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[Congressional Bills 104th Congress]
[From the U.S. Government Publishing Office]
[S. 798 Introduced in Senate (IS)]

104th CONGRESS
  1st Session
                                 S. 798

To amend title XVI of the Social Security Act to improve the provision 
   of supplemental security income benefits, and for other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                 May 11 (legislative day, May 1), 1995

Mr. Conrad (for himself, Mr. Chafee, Mr. Jeffords, Mr. Bradley, and Mr. 
 Rockefeller) introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL

 
To amend title XVI of the Social Security Act to improve the provision 
   of supplemental security income benefits, and for other purposes.
    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Children's SSI Eligibility Reform 
Act''.

SEC. 2. PURPOSE.

    It is the purpose of this Act to ensure that supplemental security 
income benefits--
            (1) provide basic necessities to maintain a child with a 
        disability at home or in another appropriate and cost effective 
        setting;
            (2) cover the additional costs of caring for and raising 
        such a child; and
            (3) enhance the child's opportunity to develop into an 
        independent adult.

SEC. 3. SUPPLEMENTAL SECURITY INCOME BENEFITS FOR DISABLED CHILDREN.

    (a) Modification of Benefit Eligibility.--
            (1) In general.--Section 1614(a)(3)(A) of the Social 
        Security Act (42 U.S.C. 1382c(a)(3)(A)) is amended--
                    (A) by inserting ``(i)'' after ``(3)(A)'';
                    (B) by inserting ``(other than an individual under 
                the age of 18)'' before ``shall be considered'';
                    (C) by striking ``he'' and inserting ``the 
                individual'';
                    (D) by striking ``(or, in the case of an individual 
                under the age of 18, if he suffers from any medically 
                determinable physical or mental impairment of 
                comparable severity)''; and
                    (E) by adding after and below the end the 
                following:
    ``(ii)(I) An individual under the age of 18 shall be considered to 
be disabled for purposes of this title for a month if the individual 
has any medically determinable physical or mental impairment of 
comparable severity to an impairment described in clause (i).
    ``(II) For purposes of subclause (I), an impairment is of 
comparable severity if such impairment is severe and persistent and 
substantially limits the individual's ability to develop or function.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to applicants for benefits for months beginning 6 
        months after the date of the enactment of this Act, without 
        regard to whether regulations have been issued to implement 
        such amendments.
    (b) Additional Modifications.--
            (1) Modification to medical criteria for evaluation of 
        mental and emotional disorders.--The Commissioner of Social 
        Security shall modify paragraph (2) of section 112.02B.2.c. of 
        appendix 1 to subpart P of part 404 of title 20, Code of 
        Federal Regulations, to eliminate references to maladaptive 
        behaviors and to require instead evidence of a persistent 
        pattern of behavior destructive to self or others requiring 
        protective intervention.
            (2) Modifications to individualized functional 
        assessment.--
                    (A) Increase in severity.--The Commissioner of 
                Social Security shall modify the level of severity 
                required to establish comparable severity under section 
                416.924e of title 20, Code of Federal Regulations, to 
                either--
                            (i) a marked level of impairment in 2 or 
                        more domains; or
                            (ii) a marked level of impairment in at 
                        least 1 domain and a moderate level of 
                        impairment in at least 1 additional domain.
                    (B) Domains of development or functioning.--The 
                Commissioner of Social Security shall modify the 
                individualized functional assessment for children set 
                forth in section 416.924d of title 20, Code of Federal 
                Regulations, to include the following domains of 
                development or functioning, to ensure the domains do 
                not overlap from a clinical perspective, and to compare 
                the child's abilities in each of these domains with 
                those of children of similar age who do not have a 
                disability:
                            (i) Cognition (the ability to understand 
                        and reason and to learn required skills).
                            (ii) Communication (the ability to receive 
                        and convey information; the ability to produce 
                        speech audibly and intelligibly).
                            (iii) Motor abilities (the ability to move 
                        and coordinate the body and extremities in 
                        gross and fine motions).
                            (iv) Ability to care for oneself (the 
                        ability to perform normal childhood activities 
                        in the home, school, or community with adult 
                        assistance or supervision appropriate to one's 
                        age and to control behaviors that could harm 
                        oneself or others).
                            (v) Ability to engage in interpersonal 
                        relations (the ability to develop and maintain 
                        positive and productive interpersonal 
                        relationships so as to function within the 
                        family, peer groups, and community).
                            (vi) Responsiveness to stimuli (the ability 
                        of children from birth to the attainment of age 
                        1 to react appropriately to visual, auditory, 
                        or tactile stimulation).
                            (vii) Ability to concentrate, persist, 
                        maintain pace, and have physical stamina to 
                        complete essential tasks in the home, school, 
                        or community (in children from age 3 to the 
                        attainment of age 18).
            (3) Effective date.--
                    (A) In general.--The modifications required by this 
                subsection shall apply to applicants for benefits for 
                months beginning 6 months after the date of the 
                enactment of this Act, without regard to whether 
                regulations have been issued to implement such 
                amendments.
                    (B) Continuing review.--The Commissioner of Social 
                Security shall review and report to the Congress not 
                later than 5 months after the date of the enactment of 
                this Act whether the required modifications described 
                in this subsection should be further modified.
    (c) Additional Review and Revision of Individualized Functional 
Assessment.--
            (1) In general.--The Commissioner of Social Security shall 
        review and revise the individual functional assessment for 
        children set forth in sections 416.924d and 416.924e of title 
        20, Code of Federal Regulations, to ensure that such assessment 
        is applied to children who--
                    (A) have multiple impairments, none of which meet 
                or equal the Listings of Impairments set forth in 
                appendix 1 of subpart P of part 404 of such title 20, 
                but which in combination result in the child being 
                disabled under section 1614(a)(3)(A)(ii) of the Social 
                Security Act, as added by subsection (a);
                    (B) are too young, or for other reasons, cannot be 
                fully evaluated;
                    (C) have physical or mental impairments or 
                illnesses which are not explicitly included in such 
                Listings; and
                    (D) have conditions which do not meet or equal the 
                severity of any such Listing, but meet the functional 
                test of severity under such section 1614(a)(3)(A)(ii).
            (2) Testing.--The Commissioner of Social Security shall 
        ensure that pursuant to the revised individual functional 
        assessment for children under paragraph (1)--
                    (A) valid and reliable tests are used, if 
                available, which provide qualitative and quantifiable 
                measures of childhood functioning, or
                    (B) criteria of childhood functioning are developed 
                which are equivalent to the findings of a standardized 
                test.
            (3) Applicability.--The Commissioner of Social Security 
        shall issue final regulations relating to the individual 
        functional assessment for children under paragraph (1) not 
        later than 6 months after the date of the enactment of this Act 
        and such regulations shall apply to applicants for benefits for 
        months beginning 6 months after such date.
    (d) Application to Current Beneficiaries.--Notwithstanding any 
other provision of law, if the Commissioner of Social Security 
determines that the eligibility an individual who is a recipient of 
supplemental security income benefits under title XVI of the Social 
Security Act for the month in which the date of the enactment of this 
Act occurs is affected by the amendments made by, and provisions of, 
this section, the Commissioner shall, not later than 1 year after such 
date, provide for a continuing disability review with respect to such 
individual in accordance with the provisions of such title.

SEC. 4. BETTER TARGETING AND USE OF BENEFITS.

    (a) Prohibition on Coaching of Children To Obtain Benefits.--
            (1) In general.--Section 1632 of the Social Security Act 
        (42 U.S.C. 1383a) is amended by adding at the end the following 
        new subsection:
    ``(c) In any case in which the court determines that a violation 
described in paragraph (1), (2), or (3) of subsection (a) includes--
            ``(1) any knowing and willful coaching of a child by a 
        parent or guardian to feign an impairment for the purposes of 
        gaining eligibility under this title, the court, in addition to 
        any penalty imposed under subsection (a), may require full 
        restitution of the benefit such child has received under this 
        title, plus up to $100 for each month the child received such 
        benefit; and
            ``(2) any attorney or legal representative, interpreter, or 
        social service worker knowingly and willfully causing a parent 
        or guardian to so coach a child, subsection (a) shall be 
        applied by substituting `$5000, plus $500 for each child 
        involved' for `$1,000'.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to actions occurring after the date of the 
        enactment of this Act.
    (b) Tightening of Representative Payee Requirements.--
            (1) Clarification of role.--Section 1631(a)(2)(B)(ii) of 
        the Social Security Act (42 U.S.C. 1383(a)(2)(B)(ii)) is 
        amended by striking ``and'' at the end of subclause (II), by 
        striking the period at the end of subclause (IV) and inserting 
        ``; and'', and by adding after subclause (IV) the following new 
        subclause:
            ``(V) advise such person through the notice of award of 
        benefits, and at such other times as the Commissioner of Social 
        Security deems appropriate, of specific examples of appropriate 
        expenditures of benefits under this title and the proper role 
        of a representative payee.''.
            (2) Documentation of expenditures required.--
                    (A) In general.--Subparagraph (C)(i) of section 
                1631(a)(2) of such Act (42 U.S.C. 1383(a)(2)) is 
                amended to read as follows:
    ``(C)(i) In any case where payment is made to a representative 
payee of an individual or spouse, the Commissioner of Social Security 
shall--
            ``(I) require such representative payee to document 
        expenditures and keep contemporaneous records of transactions 
        made using such payment;
            ``(II) establish a system of accountability monitoring 
        under which such representative payee shall report at least 
        annually with respect to the use of such payment; and
            ``(III) implement statistically valid procedures for 
        reviewing each such report in order to identify instances in 
        which such representative payee is not properly using such 
        payment.''.
                    (B) Conforming amendment with respect to parent 
                payees.--Clause (ii) of section 1631(a)(2)(C) of such 
                Act (42 U.S.C. 1383(a)(2)(C)) is amended by striking 
                ``Clause (i)'' and inserting ``Subclauses (II) and 
                (III) of clause (i)''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to benefits paid after the date of the enactment of 
        this Act.
    (c) Graduated Benefits for Additional Children.--
            (1) In general.--Section 1611(b) of the Social Security Act 
        (42 U.S.C. 1382(b)) is amended by adding at the end the 
        following new paragraph:
    ``(3) In the case of a family (other than a foster or group home) 
with more than 1 child eligible for a benefit under this title, the 
benefit under this title for each additional child (other than an 
adopted child with special needs (within the meaning of paragraphs (1) 
and (2) of section 473(c)) shall be determined under the following 
table:

``If the child is the:              The benefit is:
    2nd child......................
                                        85 percent of the otherwise 
                                                determined benefit
    3rd child......................
                                        65 percent of such benefit
    4th child......................
                                        45 percent of such benefit
    5th child......................
                                        35 percent of such benefit
    6th child......................
                                        25 percent of such benefit
    7th child or more..............
                                        $50 for each child.''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply to determinations made after the date of the 
        enactment of this Act.
    (d) Continuing Disability Reviews.--
            (1) Continuing disability reviews for certain children.--
        Section 1614(a)(3)(G) of the Social Security Act (42 U.S.C. 
        1382c(a)(3)(G)) is amended--
                    (A) by inserting ``(i)'' after ``(G)''; and
                    (B) by adding at the end the following:
    ``(ii)(I) Not less frequently than once every 7 years, the 
Commissioner of Social Security shall redetermine in accordance with 
paragraph (4) the eligibility for benefits under this title of each 
child who is eligible for benefits by reason of disability with respect 
to which medical improvement is not expected.
    ``(II) If a child has a disability with respect to which medical 
improvement is possible, subclause (I) shall be applied by substituting 
`3 years' for `7 years'.
    ``(III) If a child has a disability with respect to which medical 
improvement is expected subclause (I) shall be applied by substituting 
`year' for `7 years'.
    ``(IV) A parent or guardian of a recipient whose case is reviewed 
under this clause shall present, at the time of review, evidence 
demonstrating that the recipient is, and has been, receiving treatment, 
to the extent considered medically necessary and available, of the 
condition which was the basis for providing benefits under this 
title.''.
            (2) Disability review required for low birth weight babies 
        who have received ssi benefits for 12 months.--Section 
        1614(a)(3)(G) of such Act (42 U.S.C. 1382c(a)(3)(G)), as 
        amended by paragraph (1) of this subsection, is amended by 
        adding at the end the following:
    ``(iii)(I) The Commissioner of Social Security shall redetermine 
the eligibility for benefits under this title by reason of disability 
of a child whose low birth weight is
 a contributing factor material to the Commissioner's determination 
that the child is disabled.
    ``(II) The redetermination required by subclause (I) shall be 
conducted once the child has received such benefits for 12 months.
    ``(III) A redetermination under subclause (I) shall be considered a 
substitute for a review required under any other provision of this 
subparagraph.
    ``(IV) A parent or guardian of a recipient whose case is reviewed 
under this clause shall present, at the time of review, evidence 
demonstrating that the recipient is, and has been, receiving treatment, 
to the extent considered medically necessary and available, of the 
condition which was the basis for providing benefits under this 
title.''.
            (3) Disability review required for ssi recipients who are 
        18 years of age.--
                    (A) In general.--Section 1614(a)(3)(G) of such Act 
                (42 U.S.C. 1382c(a)(3)(G)), as amended by paragraphs 
                (1) and (2) of this subsection, is amended by adding at 
                the end the following:
    ``(iv)(I) The Commissioner of Social Security shall redetermine the 
eligibility of a qualified individual for supplemental security income 
benefits under this title by reason of disability, by applying the 
criteria used in determining eligibility for such benefits of 
applicants who have attained 18 years of age.
    ``(II) The redetermination required by subclause (I) with respect 
to a qualified individual shall be conducted during the 1-year period 
that begins on the date the qualified individual attains 18 years of 
age.
    ``(III) As used in this clause, the term `qualified individual' 
means an individual who attains 18 years of age and for whom, for the 
month preceding the month in which the individual attained such age, a 
determination was in effect that the individual is eligible for 
benefits under this title by reason of disability.
    ``(IV) A redetermination under subclause (I) of this clause shall 
be considered a substitute for a review required under any other 
provision of this subparagraph.''.
                    (B) Report to the congress.--Not later than October 
                1, 1998, the Commissioner of Social Security shall 
                submit to the Committee on Ways and Means of the House 
                of Representatives and the Committee on Finance of the 
                Senate a report on the activities conducted under 
                section 1614(a)(3)(G)(iv) of the Social Security Act.
                    (C) Conforming repeal.--Section 207 of the Social 
                Security Independence and Program Improvements Act of 
                1994 (42 U.S.C. 1382 note; 108 Stat. 1516) is hereby 
                repealed.
            (4) Revolving fund.--The Secretary of the Treasury shall 
        pay into a revolving fund for each fiscal year an amount equal 
        to 50 percent of the savings resulting from the amendments made 
        by subsection (c) with respect to such fiscal year. Such fund 
        shall be available to the Commissioner of Social Security, 
        without regard to appropriation Acts and without fiscal year 
        limitation, to supplement funds otherwise made available for 
        disability reviews required by the amendments made by this 
        subsection.
            (5) Effective date.--The amendments made by this subsection 
        shall apply to benefits for months beginning after the date of 
        the enactment of this Act.

SEC. 5. ENCOURAGING MOVEMENT TOWARD INDEPENDENCE.

    (a) Dedicated Savings Accounts.--
            (1) In general.--Section 1631(a)(2)(B) of the Social 
        Security Act (42 U.S.C. 1383(a)(2)(B)) is amended by adding at 
        the end the following new clause:
    ``(xiv) Notwithstanding clause (x), the Commissioner of Social 
Security may, at the request of the representative payee, pay any lump 
sum payment for the benefit of a child into a dedicated savings account 
that could only be used to purchase for such child--
            ``(I) education and job skills training;
            ``(II) special equipment or housing modifications or both 
        specifically related to, and required by the nature of, the 
        child's disability; and
            ``(III) appropriate therapy and rehabilitation.''.
            (2) Disregard of trust funds.--Section 1613(a) of such Act 
        (42 U.S.C. 1382b) is amended--
                    (A) by striking ``and'' at the end of paragraph 
                (9),
                    (B) by striking the period at the end of paragraph 
                (10) the first place it appears and inserting a 
                semicolon,
                    (C) by redesignating paragraph (10) the second 
                place it appears as paragraph (11) and striking the 
                period at the end of such paragraph and inserting ``; 
                and'', and
                    (D) by inserting after paragraph (11), as so 
                redesignated, the following new paragraph:
            ``(12) all amounts deposited in, or interest credited to, a 
        dedicated savings account described in section 
        1631(a)(2)(B)(xiv).''.
            (3) Effective date.--The amendments made by this subsection 
        shall apply to payments made after the date of the enactment of 
        this Act.
    (b) Information and Referral System.--Section 1631 of the Social 
Security Act (42 U.S.C. 1383) is amended by redesignating subsection 
(n) (relating to notice requirements) as subsection (o) and by adding 
at the end the following new subsection:

             ``information and referral system for children

    ``(p) The Commissioner of Social Security shall establish or 
identify a system of information and referral for treatment and 
services available to children receiving benefits under this title 
under State and Federal programs.''.
                                 <all>
S 798 IS----2
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