTEM.—

4 ‘‘(1) DISTRIBUTION OF TICKETS.—The Com5 missioner may issue a ticket to work and self-suffi6 ciency to disabled beneficiaries for participation in

7 the Program.

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

9 beneficiary holding a ticket to work and self-suffi10 ciency may assign the ticket to any employment net11 work of the beneficiary’s choice which is serving

12 under the Program and is willing to accept the as13 signment.

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

15 paragraph (1) shall consist of a document which evi16 dences the Commissioner’s agreement to pay (as

17 provided in paragraph (4)) an employment network,

18 which is serving under the Program and to which

19 such ticket is assigned by the beneficiary, for such

20 employment services, vocational rehabilitation serv21 ices, and other support services as the employment

22 network may provide to the beneficiary.

23 ‘‘(4) PAYMENTS TO EMPLOYMENT NET24 WORKS.—The Commissioner shall pay an employ25 ment network under the Program in accordance with
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1 the outcome payment system under subsection

2 (h)(2) or under the outcome-milestone payment sys3 tem under subsection (h)(3) (whichever is elected

4 pursuant to subsection (h)(1)). An employment net5 work may not request or receive compensation for

6 such services from the beneficiary.

7 ‘‘(c) STATE PARTICIPATION.—

8 ‘‘(1) IN GENERAL.—Each State agency admin9 istering or supervising the administration of the

10 State plan approved under title I of the Rehabilita11 tion Act of 1973 may elect to participate in the Pro12 gram as an employment network with respect to a

13 disabled beneficiary. If the State agency does elect

14 to participate in the Program, the State agency also

15 shall elect to be paid under the outcome payment

16 system or the outcome-milestone payment system in

17 accordance with subsection (h)(1). With respect to a

18 disabled beneficiary that the State agency does not

19 elect to have participate in the Program, the State

20 agency shall be paid for services provided to that

21 beneficiary under the system for payment applicable

22 under section 222(d) and subsections (d) and (e) of

23 section 1615. The Commissioner shall provide for

24 periodic opportunities for exercising such elections

25 (and revocations).
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1 ‘‘(2) EFFECT OF PARTICIPATION BY STATE

2 AGENCY.—

3 ‘‘(A) STATE AGENCIES PARTICIPATING.—

4 In any case in which a State agency described

5 in paragraph (1) elects under that paragraph to

6 participate in the Program, the employment

7 services, vocational rehabilitation services, and

8 other support services which, upon assignment

9 of tickets to work and self-sufficiency, are pro10 vided to disabled beneficiaries by the State

11 agency acting as an employment network shall

12 be governed by plans for vocational rehabilita13 tion services approved under title I of the Reha14 bilitation Act of 1973.

15 ‘‘(B) STATE AGENCIES ADMINISTERING

16 MATERNAL AND CHILD HEALTH SERVICES PRO17 GRAMS.—Subparagraph (A) shall not apply

18 with respect to any State agency administering

19 a program under title V of this Act.

20 ‘‘(3) SPECIAL REQUIREMENTS APPLICABLE TO

21 CROSS-REFERRAL TO CERTAIN STATE AGENCIES.—

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

23 an employment network has been assigned a

24 ticket to work and self-sufficiency by a disabled

25 beneficiary, no State agency shall be deemed re-
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1 quired, under this section, title I of the Work2 force Investment Act of 1998, title I of the Re3 habilitation Act of 1973, or a State plan ap4 proved under such title, to accept any referral

5 of such disabled beneficiary from such employ6 ment network unless such employment network

7 and such State agency have entered into a writ8 ten agreement that meets the requirements of

9 subparagraph (B). Any beneficiary who has as10 signed a ticket to work and self-sufficiency to

11 an employment network that has not entered

12 into such a written agreement with such a

13 State agency may not access vocational rehabili14 tation services under title I of the Rehabilita15 tion Act of 1973 until such time as the bene16 ficiary is reassigned to a State vocational reha17 bilitation agency by the Program Manager.

18 ‘‘(B) TERMS OF AGREEMENT.—An agree19 ment required by subparagraph (A) shall speci20 fy, in accordance with regulations prescribed

21 pursuant to subparagraph (C)—

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

23 employment network holding the ticket will

24 provide to the State agency—
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1 ‘‘(I) reimbursement for costs in2 curred in providing services described

3 in subparagraph (A) to the disabled

4 beneficiary; and

5 ‘‘(II) other amounts from pay6 ments made by the Commissioner to

7 the employment network pursuant to

8 subsection (h); and

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

10 required by such regulations.

11 ‘‘(C) REGULATIONS.—The Commissioner

12 and the Secretary of Education shall jointly

13 prescribe regulations specifying the terms of

14 agreements required by subparagraph (A) and

15 otherwise necessary to carry out the provisions

16 of this paragraph.

17 ‘‘(D) PENALTY.—No payment may be

18 made to an employment network pursuant to

19 subsection (h) in connection with services pro20 vided to any disabled beneficiary if such em21 ployment network makes referrals described in

22 subparagraph (A) in violation of the terms of

23 the agreement required under subparagraph (A)

24 or without having entered into such an agree25 ment.
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1 ‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER.—

2 ‘‘(1) SELECTION AND QUALIFICATIONS OF PRO3 GRAM MANAGERS.—The Commissioner shall enter

4 into agreements with 1 or more organizations in the

5 private or public sector for service as a program

6 manager to assist the Commissioner in admin7 istering the Program. Any such program manager

8 shall be selected by means of a competitive bidding

9 process, from among organizations in the private or

10 public sector with available expertise and experience

11 in the field of vocational rehabilitation and employ12 ment services.

13 ‘‘(2) TENURE, RENEWAL, AND EARLY TERMI14 NATION.—Each agreement entered into under para15 graph (1) shall provide for early termination upon

16 failure to meet performance standards which shall be

17 specified in the agreement and which shall be

18 weighted to take into account any performance in

19 prior terms. Such performance standards shall

20 include—

21 ‘‘(A) measures for ease of access by bene22 ficiaries to services; and

23 ‘‘(B) measures for determining the extent

24 to which failures in obtaining services for bene-
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1 ficiaries fall within acceptable parameters, as

2 determined by the Commissioner.

3 ‘‘(3) PRECLUSION FROM DIRECT PARTICIPA4 TION IN DELIVERY OF SERVICES IN OWN SERVICE

5 AREA.—Agreements under paragraph (1) shall

6 preclude—

7 ‘‘(A) direct participation by a program

8 manager in the delivery of employment services,

9 vocational rehabilitation services, or other sup10 port services to beneficiaries in the service area

11 covered by the program manager’s agreement;

12 and

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

14 a financial interest in an employment network

15 or service provider which provides services in a

16 geographic area covered under the program

17 manager’s agreement.

18 ‘‘(4) SELECTION OF EMPLOYMENT NET19 WORKS.—

20 ‘‘(A) IN GENERAL.—The Commissioner

21 shall select and enter into agreements with em22 ployment networks for service under the Pro23 gram. Such employment networks shall be in

24 addition to State agencies serving as employ-
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1 ment networks pursuant to elections under sub2 section (c).

3 ‘‘(B) ALTERNATE PARTICIPANTS.—In any

4 State where the Program is being implemented,

5 the Commissioner shall enter into an agreement

6 with any alternate participant that is operating

7 under the authority of section 222(d)(2) in the

8 State as of the date of enactment of this section

9 and chooses to serve as an employment network

10 under the Program.

11 ‘‘(5) TERMINATION OF AGREEMENTS WITH EM12 PLOYMENT NETWORKS.—The Commissioner shall

13 terminate agreements with employment networks for

14 inadequate performance, as determined by the Com15 missioner.

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

17 shall provide for such periodic reviews as are nec18 essary to provide for effective quality assurance in

19 the provision of services by employment networks.

20 The Commissioner shall solicit and consider the

21 views of consumers and the program manager under

22 which the employment networks serve and shall con23 sult with providers of services to develop perform24 ance measurements. The Commissioner shall ensure

25 that the results of the periodic reviews are made
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1 available to beneficiaries who are prospective service

2 recipients as they select employment networks. The

3 Commissioner shall ensure that the periodic surveys

4 of beneficiaries receiving services under the Program

5 are designed to measure customer service satisfac6 tion.

7 ‘‘(7) DISPUTE RESOLUTION.—The Commis8 sioner shall provide for a mechanism for resolving

9 disputes between beneficiaries and employment net10 works, between program managers and employment

11 networks, and between program managers and pro12 viders of services. The Commissioner shall afford a

13 party to such a dispute a reasonable opportunity for

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

15 ‘‘(e) PROGRAM MANAGERS.—

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

17 conduct tasks appropriate to assist the Commis18 sioner in carrying out the Commissioner’s duties in

19 administering the Program.

20 ‘‘(2) RECRUITMENT OF EMPLOYMENT NET21 WORKS.—A program manager shall recruit, and rec22 ommend for selection by the Commissioner, employ23 ment networks for service under the Program. The

24 program manager shall carry out such recruitment

25 and provide such recommendations, and shall mon-
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1 itor all employment networks serving in the Program

2 in the geographic area covered under the program

3 manager’s agreement, to the extent necessary and

4 appropriate to ensure that adequate choices of serv5 ices are made available to beneficiaries. Employment

6 networks may serve under the Program only pursu7 ant to an agreement entered into with the Commis8 sioner under the Program incorporating the applica9 ble provisions of this section and regulations there10 under, and the program manager shall provide and

11 maintain assurances to the Commissioner that pay12 ment by the Commissioner to employment networks

13 pursuant to this section is warranted based on com14 pliance by such employment networks with the terms

15 of such agreement and this section. The program

16 manager shall not impose numerical limits on the

17 number of employment networks to be recommended

18 pursuant to this paragraph.

19 ‘‘(3) FACILITATION OF ACCESS BY BENE20 FICIARIES TO EMPLOYMENT NETWORKS.—A pro21 gram manager shall facilitate access by beneficiaries

22 to employment networks. The program manager

23 shall ensure that each beneficiary is allowed changes

24 in employment networks for good cause, as deter25 mined by the Commissioner, without being deemed
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1 to have rejected services under the Program. The

2 program manager shall establish and maintain lists

3 of employment networks available to beneficiaries

4 and shall make such lists generally available to the

5 public. The program manager shall ensure that all

6 information provided to disabled beneficiaries pursu7 ant to this paragraph is provided in accessible for8 mats.

9 ‘‘(4) ENSURING AVAILABILITY OF ADEQUATE

10 SERVICES.—The program manager shall ensure that

11 employment services, vocational rehabilitation serv12 ices, and other support services are provided to

13 beneficiaries throughout the geographic area covered

14 under the program manager’s agreement, including

15 rural areas.

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

17 program manager shall take such measures as are

18 necessary to ensure that sufficient employment net19 works are available and that each beneficiary receiv20 ing services under the Program has reasonable ac21 cess to employment services, vocational rehabilitation

22 services, and other support services. Services pro23 vided under the Program may include case manage24 ment, work incentives planning, supported employ25 ment, career planning, career plan development, vo-
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1 cational assessment, job training, placement, fol2 lowup services, and such other services as may be

3 specified by the Commissioner under the Program.

4 The program manager shall ensure that such serv5 ices are available in each service area.

6 ‘‘(f) EMPLOYMENT NETWORKS.—

7 ‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET8 WORKS.—

9 ‘‘(A) IN GENERAL.—Each employment net10 work serving under the Program shall consist of

11 an agency or instrumentality of a State (or a

12 political subdivision thereof) or a private entity

13 that assumes responsibility for the coordination

14 and delivery of services under the Program to

15 individuals assigning to the employment net16 work tickets to work and self-sufficiency issued

17 under subsection (b).

18 ‘‘(B) ONE-STOP DELIVERY SYSTEMS.—An

19 employment network serving under the Pro20 gram may consist of a one-stop delivery system

21 established under subtitle B of title I of the

22 Workforce Investment Act of 1998.

23 ‘‘(C) COMPLIANCE WITH SELECTION CRI24 TERIA.—No employment network may serve

25 under the Program unless it meets and main-
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1 tains compliance with both general selection cri2 teria (such as professional and educational

3 qualifications (where applicable)) and specific

4 selection criteria (such as substantial expertise

5 and experience in providing relevant employ6 ment services and supports).

7 ‘‘(D) SINGLE OR ASSOCIATED PROVIDERS

8 ALLOWED.—An employment network shall con9 sist of either a single provider of such services

10 or of an association of such providers organized

11 so as to combine their resources into a single

12 entity. An employment network may meet the

13 requirements of subsection (e)(4) by providing

14 services directly, or by entering into agreements

15 with other individuals or entities providing ap16 propriate employment services, vocational reha17 bilitation services, or other support services.

18 ‘‘(2) REQUIREMENTS RELATING TO PROVISION

19 OF SERVICES.—Each employment network serving

20 under the Program shall be required under the

21 terms of its agreement with the Commissioner to—

22 ‘‘(A) serve prescribed service areas; and

23 ‘‘(B) take such measures as are necessary

24 to ensure that employment services, vocational

25 rehabilitation services, and other support serv-
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1 ices provided under the Program by, or under

2 agreements entered into with, the employment

3 network are provided under appropriate indi4 vidual work plans meeting the requirements of

5 subsection (g).

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

7 employment network shall meet financial reporting

8 requirements as prescribed by the Commissioner.

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

10 employment network shall prepare periodic reports,

11 on at least an annual basis, itemizing for the covered

12 period specific outcomes achieved with respect to

13 specific services provided by the employment net14 work. Such reports shall conform to a national

15 model prescribed under this section. Each employ16 ment network shall provide a copy of the latest re17 port issued by the employment network pursuant to

18 this paragraph to each beneficiary upon enrollment

19 under the Program for services to be received

20 through such employment network. Upon issuance of

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

22 shall be maintained in the files of the employment

23 network. The program manager shall ensure that

24 copies of all such reports issued under this para-
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1 graph are made available to the public under reason2 able terms.

3 ‘‘(g) INDIVIDUAL WORK PLANS.—

4 ‘‘(1) REQUIREMENTS.—Each employment net5 work shall—

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

7 to ensure that employment services, vocational

8 rehabilitation services, and other support serv9 ices provided under the Program by, or under

10 agreements entered into with, the employment

11 network are provided under appropriate indi12 vidual work plans that meet the requirements of

13 subparagraph (C);

14 ‘‘(B) develop and implement each such in15 dividual work plan in partnership with each

16 beneficiary receiving such services in a manner

17 that affords the beneficiary the opportunity to

18 exercise informed choice in selecting an employ19 ment goal and specific services needed to

20 achieve that employment goal;

21 ‘‘(C) ensure that each individual work plan

22 includes at least—

23 ‘‘(i) a statement of the vocational goal

24 developed with the beneficiary;
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1 ‘‘(ii) a statement of the services and

2 supports that have been deemed necessary

3 for the beneficiary to accomplish that goal;

4 ‘‘(iii) a statement of any terms and

5 conditions related to the provision of such

6 services and supports; and

7 ‘‘(iv) a statement of understanding re8 garding the beneficiary’s rights under the

9 Program (such as the right to retrieve the

10 ticket to work and self-sufficiency if the

11 beneficiary is dissatisfied with the services

12 being provided by the employment net13 work) and remedies available to the indi14 vidual, including information on the avail15 ability of advocacy services and assistance

16 in resolving disputes through the State

17 grant program authorized under section

18 1150;

19 ‘‘(D) provide a beneficiary the opportunity

20 to amend the individual work plan if a change

21 in circumstances necessitates a change in the

22 plan; and

23 ‘‘(E) make each beneficiary’s individual

24 work plan available to the beneficiary in, as ap-
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1 propriate, an accessible format chosen by the

2 beneficiary.

3 ‘‘(2) EFFECTIVE UPON WRITTEN APPROVAL.—

4 A beneficiary’s individual work plan shall take effect

5 upon written approval by the beneficiary or a rep6 resentative of the beneficiary and a representative of

7 the employment network that, in providing such

8 written approval, acknowledges assignment of the

9 beneficiary’s ticket to work and self-sufficiency.

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

11 ‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM12 PLOYMENT NETWORKS.—

13 ‘‘(A) IN GENERAL.—The Program shall

14 provide for payment authorized by the Commis15 sioner to employment networks under either an

16 outcome payment system or an outcome-mile17 stone payment system. Each employment net18 work shall elect which payment system will be

19 utilized by the employment network, and, for

20 such period of time as such election remains in

21 effect, the payment system so elected shall be

22 utilized exclusively in connection with such em23 ployment network (except as provided in sub24 paragraph (B)).
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1 ‘‘(B) NO CHANGE IN METHOD OF PAY2 MENT FOR BENEFICIARIES WITH TICKETS AL3 READY ASSIGNED TO THE EMPLOYMENT NET4 WORKS.—Any election of a payment system by

5 an employment network that would result in a

6 change in the method of payment to the em7 ployment network for services provided to a

8 beneficiary who is receiving services from the

9 employment network at the time of the election

10 shall not be effective with respect to payment

11 for services provided to that beneficiary and the

12 method of payment previously selected shall

13 continue to apply with respect to such services.

14 ‘‘(2) OUTCOME PAYMENT SYSTEM.—

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

16 system shall consist of a payment structure gov17 erning employment networks electing such sys18 tem under paragraph (1)(A) which meets the

19 requirements of this paragraph.

20 ‘‘(B) PAYMENTS MADE DURING OUTCOME

21 PAYMENT PERIOD.—The outcome payment sys22 tem shall provide for a schedule of payments to

23 an employment network in connection with each

24 individual who is a beneficiary for each month

25 during the individual’s outcome payment period
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1 for which benefits (described in paragraphs (3)

2 and (4) of subsection (k)) are not payable to

3 such individual because of work or earnings.

4 ‘‘(C) COMPUTATION OF PAYMENTS TO EM5 PLOYMENT NETWORK.—The payment schedule

6 of the outcome payment system shall be de7 signed so that—

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

9 months during the outcome payment pe10 riod for which benefits (described in para11 graphs (3) and (4) of subsection (k)) are

12 not payable is equal to a fixed percentage

13 of the payment calculation base for the cal14 endar year in which such month occurs;

15 and

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

17 percentage which does not exceed 40 per18 cent.

19 ‘‘(3) OUTCOME-MILESTONE PAYMENT SYS20 TEM.—

21 ‘‘(A) IN GENERAL.—The outcome-mile22 stone payment system shall consist of a pay23 ment structure governing employment networks

24 electing such system under paragraph (1)(A)
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1 which meets the requirements of this para2 graph.

3 ‘‘(B) EARLY PAYMENTS UPON ATTAIN4 MENT OF MILESTONES IN ADVANCE OF OUT5 COME PAYMENT PERIODS.—The outcome-mile6 stone payment system shall provide for 1 or

7 more milestones with respect to beneficiaries re8 ceiving services from an employment network

9 under the Program that are directed toward the

10 goal of permanent employment. Such milestones

11 shall form a part of a payment structure that

12 provides, in addition to payments made during

13 outcome payment periods, payments made prior

14 to outcome payment periods in amounts based

15 on the attainment of such milestones.

16 ‘‘(C) LIMITATION ON TOTAL PAYMENTS TO

17 EMPLOYMENT NETWORK.—The payment sched18 ule of the outcome-milestone payment system

19 shall be designed so that the total of the pay20 ments to the employment network with respect

21 to each beneficiary is less than, on a net

22 present value basis (using an interest rate de23 termined by the Commissioner that appro24 priately reflects the cost of funds faced by pro25 viders), the total amount to which payments to
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1 the employment network with respect to the

2 beneficiary would be limited if the employment

3 network were paid under the outcome payment

4 system.

5 ‘‘(4) DEFINITIONS.—In this subsection:

6 ‘‘(A) PAYMENT CALCULATION BASE.—The

7 term ‘payment calculation base’ means, for any

8 calendar year—

9 ‘‘(i) in connection with a title II dis10 ability beneficiary, the average disability

11 insurance benefit payable under section

12 223 for all beneficiaries for months during

13 the preceding calendar year; and

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

15 disability beneficiary (who is not concur16 rently a title II disability beneficiary), the

17 average payment of supplemental security

18 income benefits based on disability payable

19 under title XVI (excluding State sup20 plementation) for months during the pre21 ceding calendar year to all beneficiaries

22 who have attained age 18 but have not at23 tained age 65.

24 ‘‘(B) OUTCOME PAYMENT PERIOD.—The

25 term ‘outcome payment period’ means, in con-
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1 nection with any individual who had assigned a

2 ticket to work and self-sufficiency to an employ3 ment network under the Program, a period—

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

5 ending after the date on which such ticket

6 was assigned to the employment network,

7 for which benefits (described in paragraphs

8 (3) and (4) of subsection (k)) are not pay9 able to such individual by reason of en10 gagement in substantial gainful activity or

11 by reason of earnings from work activity;

12 and

13 ‘‘(ii) ending with the 60th month

14 (consecutive or otherwise), ending after

15 such date, for which such benefits are not

16 payable to such individual by reason of en17 gagement in substantial gainful activity or

18 by reason of earnings from work activity.

19 ‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF

20 PRESCRIBED SCHEDULES.—

21 ‘‘(A) PERCENTAGES AND PERIODS.—The

22 Commissioner shall periodically review the per23 centage specified in paragraph (2)(C), the total

24 payments permissible under paragraph (3)(C),

25 and the period of time specified in paragraph
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1 (4)(B) to determine whether such percentages,

2 such permissible payments, and such period

3 provide an adequate incentive for employment

4 networks to assist beneficiaries to enter the

5 workforce, while providing for appropriate

6 economies. The Commissioner may alter such

7 percentage, such total permissible payments, or

8 such period of time to the extent that the Com9 missioner determines, on the basis of the Com10 missioner’s review under this paragraph, that

11 such an alteration would better provide the in12 centive and economies described in the pre13 ceding sentence.

14 ‘‘(B) NUMBER AND AMOUNTS OF MILE15 STONE PAYMENTS.—The Commissioner shall

16 periodically review the number and amounts of

17 milestone payments established by the Commis18 sioner pursuant to this section to determine

19 whether they provide an adequate incentive for

20 employment networks to assist beneficiaries to

21 enter the workforce, taking into account infor22 mation provided to the Commissioner by pro23 gram managers, the Work Incentives Advisory

24 Panel established under section 201(f) of the

25 Work Incentives Improvement Act of 1999, and
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1 other reliable sources. The Commissioner may

2 from time to time alter the number and

3 amounts of milestone payments initially estab4 lished by the Commissioner pursuant to this

5 section to the extent that the Commissioner de6 termines that such an alteration would allow an

7 adequate incentive for employment networks to

8 assist beneficiaries to enter the workforce. Such

9 alteration shall be based on information pro10 vided to the Commissioner by program man11 agers, the Work Incentives Advisory Panel es12 tablished under section 201(f) of the Work In13 centives Improvement Act of 1999, or other re14 liable sources.

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

16 any period for which an individual is using, as defined by

17 the Commissioner, a ticket to work and self-sufficiency

18 issued under this section, the Commissioner (and any ap19 plicable State agency) may not initiate a continuing dis20 ability review or other review under section 221 of whether

21 the individual is or is not under a disability or a review

22 under title XVI similar to any such review under section

23 221.

24 ‘‘(j) ALLOCATION OF COSTS.—
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1 ‘‘(1) PAYMENTS TO EMPLOYMENT NET2 WORKS.—Payments to employment networks (in3 cluding State agencies that elect to participate in the

4 Program as an employment network) shall be made

5 from the Federal Old-Age and Survivors Insurance

6 Trust Fund or the Federal Disability Insurance

7 Trust Fund, as appropriate, in the case of ticketed

8 title II disability beneficiaries who return to work, or

9 from the appropriation made available for making

10 supplemental security income payments under title

11 XVI, in the case of title XVI disability beneficiaries

12 who return to work. With respect to ticketed bene13 ficiaries who concurrently are entitled to benefits

14 under title II and eligible for payments under title

15 XVI who return to work, the Commissioner shall al16 locate the cost of payments to employment networks

17 to which the tickets of such beneficiaries have been

18 assigned among such Trust Funds and appropria19 tion, as appropriate.

20 ‘‘(2) ADMINISTRATIVE EXPENSES.—The costs

21 of administering this section (other than payments

22 to employment networks) shall be paid from

23 amounts made available for the administration of

24 title II and amounts made available for the adminis-
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1 tration of title XVI, and shall be allocated among

2 those amounts as appropriate.

3 ‘‘(k) DEFINITIONS.—In this section:

4 ‘‘(1) COMMISSIONER.—The term ‘Commis5 sioner’ means the Commissioner of Social Security.

6 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis7 abled beneficiary’ means a title II disability bene8 ficiary or a title XVI disability beneficiary.

9 ‘‘(3) TITLE II DISABILITY BENEFICIARY.—The

10 term ‘title II disability beneficiary’ means an indi11 vidual entitled to disability insurance benefits under

12 section 223 or to monthly insurance benefits under

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

14 defined in section 223(d)). An individual is a title II

15 disability beneficiary for each month for which such

16 individual is entitled to such benefits.

17 ‘‘(4) TITLE XVI DISABILITY BENEFICIARY.—

18 The term ‘title XVI disability beneficiary’ means an

19 individual eligible for supplemental security income

20 benefits under title XVI on the basis of blindness

21 (within the meaning of section 1614(a)(2)) or dis22 ability (within the meaning of section 1614(a)(3)).

23 An individual is a title XVI disability beneficiary for

24 each month for which such individual is eligible for

25 such benefits.
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1 ‘‘(5) SUPPLEMENTAL SECURITY INCOME BEN2 EFIT UNDER TITLE XVI.—The term ‘supplemental

3 security income benefit under title XVI’ means a

4 cash benefit under section 1611 or 1619(a), and

5 does not include a State supplementary payment,

6 administered federally or otherwise.

7 ‘‘(l) REGULATIONS.—Not later than 1 year after the

8 date of enactment of this section, the Commissioner shall

9 prescribe such regulations as are necessary to carry out

10 the provisions of this section.’’.

11 (b) CONFORMING AMENDMENTS.—

12 (1) AMENDMENTS TO TITLE II.—

13 (A) Section 221(i) of the Social Security

14 Act (42 U.S.C. 421(i)) is amended by adding at

15 the end the following:

16 ‘‘(5) For suspension of reviews under this subsection

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

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

19 (B) Section 222(a) of the Social Security

20 Act (42 U.S.C. 422(a)) is repealed.

21 (C) Section 222(b) of the Social Security

22 Act (42 U.S.C. 422(b)) is repealed.

23 (D) Section 225(b)(1) of the Social Secu24 rity Act (42 U.S.C. 425(b)(1)) is amended by

25 striking ‘‘a program of vocational rehabilitation
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1 services’’ and inserting ‘‘a program consisting

2 of the Ticket to Work and Self-Sufficiency Pro3 gram under section 1148 or another program of

4 vocational rehabilitation services, employment

5 services, or other support services’’.

6 (2) AMENDMENTS TO TITLE XVI.—

7 (A) Section 1615(a) of the Social Security

8 Act (42 U.S.C. 1382d(a)) is amended to read

9 as follows:

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

11 individual who—

12 ‘‘(1) has not attained age 16, and

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

14 under this title,

15 the Commissioner of Social Security shall make provision

16 for referral of such individual to the appropriate State

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

18 (B) Section 1615(c) of the Social Security

19 Act (42 U.S.C. 1382d(c)) is repealed.

20 (C) Section 1631(a)(6)(A) of the Social

21 Security Act (42 U.S.C. 1383(a)(6)(A)) is

22 amended by striking ‘‘a program of vocational

23 rehabilitation services’’ and inserting ‘‘a pro24 gram consisting of the Ticket to Work and Self25 Sufficiency Program under section 1148 or an-
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1 other program of vocational rehabilitation serv2 ices, employment services, or other support

3 services’’.

4 (D) Section 1633(c) of the Social Security

5 Act (42 U.S.C. 1383b(c)) is amended—

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

7 (ii) by adding at the end the fol8 lowing:

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

10 and other reviews under this title similar to reviews under

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

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

13 (c) EFFECTIVE DATE.—Subject to subsection (d),

14 the amendments made by subsections (a) and (b) shall

15 take effect with the first month following 1 year after the

16 date of enactment of this Act.

17 (d) GRADUATED IMPLEMENTATION OF PROGRAM.—

18 (1) IN GENERAL.—Not later than 1 year after

19 the date of enactment of this Act, the Commissioner

20 of Social Security shall commence implementation of

21 the amendments made by this section (other than

22 paragraphs (1)(C) and (2)(B) of subsection (b)) in

23 graduated phases at phase-in sites selected by the

24 Commissioner. Such phase-in sites shall be selected

25 so as to ensure, prior to full implementation of the
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1 Ticket to Work and Self-Sufficiency Program, the

2 development and refinement of referral processes,

3 payment systems, computer linkages, management

4 information systems, and administrative processes

5 necessary to provide for full implementation of such

6 amendments. Subsection (c) shall apply with respect

7 to paragraphs (1)(C) and (2)(B) of subsection (b)

8 without regard to this subsection.

9 (2) REQUIREMENTS.—Implementation of the

10 Program at each phase-in site shall be carried out

11 on a wide enough scale to permit a thorough evalua12 tion of the alternative methods under consideration,

13 so as to ensure that the most efficacious methods

14 are determined and in place for full implementation

15 of the Program on a timely basis.

16 (3) FULL IMPLEMENTATION.—The Commis17 sioner shall ensure that the ability to provide tickets

18 and services to individuals under the Program exists

19 in every State as soon as practicable on or after the

20 effective date specified in subsection (c) but not later

21 than 3 years after such date.

22 (4) ONGOING EVALUATION OF PROGRAM.—

23 (A) IN GENERAL.—The Commissioner

24 shall design and conduct a series of evaluations

25 to assess the cost-effectiveness of activities car-
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1 ried out under this section and the amendments

2 made thereby, as well as the effects of this sec3 tion and the amendments made thereby on

4 work outcomes for beneficiaries receiving tickets

5 to work and self-sufficiency under the Program.

6 (B) CONSULTATION.—The Commissioner

7 shall design and carry out the series of evalua8 tions after receiving relevant advice from ex9 perts in the fields of disability, vocational reha10 bilitation, and program evaluation and individ11 uals using tickets to work and self-sufficiency

12 under the Program and consulting with the

13 Work Incentives Advisory Panel established

14 under section 201(f), the Comptroller General

15 of the United States, other agencies of the Fed16 eral Government, and private organizations

17 with appropriate expertise.

18 (C) METHODOLOGY.—

19 (i) IMPLEMENTATION.—The Commis20 sioner, in consultation with the Work In21 centives Advisory Panel established under

22 section 201(f), shall ensure that plans for

23 evaluations and data collection methods

24 under the Program are appropriately de-
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1 signed to obtain detailed employment infor2 mation.

3 (ii) SPECIFIC MATTERS TO BE AD4 DRESSED.—Each such evaluation shall ad5 dress (but is not limited to)—

6 (I) the annual cost (including net

7 cost) of the Program and the annual

8 cost (including net cost) that would

9 have been incurred in the absence of

10 the Program;

11 (II) the determinants of return to

12 work, including the characteristics of

13 beneficiaries in receipt of tickets

14 under the Program;

15 (III) the types of employment

16 services, vocational rehabilitation serv17 ices, and other support services fur18 nished to beneficiaries in receipt of

19 tickets under the Program who return

20 to work and to those who do not re21 turn to work;

22 (IV) the duration of employment

23 services, vocational rehabilitation serv24 ices, and other support services fur25 nished to beneficiaries in receipt of
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1 tickets under the Program who return

2 to work and the duration of such serv3 ices furnished to those who do not re4 turn to work and the cost to employ5 ment networks of furnishing such

6 services;

7 (V) the employment outcomes,

8 including wages, occupations, benefits,

9 and hours worked, of beneficiaries

10 who return to work after receiving

11 tickets under the Program and those

12 who return to work without receiving

13 such tickets;

14 (VI) the characteristics of pro15 viders whose services are provided

16 within an employment network under

17 the Program;

18 (VII) the extent (if any) to which

19 employment networks display a great20 er willingness to provide services to

21 beneficiaries with a range of disabil22 ities;

23 (VIII) the characteristics (includ24 ing employment outcomes) of those

25 beneficiaries who receive services
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1 under the outcome payment system

2 and of those beneficiaries who receive

3 services under the outcome-milestone

4 payment system;

5 (IX) measures of satisfaction

6 among beneficiaries in receipt of tick7 ets under the Program; and

8 (X) reasons for (including com9 ments solicited from beneficiaries re10 garding) their choice not to use their

11 tickets or their inability to return to

12 work despite the use of their tickets.

13 (D) PERIODIC EVALUATION REPORTS.—

14 Following the close of the third and fifth fiscal

15 years ending after the effective date under sub16 section (c), and prior to the close of the seventh

17 fiscal year ending after such date, the Commis18 sioner shall transmit to the Committee on Ways

19 and Means of the House of Representatives and

20 the Committee on Finance of the Senate a re21 port containing the Commissioner’s evaluation

22 of the progress of activities conducted under the

23 provisions of this section and the amendments

24 made thereby. Each such report shall set forth

25 the Commissioner’s evaluation of the extent to
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1 which the Program has been successful and the

2 Commissioner’s conclusions on whether or how

3 the Program should be modified. Each such re4 port shall include such data, findings, materials,

5 and recommendations as the Commissioner may

6 consider appropriate.

7 (5) EXTENT OF STATE’S RIGHT OF FIRST RE8 FUSAL IN ADVANCE OF FULL IMPLEMENTATION OF

9 AMENDMENTS IN SUCH STATE.—

10 (A) IN GENERAL.—In the case of any

11 State in which the amendments made by sub12 section (a) have not been fully implemented

13 pursuant to this subsection, the Commissioner

14 shall determine by regulation the extent to

15 which—

16 (i) the requirement under section

17 222(a) of the Social Security Act for

18 prompt referrals to a State agency, and

19 (ii) the authority of the Commissioner

20 under section 222(d)(2) of the Social Secu21 rity Act to provide vocational rehabilitation

22 services in such State by agreement or

23 contract with other public or private agen24 cies, organizations, institutions, or individ25 uals,
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1 shall apply in such State.

2 (B) EXISTING AGREEMENTS.—Nothing in

3 subparagraph (A) or the amendments made by

4 subsection (a) shall be construed to limit, im5 pede, or otherwise affect any agreement entered

6 into pursuant to section 222(d)(2) of the Social

7 Security Act before the date of enactment of

8 this Act with respect to services provided pursu9 ant to such agreement to beneficiaries receiving

10 services under such agreement as of such date,

11 except with respect to services (if any) to be

12 provided after 3 years after the effective date

13 provided in subsection (c).

14 (e) SPECIFIC REGULATIONS REQUIRED.—

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

16 Security shall prescribe such regulations as are nec17 essary to implement the amendments made by this

18 section.

19 (2) SPECIFIC MATTERS TO BE INCLUDED IN

20 REGULATIONS.—The matters which shall be ad21 dressed in such regulations shall include—

22 (A) the form and manner in which tickets

23 to work and self-sufficiency may be distributed

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

25 of the Social Security Act;
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1 (B) the format and wording of such tick2 ets, which shall incorporate by reference any

3 contractual terms governing service by employ4 ment networks under the Program;

5 (C) the form and manner in which State

6 agencies may elect participation in the Ticket to

7 Work and Self-Sufficiency Program (and revoke

8 such an election) pursuant to section

9 1148(c)(1) of the Social Security Act and provi10 sion for periodic opportunities for exercising

11 such elections (and revocations);

12 (D) the status of State agencies under sec13 tion 1148(c)(1) at the time that State agencies

14 exercise elections (and revocations) under that

15 section;

16 (E) the terms of agreements to be entered

17 into with program managers pursuant to sec18 tion 1148(d) of the Social Security Act,

19 including—

20 (i) the terms by which program man21 agers are precluded from direct participa22 tion in the delivery of services pursuant to

23 section 1148(d)(3) of the Social Security

24 Act;
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1 (ii) standards which must be met by

2 quality assurance measures referred to in

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

4 methods of recruitment of employment net5 works utilized pursuant to paragraph (2)

6 of section 1148(e); and

7 (iii) the format under which dispute

8 resolution will operate under section

9 1148(d)(7);

10 (F) the terms of agreements to be entered

11 into with employment networks pursuant to sec12 tion 1148(d)(4) of the Social Security Act,

13 including—

14 (i) the manner in which service areas

15 are specified pursuant to section

16 1148(f)(2)(A) of the Social Security Act;

17 (ii) the general selection criteria and

18 the specific selection criteria which are ap19 plicable to employment networks under

20 section 1148(f)(1)(C) of the Social Secu21 rity Act in selecting service providers;

22 (iii) specific requirements relating to

23 annual financial reporting by employment

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

25 the Social Security Act; and
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1 (iv) the national model to which peri2 odic outcomes reporting by employment

3 networks must conform under section

4 1148(f)(4) of the Social Security Act;

5 (G) standards which must be met by indi6 vidual work plans pursuant to section 1148(g)

7 of the Social Security Act;

8 (H) standards which must be met by pay9 ment systems required under section 1148(h) of

10 the Social Security Act, including—

11 (i) the form and manner in which

12 elections by employment networks of pay13 ment systems are to be exercised pursuant

14 to section 1148(h)(1)(A);

15 (ii) the terms which must be met by

16 an outcome payment system under section

17 1148(h)(2);

18 (iii) the terms which must be met by

19 an outcome-milestone payment system

20 under section 1148(h)(3);

21 (iv) any revision of the percentage

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

23 1148(h) of the Social Security Act or the

24 period of time specified in paragraph

25 (4)(B) of such section 1148(h); and
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1 (v) annual oversight procedures for

2 such systems; and

3 (I) procedures for effective oversight of the

4 Program by the Commissioner of Social Secu5 rity, including periodic reviews and reporting

6 requirements.

7 (f) WORK INCENTIVES ADVISORY PANEL.—

8 (1) ESTABLISHMENT.—There is established

9 within the Social Security Administration a panel to

10 be known as the ‘‘Work Incentives Advisory Panel’’

11 (in this subsection referred to as the ‘‘Panel’’).

12 (2) DUTIES OF PANEL.—It shall be the duty of

13 the Panel to—

14 (A) advise the President, Congress, and

15 the Commissioner of Social Security on issues

16 related to work incentives programs, planning,

17 and assistance for individuals with disabilities,

18 including work incentive provisions under titles

19 II, XI, XVI, XVIII, and XIX of the Social Se20 curity Act (42 U.S.C. 401 et seq., 1301 et seq.,

21 1381 et seq., 1395 et seq., 1396 et seq.); and

22 (B) with respect to the Ticket to Work and

23 Self-Sufficiency Program established under sec24 tion 1148 of the Social Security Act—
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1 (i) advise the Commissioner of Social

2 Security with respect to establishing phase3 in sites for such Program and fully imple4 menting the Program thereafter, the re5 finement of access of disabled beneficiaries

6 to employment networks, payment systems,

7 and management information systems, and

8 advise the Commissioner whether such

9 measures are being taken to the extent

10 necessary to ensure the success of the Pro11 gram;

12 (ii) advise the Commissioner regard13 ing the most effective designs for research

14 and demonstration projects associated with

15 the Program or conducted pursuant to sec16 tion 302;

17 (iii) advise the Commissioner on the

18 development of performance measurements

19 relating to quality assurance under section

20 1148(d)(6) of the Social Security Act; and

21 (iv) furnish progress reports on the

22 Program to the Commissioner and each

23 House of Congress.

24 (3) MEMBERSHIP.—
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1 (A) NUMBER AND APPOINTMENT.—The

2 Panel shall be composed of 12 members ap3 pointed as follows:

4 (i) 4 members appointed by the Presi5 dent.

6 (ii) 2 members appointed by the

7 Speaker of the House of Representatives,

8 in consultation with the chairman of the

9 Committee on Ways and Means of the

10 House of Representatives.

11 (iii) 2 members appointed by the Mi12 nority Leader of the House of Representa13 tives, in consultation with the ranking

14 member of the Committee on Ways and

15 Means of the House of Representatives.

16 (iv) 2 members appointed by the Ma17 jority Leader of the Senate, in consultation

18 with the chairman of the Committee on Fi19 nance of the Senate.

20 (v) 2 members appointed by the Mi21 nority Leader of the Senate, in consulta22 tion with the ranking member of the Com23 mittee on Finance of the Senate.

24 (B) REPRESENTATION.—All members ap25 pointed to the Panel shall have experience or
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1 expert knowledge in the fields of, or related to,

2 work incentive programs, employment services,

3 vocational rehabilitation services, health care

4 services, and other support services for individ5 uals with disabilities. At least one-half of the

6 members described in each clause of subpara7 graph (A) shall be individuals with disabilities,

8 or representatives of individuals with disabil9 ities, with consideration to current or former

10 title II disability beneficiaries or title XVI dis11 ability beneficiaries (as such terms are defined

12 in section 1148(k) of the Social Security Act

13 (as added by subsection (a)).

14 (C) TERMS.—

15 (i) IN GENERAL.—Each member shall

16 be appointed for a term of 4 years (or, if

17 less, for the remaining life of the Panel),

18 except as provided in clauses (ii) and (iii).

19 The initial members shall be appointed not

20 later than 90 days after the date of enact21 ment of this Act.

22 (ii) TERMS OF INITIAL AP23 POINTEES.—As designated by the Commis24 sioner at the time of appointment, of the

25 members first appointed—
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1 (I) one-half of the members ap2 pointed under each clause of subpara3 graph (A) shall be appointed for a

4 term of 2 years; and

5 (II) the remaining members ap6 pointed under each such clause shall

7 be appointed for a term of 4 years.

8 (iii) VACANCIES.—Any member ap9 pointed to fill a vacancy occurring before

10 the expiration of the term for which the

11 member’s predecessor was appointed shall

12 be appointed only for the remainder of that

13 term. A member may serve after the expi14 ration of that member’s term until a suc15 cessor has taken office. A vacancy in the

16 Panel shall be filled in the manner in

17 which the original appointment was made.

18 (D) BASIC PAY.—Members shall each be

19 paid at a rate, and in a manner, that is con20 sistent with guidelines established under section

21 7 of the Federal Advisory Committee Act (5

22 U.S.C. App.).

23 (E) TRAVEL EXPENSES.—Each member

24 shall receive travel expenses, including per diem

25 in lieu of subsistence, in accordance with sec-
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1 tions 5702 and 5703 of title 5, United States

2 Code.

3 (F) QUORUM.—Eight members of the

4 Panel shall constitute a quorum but a lesser

5 number may hold hearings.

6 (G) CHAIRPERSON.—The Chairperson of

7 the Panel shall be designated by the President.

8 The term of office of the Chairperson shall be

9 4 years.

10 (H) MEETINGS.—The Panel shall meet at

11 least quarterly and at other times at the call of

12 the Chairperson or a majority of its members.

13 (4) DIRECTOR AND STAFF OF PANEL; EXPERTS

14 AND CONSULTANTS.—

15 (A) DIRECTOR.—The Panel shall have a

16 Director who shall be appointed by the Commis17 sioner and paid at a rate, and in a manner,

18 that is consistent with guidelines established

19 under section 7 of the Federal Advisory Com20 mittee Act (5 U.S.C. App.).

21 (B) STAFF.—Subject to rules prescribed

22 by the Commissioner, the Director may appoint

23 and fix the pay of additional personnel as the

24 Director considers appropriate.
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1 (C) EXPERTS AND CONSULTANTS.—Sub2 ject to rules prescribed by the Commissioner,

3 the Director may procure temporary and inter4 mittent services under section 3109(b) of title

5 5, United States Code.

6 (D) STAFF OF FEDERAL AGENCIES.—

7 Upon request of the Panel, the head of any

8 Federal department or agency may detail, on a

9 reimbursable basis, any of the personnel of that

10 department or agency to the Panel to assist it

11 in carrying out its duties under this subsection.

12 (5) POWERS OF PANEL.—

13 (A) HEARINGS AND SESSIONS.—The Panel

14 may, for the purpose of carrying out its duties

15 under this subsection, hold such hearings, sit

16 and act at such times and places, and take such

17 testimony and evidence as the Panel considers

18 appropriate.

19 (B) POWERS OF MEMBERS AND AGENTS.—

20 Any member or agent of the Panel may, if au21 thorized by the Panel, take any action which

22 the Panel is authorized to take by this sub23 section.

24 (C) MAILS.—The Panel may use the

25 United States mails in the same manner and
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1 under the same conditions as other departments

2 and agencies of the United States.

3 (6) REPORTS.—

4 (A) INTERIM REPORTS.—The Panel shall

5 submit directly to the President and Congress

6 interim reports at least annually.

7 (B) FINAL REPORT.—The Panel shall

8 transmit a final report directly to the President

9 and Congress not later than 8 years after the

10 date of enactment of this Act. The final report

11 shall contain a detailed statement of the find12 ings and conclusions of the Panel, together with

13 its recommendations for legislation and admin14 istrative actions which the Panel considers ap15 propriate.

16 (7) TERMINATION.—The Panel shall terminate

17 30 days after the date of the submission of its final

18 report under paragraph (6)(B).

19 (8) ALLOCATION OF COSTS.—The costs of car20 rying out this subsection shall be paid from amounts

21 made available for the administration of title II of

22 the Social Security Act (42 U.S.C. 401 et seq.) and

23 amounts made available for the administration of

24 title XVI of that Act (42 U.S.C. 1381 et seq.), and
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1 shall be allocated among those amounts as appro2 priate.

3 Subtitle B—Elimination of Work

4 Disincentives

5 SEC. 211. WORK ACTIVITY STANDARD AS A BASIS FOR RE6 VIEW OF AN INDIVIDUAL’S DISABLED STATUS.

7 Section 221 of the Social Security Act (42 U.S.C.

8 421) is amended by adding at the end the following:

9 ‘‘(m)(1) In any case where an individual entitled to

10 disability insurance benefits under section 223 or to

11 monthly insurance benefits under section 202 based on

12 such individual’s disability (as defined in section 223(d))

13 has received such benefits for at least 24 months—

14 ‘‘(A) no continuing disability review conducted

15 by the Commissioner may be scheduled for the indi16 vidual solely as a result of the individual’s work ac17 tivity;

18 ‘‘(B) no work activity engaged in by the indi19 vidual may be used as evidence that the individual

20 is no longer disabled; and

21 ‘‘(C) no cessation of work activity by the indi22 vidual may give rise to a presumption that the indi23 vidual is unable to engage in work.

24 ‘‘(2) An individual to which paragraph (1) applies

25 shall continue to be subject to—
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1 ‘‘(A) continuing disability reviews on a regularly

2 scheduled basis that is not triggered by work; and

3 ‘‘(B) termination of benefits under this title in

4 the event that the individual has earnings that ex5 ceed the level of earnings established by the Com6 missioner to represent substantial gainful activity.’’.

7 SEC. 212. EXPEDITED REINSTATEMENT OF DISABILITY

8 BENEFITS.

9 (a) OASDI BENEFITS.—Section 223 of the Social

10 Security Act (42 U.S.C. 423) is amended—

11 (1) by redesignating subsection (i) as subsection

12 (j); and

13 (2) by inserting after subsection (h) the fol14 lowing:

15 ‘‘Reinstatement of Entitlement

16 ‘‘(i)(1)(A) Entitlement to benefits described in sub17 paragraph (B)(i)(I) shall be reinstated in any case where

18 the Commissioner determines that an individual described

19 in subparagraph (B) has filed a request for reinstatement

20 meeting the requirements of paragraph (2)(A) during the

21 period prescribed in subparagraph (C). Reinstatement of

22 such entitlement shall be in accordance with the terms of

23 this subsection.

24 ‘‘(B) An individual is described in this subparagraph

25 if—
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1 ‘‘(i) prior to the month in which the individual

2 files a request for reinstatement—

3 ‘‘(I) the individual was entitled to benefits

4 under this section or section 202 on the basis

5 of disability pursuant to an application filed

6 therefore; and

7 ‘‘(II) such entitlement terminated due to

8 the performance of substantial gainful activity;

9 ‘‘(ii) the individual is under a disability and the

10 physical or mental impairment that is the basis for

11 the finding of disability is the same as (or related

12 to) the physical or mental impairment that was the

13 basis for the finding of disability that gave rise to

14 the entitlement described in clause (i); and

15 ‘‘(iii) the individual’s disability renders the indi16 vidual unable to perform substantial gainful activity.

17 ‘‘(C)(i) Except as provided in clause (ii), the period

18 prescribed in this subparagraph with respect to an indi19 vidual is 60 consecutive months beginning with the month

20 following the most recent month for which the individual

21 was entitled to a benefit described in subparagraph

22 (B)(i)(I) prior to the entitlement termination described in

23 subparagraph (B)(i)(II).

24 ‘‘(ii) In the case of an individual who fails to file a

25 reinstatement request within the period prescribed in
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1 clause (i), the Commissioner may extend the period if the

2 Commissioner determines that the individual had good

3 cause for the failure to so file.

4 ‘‘(2)(A)(i) A request for reinstatement shall be filed

5 in such form, and containing such information, as the

6 Commissioner may prescribe.

7 ‘‘(ii) A request for reinstatement shall include express

8 declarations by the individual that the individual meets the

9 requirements specified in clauses (ii) and (iii) of para10 graph (1)(B).

11 ‘‘(B) A request for reinstatement filed in accordance

12 with subparagraph (A) may constitute an application for

13 benefits in the case of any individual who the Commis14 sioner determines is not entitled to reinstated benefits

15 under this subsection.

16 ‘‘(3) In determining whether an individual meets the

17 requirements of paragraph (1)(B)(ii), the provisions of

18 subsection (f) shall apply.

19 ‘‘(4)(A)(i) Subject to clause (ii), entitlement to bene20 fits reinstated under this subsection shall commence with

21 the benefit payable for the month in which a request for

22 reinstatement is filed.

23 ‘‘(ii) An individual whose entitlement to a benefit for

24 any month would have been reinstated under this sub25 section had the individual filed a request for reinstatement
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1 before the end of such month shall be entitled to such ben2 efit for such month if such request for reinstatement is

3 filed before the end of the twelfth month immediately suc4 ceeding such month.

5 ‘‘(B)(i) Subject to clauses (ii) and (iii), the amount

6 of the benefit payable for any month pursuant to the rein7 statement of entitlement under this subsection shall be de8 termined in accordance with the provisions of this title.

9 ‘‘(ii) For purposes of computing the primary insur10 ance amount of an individual whose entitlement to benefits

11 under this section is reinstated under this subsection, the

12 date of onset of the individual’s disability shall be the date

13 of onset used in determining the individual’s most recent

14 period of disability arising in connection with such benefits

15 payable on the basis of an application.

16 ‘‘(iii) Benefits under this section or section 202 pay17 able for any month pursuant to a request for reinstate18 ment filed in accordance with paragraph (2) shall be re19 duced by the amount of any provisional benefit paid to

20 such individual for such month under paragraph (7).

21 ‘‘(C) No benefit shall be payable pursuant to an enti22 tlement reinstated under this subsection to an individual

23 for any month in which the individual engages in substan24 tial gainful activity.
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1 ‘‘(D) The entitlement of any individual that is rein2 stated under this subsection shall end with the benefits

3 payable for the month preceding whichever of the following

4 months is the earliest:

5 ‘‘(i) The month in which the individual dies.

6 ‘‘(ii) The month in which the individual attains

7 retirement age.

8 ‘‘(iii) The third month following the month in

9 which the individual’s disability ceases.

10 ‘‘(5) Whenever an individual’s entitlement to benefits

11 under this section is reinstated under this subsection, enti12 tlement to benefits payable on the basis of such individ13 ual’s wages and self-employment income may be reinstated

14 with respect to any person previously entitled to such ben15 efits on the basis of an application if the Commissioner

16 determines that such person satisfies all the requirements

17 for entitlement to such benefits except requirements re18 lated to the filing of an application. The provisions of

19 paragraph (4) shall apply to the reinstated entitlement of

20 any such person to the same extent that they apply to

21 the reinstated entitlement of such individual.

22 ‘‘(6) An individual to whom benefits are payable

23 under this section or section 202 pursuant to a reinstate24 ment of entitlement under this subsection for 24 months

25 (whether or not consecutive) shall, with respect to benefits
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1 so payable after such twenty-fourth month, be deemed for

2 purposes of paragraph (1)(B)(i)(I) and the determination,

3 if appropriate, of the termination month in accordance

4 with subsection (a)(1) of this section, or subsection (d)(1),

5 (e)(1), or (f)(1) of section 202, to be entitled to such bene6 fits on the basis of an application filed therefore.

7 ‘‘(7)(A) An individual described in paragraph (1)(B)

8 who files a request for reinstatement in accordance with

9 the provisions of paragraph (2)(A) shall be entitled to pro10 visional benefits payable in accordance with this para11 graph, unless the Commissioner determines that the indi12 vidual does not meet the requirements of paragraph

13 (1)(B)(i) or that the individual’s declaration under para14 graph (2)(A)(ii) is false. Any such determination by the

15 Commissioner shall be final and not subject to review

16 under subsection (b) or (g) of section 205.

17 ‘‘(B) The amount of a provisional benefit for a month

18 shall equal the amount of the last monthly benefit payable

19 to the individual under this title on the basis of an applica20 tion increased by an amount equal to the amount, if any,

21 by which such last monthly benefit would have been in22 creased as a result of the operation of section 215(i).

23 ‘‘(C)(i) Provisional benefits shall begin with the

24 month in which a request for reinstatement is filed in ac25 cordance with paragraph (2)(A).
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1 ‘‘(ii) Provisional benefits shall end with the earliest

2 of—

3 ‘‘(I) the month in which the Commissioner

4 makes a determination regarding the individual’s en5 titlement to reinstated benefits;

6 ‘‘(II) the fifth month following the month de7 scribed in clause (i);

8 ‘‘(III) the month in which the individual per9 forms substantial gainful activity; or

10 ‘‘(IV) the month in which the Commissioner de11 termines that the individual does not meet the re12 quirements of paragraph (1)(B)(i) or that the indi13 vidual’s declaration made in accordance with para14 graph (2)(A)(ii) is false.

15 ‘‘(D) In any case in which the Commissioner deter16 mines that an individual is not entitled to reinstated bene17 fits, any provisional benefits paid to the individual under

18 this paragraph shall not be subject to recovery as an over19 payment unless the Commissioner determines that the in20 dividual knew or should have known that the individual

21 did not meet the requirements of paragraph (1)(B).’’.

22 (b) SSI BENEFITS.—

23 (1) IN GENERAL.—Section 1631 of the Social

24 Security Act (42 U.S.C. 1383) is amended by add25 ing at the end the following:
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1 ‘‘Reinstatement of Eligibility on the Basis of Blindness

2 or Disability

3 ‘‘(p)(1)(A) Eligibility for benefits under this title

4 shall be reinstated in any case where the Commissioner

5 determines that an individual described in subparagraph

6 (B) has filed a request for reinstatement meeting the re7 quirements of paragraph (2)(A) during the period pre8 scribed in subparagraph (C). Reinstatement of eligibility

9 shall be in accordance with the terms of this subsection.

10 ‘‘(B) An individual is described in this subparagraph

11 if—

12 ‘‘(i) prior to the month in which the individual

13 files a request for reinstatement—

14 ‘‘(I) the individual was eligible for benefits

15 under this title on the basis of blindness or dis16 ability pursuant to an application filed there17 fore; and

18 ‘‘(II) the individual thereafter was ineli19 gible for such benefits due to earned income (or

20 earned and unearned income) for a period of 12

21 or more consecutive months;

22 ‘‘(ii) the individual is blind or disabled and the

23 physical or mental impairment that is the basis for

24 the finding of blindness or disability is the same as

25 (or related to) the physical or mental impairment
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1 that was the basis for the finding of blindness or

2 disability that gave rise to the eligibility described in

3 clause (i);

4 ‘‘(iii) the individual’s blindness or disability ren5 ders the individual unable to perform substantial

6 gainful activity; and

7 ‘‘(iv) the individual satisfies the nonmedical re8 quirements for eligibility for benefits under this title.

9 ‘‘(C)(i) Except as provided in clause (ii), the period

10 prescribed in this subparagraph with respect to an indi11 vidual is 60 consecutive months beginning with the month

12 following the most recent month for which the individual

13 was eligible for a benefit under this title (including section

14 1619) prior to the period of ineligibility described in sub15 paragraph (B)(i)(II).

16 ‘‘(ii) In the case of an individual who fails to file a

17 reinstatement request within the period prescribed in

18 clause (i), the Commissioner may extend the period if the

19 Commissioner determines that the individual had good

20 cause for the failure to so file.

21 ‘‘(2)(A)(i) A request for reinstatement shall be filed

22 in such form, and containing such information, as the

23 Commissioner may prescribe.

24 ‘‘(ii) A request for reinstatement shall include express

25 declarations by the individual that the individual meets the
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1 requirements specified in clauses (ii) through (iv) of para2 graph (1)(B).

3 ‘‘(B) A request for reinstatement filed in accordance

4 with subparagraph (A) may constitute an application for

5 benefits in the case of any individual who the Commis6 sioner determines is not eligible for reinstated benefits

7 under this subsection.

8 ‘‘(3) In determining whether an individual meets the

9 requirements of paragraph (1)(B)(ii), the provisions of

10 section 1614(a)(4) shall apply.

11 ‘‘(4)(A) Eligibility for benefits reinstated under this

12 subsection shall commence with the benefit payable for the

13 month following the month in which a request for rein14 statement is filed.

15 ‘‘(B)(i) Subject to clause (ii), the amount of the ben16 efit payable for any month pursuant to the reinstatement

17 of eligibility under this subsection shall be determined in

18 accordance with the provisions of this title.

19 ‘‘(ii) The benefit under this title payable for any

20 month pursuant to a request for reinstatement filed in ac21 cordance with paragraph (2) shall be reduced by the

22 amount of any provisional benefit paid to such individual

23 for such month under paragraph (7).

24 ‘‘(C) Except as otherwise provided in this subsection,

25 eligibility for benefits under this title reinstated pursuant
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1 to a request filed under paragraph (2) shall be subject

2 to the same terms and conditions as eligibility established

3 pursuant to an application filed therefore.

4 ‘‘(5) Whenever an individual’s eligibility for benefits

5 under this title is reinstated under this subsection, eligi6 bility for such benefits shall be reinstated with respect to

7 the individual’s spouse if such spouse was previously an

8 eligible spouse of the individual under this title and the

9 Commissioner determines that such spouse satisfies all the

10 requirements for eligibility for such benefits except re11 quirements related to the filing of an application. The pro12 visions of paragraph (4) shall apply to the reinstated eligi13 bility of the spouse to the same extent that they apply

14 to the reinstated eligibility of such individual.

15 ‘‘(6) An individual to whom benefits are payable

16 under this title pursuant to a reinstatement of eligibility

17 under this subsection for twenty-four months (whether or

18 not consecutive) shall, with respect to benefits so payable

19 after such twenty-fourth month, be deemed for purposes

20 of paragraph (1)(B)(i)(I) to be eligible for such benefits

21 on the basis of an application filed therefore.

22 ‘‘(7)(A) An individual described in paragraph (1)(B)

23 who files a request for reinstatement in accordance with

24 the provisions of paragraph (2)(A) shall be eligible for pro25 visional benefits payable in accordance with this para-
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1 graph, unless the Commissioner determines that the indi2 vidual does not meet the requirements of paragraph

3 (1)(B)(i) or that the individual’s declaration under para4 graph (2)(A)(ii) is false. Any such determination by the

5 Commissioner shall be final and not subject to review

6 under paragraph (1) or (3) of subsection (c).

7 ‘‘(B)(i) Except as otherwise provided in clause (ii),

8 the amount of a provisional benefit for a month shall equal

9 the amount of the monthly benefit that would be payable

10 to an eligible individual under this title with the same kind

11 and amount of income.

12 ‘‘(ii) If the individual has a spouse who was pre13 viously an eligible spouse of the individual under this title

14 and the Commissioner determines that such spouse satis15 fies all the requirements of section 1614(b) except require16 ments related to the filing of an application, the amount

17 of a provisional benefit for a month shall equal the amount

18 of the month benefit that would be payable to an eligible

19 individual and eligible spouse under this title with the

20 same kind and amount of income.

21 ‘‘(C)(i) Provisional benefits shall begin with the

22 month following the month in which a request for rein23 statement is filed in accordance with paragraph (2)(A).

24 ‘‘(ii) Provisional benefits shall end with the earliest

25 of—
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1 ‘‘(I) the month in which the Commissioner

2 makes a determination regarding the individual’s eli3 gibility for reinstated benefits;

4 ‘‘(II) the fifth month following the month for

5 which provisional benefits are first payable under

6 clause (i); or

7 ‘‘(III) the month in which the Commissioner de8 termines that the individual does not meet the re9 quirements of paragraph (1)(B)(i) or that the indi10 vidual’s declaration made in accordance with para11 graph (2)(A)(ii) is false.

12 ‘‘(D) In any case in which the Commissioner deter13 mines that an individual is not eligible for reinstated bene14 fits, any provisional benefits paid to the individual under

15 this paragraph shall not be subject to recovery as an over16 payment unless the Commissioner determines that the in17 dividual knew or should have known that the individual

18 did not meet the requirements of paragraph (1)(B).

19 ‘‘(8) For purposes of this subsection other than para20 graph (7), the term ‘benefits under this title’ includes

21 State supplementary payments made pursuant to an

22 agreement under section 1616(a) or section 212(b) of

23 Public Law 93–66.’’.

24 (2) CONFORMING AMENDMENTS.—
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1 (A) Section 1631(j)(1) of such Act (42

2 U.S.C. 1383(j)(1)) is amended by striking the

3 period and inserting ‘‘, or has filed a request

4 for reinstatement of eligibility under subsection

5 (p)(2) and been determined to be eligible for re6 instatement.’’.

7 (B) Section 1631(j)(2)(A)(i)(I) of such Act

8 (42 U.S.C. 1383(j)(2)(A)(i)(I)) is amended by

9 inserting ‘‘(other than pursuant to a request for

10 reinstatement under subsection (p))’’ after ‘‘eli11 gible’’.

12 (c) EFFECTIVE DATE.—

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

14 this section shall take effect on the first day of the

15 thirteenth month beginning after the date of enact16 ment of this Act.

17 (2) LIMITATION.—No benefit shall be payable

18 under title II or XVI of the Social Security Act on

19 the basis of a request for reinstatement filed under

20 section 223(i) or 1631(p) of such Act before the ef21 fective date described in paragraph (1).
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1 Subtitle C—Work Incentives

2 Planning, Assistance, and Outreach

3 SEC. 221. WORK INCENTIVES OUTREACH PROGRAM.

4 Part A of title XI of the Social Security Act (42

5 U.S.C. 1301 et seq.), as amended by section 201, is

6 amended by adding after section 1148 the following:

7 ‘‘WORK INCENTIVES OUTREACH PROGRAM

8 ‘‘SEC. 1149. (a) ESTABLISHMENT.—

9 ‘‘(1) IN GENERAL.—The Commissioner, in con10 sultation with the Work Incentives Advisory Panel

11 established under section 201(f) of the Work Incen12 tives Improvement Act of 1999, shall establish a

13 community-based work incentives planning and as14 sistance program for the purpose of disseminating

15 accurate information to disabled beneficiaries on

16 work incentives programs and issues related to such

17 programs.

18 ‘‘(2) GRANTS, COOPERATIVE AGREEMENTS,

19 CONTRACTS, AND OUTREACH.—Under the program

20 established under this section, the Commissioner

21 shall—

22 ‘‘(A) establish a competitive program of

23 grants, cooperative agreements, or contracts to

24 provide benefits planning and assistance, in25 cluding information on the availability of pro-
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1 tection and advocacy services, to disabled bene2 ficiaries, including individuals participating in

3 the Ticket to Work and Self-Sufficiency Pro4 gram established under section 1148, the pro5 gram established under section 1619, and other

6 programs that are designed to encourage dis7 abled beneficiaries to work;

8 ‘‘(B) conduct directly, or through grants,

9 cooperative agreements, or contracts, ongoing

10 outreach efforts to disabled beneficiaries (and

11 to the families of such beneficiaries) who are

12 potentially eligible to participate in Federal or

13 State work incentive programs that are de14 signed to assist disabled beneficiaries to work,

15 including—

16 ‘‘(i) preparing and disseminating in17 formation explaining such programs; and

18 ‘‘(ii) working in cooperation with

19 other Federal, State, and private agencies

20 and nonprofit organizations that serve dis21 abled beneficiaries, and with agencies and

22 organizations that focus on vocational re23 habilitation and work-related training and

24 counseling;
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1 ‘‘(C) establish a corps of trained, acces2 sible, and responsive work incentives specialists

3 within the Social Security Administration who

4 will specialize in disability work incentives

5 under titles II and XVI for the purpose of dis6 seminating accurate information with respect to

7 inquiries and issues relating to work incentives

8 to—

9 ‘‘(i) disabled beneficiaries;

10 ‘‘(ii) benefit applicants under titles II

11 and XVI; and

12 ‘‘(iii) individuals or entities awarded

13 grants under subparagraphs (A) or (B);

14 and

15 ‘‘(D) provide—

16 ‘‘(i) training for work incentives spe17 cialists and individuals providing planning

18 assistance described in subparagraph (C);

19 and

20 ‘‘(ii) technical assistance to organiza21 tions and entities that are designed to en22 courage disabled beneficiaries to return to

23 work.

24 ‘‘(3) COORDINATION WITH OTHER PRO25 GRAMS.—The responsibilities of the Commissioner
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1 established under this section shall be coordinated

2 with other public and private programs that provide

3 information and assistance regarding rehabilitation

4 services and independent living supports and bene5 fits planning for disabled beneficiaries including the

6 program under section 1619, the plans for achieving

7 self-support program (PASS), and any other Federal

8 or State work incentives programs that are designed

9 to assist disabled beneficiaries, including educational

10 agencies that provide information and assistance re11 garding rehabilitation, school-to-work programs,

12 transition services (as defined in, and provided in ac13 cordance with, the Individuals with Disabilities Edu14 cation Act (20 U.S.C. 1400 et seq.)), a one-stop de15 livery system established under subtitle B of title I

16 of the Workforce Investment Act of 1998, and other

17 services.

18 ‘‘(b) CONDITIONS.—

19 ‘‘(1) SELECTION OF ENTITIES.—

20 ‘‘(A) APPLICATION.—An entity shall sub21 mit an application for a grant, cooperative

22 agreement, or contract to provide benefits plan23 ning and assistance to the Commissioner at

24 such time, in such manner, and containing such

25 information as the Commissioner may deter-
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1 mine is necessary to meet the requirements of

2 this section.

3 ‘‘(B) STATEWIDENESS.—The Commis4 sioner shall ensure that the planning, assist5 ance, and information described in paragraph

6 (2) shall be available on a statewide basis.

7 ‘‘(C) ELIGIBILITY OF STATES AND PRI8 VATE ORGANIZATIONS.—

9 ‘‘(i) IN GENERAL.—The Commissioner

10 may award a grant, cooperative agreement,

11 or contract under this section to a State or

12 a private agency or organization (other

13 than Social Security Administration Field

14 Offices and the State agency administering

15 the State medicaid program under title

16 XIX, including any agency or entity de17 scribed in clause (ii), that the Commis18 sioner determines is qualified to provide

19 the planning, assistance, and information

20 described in paragraph (2)).

21 ‘‘(ii) AGENCIES AND ENTITIES DE22 SCRIBED.—The agencies and entities de23 scribed in this clause are the following:

24 ‘‘(I) Any public or private agency

25 or organization (including Centers for
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1 Independent Living established under

2 title VII of the Rehabilitation Act of

3 1973, protection and advocacy organi4 zations, client assistance programs es5 tablished in accordance with section

6 112 of the Rehabilitation Act of 1973,

7 and State Developmental Disabilities

8 Councils established in accordance

9 with section 124 of the Developmental

10 Disabilities Assistance and Bill of

11 Rights Act (42 U.S.C. 6024)) that the

12 Commissioner determines satisfies the

13 requirements of this section.

14 ‘‘(II) The State agency admin15 istering the State program funded

16 under part A of title IV.

17 ‘‘(D) EXCLUSION FOR CONFLICT OF IN18 TEREST.—The Commissioner may not award a

19 grant, cooperative agreement, or contract under

20 this section to any entity that the Commissioner

21 determines would have a conflict of interest if

22 the entity were to receive a grant, cooperative

23 agreement, or contract under this section.

24 ‘‘(2) SERVICES PROVIDED.—A recipient of a

25 grant, cooperative agreement, or contract to provide
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1 benefits planning and assistance shall select individ2 uals who will act as planners and provide informa3 tion, guidance, and planning to disabled beneficiaries

4 on the—

5 ‘‘(A) availability and interrelation of any

6 Federal or State work incentives programs de7 signed to assist disabled beneficiaries that the

8 individual may be eligible to participate in;

9 ‘‘(B) adequacy of any health benefits cov10 erage that may be offered by an employer of

11 the individual and the extent to which other

12 health benefits coverage may be available to the

13 individual; and

14 ‘‘(C) availability of protection and advo15 cacy services for disabled beneficiaries and how

16 to access such services.

17 ‘‘(3) AMOUNT OF GRANTS, COOPERATIVE

18 AGREEMENTS, OR CONTRACTS.—

19 ‘‘(A) BASED ON POPULATION OF DIS20 ABLED BENEFICIARIES.—Subject to subpara21 graph (B), the Commissioner shall award a

22 grant, cooperative agreement, or contract under

23 this section to an entity based on the percent24 age of the population of the State where the en25 tity is located who are disabled beneficiaries.
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1 ‘‘(B) LIMITATION PER GRANT.—No entity

2 shall receive a grant, cooperative agreement, or

3 contract under this section for a fiscal year that

4 is less than $50,000 or more than $300,000.

5 ‘‘(ii) TOTAL AMOUNT FOR ALL

6 GRANTS, COOPERATIVE AGREEMENTS, AND

7 CONTRACTS.—The total amount of all

8 grants, cooperative agreements, and con9 tracts awarded under this section for a fis10 cal year may not exceed $23,000,000.

11 ‘‘(4) ALLOCATION OF COSTS.—The costs of car12 rying out this section shall be paid from amounts

13 made available for the administration of title II and

14 amounts made available for the administration of

15 title XVI, and shall be allocated among those

16 amounts as appropriate.

17 ‘‘(c) DEFINITIONS.—In this section:

18 ‘‘(1) COMMISSIONER.—The term ‘Commis19 sioner’ means the Commissioner of Social Security.

20 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis21 abled beneficiary’ has the meaning given that term

22 in section 1148(k)(2).

23 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There

24 is authorized to be appropriated to carry out this section

25 $23,000,000 for each of fiscal years 2000 through 2004.’’.
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1 SEC. 222. STATE GRANTS FOR WORK INCENTIVES ASSIST2 ANCE TO DISABLED BENEFICIARIES.

3 Part A of title XI of the Social Security Act (42

4 U.S.C. 1301 et seq.), as amended by section 221, is

5 amended by adding after section 1149 the following:

6 ‘‘STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO

7 DISABLED BENEFICIARIES

8 ‘‘SEC. 1150. (a) IN GENERAL.—Subject to subsection

9 (c), the Commissioner may make payments in each State

10 to the protection and advocacy system established pursu11 ant to part C of title I of the Developmental Disabilities

12 Assistance and Bill of Rights Act (42 U.S.C. 6041 et seq.)

13 for the purpose of providing services to disabled bene14 ficiaries.

15 ‘‘(b) SERVICES PROVIDED.—Services provided to dis16 abled beneficiaries pursuant to a payment made under this

17 section may include—

18 ‘‘(1) information and advice about obtaining vo19 cational rehabilitation and employment services; and

20 ‘‘(2) advocacy or other services that a disabled

21 beneficiary may need to secure or regain gainful em22 ployment.

23 ‘‘(c) APPLICATION.—In order to receive payments

24 under this section, a protection and advocacy system shall

25 submit an application to the Commissioner, at such time,
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1 in such form and manner, and accompanied by such infor2 mation and assurances as the Commissioner may require.

3 ‘‘(d) AMOUNT OF PAYMENTS.—

4 ‘‘(1) IN GENERAL.—Subject to the amount ap5 propriated for a fiscal year for making payments

6 under this section, a protection and advocacy system

7 shall not be paid an amount that is less than—

8 ‘‘(A) in the case of a protection and advo9 cacy system located in a State (including the

10 District of Columbia and Puerto Rico) other

11 than Guam, American Samoa, the United

12 States Virgin Islands, and the Commonwealth

13 of the Northern Mariana Islands, the greater

14 of—

15 ‘‘(i) $100,000; or

‘‘(ii) 1 16 ⁄3 of 1 percent of the amount

17 available for payments under this section;

18 and

19 ‘‘(B) in the case of a protection and advo20 cacy system located in Guam, American Samoa,

21 the United States Virgin Islands, and the Com22 monwealth of the Northern Mariana Islands,

23 $50,000.

24 ‘‘(2) INFLATION ADJUSTMENT.—For each fiscal

25 year in which the total amount appropriated to carry
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1 out this section exceeds the total amount appro2 priated to carry out this section in the preceding fis3 cal year, the Commissioner shall increase each min4 imum payment under subparagraphs (A) and (B) of

5 paragraph (1) by a percentage equal to the percent6 age increase in the total amount appropriated to

7 carry out this section between the preceding fiscal

8 year and the fiscal year involved.

9 ‘‘(e) ANNUAL REPORT.—Each protection and advo10 cacy system that receives a payment under this section

11 shall submit an annual report to the Commissioner and

12 the Work Incentives Advisory Panel established under sec13 tion 201(f) of the Work Incentives Improvement Act of

14 1999 on the services provided to individuals by the system.

15 ‘‘(f) FUNDING.—

16 ‘‘(1) ALLOCATION OF PAYMENTS.—Payments

17 under this section shall be made from amounts made

18 available for the administration of title II and

19 amounts made available for the administration of

20 title XVI, and shall be allocated among those

21 amounts as appropriate.

22 ‘‘(2) CARRYOVER.—Any amounts allotted for

23 payment to a protection and advocacy system under

24 this section for a fiscal year shall remain available

25 for payment to or on behalf of the protection and
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1 advocacy system until the end of the succeeding fis2 cal year.

3 ‘‘(g) DEFINITIONS.—In this section:

4 ‘‘(1) COMMISSIONER.—The term ‘Commis5 sioner’ means the Commissioner of Social Security.

6 ‘‘(2) DISABLED BENEFICIARY.—The term ‘dis7 abled beneficiary’ has the meaning given that term

8 in section 1148(k)(2).

9 ‘‘(3) PROTECTION AND ADVOCACY SYSTEM.—

10 The term ‘protection and advocacy system’ means a

11 protection and advocacy system established pursuant

12 to part C of title I of the Developmental Disabilities

13 Assistance and Bill of Rights Act (42 U.S.C. 6041

14 et seq.).

15 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There

16 is authorized to be appropriated to carry out this section

17 $7,000,000 for each of fiscal years 2000 through 2004.’’.

18 TITLE III—DEMONSTRATION

19 PROJECTS AND STUDIES

20 SEC. 301. PERMANENT EXTENSION OF DISABILITY INSUR21 ANCE PROGRAM DEMONSTRATION PROJECT

22 AUTHORITY.

23 (a) PERMANENT EXTENSION OF AUTHORITY.—Title

24 II of the Social Security Act (42 U.S.C. 401 et seq.) is

25 amended by adding at the end the following:
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1 ‘‘DEMONSTRATION PROJECT AUTHORITY

2 ‘‘SEC. 234. (a) AUTHORITY.—

3 ‘‘(1) IN GENERAL.—The Commissioner of So4 cial Security (in this section referred to as the ‘Com5 missioner’) shall develop and carry out experiments

6 and demonstration projects designed to determine

7 the relative advantages and disadvantages of—

8 ‘‘(A) various alternative methods of treat9 ing the work activity of individuals entitled to

10 disability insurance benefits under section 223

11 or to monthly insurance benefits under section

12 202 based on such individual’s disability (as de13 fined in section 223(d)), including such meth14 ods as a reduction in benefits based on earn15 ings, designed to encourage the return to work

16 of such individuals;

17 ‘‘(B) altering other limitations and condi18 tions applicable to such individuals (including

19 lengthening the trial work period (as defined in

20 section 222(c)), altering the 24-month waiting

21 period for hospital insurance benefits under sec22 tion 226, altering the manner in which the pro23 gram under this title is administered, earlier re24 ferral of such individuals for rehabilitation, and

25 greater use of employers and others to develop,
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1 perform, and otherwise stimulate new forms of

2 rehabilitation); and

3 ‘‘(C) implementing sliding scale benefit off4 sets using variations in—

5 ‘‘(i) the amount of the offset as a pro6 portion of earned income;

7 ‘‘(ii) the duration of the offset period;

8 and

9 ‘‘(iii) the method of determining the

10 amount of income earned by such individ11 uals,

12 to the end that savings will accrue to the Trust

13 Funds, or to otherwise promote the objectives or fa14 cilitate the administration of this title.

15 ‘‘(2) AUTHORITY FOR EXPANSION OF SCOPE.—

16 The Commissioner may expand the scope of any

17 such experiment or demonstration project to include

18 any group of applicants for benefits under the pro19 gram established under this title with impairments

20 that reasonably may be presumed to be disabling for

21 purposes of such demonstration project, and may

22 limit any such demonstration project to any such

23 group of applicants, subject to the terms of such

24 demonstration project which shall define the extent

25 of any such presumption.
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1 ‘‘(b) REQUIREMENTS.—The experiments and dem2 onstration projects developed under subsection (a) shall be

3 of sufficient scope and shall be carried out on a wide

4 enough scale to permit a thorough evaluation of the alter5 native methods under consideration while giving assurance

6 that the results derived from the experiments and projects

7 will obtain generally in the operation of the disability in8 surance program under this title without committing such

9 program to the adoption of any particular system either

10 locally or nationally.

11 ‘‘(c) AUTHORITY TO WAIVE COMPLIANCE WITH

12 BENEFITS REQUIREMENTS.—In the case of any experi13 ment or demonstration project conducted under subsection

14 (a), the Commissioner may waive compliance with the ben15 efit requirements of this title, and the Secretary may

16 (upon the request of the Commissioner) waive compliance

17 with the benefits requirements of title XVIII, insofar as

18 is necessary for a thorough evaluation of the alternative

19 methods under consideration. No such experiment or

20 project shall be actually placed in operation unless at least

21 90 days prior thereto a written report, prepared for pur22 poses of notification and information only and containing

23 a full and complete description thereof, has been trans24 mitted by the Commissioner to the Committee on Ways

25 and Means of the House of Representatives and to the
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1 Committee on Finance of the Senate. Periodic reports on

2 the progress of such experiments and demonstration

3 projects shall be submitted by the Commissioner to such

4 committees. When appropriate, such reports shall include

5 detailed recommendations for changes in administration

6 or law, or both, to carry out the objectives stated in sub7 section (a).

8 ‘‘(d) REPORTS.—

9 ‘‘(1) INTERIM REPORTS.—On or before June 9

10 of each year, the Commissioner shall submit to the

11 Committee on Ways and Means of the House of

12 Representatives and to the Committee on Finance of

13 the Senate an interim report on the progress of the

14 experiments and demonstration projects carried out

15 under this subsection together with any related data

16 and materials that the Commissioner may consider

17 appropriate.

18 ‘‘(2) FINAL REPORTS.—Not later than 90 days

19 after the termination of any experiment or dem20 onstration project carried out under this section, the

21 Commissioner shall submit to the Committee on

22 Ways and Means of the House of Representatives

23 and to the Committee on Finance of the Senate a

24 final report with respect to that experiment and

25 demonstration project.’’.
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1 (b) CONFORMING AMENDMENTS; TRANSFER OF

2 PRIOR AUTHORITY.—

3 (1) CONFORMING AMENDMENTS.—

4 (A) REPEAL OF PRIOR AUTHORITY.—Para5 graphs (1) through (4) of subsection (a) and

6 subsection (c) of section 505 of the Social Secu7 rity Disability Amendments of 1980 (42 U.S.C.

8 1310 note) are repealed.

9 (B) CONFORMING AMENDMENT REGARD10 ING FUNDING.—Section 201(k) of the Social

11 Security Act (42 U.S.C. 401(k)) is amended by

12 striking ‘‘section 505(a) of the Social Security

13 Disability Amendments of 1980’’ and inserting

14 ‘‘section 234’’.

15 (2) TRANSFER OF PRIOR AUTHORITY.—With

16 respect to any experiment or demonstration project

17 being conducted under section 505(a) of the Social

18 Security Disability Amendments of 1980 (42 U.S.C.

19 1310 note) as of the date of enactment of this Act,

20 the authority to conduct such experiment or dem21 onstration project (including the terms and condi22 tions applicable to the experiment or demonstration

23 project) shall be treated as if that authority (and

24 such terms and conditions) had been established
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1 under section 234 of the Social Security Act, as

2 added by subsection (a).

3 SEC. 302. DEMONSTRATION PROJECTS PROVIDING FOR RE4 DUCTIONS IN DISABILITY INSURANCE BENE5 FITS BASED ON EARNINGS.

6 (a) AUTHORITY.—The Commissioner of Social Secu7 rity shall conduct demonstration projects for the purpose

8 of evaluating, through the collection of data, a program

9 for title II disability beneficiaries (as defined in section

10 1148(k)(3) of the Social Security Act) under which each

11 $1 of benefits payable under section 223, or under section

12 202 based on the beneficiary’s disability, is reduced for

13 each $2 of such beneficiary’s earnings that is above a level

14 to be determined by the Commissioner. Such projects shall

15 be conducted at a number of localities which the Commis16 sioner shall determine is sufficient to adequately evaluate

17 the appropriateness of national implementation of such a

18 program. Such projects shall identify reductions in Fed19 eral expenditures that may result from the permanent im20 plementation of such a program.

21 (b) SCOPE AND SCALE AND MATTERS TO BE DETER22 MINED.—

23 (1) IN GENERAL.—The demonstration projects

24 developed under subsection (a) shall be of sufficient

25 duration, shall be of sufficient scope, and shall be
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1 carried out on a wide enough scale to permit a thor2 ough evaluation of the project to determine—

3 (A) the effects, if any, of induced entry

4 into the project and reduced exit from the

5 project;

6 (B) the extent, if any, to which the project

7 being tested is affected by whether it is in oper8 ation in a locality within an area under the ad9 ministration of the Ticket to Work and Self10 Sufficiency Program established under section

11 1148 of the Social Security Act; and

12 (C) the savings that accrue to the Federal

13 Old-Age and Survivors Insurance Trust Fund,

14 the Federal Disability Insurance Trust Fund,

15 and other Federal programs under the project

16 being tested.

17 The Commissioner shall take into account advice

18 provided by the Work Incentives Advisory Panel pur19 suant to section 201(f)(2)(B)(ii).

20 (2) ADDITIONAL MATTERS.—The Commissioner

21 shall also determine with respect to each project—

22 (A) the annual cost (including net cost) of

23 the project and the annual cost (including net

24 cost) that would have been incurred in the ab25 sence of the project;
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1 (B) the determinants of return to work, in2 cluding the characteristics of the beneficiaries

3 who participate in the project; and

4 (C) the employment outcomes, including

5 wages, occupations, benefits, and hours worked,

6 of beneficiaries who return to work as a result

7 of participation in the project.

8 The Commissioner may include within the matters

9 evaluated under the project the merits of trial work

10 periods and periods of extended eligibility.

11 (c) WAIVERS.—The Commissioner may waive compli12 ance with the benefit provisions of title II of the Social

13 Security Act, and the Secretary of Health and Human

14 Services may waive compliance with the benefit require15 ments of title XVIII of that Act, insofar as is necessary

16 for a thorough evaluation of the alternative methods under

17 consideration. No such project shall be actually placed in

18 operation unless at least 90 days prior thereto a written

19 report, prepared for purposes of notification and informa20 tion only and containing a full and complete description

21 thereof, has been transmitted by the Commissioner to the

22 Committee on Ways and Means of the House of Rep23 resentatives and to the Committee on Finance of the Sen24 ate. Periodic reports on the progress of such projects shall

25 be submitted by the Commissioner to such committees.
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1 When appropriate, such reports shall include detailed rec2 ommendations for changes in administration or law, or

3 both, to carry out the objectives stated in subsection (a).

4 (d) INTERIM REPORTS.—Not later than 2 years after

5 the date of enactment of this Act, and annually thereafter,

6 the Commissioner of Social Security shall submit to Con7 gress an interim report on the progress of the demonstra8 tion projects carried out under this subsection together

9 with any related data and materials that the Commis10 sioner of Social Security may consider appropriate.

11 (e) FINAL REPORT.—The Commissioner of Social Se12 curity shall submit to Congress a final report with respect

13 to all demonstration projects carried out under this section

14 not later than 1 year after their completion.

15 (f) EXPENDITURES.—Expenditures made for dem16 onstration projects under this section shall be made from

17 the Federal Disability Insurance Trust Fund and the Fed18 eral Old-Age and Survivors Insurance Trust Fund, as de19 termined appropriate by the Commissioner of Social Secu20 rity, and from the Federal Hospital Insurance Trust Fund

21 and the Federal Supplementary Medical Insurance Trust

22 Fund, as determined appropriate by the Secretary of

23 Health and Human Services, to the extent provided in ad24 vance in appropriation Acts.
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1 SEC. 303. STUDIES AND REPORTS.

2 (a) STUDY BY GENERAL ACCOUNTING OFFICE OF

3 EXISTING DISABILITY-RELATED EMPLOYMENT INCEN4 TIVES.—

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

6 date of enactment of this Act, the Comptroller Gen7 eral of the United States shall undertake a study to

8 assess existing tax credits and other disability-re9 lated employment incentives under the Americans

10 with Disabilities Act of 1990 and other Federal

11 laws. In such study, the Comptroller General shall

12 specifically address the extent to which such credits

13 and other incentives would encourage employers to

14 hire and retain individuals with disabilities.

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

16 date of enactment of this Act, the Comptroller Gen17 eral shall transmit to the Committee on Ways and

18 Means of the House of Representatives and the

19 Committee on Finance of the Senate a written re20 port presenting the results of the Comptroller Gen21 eral’s study conducted pursuant to this subsection,

22 together with such recommendations for legislative

23 or administrative changes as the Comptroller Gen24 eral determines are appropriate.

25 (b) STUDY BY GENERAL ACCOUNTING OFFICE OF

26 EXISTING COORDINATION OF THE DI AND SSI PROGRAMS
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1 AS THEY RELATE TO INDIVIDUALS ENTERING OR LEAV2 ING CONCURRENT ENTITLEMENT.—

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

4 date of enactment of this Act, the Comptroller Gen5 eral of the United States shall undertake a study to

6 evaluate the coordination under current law of the

7 disability insurance program under title II of the So8 cial Security Act and the supplemental security in9 come program under title XVI of that Act, as such

10 programs relate to individuals entering or leaving

11 concurrent entitlement under such programs. In

12 such study, the Comptroller General shall specifically

13 address the effectiveness of work incentives under

14 such programs with respect to such individuals and

15 the effectiveness of coverage of such individuals

16 under titles XVIII and XIX of the Social Security

17 Act.

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

19 date of enactment of this Act, the Comptroller Gen20 eral shall transmit to the Committee on Ways and

21 Means of the House of Representatives and the

22 Committee on Finance of the Senate a written re23 port presenting the results of the Comptroller Gen24 eral’s study conducted pursuant to this subsection,

25 together with such recommendations for legislative
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1 or administrative changes as the Comptroller Gen2 eral determines are appropriate.

3 (c) STUDY BY GENERAL ACCOUNTING OFFICE OF

4 THE IMPACT OF THE SUBSTANTIAL GAINFUL ACTIVITY

5 LIMIT ON RETURN TO WORK.—

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

7 date of enactment of this Act, the Comptroller Gen8 eral of the United States shall undertake a study of

9 the substantial gainful activity level applicable as of

10 that date to recipients of benefits under section 223

11 of the Social Security Act (42 U.S.C. 423) and

12 under section 202 of that Act (42 U.S.C. 402) on

13 the basis of a recipient having a disability, and the

14 effect of such level as a disincentive for those recipi15 ents to return to work. In the study, the Comptroller

16 General also shall address the merits of increasing

17 the substantial gainful activity level applicable to

18 such recipients of benefits and the rationale for not

19 yearly indexing that level to inflation.

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

21 date of enactment of this Act, the Comptroller Gen22 eral shall transmit to the Committee on Ways and

23 Means of the House of Representatives and the

24 Committee on Finance of the Senate a written re25 port presenting the results of the Comptroller Gen-
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1 eral’s study conducted pursuant to this subsection,

2 together with such recommendations for legislative

3 or administrative changes as the Comptroller Gen4 eral determines are appropriate.

5 (d) REPORT ON DISREGARDS UNDER THE DI AND

6 SSI PROGRAMS.—Not later than 90 days after the date

7 of enactment of this Act, the Commissioner of Social Secu8 rity shall submit to the Committee on Ways and Means

9 of the House of Representatives and the Committee on

10 Finance of the Senate a report that—

11 (1) identifies all income, assets, and resource

12 disregards (imposed under statutory or regulatory

13 authority) that are applicable to individuals receiving

14 benefits under title II or XVI of the Social Security

15 Act (42 U.S.C. 401 et seq., 1381 et seq.);

16 (2) with respect to each such disregard—

17 (A) specifies the most recent statutory or

18 regulatory modification of the disregard; and

19 (B) recommends whether further statutory

20 or regulatory modification of the disregard

21 would be appropriate; and

22 (3) with respect to the disregard described in

23 section 1612(b)(7) of the Social Security Act (42

24 U.S.C. 1382a(b)(7)) (relating to grants, scholar25 ships, or fellowships received for use in paying the
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1 cost of tuition and fees at any educational (including

2 technical or vocational education) institution)—

3 (A) identifies the number of individuals re4 ceiving benefits under title XVI of such Act (42

5 U.S.C. 1381 et seq.) who have attained age 22

6 and have not had any portion of any grant,

7 scholarship, or fellowship received for use in

8 paying the cost of tuition and fees at any edu9 cational (including technical or vocational edu10 cation) institution excluded from their income

11 in accordance with that section;

12 (B) recommends whether the age at which

13 such grants, scholarships, or fellowships are ex14 cluded from income for purposes of determining

15 eligibility under title XVI of the Social Security

16 Act should be increased to age 25; and

17 (C) recommends whether such disregard

18 should be expanded to include any such grant,

19 scholarship, or fellowship received for use in

20 paying the cost of room and board at any such

21 institution.
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1 TITLE IV—MISCELLANEOUS AND

2 TECHNICAL AMENDMENTS

3 SEC. 401. TECHNICAL AMENDMENTS RELATING TO DRUG

4 ADDICTS AND ALCOHOLICS.

5 (a) CLARIFICATION RELATING TO THE EFFECTIVE

6 DATE OF THE DENIAL OF SOCIAL SECURITY DISABILITY

7 BENEFITS TO DRUG ADDICTS AND ALCOHOLICS.—Sec8 tion 105(a)(5) of the Contract with America Advancement

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

10 amended—

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

12 Commissioner of Social Security’’ and ‘‘by the Com13 missioner’’; and

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

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

16 individual’s claim, with respect to benefits

17 under title II of the Social Security Act based

18 on disability, which has been denied in whole

19 before the date of enactment of this Act, may

20 not be considered to be finally adjudicated be21 fore such date if, on or after such date—

22 ‘‘(i) there is pending a request for ei23 ther administrative or judicial review with

24 respect to such claim, or
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1 ‘‘(ii) there is pending, with respect to

2 such claim, a readjudication by the Com3 missioner of Social Security pursuant to

4 relief in a class action or implementation

5 by the Commissioner of a court remand

6 order.

7 ‘‘(E) Notwithstanding the provisions of

8 this paragraph, with respect to any individual

9 for whom the Commissioner of Social Security

10 does not perform the entitlement redetermina11 tion before the date prescribed in subparagraph

12 (C), the Commissioner shall perform such enti13 tlement redetermination in lieu of a continuing

14 disability review whenever the Commissioner de15 termines that the individual’s entitlement is

16 subject to redetermination based on the pre17 ceding provisions of this paragraph, and the

18 provisions of section 223(f) of the Social Secu19 rity Act shall not apply to such redetermina20 tion.’’.

21 (b) CORRECTION TO EFFECTIVE DATE OF PROVI22 SIONS CONCERNING REPRESENTATIVE PAYEES AND

23 TREATMENT REFERRALS OF SOCIAL SECURITY BENE24 FICIARIES WHO ARE DRUG ADDICTS AND ALCOHOLICS.—

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

2 to read as follows:

3 ‘‘(B) The amendments made by para4 graphs (2) and (3) shall take effect on July 1,

5 1996, with respect to any individual—

6 ‘‘(i) whose claim for benefits is finally

7 adjudicated on or after the date of enact8 ment of this Act; or

9 ‘‘(ii) whose entitlement to benefits is

10 based on an entitlement redetermination

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

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

13 this section shall take effect as if included in the enact14 ment of section 105 of the Contract with America Ad15 vancement Act of 1996 (Public Law 104–121; 110 Stat.

16 852 et seq.).

17 SEC. 402. TREATMENT OF PRISONERS.

18 (a) IMPLEMENTATION OF PROHIBITION AGAINST

19 PAYMENT OF TITLE II BENEFITS TO PRISONERS.—

20 (1) IN GENERAL.—Section 202(x)(3) of the So21 cial Security Act (42 U.S.C. 402(x)(3)) is

22 amended—

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

24 (B) by adding at the end the following:
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1 ‘‘(B)(i) The Commissioner shall enter into an agree2 ment under this subparagraph with any interested State

3 or local institution comprising a jail, prison, penal institu4 tion, or correctional facility, or comprising any other insti5 tution a purpose of which is to confine individuals as de6 scribed in paragraph (1)(A)(ii). Under such agreement—

7 ‘‘(I) the institution shall provide to the Com8 missioner, on a monthly basis and in a manner spec9 ified by the Commissioner, the names, Social Secu10 rity account numbers, dates of birth, confinement

11 commencement dates, and, to the extent available to

12 the institution, such other identifying information

13 concerning the individuals confined in the institution

14 as the Commissioner may require for the purpose of

15 carrying out paragraph (1); and

16 ‘‘(II) the Commissioner shall pay to the institu17 tion, with respect to information described in sub18 clause (I) concerning each individual who is confined

19 therein as described in paragraph (1)(A), who re20 ceives a benefit under this title for the month pre21 ceding the first month of such confinement, and

22 whose benefit under this title is determined by the

23 Commissioner to be not payable by reason of con24 finement based on the information provided by the

25 institution, $400 (subject to reduction under clause
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1 (ii)) if the institution furnishes the information to

2 the Commissioner within 30 days after the date such

3 individual’s confinement in such institution begins,

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

5 the institution furnishes the information after 30

6 days after such date but within 90 days after such

7 date.

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

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

10 required to make a payment to the institution with respect

11 to the same individual under an agreement entered into

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

13 ‘‘(iii) There is authorized to be transferred from the

14 Federal Old-Age and Survivors Insurance Trust Fund and

15 the Federal Disability Insurance Trust Fund, as appro16 priate, such sums as may be necessary to enable the Com17 missioner to make payments to institutions required by

18 clause (i)(II).

19 ‘‘(iv) The Commissioner is authorized to provide, on

20 a reimbursable basis, information obtained pursuant to

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

22 administering a Federal or federally assisted cash, food,

23 or medical assistance program for eligibility purposes.’’.
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1 (2) CONFORMING AMENDMENT TO THE PRI2 VACY ACT.—Section 552a(a)(8)(B) of title 5, United

3 States Code, is amended—

4 (A) in clause (vi), by striking ‘‘or’’ at the

5 end;

6 (B) in clause (vii), by adding ‘‘or’’ at the

7 end; and

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

9 ‘‘(viii) matches performed pursuant to

10 section 202(x)(3)(B) or 1611(e)(1)(I) of

11 the Social Security Act (42 U.S.C.

12 402(x)(3)(B), 1382(e)(1)(I));’’.

13 (3) EFFECTIVE DATE.—The amendments made

14 by this subsection shall apply to individuals whose

15 period of confinement in an institution commences

16 on or after the first day of the fourth month begin17 ning after the month in which this Act is enacted.

18 (b) ELIMINATION OF TITLE II REQUIREMENT THAT

19 CONFINEMENT STEM FROM CRIME PUNISHABLE BY IM20 PRISONMENT FOR MORE THAN 1 YEAR.—

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

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

23 amended—

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

25 striking ‘‘during’’ and inserting ‘‘throughout’’;
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1 (B) in clause (i), by striking ‘‘an offense

2 punishable by imprisonment for more than 1

3 year (regardless of the actual sentence im4 posed)’’ and inserting ‘‘a criminal offense’’; and

5 (C) in clause (ii)(I), by striking ‘‘an of6 fense punishable by imprisonment for more

7 than 1 year’’ and inserting ‘‘a criminal of8 fense’’.

9 (2) EFFECTIVE DATE.—The amendments made

10 by this subsection shall apply to individuals whose

11 period of confinement in an institution commences

12 on or after the first day of the fourth month begin13 ning after the month in which this Act is enacted.

14 (c) CONFORMING TITLE XVI AMENDMENTS.—

15 (1) FIFTY PERCENT REDUCTION IN TITLE XVI

16 PAYMENT IN CASE INVOLVING COMPARABLE TITLE II

17 PAYMENT.—Section 1611(e)(1)(I) of the Social Se18 curity Act (42 U.S.C. 1382(e)(1)(I)) is amended—

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

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

21 and after ‘‘$200’’;

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

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

24 (C) by inserting after clause (i) the fol25 lowing:
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1 ‘‘(ii) The dollar amounts specified in clause (i)(II)

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

3 required to make a payment to the institution with respect

4 to the same individual under an agreement entered into

5 under section 202(x)(3)(B).’’.

6 (2) EXPANSION OF CATEGORIES OF INSTITU7 TIONS ELIGIBLE TO ENTER INTO AGREEMENTS WITH

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

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

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

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

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

13 comprising a jail, prison, penal institution, or correc14 tional facility, or with any other interested State or

15 local institution a purpose of which is to confine in16 dividuals as described in section 202(x)(1)(A)(ii),’’.

17 (3) ELIMINATION OF OVERLY BROAD EXEMP18 TION.—Section 1611(e)(1)(I)(iii) of such Act (42

19 U.S.C. 1382(e)(1)(I)(iii)) (as redesignated by para20 graph (1)(B), is amended by striking ‘‘(I) The provi21 sions’’ and all that follows through ‘‘(II)’’.

22 (4) EFFECTIVE DATE.—The amendments made

23 by this subsection shall take effect as if included in

24 the enactment of section 203(a) of the Personal Re25 sponsibility and Work Opportunity Reconciliation
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1 Act of 1996 (Public Law 104–193; 110 Stat. 2186).

2 The reference to section 202(x)(1)(A)(ii) of the So3 cial Security Act in section 1611(e)(1)(I)(i) of the

4 Social Security Act as amended by paragraph (2)

5 shall be deemed a reference to such section

6 202(x)(1)(A)(ii) as amended by subsection (b)(1)(C).

7 (d) CONTINUED DENIAL OF BENEFITS TO SEX OF8 FENDERS REMAINING CONFINED TO PUBLIC INSTITU9 TIONS UPON COMPLETION OF PRISON TERM.—

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

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

12 amended—

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

14 end;

15 (B) in clause (ii)(IV), by striking the pe16 riod and inserting ‘‘, or’’; and

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

18 ‘‘(iii) immediately upon completion of confine19 ment as described in clause (i) pursuant to convic20 tion of a criminal offense an element of which is sex21 ual activity, is confined by court order in an institu22 tion at public expense pursuant to a finding that the

23 individual is a sexually dangerous person or a sexual

24 predator or a similar finding.’’.
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1 (2) CONFORMING AMENDMENT.—Section

2 202(x)(1)(B)(ii) of the Social Security Act (42

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

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

5 (3) EFFECTIVE DATE.—The amendments made

6 by this subsection shall apply with respect to bene7 fits for months ending after the date of enactment

8 of this Act.

9 SEC. 403. REVOCATION BY MEMBERS OF THE CLERGY OF

10 EXEMPTION FROM SOCIAL SECURITY COV11 ERAGE.

12 (a) IN GENERAL.—Notwithstanding section

13 1402(e)(4) of the Internal Revenue Code of 1986, any ex14 emption which has been received under section 1402(e)(1)

15 of such Code by a duly ordained, commissioned, or li16 censed minister of a church, a member of a religious order,

17 or a Christian Science practitioner, and which is effective

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

19 revoked by filing an application therefore (in such form

20 and manner, and with such official, as may be prescribed

21 by the Commissioner of the Internal Revenue Service), if

22 such application is filed no later than the due date of the

23 Federal income tax return (including any extension there24 of) for the applicant’s second taxable year beginning after

25 December 31, 1999. Any such revocation shall be effective
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1 (for purposes of chapter 2 of the Internal Revenue Code

2 of 1986 and title II of the Social Security Act), as speci3 fied in the application, either with respect to the appli4 cant’s first taxable year beginning after December 31,

5 1999, or with respect to the applicant’s second taxable

6 year beginning after such date, and for all succeeding tax7 able years; and the applicant for any such revocation may

8 not thereafter again file application for an exemption

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

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

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

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

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

14 taxes that would have been imposed by section 1401 of

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

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

17 would have constituted net earnings from self-employment

18 for purposes of chapter 2 of such Code (notwithstanding

19 paragraph (4) or (5) of section 1402(c) of such Code) ex20 cept for the exemption under section 1402(e)(1) of such

21 Code.

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

23 with respect to service performed (to the extent specified

24 in such subsection) in taxable years beginning after De25 cember 31, 1999, and with respect to monthly insurance
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1 benefits payable under title II of the Social Security Act

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

3 any individual for months in or after the calendar year

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

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

6 death payments payable under such title on the basis of

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

8 deaths occurring in or after such calendar year).

9 SEC. 404. ADDITIONAL TECHNICAL AMENDMENT RELATING

10 TO COOPERATIVE RESEARCH OR DEM11 ONSTRATION PROJECTS UNDER TITLES II

12 AND XVI.

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

14 Security Act (42 U.S.C. 1310(a)(3)) is amended by strik15 ing ‘‘title XVI’’ and inserting ‘‘title II or XVI’’.

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

17 subsection (a) shall take effect as if included in the enact18 ment of the Social Security Independence and Program

19 Improvements Act of 1994 (Public Law 103–296; 108

20 Stat. 1464).

21 SEC. 405. AUTHORIZATION FOR STATE TO PERMIT ANNUAL

22 WAGE REPORTS.

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

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

25 inserting before the semicolon the following: ‘‘, and except
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1 that in the case of wage reports with respect to domestic

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

3 defined) that make returns with respect to such employ4 ment on a calendar year basis pursuant to section 3510

5 of the Internal Revenue Code of 1986 to make such re6 ports on an annual basis’’.

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

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

9 amended—

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

11 453A(a)(2)(B)(iii))’’; and

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

13 453A(a)(2)(B))’’ after ‘‘employers’’ .

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

15 this section shall apply to wage reports required to be sub16 mitted on and after the date of enactment of this Act.

Passed the Senate June 16, 1999.

Attest:

Secretary.
106TH CONGRESS

1ST SESSION S. 331

AN ACT

To amend the Social Security Act to expand the

and for other purposes.viduals with meaningful opportunities to work,cial Security Administration to provide such indito Work and Self-Sufficiency Program in the Soindividuals with disabilities, to establish a Ticketavailability of health care coverage for working
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