II

106TH CONGRESS

1ST SESSION S. 86

To amend the Social Security Act to establish a Ticket to Work and SelfSufficiency Program in the Social Security Administration to provide

beneficiaries with disabilities meaningful opportunities to work, to extend

Medicare coverage for such beneficiaries, and to make additional miscellaneous amendments relating to Social Security.

IN THE SENATE OF THE UNITED STATES

JANUARY 19, 1999

Mr. BUNNING introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend the Social Security Act to establish a Ticket

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

Medicare coverage for such beneficiaries, and to make

additional miscellaneous amendments relating to Social

Security.

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 AND TABLE OF CONTENTS.

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

5 ‘‘Ticket to Work and Self-Sufficiency Act of 1999’’.
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1 (b) TABLE OF CONTENTS.—The table of contents is

2 as follows:

Sec. 1. Short title and table of contents.

Sec. 2. The Ticket to Work and Self-Sufficiency Program.

Sec. 3. Extending Medicare coverage for OASDI disability benefit recipients

who are using tickets to work and self-sufficiency.

Sec. 4. Technical amendments relating to drug addicts and alcoholics.

Sec. 5. Extension of disability insurance program demonstration project authority.

Sec. 6. Treatment of prisoners.

Sec. 7. Revocation by members of the clergy of exemption from Social Security

coverage.

Sec. 8. Additional technical amendment relating to cooperative research or demonstration projects under titles II and XVI.

3 SEC. 2. THE TICKET TO WORK AND SELF-SUFFICIENCY

4 PROGRAM.

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

6 Security Act (42 U.S.C. 1301 et seq.) is amended by add7 ing at the end the following new section:

8 ‘‘THE TICKET TO WORK AND SELF-SUFFICIENCY

9 PROGRAM

10 ‘‘SEC. 1147. (a) IN GENERAL.—The Commissioner

11 of Social Security shall establish a Ticket to Work and

12 Self-Sufficiency Program, under which a disabled bene13 ficiary may use a ticket to work and self-sufficiency issued

14 by the Commissioner in accordance with this section to

15 obtain employment services, vocational rehabilitation serv16 ices, or other support services from an employment net17 work which is of the beneficiary’s choice and which is will18 ing to provide such services to such beneficiary.

19 ‘‘(b) TICKET SYSTEM.—
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1 ‘‘(1) DISTRIBUTION OF TICKETS.—The Com2 missioner of Social Security may issue a ticket to

3 work and self-sufficiency to disabled beneficiaries for

4 participation in the Program.

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

6 beneficiary holding a ticket to work and self-suffi7 ciency may assign the ticket to any employment net8 work of the beneficiary’s choice which is serving

9 under the Program and is willing to accept the as10 signment.

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

12 paragraph (1) shall consist of a document which evi13 dences the Commissioner’s agreement to pay (as

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

15 which is serving under the Program and to which

16 such ticket is assigned by the beneficiary, for such

17 employment services, vocational rehabilitation serv18 ices, and other support services as the employment

19 network may provide to the beneficiary.

20 ‘‘(4) PAYMENTS TO EMPLOYMENT NET21 WORKS.—The Commissioner shall pay an employ22 ment network under the Program in accordance with

23 the outcome payment system under subsection

24 (h)(2) or under the outcome-milestone payment sys25 tem under subsection (h)(3) (whichever is elected
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1 pursuant to subsection (h)(1)). An employment net2 work may not request or receive compensation for

3 such services from the beneficiary.

4 ‘‘(c) STATE PARTICIPATION.—

5 ‘‘(1) PERIODIC ELECTIONS.—Each State agen6 cy administering or supervising the administration

7 of the State plan approved under title I of the Reha8 bilitation Act of 1973 may elect to participate in the

9 Program (or to revoke any such election) as an em10 ployment network. The Commissioner shall provide

11 for periodic opportunities for exercising such elec12 tions (and revocations).

13 ‘‘(2) TREATMENT OF STATE AGENCIES.—Any

14 such election (or revocation) by a State agency de15 scribed in paragraph (1) taking effect during any

16 period for which an individual residing in the State

17 is a disabled beneficiary and a client of the State

18 agency shall not be effective with respect to such in19 dividual to the extent that such election (or revoca20 tion) would result in any change in the method of

21 payment to the State agency with respect to the in22 dividual from the method of payment to the State

23 agency with respect to the individual in effect imme24 diately before such election (or revocation).
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1 ‘‘(3) 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 paragraph (1) to

6 participate in the Program—

7 ‘‘(i) the employment services, voca8 tional rehabilitation services, and other

9 support services which, upon assignment of

10 tickets to work and self-sufficiency, are

11 provided to disabled beneficiaries by the

12 State agency acting as an employment net13 work shall be governed by plans for voca14 tional rehabilitation services approved

15 under title I of the Rehabilitation Act of

16 1973; and

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

18 and the provisions of subsections (d) and

19 (e) of section 1615 shall not apply with re20 spect to such State.

21 ‘‘(B) STATE AGENCIES ADMINISTERING

22 MATERNAL AND CHILD HEALTH SERVICES PRO23 GRAMS.—Subparagraph (A) shall not apply

24 with respect to any State agency administering

25 a program under title V of this Act.
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1 ‘‘(4) SPECIAL REQUIREMENTS APPLICABLE TO

2 CROSS-REFERRAL TO CERTAIN STATE AGENCIES.—

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

4 an employment network has been assigned a

5 ticket to work and self-sufficiency by a disabled

6 beneficiary, no State agency shall be deemed re7 quired, under this section, title I of the Reha8 bilitation Act of 1973, or a State plan approved

9 under such title, to accept any referral of such

10 disabled beneficiary from such employment net11 work unless such employment network and such

12 State agency have entered into a written agree13 ment that meets the requirements of subpara14 graph (B).

15 ‘‘(B) TERMS OF AGREEMENT.—An agree16 ment required by subparagraph (A) shall speci17 fy, in accordance with regulations prescribed

18 pursuant to subparagraph (C)—

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

20 employment network holding the ticket will

21 provide to the State agency—

22 ‘‘(I) reimbursement for costs in23 curred in providing services described

24 in subparagraph (A) to the disabled

25 beneficiary; and
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1 ‘‘(II) other amounts from pay2 ments made by the Commissioner to

3 the employment network pursuant to

4 subsection (h); and

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

6 required by such regulations.

7 ‘‘(C) REGULATIONS.—The Commissioner

8 of Social Security and the Secretary of Edu9 cation shall jointly prescribe regulations specify10 ing the terms of agreements required by sub11 paragraph (A) and otherwise necessary to carry

12 out the provisions of this paragraph.

13 ‘‘(D) PENALTY.—No payment may be

14 made to an employment network pursuant to

15 subsection (h) in connection with services pro16 vided to any disabled beneficiary if such em17 ployment network makes referrals described in

18 subparagraph (A) in violation of the terms of

19 the contract required under subparagraph (A)

20 or without having entered into such a contract.

21 ‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF

22 SOCIAL SECURITY.—

23 ‘‘(1) SELECTION AND QUALIFICATIONS OF PRO24 GRAM MANAGERS.—The Commissioner of Social Se25 curity shall enter into agreements with 1 or more or-
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1 ganizations in the private or public sector for service

2 as a program manager to assist the Commissioner in

3 administering the Program. Any such program man4 ager shall be selected by means of a competitive bid5 ding process, from among organizations in the pri6 vate or public sector with available expertise and ex7 perience in the field of vocational rehabilitation or

8 employment services.

9 ‘‘(2) TENURE, RENEWAL, AND EARLY TERMI10 NATION.—Each agreement entered into under para11 graph (1) shall provide for early termination upon

12 failure to meet performance standards which shall be

13 specified in the agreement and which shall be

14 weighted to take into account any performance in

15 prior terms. Such performance standards shall in16 clude (but are not limited to)—

17 ‘‘(A) measures for ease of access by bene18 ficiaries to services; and

19 ‘‘(B) measures for determining the extent

20 to which failures in obtaining services for bene21 ficiaries fall within acceptable parameters, as

22 determined by the Commissioner.

23 ‘‘(3) PRECLUSION FROM DIRECT PARTICIPA24 TION IN DELIVERY OF SERVICES IN OWN SERVICE
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1 AREA.—Agreements under paragraph (1) shall

2 preclude—

3 ‘‘(A) direct participation by a program

4 manager in the delivery of employment services,

5 vocational rehabilitation services, or other sup6 port services to beneficiaries in the service area

7 covered by the program manager’s agreement;

8 and

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

10 a financial interest in an employment network

11 or service provider which provides services in a

12 geographic area covered under the program

13 manager’s agreement.

14 ‘‘(4) SELECTION OF EMPLOYMENT NET15 WORKS.—The Commissioner shall select and enter

16 into agreements with employment networks for serv17 ice under the Program. Such employment networks

18 shall be in addition to State agencies serving as em19 ployment networks pursuant to elections under sub20 section (c).

21 ‘‘(5) TERMINATION OF AGREEMENTS WITH EM22 PLOYMENT NETWORKS.—The Commissioner shall

23 terminate agreements with employment networks for

24 inadequate performance, as determined by the Com25 missioner.
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1 ‘‘(6) QUALITY ASSURANCE.—The Commissioner

2 shall provide for such periodic reviews as are nec3 essary to provide for effective quality assurance in

4 the provision of services by employment networks.

5 The Commissioner shall take into account the views

6 of consumers and the program manager under which

7 the employment networks serve and shall consult

8 with providers of services to develop performance

9 measurements. The Commissioner shall ensure that

10 the results of the periodic reviews are made available

11 to beneficiaries who are prospective service recipients

12 as they select employment networks. The Commis13 sioner shall ensure the performance of periodic sur14 veys of beneficiaries receiving services under the

15 Program designed to measure customer service satis16 faction.

17 ‘‘(7) DISPUTE RESOLUTION.—The Commis18 sioner shall provide for a mechanism for resolving

19 disputes between beneficiaries and employment net20 works and between program managers and employ21 ment networks. The Commissioner shall afford a

22 party to such a dispute a reasonable opportunity for

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

24 ‘‘(e) PROGRAM MANAGERS.—
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1 ‘‘(1) IN GENERAL.—A program manager shall

2 conduct tasks appropriate to assist the Commis3 sioner in carrying out the Commissioner’s duties in

4 administering the Program.

5 ‘‘(2) RECRUITMENT OF EMPLOYMENT NET6 WORKS.—A program manager shall recruit, and rec7 ommend for selection by the Commissioner, employ8 ment networks for service under the Program. The

9 program manager shall carry out such recruitment

10 and provide such recommendations, and shall mon11 itor all employment networks serving in the Program

12 in the geographic area covered under the program

13 manager’s agreement, to the extent necessary and

14 appropriate to ensure that adequate choices of serv15 ices are made available to beneficiaries. Employment

16 networks may serve under the Program only pursu17 ant to an agreement entered into with the Commis18 sioner under the Program incorporating the applica19 ble provisions of this section and regulations there20 under, and the program manager shall provide and

21 maintain assurances to the Commissioner that pay22 ment by the Commissioner to employment networks

23 pursuant to this section is warranted based on com24 pliance by such employment networks with the terms

25 of such agreement and this section. The program
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1 manager shall not impose numerical limits on the

2 number of employment networks to be recommended

3 pursuant to this paragraph.

4 ‘‘(3) FACILITATION OF ACCESS BY BENE5 FICIARIES TO EMPLOYMENT NETWORKS.—A pro6 gram manager shall facilitate access by beneficiaries

7 to employment networks. The program manager

8 shall ensure that each beneficiary is allowed changes

9 in employment networks for good cause, as deter10 mined by the Commissioner, without being deemed

11 to have rejected services under the Program. The

12 program manager shall establish and maintain lists

13 of employment networks available to beneficiaries

14 and shall make such lists generally available to the

15 public. The program manager shall ensure that all

16 information provided to disabled beneficiaries pursu17 ant to this paragraph is provided in accessible for18 mat.

19 ‘‘(4) ENSURING AVAILABILITY OF ADEQUATE

20 SERVICES.—The program manager shall ensure that

21 employment services, vocational rehabilitation serv22 ices, and other support services are provided to

23 beneficiaries throughout the geographic area covered

24 under the program manager’s agreement, including

25 rural areas.
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1 ‘‘(5) REASONABLE ACCESS TO SERVICES.—The

2 program manager shall take such measures as are

3 necessary to ensure that sufficient employment net4 works are available and that each beneficiary receiv5 ing services under the Program has reasonable ac6 cess to employment services, vocational rehabilitation

7 services, and other support services. Such services

8 may include case management, benefits counseling,

9 supported employment, career planning, career plan

10 development, vocational assessment, job training,

11 placement, follow-up services, and such other serv12 ices as may be specified by the Commissioner under

13 the Program. The program manager shall ensure

14 that such services are coordinated.

15 ‘‘(f) EMPLOYMENT NETWORKS.—

16 ‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET17 WORKS.—Each employment network serving under

18 the Program shall consist of an agency or instru19 mentality of a State (or a political subdivision there20 of) or a private entity, which assumes responsibility

21 for the coordination and delivery of services under

22 the Program to individuals assigning to the employ23 ment network tickets to work and self-sufficiency

24 issued under subsection (b). No employment network

25 may serve under the Program unless it demonstrates
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1 to the Commissioner substantial expertise and expe2 rience in the field of employment services, vocational

3 rehabilitation services, or other support services for

4 individuals with disabilities and provides an array of

5 such services. An employment network shall consist

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

7 association of such providers organized so as to com8 bine their resources into a single entity. An employ9 ment network may meet the requirements of sub10 section (e)(4) by providing services directly, or by

11 entering into agreements with other individuals or

12 entities providing appropriate employment services,

13 vocational rehabilitation services, or other support

14 services.

15 ‘‘(2) REQUIREMENTS RELATING TO PROVISION

16 OF SERVICES.—Each employment network serving

17 under the Program shall be required under the

18 terms of its agreement with the Commissioner to—

19 ‘‘(A) serve prescribed service areas;

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

21 both general selection criteria (such as profes22 sional and governmental certification and edu23 cational credentials) and specific selection cri24 teria (such as the extent of work experience by

25 the provider with specific populations); and
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1 ‘‘(C) take such measures as are necessary

2 to ensure that employment services, vocational

3 rehabilitation services, and other support serv4 ices provided under the Program by, or under

5 agreements entered into with, the employment

6 network are provided under appropriate individ7 ual work plans meeting the requirements of

8 subsection (g).

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

10 employment network shall meet financial reporting

11 requirements as prescribed by the Commissioner.

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

13 employment network shall prepare periodic reports,

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

15 period specific outcomes achieved with respect to

16 specific services provided by the employment net17 work. Such reports shall conform to a national

18 model prescribed under this section. Each employ19 ment network shall provide a copy of the latest re20 port issued by the employment network pursuant to

21 this paragraph to each beneficiary upon enrollment

22 under the Program for services to be received

23 through such employment network. Upon issuance of

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

25 shall be maintained in the files of the employment
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1 network pertaining to the beneficiary. The program

2 manager shall ensure that copies of all such reports

3 issued under this paragraph are made available to

4 the public under reasonable terms.

5 ‘‘(g) INDIVIDUAL WORK PLANS.—

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

7 shall—

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

9 to ensure that employment services, vocational

10 rehabilitation services, and other support serv11 ices provided under the Program by, or under

12 agreements entered into with, the employment

13 network are provided under appropriate individ14 ual work plans as defined by the Commissioner;

15 and

16 ‘‘(B) develop and implement each such in17 dividual work plan, in the case of each bene18 ficiary receiving such services, in a manner that

19 affords such beneficiary the opportunity to ex20 ercise informed choice in selecting an employ21 ment goal and specific services needed to

22 achieve that employment goal.

23 A beneficiary’s individual work plan shall take effect

24 upon approval by the beneficiary.
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1 ‘‘(2) VOCATIONAL EVALUATION.—In devising

2 the work plan, the employment network shall under3 take a vocational evaluation with respect to the ben4 eficiary. Each vocational evaluation shall set forth in

5 writing such elements and shall be in such format as

6 the Commissioner shall prescribe. The Commissioner

7 may provide for waiver by the beneficiary of such a

8 vocational evaluation, subject to regulations which

9 shall be prescribed by the Commissioner providing

10 for the permissible timing of, and the circumstances

11 permitting, such a waiver.

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

13 ‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM14 PLOYMENT NETWORKS.—

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

16 provide for payment authorized by the Commis17 sioner to employment networks under either an

18 outcome payment system or an outcome-mile19 stone payment system. Each employment net20 work shall elect which payment system will be

21 utilized by the employment network, and, for

22 such period of time as such election remains in

23 effect, the payment system so elected shall be

24 utilized exclusively in connection with such em-
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1 ployment network (except as provided in sub2 paragraph (B)).

3 ‘‘(B) METHOD OF PAYMENT TO EMPLOY4 MENT NETWORKS.—Any such election by an

5 employment network taking effect during any

6 period for which a disabled beneficiary is receiv7 ing services from such employment network

8 shall not be effective with respect to such bene9 ficiary to the extent that such election would re10 sult in any change in the method of payment to

11 the employment network with respect to serv12 ices provided to such beneficiary from the meth13 od of payment to the employment network with

14 respect to services provided to such beneficiary

15 as of immediately before such election.

16 ‘‘(2) OUTCOME PAYMENT SYSTEM.—

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

18 system shall consist of a payment structure gov19 erning employment networks electing such sys20 tem under paragraph (1)(A) which meets the

21 requirements of this paragraph.

22 ‘‘(B) PAYMENTS MADE DURING OUTCOME

23 PAYMENT PERIOD.—The outcome payment sys24 tem shall provide for a schedule of payments to

25 an employment network, in connection with
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1 each individual who is a beneficiary, for each

2 month, during the individual’s outcome pay3 ment period, for which benefits (described in

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

5 not payable to such individual.

6 ‘‘(C) COMPUTATION OF PAYMENTS TO EM7 PLOYMENT NETWORK.—The payment schedule

8 of the outcome payment system shall be de9 signed so that—

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

11 months during the outcome payment pe12 riod for which benefits (described in para13 graphs (2) and (3) of subsection (k)) are

14 not payable is equal to a fixed percentage

15 of the payment calculation base for the cal16 endar year in which such month occurs;

17 and

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

19 percentage which does not exceed 40 per20 cent.

21 ‘‘(3) OUTCOME-MILESTONE PAYMENT SYS22 TEM.—

23 ‘‘(A) IN GENERAL.—The outcome-mile24 stone payment system shall consist of a pay25 ment structure governing employment networks
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1 electing such system under paragraph (1)(A)

2 which meets the requirements of this para3 graph.

4 ‘‘(B) EARLY PAYMENTS UPON ATTAIN5 MENT OF MILESTONES IN ADVANCE OF OUT6 COME PAYMENT PERIODS.—The outcome-mile7 stone payment system shall provide for 1 or

8 more milestones, with respect to beneficiaries

9 receiving services from an employment network

10 under the Program, which are directed toward

11 the goal of permanent employment. Such mile12 stones shall form a part of a payment structure

13 which provides, in addition to payments made

14 during outcome payment periods, payments

15 made prior to outcome payment periods in

16 amounts based on the attainment of such mile17 stones.

18 ‘‘(C) LIMITATION ON TOTAL PAYMENTS TO

19 EMPLOYMENT NETWORK.—The payment sched20 ule of the outcome milestone payment system

21 shall be designed so that the total of the pay22 ments to the employment network with respect

23 to each beneficiary is less than, on a net

24 present value basis (using an interest rate de25 termined by the Commissioner that appro-
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1 priately reflects the cost of funds faced by pro2 viders), the total amount to which payments to

3 the employment network with respect to the

4 beneficiary would be limited if the employment

5 network were paid under the outcome payment

6 system.

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

8 subsection—

9 ‘‘(A) PAYMENT CALCULATION BASE.—The

10 term ‘payment calculation base’ means, for any

11 calendar year—

12 ‘‘(i) in connection with a title II dis13 ability beneficiary, the average disability

14 insurance benefit payable under section

15 223 for all beneficiaries for months during

16 the preceding calendar year; and

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

18 disability beneficiary (who is not concur19 rently a title II disability beneficiary), the

20 average payment of supplemental security

21 income benefits based on disability payable

22 under title XVI (excluding State sup23 plementation) for months during the pre24 ceding calendar year to all beneficiaries

25 who have attained at least 18 years of age.
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1 ‘‘(B) OUTCOME PAYMENT PERIOD.—The

2 term ‘outcome payment period’ means, in con3 nection with any individual who had assigned a

4 ticket to work and self-sufficiency to an employ5 ment network under the Program, a period—

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

7 ending after the date on which such ticket

8 was assigned to the employment network,

9 for which benefits (described in paragraphs

10 (2) and (3) of subsection (k)) are not pay11 able to such individual by reason of en12 gagement in work activity; 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 work activity.

18 ‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF

19 PRESCRIBED SCHEDULES.—

20 ‘‘(A) PERCENTAGES AND PERIODS.—The

21 Commissioner of Social Security shall periodi22 cally review the percentage specified in para23 graph (2)(C), the total payments permissible

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

25 specified in paragraph (4)(B) to determine
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1 whether such percentages, such permissible pay2 ments, and such period provide an adequate in3 centive for employment networks to assist bene4 ficiaries to enter the workforce, while providing

5 for appropriate economies. The Commissioner

6 may alter such percentage, such total permis7 sible payments, or such period of time to the

8 extent that the Commissioner determines, on

9 the basis of the Commissioner’s review under

10 this paragraph, that such an alteration would

11 better provide the incentive and economies de12 scribed in the preceding sentence.

13 ‘‘(B) NUMBER AND AMOUNT OF MILE14 STONE PAYMENTS.—The Commissioner shall

15 periodically review the number and amounts of

16 milestone payments established by the Commis17 sioner pursuant to this section to determine

18 whether they provide an adequate incentive for

19 employment networks to assist beneficiaries to

20 enter the workforce, taking into account infor21 mation provided to the Commissioner by pro22 gram managers, the Ticket to Work and Self23 Sufficiency Advisory Panel, and other reliable

24 sources. The Commissioner may from time to

25 time alter the number and amounts of mile-
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1 stone payments initially established by the

2 Commissioner pursuant to this section to the

3 extent that the Commissioner determines that

4 such an alteration would allow an adequate in5 centive for employment networks to assist bene6 ficiaries to enter the workforce. Such alteration

7 shall be based on information provided to the

8 Commissioner by program managers, the Ticket

9 to Work and Self-Sufficiency Advisory Panel, or

10 other reliable sources.

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

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

13 and self-sufficiency issued under this section, the Commis14 sioner (and any applicable State agency) may not initiate

15 a continuing disability review or other review under section

16 221 of whether the individual is or is not under a disability

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

18 under section 221.

19 ‘‘(j) AUTHORIZATIONS.—

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

21 There are authorized to be transferred from the

22 Federal Old-Age and Survivors Insurance Trust

23 Fund and the Federal Disability Insurance Trust

24 Fund each fiscal year such sums as may be nec25 essary to carry out the provisions of this section
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1 with respect to title II disability beneficiaries. Money

2 paid from the Trust Funds under this section with

3 respect to title II disability beneficiaries who are en4 titled to benefits under section 223 or who are enti5 tled to benefits under section 202(d) on the basis of

6 the wages and self-employment income of such bene7 ficiaries, shall be charged to the Federal Disability

8 Insurance Trust Fund, and all other money paid

9 from the Trust Funds under this section shall be

10 charged to the Federal Old-Age and Survivors Insur11 ance Trust Fund. The Commissioner of Social Secu12 rity shall determine according to such methods and

13 procedures as shall be prescribed under this

14 section—

15 ‘‘(A) the total amount to be paid to pro16 gram managers and employment networks

17 under this section; and

18 ‘‘(B) subject to the provisions of the pre19 ceding sentence, the amount which should be

20 charged to each of the Trust Funds.

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

22 Amounts authorized to be appropriated to the Social

23 Security Administration under section 1601 (as in

24 effect pursuant to the amendments made by section

25 301 of the Social Security Amendments of 1972)
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1 shall include amounts necessary to carry out the

2 provisions of this section with respect to title XVI

3 disability beneficiaries.

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

5 ‘‘(1) DISABLED BENEFICIARY.—The term ‘dis6 abled beneficiary’ means a title II disability bene7 ficiary or a title XVI disability beneficiary.

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

9 term ‘title II disability beneficiary’ means an individ10 ual entitled to disability insurance benefits under

11 section 223 or to monthly insurance benefits under

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

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

14 disability beneficiary for each month for which such

15 individual is entitled to such benefits.

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

17 The term ‘title XVI disability beneficiary’ means an

18 individual eligible for supplemental security income

19 benefits under title XVI on the basis of blindness

20 (within the meaning of section 1614(a)(2)) or dis21 ability (within the meaning of section 1614(a)(3)).

22 An individual is a title XVI disability beneficiary for

23 each month for which such individual is eligible for

24 such benefits.
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1 ‘‘(4) SUPPLEMENTAL SECURITY INCOME BENE2 FIT.—The term ‘supplemental security income bene3 fit under title XVI’ means a cash benefit under sec4 tion 1611 or 1619(a), and does not include a State

5 supplementary payment, administered federally or

6 otherwise.

7 ‘‘(l) REGULATIONS.—The Commissioner of Social Se8 curity shall prescribe such regulations as are necessary to

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

10 (b) CONFORMING AMENDMENTS.—

11 (1) AMENDMENTS TO TITLE II.—

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

13 421(c)) is amended by adding at the end the

14 following new paragraph:

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

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

17 self-sufficiency, see section 1147(i).’’.

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

19 422(a)) is repealed.

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

21 422(b)) is repealed.

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

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

24 program of vocational rehabilitation services’’

25 and inserting ‘‘a program consisting of the
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1 Ticket to Work and Self-Sufficiency Program

2 under section 1147 or another program of voca3 tional rehabilitation services, employment serv4 ices, or other support services’’.

5 (2) AMENDMENTS TO TITLE XVI.—

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

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

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

9 individual who—

10 ‘‘(1) has not attained age 16; and

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

12 under this title,

13 the Commissioner of Social Security shall make provision

14 for referral of such individual to the appropriate State

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

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

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

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

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

20 ‘‘a program of vocational rehabilitation serv21 ices’’ and inserting ‘‘a program consisting of

22 the Ticket to Work and Self-Sufficiency Pro23 gram under section 1147 or another program of

24 vocational rehabilitation services, employment

25 services, or other support services’’.
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1 (D) Section 1633(c) of such Act (42

2 U.S.C. 1383b(c)) is amended—

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

4 (ii) by adding at the end the following

5 new paragraph:

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

7 and other reviews under this title similar to reviews under

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

9 work and self-sufficiency, see section 1147(i).’’.

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

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

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

13 date of the enactment of this Act.

14 (d) GRADUATED IMPLEMENTATION OF PROGRAM.—

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

16 the date of the enactment of this Act, the Commis17 sioner of Social Security shall commence implemen18 tation of the amendments made by this section

19 (other than paragraphs (1)(C) and (2)(B) of sub20 section (b)) in graduated phases at phase-in sites se21 lected by the Commissioner. Such phase-in sites

22 shall be selected so as to ensure, prior to full imple23 mentation of the Ticket to Work and Self-Suffi24 ciency Program, the development and refinement of

25 referral processes, payment systems, computer link-
30

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1 ages, management information systems, and admin2 istrative processes necessary to provide for full im3 plementation of such amendments. Subsection (c)

4 shall apply with respect to paragraphs (1)(C) and

5 (2)(B) of subsection (b) without regard to this sub6 section.

7 (2) REQUIREMENTS.—Implementation of the

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

9 on a wide enough scale to permit a thorough evalua10 tion of the alternative methods under consideration,

11 so as to ensure that the most efficacious methods

12 are determined and in place for full implementation

13 of the Program on a timely basis.

14 (3) FULL IMPLEMENTATION.—The Commis15 sioner shall ensure that the Program is fully imple16 mented as soon as practicable on or after the effec17 tive date specified in subsection (c) but not later

18 than 6 years after such date.

19 (4) ONGOING EVALUATION OF PROGRAM.—

20 (A) IN GENERAL.—The Commissioner

21 shall design and conduct a series of evaluations

22 to assess the cost-effectiveness of activities car23 ried out under this section and the amendments

24 made thereby, as well as the effects of this sec25 tion and the amendments made thereby on
31

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1 work outcomes for beneficiaries receiving tickets

2 to work and self-sufficiency under the Program.

3 (B) METHODOLOGY.—

4 (i) DESIGN AND IMPLEMENTATION.—

5 The Commissioner shall design the series

6 of evaluations after receiving relevant ad7 vice from experts in the fields of disability,

8 vocational rehabilitation, and program

9 evaluation and individuals using tickets to

10 work and self-sufficiency under the Pro11 gram. In designing and carrying out such

12 evaluations, the Commissioner shall consult

13 with the Comptroller General of the United

14 States and other agencies of the Federal

15 Government and with private organizations

16 with appropriate expertise. Before provi17 sion of services begins under any phase of

18 Program implementation, the Commis19 sioner shall ensure that plans for such

20 evaluations and data collection methods

21 are in place and ready for implementation.

22 (ii) SPECIFIC MATTERS TO BE AD23 DRESSED.—Each such evaluation shall ad24 dress (but is not limited to):
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1 (I) the annual cost (including net

2 cost) of the Program and the annual

3 cost (including net cost) that would

4 have been incurred in the absence of

5 the Program;

6 (II) the determinants of return to

7 work, including the characteristics of

8 beneficiaries in receipt of tickets

9 under the Program;

10 (III) the types of employment

11 services, vocational rehabilitation serv12 ices, and other support services fur13 nished to beneficiaries in receipt of

14 tickets under the Program who return

15 to work and to those who do not re16 turn to work;

17 (IV) the duration of employment

18 services, vocational rehabilitation serv19 ices, and other support services fur20 nished to beneficiaries in receipt of

21 tickets under the Program who return

22 to work and the duration of such serv23 ices furnished to those who do not re24 turn to work and the cost to employ-
33

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1 ment networks of furnishing such

2 services;

3 (V) the employment outcomes,

4 including wages, occupations, benefits,

5 and hours worked, of beneficiaries

6 who return to work after receiving

7 tickets under the Program and those

8 who return to work without receiving

9 such tickets;

10 (VI) the characteristics of provid11 ers whose services are provided within

12 an employment network under the

13 Program;

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

15 employment networks display a great16 er willingness to provide services to

17 disabled beneficiaries;

18 (VIII) the characteristics (includ19 ing employment outcomes) of those

20 beneficiaries who receive services

21 under the outcome payment system

22 and of those beneficiaries who receive

23 services under the outcome-milestone

24 payment system;
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1 (IX) measures of satisfaction

2 among beneficiaries in receipt of tick3 ets under the Program; and

4 (X) reasons for (including com5 ments solicited from beneficiaries re6 garding) their choice not to use their

7 tickets or their inability to return to

8 work despite the use of their tickets.

9 (C) PERIODIC EVALUATION REPORTS.—

10 Following the close of the third and fifth fiscal

11 years ending after the effective date under sub12 section (c), and prior to the close of the seventh

13 fiscal year ending after such date, the Commis14 sioner shall transmit to the Committee on Ways

15 and Means of the House of Representatives and

16 the Committee on Finance of the Senate a re17 port containing the Commissioner’s evaluation

18 of the progress of activities conducted under the

19 provisions of this section and the amendments

20 made thereby. Each such report shall set forth

21 the Commissioner’s evaluation of the extent to

22 which the Program has been successful and the

23 Commissioner’s conclusions on whether or how

24 the Program should be modified. Each such re25 port shall include such data, findings, materials,
35

•S 86 IS

1 and recommendations as the Commissioner may

2 consider appropriate.

3 (5) EXTENT OF STATE’S RIGHT OF FIRST RE4 FUSAL IN ADVANCE OF FULL IMPLEMENTATION OF

5 AMENDMENTS IN SUCH STATE.—

6 (A) IN GENERAL.—In the case of any

7 State in which the amendments made by sub8 section (a) have not been fully implemented

9 pursuant to this subsection, the Commissioner

10 shall determine by regulation the extent to

11 which—

12 (i) the requirement under section

13 222(a) of the Social Security Act for

14 prompt referrals to a State agency; and

15 (ii) the authority of the Commissioner

16 under section 222(d)(2) of such Act to

17 provide vocational rehabilitation services in

18 such State by agreement or contract with

19 other public or private agencies, organiza20 tions, institutions, or individuals,

21 shall apply in such State.

22 (B) EXISTING AGREEMENTS.—Nothing in

23 subparagraph (A) or the amendments made by

24 subsection (a) shall be construed to limit, im25 pede, or otherwise affect any agreement entered
36

•S 86 IS

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

2 Security Act before the date of the enactment

3 of this Act with respect to services provided

4 pursuant to such agreement to beneficiaries re5 ceiving services under such agreement as of

6 such date, except with respect to services (if

7 any) to be provided after 6 years after the ef8 fective date provided in subsection (c).

9 (e) THE TICKET TO WORK AND SELF-SUFFICIENCY

10 ADVISORY PANEL.—

11 (1) ESTABLISHMENT.—There is established in

12 the executive branch a panel to be known as the

13 ‘‘Ticket to Work and Self-Sufficiency Advisory

14 Panel’’ (in this subsection referred to as the

15 ‘‘Panel’’).

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

17 the Panel to—

18 (A) advise the Commissioner of Social Se19 curity on establishing phase-in sites for the

20 Ticket to Work and Self-Sufficiency Program

21 and on fully implementing the Program there22 after;

23 (B) advise the Commissioner with respect

24 to the refinement of access of disabled bene25 ficiaries to employment networks, payment sys-
37

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1 tems, and management information systems

2 and advise the Commissioner whether such

3 measures are being taken to the extent nec4 essary to ensure the success of the Program;

5 (C) advise the Commissioner regarding the

6 most effective designs for research and dem7 onstration projects associated with the Program

8 or conducted pursuant to subsection (h);

9 (D) advise the Commissioner on the devel10 opment of performance measurements relating

11 to quality assurance under section 1147(d)(6)

12 of the Social Security Act; and

13 (E) furnish progress reports on the Pro14 gram to the President and each House of the

15 Congress.

16 (3) MEMBERSHIP.—

17 (A) NUMBER AND APPOINTMENT.—The

18 Panel shall be composed of 6 members as fol19 lows:

20 (i) one member appointed by the

21 Chairman of the Committee on Ways and

22 Means of the House of Representatives;

23 (ii) one member appointed by the

24 ranking minority member of the Commit-
38

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1 tee on Ways and Means of the House of

2 Representatives;

3 (iii) one member appointed by the

4 Chairman of the Committee on Finance of

5 the Senate;

6 (iv) one member appointed by the

7 ranking minority member of the Commit8 tee on Finance of the Senate; and

9 (v) two members appointed by the

10 President, who may not be of the same po11 litical party.

12 (B) REPRESENTATION.—Of the members

13 appointed under subparagraph (A), at least 4

14 shall have experience or expert knowledge as a

15 recipient, provider, employer, or employee in the

16 fields of, or related to, employment services, vo17 cational rehabilitation services, and other sup18 port services, of whom—

19 (i) at least 1 shall represent the inter20 ests of recipients of employment services,

21 vocational rehabilitation services, and other

22 support services;

23 (ii) at least 1 shall represent the in24 terests of providers of employment serv-
39

•S 86 IS

1 ices, vocational rehabilitation services, and

2 other support services;

3 (iii) at least 1 shall represent the in4 terests of private employers;

5 (iv) at least 1 shall represent the in6 terests of employees; and

7 (v) at least 1 shall be an individual

8 who is or has been a recipient of benefits

9 under title II or title XVI based on disabil10 ity.

11 (C) TERMS.—

12 (i) IN GENERAL.—Each member shall

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

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

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

16 The initial members shall be appointed not

17 later than 90 days after the date of the en18 actment of this Act.

19 (ii) TERMS OF INITIAL AP20 POINTEES.—As designated by the Presi21 dent at the time of appointment, of the

22 members first appointed—

23 (I) three of the members ap24 pointed under subparagraph (A) shall
40

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1 be appointed for a term of 2 years;

2 and

3 (II) three of the members ap4 pointed under subparagraph (A) shall

5 be appointed for a term of 4 years.

6 (iii) VACANCIES.—Any member ap7 pointed to fill a vacancy occurring before

8 the expiration of the term for which the

9 member’s predecessor was appointed shall

10 be appointed only for the remainder of that

11 term. A member may serve after the expi12 ration of that member’s term until a suc13 cessor has taken office. A vacancy in the

14 Panel shall be filled in the manner in

15 which the original appointment was made.

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

17 paid at a rate equal to the daily equivalent of

18 the rate of basic pay for level 4 of the Senior

19 Executive Service, as in effect from time to

20 time under section 5382 of title 5, United

21 States Code, for each day (including travel

22 time) during which they are engaged in the ac23 tual performance of duties vested in the Panel.

24 (E) TRAVEL EXPENSES.—Each member

25 shall receive travel expenses, including per diem
41

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1 in lieu of subsistence, in accordance with sec2 tions 5702 and 5703 of title 5, United States

3 Code.

4 (F) QUORUM.—Four members of the

5 Panel shall constitute a quorum but a lesser

6 number may hold hearings.

7 (G) CHAIRPERSON.—The Chairperson of

8 the Panel shall be designated by the President.

9 The term of office of the Chairperson shall be

10 4 years.

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

12 least quarterly and at other times at the call of

13 the Chairperson or a majority of its members.

14 (4) DIRECTOR AND STAFF OF PANEL; EXPERTS

15 AND CONSULTANTS.—

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

17 Director who shall be appointed by the Panel.

18 The Director shall be paid at a rate not to ex19 ceed the maximum rate of pay payable for GS–

20 15 of the General Schedule.

21 (B) STAFF.—Subject to rules prescribed

22 by the Panel, the Director may appoint and fix

23 the pay of additional personnel as the Director

24 considers appropriate.
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1 (C) EXPERTS AND CONSULTANTS.—Sub2 ject to rules prescribed by the Panel, the Direc3 tor may procure temporary and intermittent

4 services under section 3109(b) of title 5, United

5 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 Act.

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 section.

23 (C) MAILS.—The Panel may use the

24 United States mails in the same manner and
43

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1 under the same conditions as other departments

2 and agencies of the United States.

3 (D) ADMINISTRATIVE SUPPORT SERV4 ICES.—Upon the request of the Panel, the Ad5 ministrator of General Services shall provide to

6 the Panel, on a reimbursable basis, the admin7 istrative support services necessary for the

8 Panel to carry out its duties under this sub9 section.

10 (6) REPORTS.—

11 (A) INTERIM REPORTS.—The Panel shall

12 submit to the President and the Congress in13 terim reports at least annually.

14 (B) FINAL REPORT.—The Panel shall

15 transmit a final report to the President and the

16 Congress not later than 8 years after the date

17 of the enactment of this Act. The final report

18 shall contain a detailed statement of the find19 ings and conclusions of the Panel, together with

20 its recommendations for legislation and admin21 istrative actions which the Panel considers ap22 propriate.

23 (7) TERMINATION.—The Panel shall terminate

24 30 days after the date of the submission of its final

25 report under paragraph (6)(B).
44

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1 (8) AUTHORIZATION OF APPROPRIATIONS.—

2 There are authorized to be appropriated from the

3 Federal Old-Age and Survivors Insurance Trust

4 Fund, the Federal Disability Insurance Trust Fund,

5 and the general fund of the Treasury, as appro6 priate, such sums as are necessary to carry out this

7 subsection.

8 (f) SPECIFIC REGULATIONS REQUIRED.—

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

10 Security shall prescribe such regulations as are nec11 essary to implement the amendments made by this

12 section.

13 (2) SPECIFIC MATTERS TO BE INCLUDED IN

14 REGULATIONS.—The matters which shall be ad15 dressed in such regulations shall include (but are not

16 limited to)—

17 (A) the form and manner in which tickets

18 to work and self-sufficiency may be distributed

19 to beneficiaries pursuant to section 1147(b)(1)

20 of the Social Security Act;

21 (B) the format and wording of such tick22 ets, which shall incorporate by reference any

23 contractual terms governing service by employ24 ment networks under the Program;
45

•S 86 IS

1 (C) the form and manner in which State

2 agencies may elect participation in the Ticket to

3 Work and Self-Sufficiency Program (and revoke

4 such an election) pursuant to section

5 1147(c)(1) of such Act and provision for peri6 odic opportunities for exercising such elections

7 (and revocations);

8 (D) the status of State agencies under sec9 tion 1147(c)(2) of such Act at the time that

10 State agencies exercise elections (and revoca11 tions) under section 1147(c)(1) of such Act;

12 (E) the terms of agreements to be entered

13 into with program managers pursuant to sec14 tion 1147(d) of such Act, including (but not

15 limited to)—

16 (i) the terms by which program man17 agers are precluded from direct participa18 tion in the delivery of services pursuant to

19 section 1147(d)(3) of such Act;

20 (ii) standards which must be met by

21 quality assurance measures referred to in

22 paragraph (6) of section 1147(d) of such

23 Act and methods of recruitment of employ24 ment networks utilized pursuant to para-
46

•S 86 IS

1 graph (2) of section 1147(e) of such Act;

2 and

3 (iii) the format under which dispute

4 resolution will operate under section

5 1147(d)(7) of such Act;

6 (F) the terms of agreements to be entered

7 into with employment networks pursuant to sec8 tion 1147(d)(4) of such Act, including (but not

9 limited to)—

10 (i) the manner in which service areas

11 are specified pursuant to section

12 1147(f)(2)(A) of such Act;

13 (ii) the general selection criteria and

14 the specific selection criteria which are ap15 plicable to employment networks under

16 section 1147(f)(2)(B) of such Act in select17 ing service providers;

18 (iii) specific requirements relating to

19 annual financial reporting by employment

20 networks pursuant to section 1147(f)(3) of

21 such Act; and

22 (iv) the national model to which peri23 odic outcomes reporting by employment

24 networks must conform under section

25 1147(f)(4) of such Act;
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1 (G) standards which must be met by indi2 vidual work plans pursuant to section 1147(g)

3 of such Act;

4 (H) standards which must be met by pay5 ment systems required under section 1147(h) of

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

7 (i) the form and manner in which

8 elections by employment networks of pay9 ment systems are to be exercised pursuant

10 to section 1147(h)(1)(A) of such Act;

11 (ii) the terms which must be met by

12 an outcome payment system under section

13 1147(h)(2) of such Act;

14 (iii) the terms which must be met by

15 an outcome-milestone payment system

16 under section 1147(h)(3) of such Act;

17 (iv) any revision of the percentage

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

19 1147(h) of such Act or the period of time

20 specified in paragraph (4)(B) of section

21 1147(h) of such Act; and

22 (v) annual oversight procedures for

23 such systems; and

24 (I) procedures for effective oversight of the

25 Program by the Commissioner of Social Secu-
48

•S 86 IS

1 rity, including periodic reviews and reporting

2 requirements.

3 (g) WORK INCENTIVE SPECIALISTS.—The Commis4 sioner shall establish a corps of trained, accessible, and

5 responsive work incentive specialists to specialize in title

6 II and title XVI disability work incentives for the purpose

7 of disseminating accurate information to disabled bene8 ficiaries (as defined in section 1147(k)(1) of the Social

9 Security Act, as amended by this Act) with respect to in10 quiries and issues relating to work incentives.

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

13 ON EARNINGS. —

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

17 title II disability beneficiaries (as defined in section

18 1147(k)(2) of the Social Security Act, as amended

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

20 under section 223 of the Social Security Act, or

21 under section 202 of such Act based on the bene22 ficiary’s disability, is reduced for each $2 of such

23 beneficiary’s earnings that is above a level to be de24 termined by the Commissioner. Such projects shall

25 be conducted at a number of localities which the
49

•S 86 IS

1 Commissioner shall determine is sufficient to ade2 quately evaluate the appropriateness of national im3 plementation of such a program. Such projects shall

4 identify reductions in Federal expenditures that may

5 result from the permanent implementation of such

6 a program.

7 (2) SCOPE AND SCALE AND MATTERS TO BE

8 DETERMINED.—

9 (A) IN GENERAL.—The demonstration

10 projects developed under paragraph (1) shall be

11 of sufficient duration, shall be of sufficient

12 scope, and shall be carried out on a wide

13 enough scale to permit a thorough evaluation of

14 the project to determine—

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

16 and reduced exit;

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

18 project being tested is affected by whether

19 it is in operation in a locality within an

20 area under the administration of the Tick21 et to Work and Self-Sufficiency Program;

22 and

23 (iii) the savings that accrue to the

24 Trust Funds and other Federal programs

25 under the project being tested.
50

•S 86 IS

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

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

7 project—

8 (i) the annual cost (including net

9 cost) of the project and the annual cost

10 (including net cost) that would have been

11 incurred in the absence of the project;

12 (ii) the determinants of return to

13 work, including the characteristics of the

14 beneficiaries who participate in the project;

15 and

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

18 worked, of beneficiaries who return to work

19 as a result of participation in the project.

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

22 trial work periods and periods of extended eligi23 bility.

24 (3) WAIVERS.—The Commissioner may waive

25 compliance with the benefit provisions of title II of
51

•S 86 IS

1 the Social Security Act, and the Secretary of Health

2 and Human Services may waive compliance with the

3 benefit requirements of title XVIII of such Act, in

4 so far as is necessary for a thorough evaluation of

5 the alternative methods under consideration. No

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

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

12 House of Representatives and to the Committee on

13 Finance of the Senate. Periodic reports on the

14 progress of such projects shall be submitted by the

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

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

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

21 in 2000 and each of the succeeding years thereafter,

22 the Commissioner shall submit to the Congress an

23 interim report on the progress of the demonstration

24 projects carried out under this subsection together
52

•S 86 IS

1 with any related data and materials which the Com2 missioner may consider appropriate.

3 (5) FINAL REPORT.—The Commissioner shall

4 submit to the Congress a final report with respect

5 to all demonstration projects carried out under this

6 section no later than 1 year after their completion.

7 (6) EXPENDITURES.—Expenditures made for

8 demonstration projects under this subsection shall

9 be made from the Federal Disability Insurance

10 Trust Fund and the Federal Old-Age and Survivors

11 Insurance Trust Fund, as determined appropriate by

12 the Commissioner, and from the Federal Hospital

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

16 Human Services, to the extent provided in advance

17 in appropriation Acts.

18 (i) STUDY BY GENERAL ACCOUNTING OFFICE OF

19 EXISTING DISABILITY-RELATED EMPLOYMENT INCEN20 TIVES.—

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

22 date of the enactment of this Act, the Comptroller

23 General of the United States shall undertake a study

24 to assess existing tax credits and other disability-re25 lated employment incentives under the Americans
53

•S 86 IS

1 with Disabilities Act of 1990 and other Federal

2 laws. In such study, the Comptroller General shall

3 specifically address the extent to which such credits

4 and other incentives would encourage employers to

5 hire and retain individuals with disabilities under the

6 Ticket to Work and Self-Sufficiency Program.

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

8 date of the enactment of this Act, the Comptroller

9 General shall transmit to the Committee on Ways

10 and Means of the House of Representatives and the

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

14 together with such recommendations for legislative

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

17 (j) STUDY BY GENERAL ACCOUNTING OFFICE OF

18 EXISTING COORDINATION OF THE DI AND SSI PROGRAMS

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

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

22 date of the enactment of this Act, the Comptroller

23 General of the United States shall undertake a study

24 to evaluate the coordination under current law of the

25 disability insurance program under title II of the So-
54

•S 86 IS

1 cial Security Act and the supplemental security in2 come program under title XVI of such Act, as such

3 programs relate to individuals entering or leaving

4 concurrent entitlement under such programs. In

5 such study, the Comptroller General shall specifically

6 address the effectiveness of work incentives under

7 such programs with respect to such individuals and

8 the effectiveness of coverage of such individuals

9 under titles XVIII and XIX of such Act.

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

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

13 Ways and Means of the House of Representatives

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

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

19 General may determine to be appropriate.
55

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1 SEC. 3. EXTENDING MEDICARE COVERAGE FOR OASDI DIS2 ABILITY BENEFIT RECIPIENTS WHO ARE

3 USING TICKETS TO WORK AND SELF-SUFFI4 CIENCY.

5 (a) IN GENERAL.—The next to last sentence of sec6 tion 226(b) of the Social Security Act (42 U.S.C. 426)

7 is amended—

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

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

10 and

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

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

13 such months in the case of an individual who the

14 Commissioner determines is using a ticket to work

15 and self-sufficiency issued under section 1147, but

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

17 period beginning on the date of the enactment of the

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

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

20 end of the 7-year period beginning on the date of the en21 actment of this Act, the Secretary of Health and Human

22 Services and the Commissioner of Social Security shall

23 submit in writing to each House of the Congress their rec24 ommendations for further legislative action with respect

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

26 account experience derived from efforts to achieve full im-
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1 plementation of the Ticket to Work and Self Sufficiency

2 Program under section 1147 of the Social Security Act.

3 SEC. 4. TECHNICAL AMENDMENTS RELATING TO DRUG AD4 DICTS 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 new sub15 paragraphs:

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

17 individual’s claim, with respect to benefits

18 under title II of the Social Security Act based

19 on disability, which has been denied in whole

20 before the date of the enactment of this Act,

21 may not be considered to be finally adjudicated

22 before such date if, on or after such date—

23 ‘‘(i) there is pending a request for ei24 ther administrative or judicial review with

25 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 preced17 ing provisions of this paragraph, and the provi18 sions of section 223(f) of the Social Security

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

20 (b) CORRECTION TO EFFECTIVE DATE OF PROVI21 SIONS CONCERNING REPRESENTATIVE PAYEES AND

22 TREATMENT REFERRALS OF SOCIAL SECURITY BENE23 FICIARIES WHO ARE DRUG ADDICTS AND ALCOHOLICS.—

24 Section 105(a)(5)(B) of such Act (Public Law 104–121;

25 110 Stat. 853) is amended to read as follows:
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1 ‘‘(B) The amendments made by para2 graphs (2) and (3) shall take effect on July 1,

3 1996, with respect to any individual—

4 ‘‘(i) whose claim for benefits is finally

5 adjudicated on or after the date of the en6 actment of this Act; or

7 ‘‘(ii) whose entitlement to benefits is

8 based upon an entitlement redetermination

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

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

11 this section shall take effect as if included in the enact12 ment of section 105 of the Contract with America Ad13 vancement Act of 1996 (Public Law 104–121; 110 Stat.

14 852 et seq.).

15 SEC. 5. EXTENSION OF DISABILITY INSURANCE PROGRAM

16 DEMONSTRATION PROJECT AUTHORITY.

17 (a) IN GENERAL.—Section 505 of the Social Security

18 Disability Amendments of 1980 (Public Law 96–265; 94

19 Stat. 473), as amended by section 12101 of the Consoli20 dated Omnibus Budget Reconciliation Act of 1985 (Public

21 Law 99–272; 100 Stat. 282), section 10103 of the Omni22 bus Budget Reconciliation Act of 1989 (Public Law 101–

23 239; 103 Stat. 2472), section 5120(f) of the Omnibus

24 Budget Reconciliation Act of 1990 (Public Law 101–508;

25 104 Stat. 1388–282), and section 315 of the Social Secu-
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1 rity Independence and Program Improvements Act of

2 1994 (Public Law 103–296; 108 Stat. 1531), is further

3 amended—

4 (1) in paragraph (1) of subsection (a), by add5 ing at the end the following new sentence: ‘‘The

6 Commissioner may expand the scope of any such

7 demonstration project to include any group of appli8 cants for benefits under such program with impair9 ments which may reasonably be presumed to be dis10 abling for purposes of such demonstration project,

11 and may limit any such demonstration project to

12 any such group of applicants, subject to the terms

13 of such demonstration project which shall define the

14 extent of any such presumption.’’;

15 (2) in paragraph (3) of subsection (a), by strik16 ing ‘‘June 10, 1996’’ and inserting ‘‘June 10,

17 2001’’;

18 (3) in paragraph (4) of subsection (a), by in19 serting ‘‘and on or before October 1, 2000,’’ after

20 ‘‘1995,’’; and

21 (4) in subsection (c), by striking ‘‘October 1,

22 1996’’ and inserting ‘‘October 1, 2001’’.

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

24 subsection (a) shall take effect on the date of the enact25 ment of this Act.
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1 SEC. 6. TREATMENT OF PRISONERS.

2 (a) IMPLEMENTATION OF PROHIBITION AGAINST

3 PAYMENT OF TITLE II BENEFITS TO PRISONERS.—

4 (1) IN GENERAL.—Section 202(x)(3) of the So5 cial Security Act (42 U.S.C. 402(x)(3)) is

6 amended—

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

8 (B) by adding at the end the following new

9 subparagraph:

10 ‘‘(B)(i) The Commissioner shall enter into an agree11 ment under this subparagraph with any interested State

12 or local institution comprising a jail, prison, penal institu13 tion, or correctional facility, or comprising any other insti14 tution a purpose of which is to confine individuals as de15 scribed in paragraph (1)(A)(ii). Under such agreement—

16 ‘‘(I) the institution shall provide to the Com17 missioner, on a monthly basis and in a manner spec18 ified by the Commissioner, the names, Social Secu19 rity account numbers, dates of birth, confinement

20 commencement dates, and, to the extent available to

21 the institution, such other identifying information

22 concerning the individuals confined in the institution

23 as the Commissioner may require for the purpose of

24 carrying out paragraph (1); and

25 ‘‘(II) the Commissioner shall pay to the institu26 tion, with respect to information described in sub-
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1 clause (I) concerning each individual who is confined

2 therein as described in paragraph (1)(A), who re3 ceives a benefit under this title for the month pre4 ceding the first month of such confinement, and

5 whose benefit under this title is determined by the

6 Commissioner to be not payable by reason of con7 finement based on the information provided by the

8 institution, $400 (subject to reduction under clause

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

10 the Commissioner within 30 days after the date such

11 individual’s confinement in such institution begins,

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

13 the institution furnishes the information after 30

14 days after such date but within 90 days after such

15 date.

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

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

18 required to make a payment to the institution with respect

19 to the same individual under an agreement entered into

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

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

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

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

24 such agreement.
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1 ‘‘(iv) There is authorized to be transferred from the

2 Federal Old-Age and Survivors Insurance Trust Fund and

3 the Federal Disability Insurance Trust Fund, as appro4 priate, such sums as may be necessary to enable the Com5 missioner to make payments to institutions required by

6 clause (i)(II).

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

8 a reimbursable basis, information obtained pursuant to

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

10 administering a Federal or federally-assisted cash, food,

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

12 (2) EFFECTIVE DATE.—The amendments made

13 by this subsection shall apply to individuals whose

14 period of confinement in an institution commences

15 on or after the first day of the fourth month begin16 ning after the month in which this Act is enacted.

17 (b) ELIMINATION OF TITLE II REQUIREMENT THAT

18 CONFINEMENT STEM FROM CRIME PUNISHABLE BY IM19 PRISONMENT FOR MORE THAN 1 YEAR.—

20 (1) IN GENERAL.—Section 202(x)(1)(A) of such

21 Act (42 U.S.C. 402(x)(1)(A)) is amended—

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

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

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

25 punishable by imprisonment for more than 1
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1 year (regardless of the actual sentence im2 posed)’’ and inserting ‘‘a criminal offense’’; and

3 (C) in clause (ii)(I), by striking ‘‘an of4 fense punishable by imprisonment for more

5 than 1 year’’ and inserting ‘‘a criminal of6 fense’’.

7 (2) EFFECTIVE DATE.—The amendments made

8 by this subsection shall apply to individuals whose

9 period of confinement in an institution commences

10 on or after the first day of the fourth month begin11 ning after the month in which this Act is enacted.

12 (c) CONFORMING TITLE XVI AMENDMENTS.—

13 (1) FIFTY PERCENT REDUCTION IN TITLE XVI

14 PAYMENT IN CASE INVOLVING COMPARABLE TITLE II

15 PAYMENT.—Section 1611(e)(1)(I) of the Social Se16 curity Act (42 U.S.C. 1382(e)(1)(I)) is amended—

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

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

19 and after ‘‘$200’’;

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

21 as clauses (iii) and (iv) respectively; and

22 (C) by inserting after clause (i) the follow23 ing new clause:

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

25 shall be reduced by 50 percent if the Commissioner is also
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1 required to make a payment to the institution with respect

2 to the same individual under an agreement entered into

3 under section 202(x)(3)(B).’’.

4 (2) EXPANSION OF CATEGORIES OF INSTITU5 TIONS ELIGIBLE TO ENTER INTO AGREEMENTS WITH

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

7 such Act (42 U.S.C. 1382(e)(1)(I)(i)) is amended in

8 the matter preceding subclause (I) by striking ‘‘in9 stitution’’ and all that follows through ‘‘section

10 202(x)(1)(A),’’ and inserting ‘‘institution comprising

11 a jail, prison, penal institution, or correctional facil12 ity, or with any other interested State or local insti13 tution a purpose of which is to confine individuals

14 as described in section 202(x)(1)(A)(ii),’’.

15 (3) EFFECTIVE DATE.—The amendments made

16 by this subsection shall take effect as if included in

17 the enactment of section 203(a) of the Personal Re18 sponsibility and Work Opportunity Reconciliation

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

20 The reference to section 202(x)(1)(A)(ii) of the So21 cial Security Act in section 1611(e)(1)(I)(i) of such

22 Act as amended by paragraph (2) shall be deemed

23 a reference to such section 202(x)(1)(A)(ii) as

24 amended by subsection (b)(1)(C).
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1 (d) CONTINUED DENIAL OF BENEFITS TO SEX OF2 FENDERS REMAINING CONFINED TO PUBLIC INSTITU3 TIONS UPON COMPLETION OF PRISON TERM.—

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

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

6 amended—

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

8 end;

9 (B) in clause (ii)(IV), by striking the pe10 riod and inserting ‘‘, or’’; and

11 (C) by adding at the end the following new

12 clause:

13 ‘‘(iii) immediately upon completion of confine14 ment as described in clause (i) pursuant to convic15 tion of a criminal offense an element of which is sex16 ual activity, is confined by court order in an institu17 tion at public expense pursuant to a finding that the

18 individual is a sexually dangerous person or a sexual

19 predator or a similar finding.’’.

20 (2) CONFORMING AMENDMENT.—Section

21 202(x)(1)(B)(ii) of such Act (42 U.S.C.

22 402(x)(1)(B)(ii)) is amended by striking ‘‘clause

23 (ii)’’ and inserting ‘‘clauses (ii) and (iii)’’.

24 (3) EFFECTIVE DATE.—The amendments made

25 by this subsection shall apply with respect to bene-
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1 fits for months ending after the date of the enact2 ment of this Act.

3 SEC. 7. REVOCATION BY MEMBERS OF THE CLERGY OF EX4 EMPTION FROM SOCIAL SECURITY COV5 ERAGE.

6 (a) IN GENERAL.—Notwithstanding section

7 1402(e)(4) of the Internal Revenue Code of 1986, any ex8 emption which has been received under section 1402(e)(1)

9 of such Code by a duly ordained, commissioned, or li10 censed minister of a church, a member of a religious order,

11 or a Christian Science practitioner, and which is effective

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

13 revoked by filing an application therefor (in such form and

14 manner, and with such official, as may be prescribed in

15 regulations made under chapter 2 of such Code), if such

16 application is filed no later than the due date of the Fed17 eral income tax return (including any extension thereof)

18 for the applicant’s second taxable year beginning after De19 cember 31, 1998. Any such revocation shall be effective

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

21 of 1986 and title II of the Social Security Act), as speci22 fied in the application, either with respect to the appli23 cant’s first taxable year beginning after December 31,

24 1998, or with respect to the applicant’s second taxable

25 year beginning after such date, and for all succeeding tax-
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1 able years; and the applicant for any such revocation may

2 not thereafter again file application for an exemption

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

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

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

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

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

8 taxes that would have been imposed by section 1401 of

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

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

11 would have constituted net earnings from self-employment

12 for purposes of chapter 2 of such Code (notwithstanding

13 section 1402 (c)(4) or (c)(5) of such Code) except for the

14 exemption under section 1402(e)(1) of such Code.

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

16 with respect to service performed (to the extent specified

17 in such subsection) in taxable years beginning after De18 cember 31, 1998, and with respect to monthly insurance

19 benefits payable under title II of the Social Security Act

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

21 any individual for months in or after the calendar year

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

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

24 death payments payable under such title on the basis of
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1 such wages and self-employment income in the case of

2 deaths occurring in or after such calendar year).

3 SEC. 8. ADDITIONAL TECHNICAL AMENDMENT RELATING

4 TO COOPERATIVE RESEARCH OR DEM5 ONSTRATION PROJECTS UNDER TITLES II

6 AND XVI.

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

8 Security Act (42 U.S.C. 1310(a)(3)) is amended by strik9 ing ‘‘title XVI’’ and inserting ‘‘title II or XVI’’.

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

11 subsection (a) shall take effect as if included in the enact12 ment of the Social Security Independence and Program

13 Improvements Act of 1994 (Public Law 103–296; 108

14 Stat. 1464).

Æ