I

103D CONGRESS

1ST SESSION H. R. 1712

To amend title XVI of the Social Security Act to institute certain reforms

relating to representative payees and to the provision of supplemental

security income benefits to the disabled based on substance abuse, and

for other purposes.

IN THE HOUSE OF REPRESENTATIVES

APRIL 7, 1993

Mr. THOMAS of California (for himself, Mr. SHAW, Mr. OXLEY, and Mr. LIVINGSTON) introduced the following bill; which was referred jointly to the

Committees on Ways and Means and Energy and Commerce

A BILL

To amend title XVI of the Social Security Act to institute

certain reforms relating to representative payees and to

the provision of supplemental security income benefits

to the disabled based on substance abuse, and for other

purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘SSI Disability Reform

5 Act of 1993’’.
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1 SEC. 2. REPRESENTATIVE PAYEE REFORMS.

2 (a) AUTHORITY OF GOVERNMENT AGENCIES TO BE3 COME PAID REPRESENTATIVE PAYEES.—Section

4 1631(a)(2)(D)(ii) of the Social Security Act (42 U.S.C.

5 1383(a)(2)(D)(ii)) is amended by adding at the end the

6 following: ‘‘The term ‘qualified organization’ also includes

7 any government agency that meets the requirements of

8 items (aa) and (bb) of subclause (II).’’.

9 (b) MAXIMUM FEE PAYABLE TO REPRESENTATIVE

10 PAYEES.—Section 1631(a)(2)(D)(i) of such Act (42

11 U.S.C. 1383(a)(2)(D)(i)) is amended by striking ‘‘the less12 er of—’’ and all that follows and inserting ‘‘10 percent

13 of the monthly benefit involved.’’.

14 SEC. 3. REFORM OF SSI DISABILITY BENEFITS BASED ON

15 SUBSTANCE ABUSE.

16 (a) IN GENERAL.—Section 1611(e)(3) of the Social

17 Security Act (42 U.S.C. 1382(e)(3)) is amended—

18 (1) by striking all that precedes subparagraph

19 (B) and inserting the following:

20 ‘‘(3)(A) Notwithstanding paragraphs (1) and (2), a

21 person who (but for this subparagraph) would be an eligi22 ble individual or eligible spouse for purposes of this title

23 solely by reason of disability and who is medically deter24 mined to be a drug addict or an alcoholic shall not be

25 such an eligible individual or eligible spouse until—
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1 ‘‘(i) the person, through an outpatient rehabili2 tation program, has undergone treatment appro3 priate for such condition for 3 months at an institu4 tion or facility approved by the Secretary for pur5 poses of this paragraph, and has complied with the

6 terms, conditions, and requirements of such treat7 ment and with the requirements imposed under sub8 paragraph (D); and

9 ‘‘(ii) the State in which the person resides de10 termines that—

11 ‘‘(I) the person has made progress towards

12 recovery, or has recovered; or

13 ‘‘(II) if the person has not made progress

14 towards recovery, the person meets such re15 quirements established in regulations as the

16 Secretary deems appropriate to effectuate the

17 purposes of this title.’’;

18 (2) by redesignating subparagraph (B) as sub19 paragraph (D);

20 (3) by inserting after the matter added by para21 graph (1) of this subsection the following:

22 ‘‘(B) If, after the 3-month treatment period referred

23 to in subparagraph (A)(i), the State determines that the

24 person has not recovered from the condition treated, then,

25 as a condition of receiving benefits under this title by rea-
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1 son of disability, the person must continue to comply with

2 the terms, conditions, and requirements of such treatment

3 and with the requirements imposed under subparagraph

4 (D), until recovery.

5 ‘‘(C)(i) A person who fails to continue treatment as

6 required by subparagraph (B) shall not be an eligible indi7 vidual or an eligible spouse for purposes of this title by

8 reason of disability, until the person has completed 2

9 weeks of such treatment.

10 ‘‘(ii) A person who has become an eligible individual

11 or an eligible spouse for purposes of this title by reason

12 of disability after clause (i) has been applied to the person,

13 and who fails to continue treatment as required by sub14 paragraph (B), shall not be an eligible individual or an

15 eligible spouse for purposes of this title by reason of dis16 ability, until the person has completed 2 months of such

17 treatment.

18 ‘‘(iii) A person who has become an eligible individual

19 or an eligible spouse for purposes of this title by reason

20 of disability after clause (ii) has been applied to the per21 son, and who fails to continue treatment as required by

22 subparagraph (B), shall not again become an eligible indi23 vidual or an eligible spouse for purposes of this title by

24 reason of disability.’’; and

25 (4) by adding at the end the following:
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1 ‘‘(E) The Secretary, in consultation with drug and

2 alcohol treatment professionals, shall develop standards

3 for drug and alcohol treatment programs, and in consulta4 tion with States, shall develop guidelines to be used to re5 view and evaluate the progress of participants in such

6 programs.’’.

7 (b) PRESERVATION OF MEDICAID BENEFITS.—Sec8 tion 1634 of such title (42 U.S.C. 1383c) is amended by

9 adding at the end the following:

10 ‘‘(e) For purposes of title XIX, each person who is

11 not an eligible individual or an eligible spouse solely by

12 reason of section 1611(e)(3) shall be treated as receiving

13 benefits under this title for so long as such person would

14 be eligible for such benefits in the absence of such

15 section.’’.

16 SEC. 4. MANDATORY MEDICAID COVERAGE OF SUBSTANCE

17 ABUSE TREATMENT PROGRAMS FOR DIS18 ABLED SSI BENEFICIARIES.

19 (a) IN GENERAL.—Section 1905 of the Social Secu20 rity Act (42 U.S.C. 1396d) is amended—

21 (1) in subsection (a)—

22 (A) by striking ‘‘and’’ at the end of para23 graph (21),

24 (B) by striking the comma at the end of

25 paragraph (24) and inserting a semicolon,
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1 (C) by redesignating paragraphs (22),

2 (23), and (24) as paragraphs (25), (22), and

3 (23), respectively, and by transferring and in4 serting paragraph (25) after paragraph (23), as

5 so redesignated, and

6 (D) by inserting after paragraph (23) the

7 following new paragraph:

8 ‘‘(24) approved substance abuse treatment serv9 ices for certain disabled beneficiaries (as described

10 in subsection (t)(1)); and’’; and

11 (2) by adding at the end the following new sub12 section:

13 ‘‘(t)(1) For purposes of subsection (a)(24), approved

14 substance abuse treatment services for certain disabled

15 beneficiaries are services provided to an individual de16 scribed in section 1611(e)(3)(A) through a program ap17 proved by the Secretary to provide substance abuse treat18 ment services for purposes of enabling such individuals to

19 meet the requirements of clause (i) of such section.

20 ‘‘(2) No payment shall be made under section

21 1903(a) to a State for medical assistance for approved

22 substance abuse treatment services for certain disabled

23 beneficiaries provided to any individual after the 3-month

24 period that begins on the date the individual first receives

25 such services.’’.
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1 (b) 100 PERCENT FEDERAL MATCHING RATE.—The

2 first sentence of section 1905(b) of such Act (42 U.S.C.

3 1396d(b)) is amended—

4 (1) by inserting ‘‘subject to clause (3),’’ after

5 ‘‘except that (1)’’,

6 (2) by striking ‘‘and (2)’’ and inserting ‘‘(2)’’,

7 and

8 (3) by inserting before the period at the end the

9 following: ‘‘, and (3) subject to clause (2), the Fed10 eral medical assistance percentage shall be 100 per11 cent with respect to expenditures as medical assist12 ance for approved substance abuse treatment serv13 ices for certain disabled beneficiaries (as described

14 in section 1905(t)(1))’’.

15 (c) CONFORMING AMENDMENTS.—

16 (1) Section 1902 of such Act (42 U.S.C.

17 1396a) is amended—

18 (A) in subsection (a)(10)(A) in the matter

19 preceding clause (i), by striking ‘‘(17) and

20 (21)’’ and inserting ‘‘(17), (21), and (24)’’;

21 (B) in subsection (a)(10)(C)(iv), by strik22 ing ‘‘through (21)’’ and inserting ‘‘through

23 (24)’’; and

24 (C) in subsection (j), by striking ‘‘through

25 (22)’’ and inserting ‘‘through (25)’’.
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1 (2) Section 1903(i) of such Act (42 U.S.C.

2 1396b(i)), as amended by section 2(b)(2) of the

3 Medicaid Voluntary Contribution and Provider-Spe4 cific Tax Amendments of 1991, is amended—

5 (A) in paragraph (10), by striking all that

6 follows ‘‘1927(g)’’ and inserting a semicolon;

7 (B) by redesignating the paragraph (12)

8 inserted by section 4752(a)(2) of the Omnibus

9 Budget Reconciliation Act of 1990 as para10 graph (11), by transferring and inserting it

11 after paragraph (10), and by striking the period

12 at the end and inserting a semicolon;

13 (C) by redesignating the paragraph (14)

14 inserted by section 4752(e) of the Omnibus

15 Budget Reconciliation Act of 1990 as para16 graph (12), by transferring and inserting it

17 after paragraph (11), and by striking the period

18 at the end and inserting a semicolon;

19 (D) by redesignating the paragraph (11)

20 inserted by section 4801(e)(16)(A) of the Omni21 bus Budget Reconciliation Act of 1990 as para22 graph (13), by transferring and inserting it

23 after paragraph (12), and by striking the period

24 at the end and inserting ‘‘; or’’; and
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1 (E) by inserting after paragraph (13), as

2 so redesignated, the following new paragraph:

3 ‘‘(14) with respect to any amount expended for

4 medical assistance for approved substance abuse

5 treatment services for certain disabled beneficiaries

6 (as described in section 1905(t)(1)) which are pro7 vided in violation of paragraph (2) of section

8 1905(t).’’.

9 (d) EFFECTIVE DATE.—The amendments made by

10 this section apply to payments under title XIX of the So11 cial Security Act for calendar quarters beginning on or

12 after the first day of the second calendar quarter that be13 gins on or after the date of the enactment of this Act,

14 without regard to whether or not final regulations to carry

15 out such amendments have been promulgated by such

16 date.

17 SEC. 5. EFFECTIVE DATE.

18 Except as provided in section 4(d), the amendments

19 made by this Act shall apply to benefits payable for

20 months beginning 90 or more days after the date of the

21 enactment of this Act.

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