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‘‘(A) in the case of an individual who is age
18 or older—’’;
(5) at the end of subparagraph (A)(iii) (as redes-
ignated by paragraphs (3) and (4)), by striking the
period and inserting ‘‘; or’’;
(6) by inserting after and below subparagraph
(A)(iii) (as so redesignated) the following:
‘‘(B) in the case of an individual who is
under the age of 18—
‘‘(i) substantial evidence which dem-
onstrates that there has been medical im-
provement in the individual’s impairment
or combination of impairments, and that
such impairment or combination of impair-
ments no longer results in marked and se-
vere functional limitations; or
‘‘(ii) substantial evidence which dem-
onstrates that, as determined on the basis of
new or improved diagnostic techniques or
evaluations, the individual’s impairment or
combination of impairments, is not as dis-
abling as it was considered to be at the time
of the most recent prior decision that he or
she was under a disability or continued to
be under a disability, and such impairment
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HR 2491 EAS
or combination of impairments does not re-
sult in marked or severe functional limita-
tions; or’’;
(7) by redesignating subparagraph (D) as sub-
paragraph (C) and by inserting in such subpara-
graph ‘‘in the case of any individual,’’ before ‘‘sub-
stantial evidence’’; and
(8) in the first sentence following subparagraph
(C) (as redesignated by paragraph (7)), by—
(A) inserting ‘‘(i)’’ before ‘‘to restore’’; and
(B) inserting ‘‘, or (ii) in the case of an in-
dividual under the age of 18, to eliminate or im-
prove the individual’s impairment or combina-
tion of impairments so that it no longer results
in marked and severe functional limitations’’
immediately before the period.
(d) AMOUNT
OF BENEFITS.—Section 1611(b) (42
U.S.C. 1382(b)) is amended by adding at the end the follow-
ing new paragraph:
‘‘(3)(i) Except with respect to individuals described in
clause (ii), the benefit under this title for an individual de-
scribed in section 1614(a)(3)(C) shall be payable at a rate
equal to 75 percent of the rate otherwise determined under
this subsection.
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‘‘(ii) An individual is described in this clause if such
individual is described in section 1614(a)(3)(C), and—
‘‘(I) in the case of such an individual under the
age of 6, such individual has a medical impairment
that severely limits the individual’s ability to func-
tion in a manner appropriate to individuals of the
same age and who without special personal assistance
would require specialized care outside the home; or
‘‘(II) in the case of such an individual who has
attained the age of 6, such individual requires per-
sonal care assistance with—
‘‘(aa) at least 2 activities of daily living;
‘‘(bb) continual 24-hour supervision or
monitoring to avoid causing injury or harm to
self or others; or
‘‘(cc) the administration of medical treat-
ment; and
who without such assistance would require full-time
or part-time specialized care outside the home.
‘‘(iii)(I) For purposes of clause (ii), the term ‘special-
ized care’ means medical care beyond routine administra-
tion of medication.
‘‘(II) For purposes of clause (ii)(II)—
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‘‘(aa) the term ‘personal care assistance’ means
at least hands-on and stand-by assistance, super-
vision, or cueing; and
‘‘(bb) the term ‘activities of daily living’ means
eating, toileting, dressing, bathing, and mobility.’’.
(e) EFFECTIVE DATES, ETC.—
(1) EFFECTIVE DATES.—
(A) IN GENERAL.—The provisions of, and
amendments made by, subsections (a), (b), and
(c) shall apply to applicants for benefits under
title XVI of the Social Security Act for months
beginning on or after the date of the enactment
of this Act, without regard to whether regulations
have been issued to implement such provisions
and amendments.
(B) ELIGIBILITY RULES.—The amendments
made by subsection (d) shall apply to—
(i) applicants for benefits under title
XVI of the Social Security Act for months
beginning on or after January 1, 1997; and
(ii) with respect to continuing disabil-
ity reviews of eligibility for benefits under
such title occurring on or after such date.
(2) APPLICATION TO CURRENT RECIPIENTS.—
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(A) ELIGIBILITY
DETERMINATIONS.—Not
later than 1 year after the date of the enactment
of this Act, the Commissioner of Social Security
shall redetermine the eligibility of any individ-
ual under age 18 who is receiving supplemental
security income benefits based on a disability
under title XVI of the Social Security Act as of
the date of the enactment of this Act and whose
eligibility for such benefits may terminate by
reason of the provisions of, and amendments
made by, subsections (a), (b), and (c). With re-
spect to any redetermination under this subpara-
graph—
(i) section 1614(a)(4) of the Social Se-
curity Act (42 U.S.C. 1382c(a)(4)) shall not
apply;
(ii) the Commissioner of Social Secu-
rity shall apply the eligibility criteria for
new applicants for benefits under title XVI
of such Act;
(iii) the Commissioner shall give such
redetermination priority over all continuing
eligibility reviews and other reviews under
such title; and
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HR 2491 EAS
(iv) such redetermination shall be
counted as a review or redetermination oth-
erwise required to be made under section
208 of the Social Security Independence
and Program Improvements Act of 1994 or
any other provision of title XVI of the So-
cial Security Act.
(B) GRANDFATHER PROVISION.—The provi-
sions of, and amendments made by, subsections
(a), (b), and (c), and the redetermination under
subparagraph (A), shall only apply with respect
to the benefits of an individual described in sub-
paragraph (A) for months beginning on or after
January 1, 1997.
(C) NOTICE.—Not later than 90 days after
the date of the enactment of this Act, the Com-
missioner of Social Security shall notify an in-
dividual described in subparagraph (A) of the
provisions of this paragraph.
(3) REGULATIONS.—The Commissioner of Social
Security shall submit for review to the committees of
jurisdiction in the Congress any final regulation per-
taining to the eligibility of individuals under age 18
for benefits under title XVI of the Social Security Act
at least 45 days before the effective date of such regu-
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SEC. 12212. ELIGIBILITY REDETERMINATIONS AND CON-
TINUING DISABILITY REVIEWS.
(a) CONTINUING DISABILITY REVIEWS RELATING TO
CERTAIN CHILDREN.—Section 1614(a)(3)(H) (42 U.S.C.
1382c(a)(3)(H)), as redesignated by section 12211(a)(3), is
amended—
(1) by inserting ‘‘(i)’’ after ‘‘(H)’’; and
(2) by adding at the end the following new
clause:
‘‘(ii)(I) Not less frequently than once every 3 years,
the Commissioner shall review in accordance with para-
graph (4) the continued eligibility for benefits under this
title of each individual who has not attained 18 years of
age and is eligible for such benefits by reason of an impair-
ment (or combination of impairments) which may improve
(or, at the option of the Commissioner, which is unlikely
to improve).
‘‘(II) A representative payee 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 medi-
cally necessary and available, of the condition which was
the basis for providing benefits under this title.
‘‘(III) If the representative payee refuses to comply
without good cause with the requirements of subclause (II),
the Commissioner of Social Security shall, if the Commis-
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sioner determines it is in the best interest of the individual,
promptly terminate payment of benefits to the representa-
tive payee, and provide for payment of benefits to an alter-
native representative payee of the individual or, if the inter-
est of the individual under this title would be served thereby,
to the individual.
‘‘(IV) Subclause (II) shall not apply to the representa-
tive payee of any individual with respect to whom the Com-
missioner determines such application would be inappro-
priate or unnecessary. In making such determination, the
Commissioner shall take into consideration the nature of
the individual’s impairment (or combination of impair-
ments). Section 1631(c) shall not apply to a finding by the
Commissioner that the requirements of subclause (II) should
not apply to an individual’s representative payee.’’.
(b) DISABILITY ELIGIBILITY REDETERMINATIONS RE-
QUIRED FOR SSI RECIPIENTS WHO ATTAIN 18 YEARS OF
AGE.—
(1) IN
GENERAL.—Section 1614(a)(3)(H) (42
U.S.C. 1382c(a)(3)(H)), as amended by subsection
(a), is amended by adding at the end the following
new clause:
‘‘(iii) If an individual is eligible for benefits under this
title by reason of disability for the month preceding the
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HR 2491 EAS
month in which the individual attains the age of 18 years,
the Commissioner shall redetermine such eligibility—
‘‘(I) during the 1-year period beginning on the
individual’s 18th birthday; and
‘‘(II) by applying the criteria used in determin-
ing the initial eligibility for applicants who are age
18 or older.
With respect to a redetermination under this clause, para-
graph (4) shall not apply and such redetermination shall
be considered a substitute for a review or redetermination
otherwise required under any other provision of this sub-
paragraph during that 1-year period.’’.
(2) CONFORMING REPEAL.—Section 207 of the
Social Security Independence and Program Improve-
ments Act of 1994 (42 U.S.C. 1382 note; 108 Stat.
1516) is hereby repealed.
(c) CONTINUING DISABILITY REVIEW REQUIRED FOR
LOW BIRTH WEIGHT BABIES.—Section 1614(a)(3)(H) (42
U.S.C. 1382c(a)(3)(H)), as amended by subsections (a) and
(b), is amended by adding at the end the following new
clause:
‘‘(iv)(I) Not later than 12 months after the birth of
an individual, the Commissioner shall review in accordance
with paragraph (4) the continuing eligibility for benefits
under this title by reason of disability of such individual
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HR 2491 EAS
whose low birth weight is a contributing factor material
to the Commissioner’s determination that the individual is
disabled.
‘‘(II) A review under subclause (I) shall be considered
a substitute for a review otherwise required under any other
provision of this subparagraph during that 12-month pe-
riod.
‘‘(III) A representative payee 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 medi-
cally necessary and available, of the condition which was
the basis for providing benefits under this title.
‘‘(IV) If the representative payee refuses to comply
without good cause with the requirements of subclause (III),
the Commissioner of Social Security shall, if the Commis-
sioner determines it is in the best interest of the individual,
promptly terminate payment of benefits to the representa-
tive payee, and provide for payment of benefits to an alter-
native representative payee of the individual or, if the inter-
est of the individual under this title would be served thereby,
to the individual.
‘‘(V) Subclause (III) shall not apply to the representa-
tive payee of any individual with respect to whom the Com-
missioner determines such application would be inappro-
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HR 2491 EAS
priate or unnecessary. In making such determination, the
Commissioner shall take into consideration the nature of
the individual’s impairment (or combination of impair-
ments). Section 1631(c) shall not apply to a finding by the
Commissioner that the requirements of subclause (III)
should not apply to an individual’s representative payee.’’.
(d) EFFECTIVE DATE.—The amendments made by this
section shall apply to benefits for months beginning on or
after the date of the enactment of this Act, without regard
to whether regulations have been issued to implement such
amendments.
SEC. 12213. ADDITIONAL ACCOUNTABILITY REQUIREMENTS.
(a) DISPOSAL OF RESOURCES FOR LESS THAN FAIR
MARKET VALUE.—
(1) IN GENERAL.—Section 1613(c) (42 U.S.C.
1382b(c)) is amended to read as follows:
‘‘(c) DISPOSAL OF RESOURCES FOR LESS THAN FAIR
MARKET VALUE.—(1)(A)(i) If an individual who has not
attained 18 years of age (or any person acting on such indi-
vidual’s behalf) disposes of resources of the individual for
less than fair market value on or after the look-back date
specified in clause (ii)(I), the individual is ineligible for
benefits under this title for months during the period begin-
ning on the date specified in clause (iii) and equal to the
number of months specified in clause (iv).
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HR 2491 EAS
‘‘(ii)(I) The look-back date specified in this subclause
is a date that is 36 months before the date specified in
subclause (II).
‘‘(II) The date specified in this subclause is the date
on which the individual applies for benefits under this title
or, if later, the date on which the disposal of the individual’s
resources for less than fair market value occurs.
‘‘(iii) The date specified in this clause is the first day
of the first month that follows the month in which the indi-
vidual’s resources were disposed of for less than fair market
value and that does not occur in any other period of ineli-
gibility under this paragraph.
‘‘(iv) The number of months of ineligibility under this
clause for an individual shall be equal to—
‘‘(I) the total, cumulative uncompensated value
of all the individual’s resources so disposed of on or
after the look-back date specified in clause (ii)(I), di-
vided by
‘‘(II) the amount of the maximum monthly bene-
fit payable under section 1611(b) to an eligible indi-
vidual for the month in which the date specified in
clause (ii)(II) occurs.
‘‘(B) An individual shall not be ineligible for benefits
under this title by reason of subparagraph (A) if the Com-
missioner determines that—