Union Calendar No. 232
106TH CONGRESS
1ST SESSION
H. R. 3070
[Report No. 106–393, Part I]
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 opportu-
nities to work, to extend health care coverage for
such beneficiaries, and to make additional mis-
cellaneous amendments relating to Social Secu-
rity.
OCTOBER 19, 1999
Committee on Commerce discharged; committed to the
Committee of the Whole House on the State of the
Union and ordered to be printed
IB
Union Calendar No. 232
106TH CONGRESS
1ST SESSION
H. R. 3070
[Report No. 106–393, Part I]
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
health care coverage for such beneficiaries, and to make additional mis-
cellaneous amendments relating to Social Security.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 13, 1999
Mr. HULSHOF (for himself, Mr. ARCHER, Mr. SHAW, Mr. CAMP, Ms. DUNN,
Mr. ENGLISH, Mr. FOLEY, Mr. HAYWORTH, Mr. HERGER, Mr. HOUGH-
TON, Mr. RAMSTAD, Mr. THOMAS, and Mr. WELLER) introduced the fol-
lowing bill; which was referred to the Committee on Ways and Means,
and in addition to the Committee on Commerce, for a period to be subse-
quently determined by the Speaker, in each case for consideration of such
provisions as fall within the jurisdiction of the committee concerned
OCTOBER 18, 1999
Reported from the Committee on Ways and Means with an amendment
[Strike out all after the enacting clause and insert the part printed in italic]
OCTOBER 18, 1999
Referral to the Committee on Commerce extended for a period ending not
later than October 19, 1999
OCTOBER 19, 1999
Additional sponsors: Mr. CRANE and Mr. ISAKSON
OCTOBER 19, 1999
Committee on Commerce discharged; committed to the Committee of the
Whole House on the State of the Union and ordered to be printed
[For text of introduced bill, see copy of bill as introduced on October 13, 1999]
A BILL
To amend the Social Security Act to establish a Ticket
to Work and Self-Sufficiency Program in the Social Se-
curity Administration to provide beneficiaries with dis-
abilities meaningful opportunities to work, to extend
health care coverage for such beneficiaries, and to make
additional miscellaneous amendments relating to Social
Security.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Ticket to Work and Work Incentives Improvement Act of
1999’’.
(b) TABLE OF CONTENTS.—The table of contents is as
follows:
Sec. 1. Short title; table of contents.
TITLE I—TICKET TO WORK AND SELF-SUFFICIENCY AND RELATED
PROVISIONS
Subtitle A—Ticket to Work and Self-Sufficiency
Sec. 101. Establishment of the Ticket to Work and Self-Sufficiency Program.
Subtitle B—Elimination of Work Disincentives
Sec. 111. Work activity standard as a basis for review of an individual’s disabled
status.
Sec. 112. Expedited reinstatement of disability benefits.
Subtitle C—Work Incentives Planning, Assistance, and Outreach
Sec. 121. Work incentives outreach program.
Sec. 122. State grants for work incentives assistance to disabled beneficiaries.
TITLE II—EXPANDED AVAILABILITY OF HEALTH CARE SERVICES
Sec. 201. Expanding State options under the medicaid program for workers with
disabilities.
Sec. 202. Extending medicare coverage for OASDI disability benefit recipients.
Sec. 203. Grants to develop and establish State infrastructures to support work-
ing individuals with disabilities.
Sec. 204. Demonstration of coverage under the medicaid program of workers with
potentially severe disabilities.
Sec. 205. Election by disabled beneficiaries to suspend medigap insurance when
covered under a group health plan.
TITLE III—DEMONSTRATION PROJECTS AND STUDIES
Sec. 301. Extension of disability insurance program demonstration project au-
thority.
Sec. 302. Demonstration projects providing for reductions in disability insurance
benefits based on earnings.
Sec. 303. Studies and reports.
TITLE IV—MISCELLANEOUS AND TECHNICAL AMENDMENTS
Sec. 401. Technical amendments relating to drug addicts and alcoholics.
Sec. 402. Treatment of prisoners.
Sec. 403. Revocation by members of the clergy of exemption from social security
coverage.
Sec. 404. Additional technical amendment relating to cooperative research or
demonstration projects under titles II and XVI.
Sec. 405. Authorization for State to permit annual wage reports.
Sec. 406. Assessment on attorneys who receive their fees via the Social Security
Administration.
Sec. 407. Extension of authority of State medicaid fraud control units.
Sec. 408. Elimination of fraud and abuse associated with certain payments under
the medicaid program.
TITLE I—TICKET TO WORK AND
SELF-SUFFICIENCY AND RE-
LATED PROVISIONS
Subtitle A—Ticket to Work and
Self-Sufficiency
SEC. 101. ESTABLISHMENT OF THE TICKET TO WORK AND
SELF-SUFFICIENCY PROGRAM.
(a) IN GENERAL.—Part A of title XI of the Social Se-
curity Act (42 U.S.C. 1301 et seq.) is amended by adding
after section 1147 (as added by section 8 of the Noncitizen
Benefit Clarification and Other Technical Amendments Act
of 1998 (Public Law 105–306; 112 Stat. 2928) the fol-
lowing:
‘‘THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM
‘‘SEC. 1148. (a) IN GENERAL.—The Commissioner of
Social Security shall establish a Ticket to Work and Self-
Sufficiency Program, under which a disabled beneficiary
may use a ticket to work and self-sufficiency issued by the
Commissioner in accordance with this section to obtain em-
ployment services, vocational rehabilitation services, or
other support services from an employment network which
is of the beneficiary’s choice and which is willing to provide
such services to such beneficiary.
‘‘(b) TICKET SYSTEM.—
‘‘(1) DISTRIBUTION OF TICKETS.—The Commis-
sioner of Social Security may issue a ticket to work
and self-sufficiency to disabled beneficiaries for par-
ticipation in the Program.
‘‘(2) ASSIGNMENT OF TICKETS.—A disabled ben-
eficiary holding a ticket to work and self-sufficiency
may assign the ticket to any employment network of
the beneficiary’s choice which is serving under the
Program and is willing to accept the assignment.
‘‘(3) TICKET
TERMS.—A ticket issued under
paragraph (1) shall consist of a document which evi-
dences the Commissioner’s agreement to pay (as pro-
vided in paragraph (4)) an employment network,
which is serving under the Program and to which
such ticket is assigned by the beneficiary, for such em-
ployment services, vocational rehabilitation services,
and other support services as the employment network
may provide to the beneficiary.
‘‘(4) PAYMENTS TO EMPLOYMENT NETWORKS.—
The Commissioner shall pay an employment network
under the Program in accordance with the outcome
payment system under subsection (h)(2) or under the
outcome-milestone payment system under subsection
(h)(3) (whichever is elected pursuant to subsection
(h)(1)). An employment network may not request or
receive compensation for such services from the bene-
ficiary.
‘‘(c) STATE PARTICIPATION.—
‘‘(1) IN GENERAL.—Each State agency admin-
istering or supervising the administration of the
State plan approved under title I of the Rehabilita-
tion Act of 1973 may elect to participate in the Pro-
gram as an employment network with respect to a
disabled beneficiary. If the State agency does elect to
participate in the Program, the State agency also
shall elect to be paid under the outcome payment sys-
tem or the outcome-milestone payment system in ac-
cordance with subsection (h)(1). With respect to a dis-
abled beneficiary that the State agency does not elect
to have participate in the Program, the State agency
shall be paid for services provided to that beneficiary
under the system for payment applicable under sec-
tion 222(d) and subsections (d) and (e) of section
1615. The Commissioner shall provide for periodic
opportunities for exercising such elections.
‘‘(2) EFFECT OF PARTICIPATION BY STATE AGEN-
CY.—
‘‘(A) STATE AGENCIES PARTICIPATING.—In
any case in which a State agency described in
paragraph (1) elects under that paragraph to
participate in the Program, the employment
services, vocational rehabilitation services, and
other support services which, upon assignment of
tickets to work and self-sufficiency, are provided
to disabled beneficiaries by the State agency act-
ing as an employment network shall be governed
by plans for vocational rehabilitation services
approved under title I of the Rehabilitation Act
of 1973.
‘‘(B) STATE AGENCIES ADMINISTERING MA-
TERNAL
AND
CHILD
HEALTH
SERVICES
PRO-
GRAMS.—Subparagraph (A) shall not apply with
respect to any State agency administering a pro-
gram under title V of this Act.
‘‘(3) AGREEMENTS
BETWEEN
STATE
AGENCIES
AND
EMPLOYMENT
NETWORKS.—State agencies and
employment networks shall enter into agreements re-
garding the conditions under which services will be
provided when an individual is referred by an em-
ployment network to a State agency for services. The
Commissioner of Social Security shall establish by
regulations the timeframe within which such agree-
ments must be entered into and the mechanisms for
dispute resolution between State agencies and employ-
ment networks with respect to such agreements.
‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF
SOCIAL SECURITY.—
‘‘(1) SELECTION AND QUALIFICATIONS OF PRO-
GRAM MANAGERS.—The Commissioner of Social Secu-
rity shall enter into agreements with 1 or more orga-
nizations in the private or public sector for service as
a program manager to assist the Commissioner in ad-
ministering the Program. Any such program manager
shall be selected by means of a competitive bidding
process, from among organizations in the private or
public sector with available expertise and experience
‘‘(B) the holding by a program manager of
a financial interest in an employment network
or service provider which provides services in a
geographic area covered under the program man-
ager’s agreement.
‘‘(4) SELECTION OF EMPLOYMENT NETWORKS.—
‘‘(A) IN GENERAL.—The Commissioner shall
select and enter into agreements with employ-
ment networks for service under the Program.
Such employment networks shall be in addition
to State agencies serving as employment net-
works pursuant to elections under subsection (c).
‘‘(B) ALTERNATE
PARTICIPANTS.—In any
State where the Program is being implemented,
the Commissioner shall enter into an agreement
with any alternate participant that is operating
under the authority of section 222(d)(2) in the
State as of the date of enactment of this section
and chooses to serve as an employment network
under the Program.
‘‘(5) TERMINATION OF AGREEMENTS WITH EM-
PLOYMENT NETWORKS.—The Commissioner shall ter-
minate agreements with employment networks for in-
adequate performance, as determined by the Commis-
sioner.
‘‘(6) QUALITY ASSURANCE.—The Commissioner
shall provide for such periodic reviews as are nec-
essary to provide for effective quality assurance in the
provision of services by employment networks. The
Commissioner shall solicit and consider the views of
consumers and the program manager under which the
employment networks serve and shall consult with
providers of services to develop performance measure-
ments. The Commissioner shall ensure that the results
of the periodic reviews are made available to bene-
ficiaries who are prospective service recipients as they
select employment networks. The Commissioner shall
ensure that the periodic surveys of beneficiaries re-
ceiving services under the Program are designed to
measure customer service satisfaction.
‘‘(7) DISPUTE RESOLUTION.—The Commissioner
shall provide for a mechanism for resolving disputes
between beneficiaries and employment networks, be-
tween program managers and employment networks,
and between program managers and providers of
services. The Commissioner shall afford a party to
such a dispute a reasonable opportunity for a full
and fair review of the matter in dispute.
‘‘(e) PROGRAM MANAGERS.—
‘‘(1) IN GENERAL.—A program manager shall
conduct tasks appropriate to assist the Commissioner
in carrying out the Commissioner’s duties in admin-
istering the Program.
‘‘(2) 
RECRUITMENT
OF
EMPLOYMENT
NET-
WORKS.—A program manager shall recruit, and rec-
ommend for selection by the Commissioner, employ-
ment networks for service under the Program. The
program manager shall carry out such recruitment
and provide such recommendations, and shall mon-
itor all employment networks serving in the Program
in the geographic area covered under the program
manager’s agreement, to the extent necessary and ap-
propriate to ensure that adequate choices of services
are made available to beneficiaries. Employment net-
works may serve under the Program only pursuant
to an agreement entered into with the Commissioner
under the Program incorporating the applicable pro-
visions of this section and regulations thereunder, and
the program manager shall provide and maintain as-
surances to the Commissioner that payment by the
Commissioner to employment networks pursuant to
this section is warranted based on compliance by such
employment networks with the terms of such agree-
ment and this section. The program manager shall
not impose numerical limits on the number of em-
ployment networks to be recommended pursuant to
this paragraph.
‘‘(3) 
FACILITATION
OF
ACCESS
BY
BENE-
FICIARIES TO EMPLOYMENT NETWORKS.—A program
manager shall facilitate access by beneficiaries to em-
ployment networks. The program manager shall en-
sure that each beneficiary is allowed changes in em-
ployment networks without being deemed to have re-
jected services under the Program. When such a
change occurs, the program manager shall reassign
the ticket based on the choice of the beneficiary. Upon
the request of the employment network, the program
manager shall make a determination of the allocation
of the outcome or milestone-outcome payments based
on the services provided by each employment network.
The program manager shall establish and maintain
lists of employment networks available to beneficiaries
and shall make such lists generally available to the
public. The program manager shall ensure that all in-
formation provided to disabled beneficiaries pursuant
to this paragraph is provided in accessible formats.
‘‘(4) ENSURING
AVAILABILITY
OF
ADEQUATE
SERVICES.—The program manager shall ensure that
employment services, vocational rehabilitation serv-
ices, and other support services are provided to bene-
ficiaries throughout the geographic area covered under
the program manager’s agreement, including rural
areas.
‘‘(5) REASONABLE ACCESS TO SERVICES.—The
program manager shall take such measures as are
necessary to ensure that sufficient employment net-
works are available and that each beneficiary receiv-
ing services under the Program has reasonable access
to employment services, vocational rehabilitation serv-
ices, and other support services. Services provided
under the Program may include case management,
work incentives planning, supported employment, ca-
reer planning, career plan development, vocational
assessment, job training, placement, follow-up serv-
ices, and such other services as may be specified by
the Commissioner under the Program. The program
manager shall ensure that such services are available
in each service area.
‘‘(f) EMPLOYMENT NETWORKS.—
‘‘(1) QUALIFICATIONS
FOR
EMPLOYMENT
NET-
WORKS.—
‘‘(A) IN GENERAL.—Each employment net-
work serving under the Program shall consist of
an agency or instrumentality of a State (or a
political subdivision thereof) or a private entity,
that assumes responsibility for the coordination
and delivery of services under the Program to in-
dividuals assigning to the employment network
tickets to work and self-sufficiency issued under
subsection (b).
‘‘(B) ONE-STOP
DELIVERY
SYSTEMS.—An
employment network serving under the Program
may consist of a one-stop delivery system estab-
lished under subtitle B of title I of the Workforce
Investment Act of 1998.
‘‘(C) COMPLIANCE
WITH
SELECTION
CRI-
TERIA.—No employment network may serve
under the Program unless it meets and main-
tains compliance with both general selection cri-
teria (such as professional and educational
qualifications, where applicable) and specific se-
lection criteria (such as substantial expertise and
experience in providing relevant employment
services and supports).
‘‘(D) SINGLE
OR
ASSOCIATED
PROVIDERS
ALLOWED.—An employment network shall con-
sist of either a single provider of such services or
of an association of such providers organized so
as to combine their resources into a single entity.
An employment network may meet the require-
ments of subsection (e)(4) by providing services
directly, or by entering into agreements with
other individuals or entities providing appro-
priate employment services, vocational rehabili-
tation services, or other support services.
‘‘(2) REQUIREMENTS RELATING TO PROVISION OF
SERVICES.—Each employment network serving under
the Program shall be required under the terms of its
agreement with the Commissioner to—
‘‘(A) serve prescribed service areas; and
‘‘(B) take such measures as are necessary to
ensure that employment services, vocational re-
habilitation services, and other support services
provided under the Program by, or under agree-
ments entered into with, the employment network
are provided under appropriate individual work
plans meeting the requirements of subsection (g).
‘‘(3) ANNUAL FINANCIAL REPORTING.—Each em-
ployment network shall meet financial reporting re-
quirements as prescribed by the Commissioner.
‘‘(4) PERIODIC
OUTCOMES
REPORTING.—Each
employment network shall prepare periodic reports,
on at least an annual basis, itemizing for the covered
period specific outcomes achieved with respect to spe-
and remedies available to the individual,
including information on the availability of
advocacy services and assistance in resolv-
ing disputes through the State grant pro-
gram authorized under section 1150;
‘‘(D) provide a beneficiary the opportunity
to amend the individual work plan if a change
in circumstances necessitates a change in the
plan; and
‘‘(E) make each beneficiary’s individual
work plan available to the beneficiary in, as ap-
propriate, an accessible format chosen by the
beneficiary.
‘‘(2) EFFECTIVE UPON WRITTEN APPROVAL.—A
beneficiary’s individual work plan shall take effect
upon written approval by the beneficiary or a rep-
resentative of the beneficiary and a representative of
the employment network that, in providing such writ-
ten approval, acknowledges assignment of the bene-
ficiary’s ticket to work and self-sufficiency.
‘‘(h) EMPLOYMENT NETWORK PAYMENT SYSTEMS.—
‘‘(1) ELECTION
OF
PAYMENT
SYSTEM
BY
EM-
PLOYMENT NETWORKS.—
‘‘(A) IN GENERAL.—The Program shall pro-
vide for payment authorized by the Commis-
sioner to employment networks under either an
outcome payment system or an outcome-mile-
stone payment system. Each employment net-
work shall elect which payment system will be
utilized by the employment network, and, for
such period of time as such election remains in
effect, the payment system so elected shall be uti-
lized exclusively in connection with such employ-
ment network (except as provided in subpara-
graph (B)).
‘‘(B) NO CHANGE IN METHOD OF PAYMENT
FOR BENEFICIARIES WITH TICKETS ALREADY AS-
SIGNED TO THE EMPLOYMENT NETWORKS.—Any
election of a payment system by an employment
network that would result in a change in the
method of payment to the employment network
for services provided to a beneficiary who is re-
ceiving services from the employment network at
the time of the election shall not be effective with
respect to payment for services provided to that
beneficiary and the method of payment pre-
viously selected shall continue to apply with re-
spect to such services.
‘‘(2) OUTCOME PAYMENT SYSTEM.—
‘‘(A) IN GENERAL.—The outcome payment
system shall consist of a payment structure gov-
erning employment networks electing such sys-
tem under paragraph (1)(A) which meets the re-
quirements of this paragraph.
‘‘(B) PAYMENTS
MADE
DURING
OUTCOME
PAYMENT PERIOD.—The outcome payment sys-
tem shall provide for a schedule of payments to
an employment network, in connection with each
individual who is a beneficiary, for each month,
during the individual’s outcome payment period,
for which benefits (described in paragraphs (3)
and (4) of subsection (k)) are not payable to such
individual because of work or earnings.
‘‘(C) COMPUTATION OF PAYMENTS TO EM-
PLOYMENT NETWORK.—The payment schedule of
the outcome payment system shall be designed so
that—
‘‘(i) the payment for each month dur-
ing the outcome payment period for which
benefits (described in paragraphs (3) and
(4) of subsection (k)) are not payable is
equal to a fixed percentage of the payment
calculation base for the calendar year in
which such month occurs; and
‘‘(ii) such fixed percentage is set at a
percentage which does not exceed 40 percent.
‘‘(3) OUTCOME-MILESTONE PAYMENT SYSTEM.—
‘‘(A) IN GENERAL.—The outcome-milestone
payment system shall consist of a payment
structure governing employment networks elect-
ing such system under paragraph (1)(A) which
meets the requirements of this paragraph.
‘‘(B) EARLY PAYMENTS UPON ATTAINMENT
OF MILESTONES IN ADVANCE OF OUTCOME PAY-
MENT
PERIODS.—The outcome-milestone pay-
ment system shall provide for 1 or more mile-
stones, with respect to beneficiaries receiving
services from an employment network under the
Program, that are directed toward the goal of
permanent employment. Such milestones shall
form a part of a payment structure that pro-
vides, in addition to payments made during out-
come payment periods, payments made prior to
outcome payment periods in amounts based on
the attainment of such milestones.
‘‘(C) LIMITATION ON TOTAL PAYMENTS TO
EMPLOYMENT NETWORK.—The payment schedule
of the outcome milestone payment system shall be
designed so that the total of the payments to the
employment network with respect to each bene-
ficiary is less than, on a net present value basis
(using an interest rate determined by the Com-
missioner that appropriately reflects the cost of
funds faced by providers), the total amount to
which payments to the employment network with
respect to the beneficiary would be limited if the
employment network were paid under the out-
come payment system.
‘‘(4) DEFINITIONS.—In this subsection:
‘‘(A) PAYMENT
CALCULATION
BASE.—The
term ‘payment calculation base’ means, for any
calendar year—
‘‘(i) in connection with a title II dis-
ability beneficiary, the average disability
insurance benefit payable under section 223
for all beneficiaries for months during the
preceding calendar year; and
‘‘(ii) in connection with a title XVI
disability beneficiary (who is not concur-
rently a title II disability beneficiary), the
average payment of supplemental security
income benefits based on disability payable
under title XVI (excluding State supplemen-
tation) for months during the preceding cal-
endar year to all beneficiaries who have at-
tained 18 years of age but have not attained
65 years of age.
‘‘(B) OUTCOME
PAYMENT
PERIOD.—The
term ‘outcome payment period’ means, in con-
nection with any individual who had assigned a
ticket to work and self-sufficiency to an employ-
ment network under the Program, a period—
‘‘(i) beginning with the first month,
ending after the date on which such ticket
was assigned to the employment network,
for which benefits (described in paragraphs
(3) and (4) of subsection (k)) are not pay-
able to such individual by reason of engage-
ment in substantial gainful activity or by
reason of earnings from work activity; and
‘‘(ii) ending with the 60th month (con-
secutive or otherwise), ending after such
date, for which such benefits are not pay-
able to such individual by reason of engage-
ment in substantial gainful activity or by
reason of earnings from work activity.
‘‘(5) PERIODIC
REVIEW
AND
ALTERATIONS
OF
PRESCRIBED SCHEDULES.—
‘‘(A) PERCENTAGES
AND
PERIODS.—The
Commissioner shall periodically review the per-
centage specified in paragraph (2)(C), the total
payments permissible under paragraph (3)(C),
and the period of time specified in paragraph
(4)(B) to determine whether such percentages,
such permissible payments, and such period pro-
vide an adequate incentive for employment net-
works to assist beneficiaries to enter the work-
force, while providing for appropriate economies.
The Commissioner may alter such percentage,
such total permissible payments, or such period
of time to the extent that the Commissioner de-
termines, on the basis of the Commissioner’s re-
view under this paragraph, that such an alter-
ation would better provide the incentive and
economies described in the preceding sentence.
‘‘(B) NUMBER AND AMOUNT OF MILESTONE
PAYMENTS.—The Commissioner shall periodi-
cally review the number and amounts of mile-
stone payments established by the Commissioner
pursuant to this section to determine whether
they provide an adequate incentive for employ-
ment networks to assist beneficiaries to enter the
workforce, taking into account information pro-
vided to the Commissioner by program man-
agers, the Ticket to Work and Work Incentives
Advisory Panel established by section 101(f) of
the Ticket to Work and Work Incentives Im-
provement Act of 1999, and other reliable
sources. The Commissioner may from time to
time alter the number and amounts of milestone
payments initially established by the Commis-
sioner pursuant to this section to the extent that
the Commissioner determines that such an alter-
ation would allow an adequate incentive for em-
ployment networks to assist beneficiaries to enter
the workforce. Such alteration shall be based on
information provided to the Commissioner by
program managers, the Ticket to Work and Work
Incentives Advisory Panel established by section
101(f) of the Ticket to Work and Work Incentives
Improvement Act of 1999, or other reliable
sources.
‘‘(C) REPORT ON THE ADEQUACY OF INCEN-
TIVES.—The Commissioner shall submit to Con-
gress not later than 36 months after the date of
the enactment of the Ticket to Work and Work
Incentives Improvement Act of 1999 a report
with recommendations for a method or methods
to adjust payment rates under subparagraphs
(A) and (B), that would ensure adequate incen-
tives for the provision of services by employment
networks of—
‘‘(i) individuals with a need for ongo-
ing support and services;
‘‘(ii) individuals with a need for high-
cost accommodations;
‘‘(iii) individuals who earn a submin-
imum wage; and
‘‘(iv) individuals who work and receive
partial cash benefits.
The Commissioner shall consult with the Ticket
to Work and Work Incentives Advisory Panel es-
tablished under section 101(f) of the Ticket to
Work and Work Incentives Improvement Act of
1999 during the development and evaluation of
the study. The Commissioner shall implement the
necessary adjusted payment rates prior to full
implementation of the Ticket to Work and Self-
Sufficiency Program.
‘‘(i) SUSPENSION OF DISABILITY REVIEWS.—During
any period for which an individual is using, as defined
by the Commissioner, a ticket to work and self-sufficiency
issued under this section, the Commissioner (and any ap-
plicable State agency) may not initiate a continuing dis-
ability review or other review under section 221 of whether
the individual is or is not under a disability or a review
under title XVI similar to any such review under section
221.
‘‘(j) AUTHORIZATIONS.—
‘‘(1) PAYMENTS TO EMPLOYMENT NETWORKS.—
‘‘(A) 
TITLE
II
DISABILITY
BENE-
FICIARIES.—There are authorized to be trans-
ferred from the Federal Old-Age and Survivors
Insurance Trust Fund and the Federal Dis-
ability Insurance Trust Fund each fiscal year
such sums as may be necessary to make pay-
ments to employment networks under this sec-
tion. Money paid from the Trust Funds under
this section with respect to title II disability
beneficiaries who are entitled to benefits under
section 223 or who are entitled to benefits under
section 202(d) on the basis of the wages and self-
employment income of such beneficiaries, shall be
charged to the Federal Disability Insurance
Trust Fund, and all other money paid from the
Trust Funds under this section shall be charged
to the Federal Old-Age and Survivors Insurance
Trust Fund.
‘‘(B) 
TITLE
XVI
DISABILITY
BENE-
FICIARIES.—Amounts authorized to be appro-
priated to the Social Security Administration
under section 1601 (as in effect pursuant to the
amendments made by section 301 of the Social
Security Amendments of 1972) shall include
amounts necessary to carry out the provisions of
this section with respect to title XVI disability
beneficiaries.
‘‘(2) ADMINISTRATIVE EXPENSES.—The costs of
administering this section (other than payments to
employment networks) shall be paid from amounts
made available for the administration of title II and
amounts made available for the administration of
title XVI, and shall be allocated among such amounts
as appropriate.
‘‘(k) DEFINITIONS.—In this section:
‘‘(1) COMMISSIONER.—The term ‘Commissioner’
means the Commissioner of Social Security.
‘‘(2) DISABLED
BENEFICIARY.—The term ‘dis-
abled beneficiary’ means a title II disability bene-
ficiary or a title XVI disability beneficiary.
‘‘(3) TITLE
II
DISABILITY
BENEFICIARY.—The
term ‘title II disability beneficiary’ means an indi-
vidual entitled to disability insurance benefits under
section 223 or to monthly insurance benefits under
section 202 based on such individual’s disability (as
defined in section 223(d)). An individual is a title II
disability beneficiary for each month for which such
individual is entitled to such benefits.
‘‘(4) TITLE XVI DISABILITY BENEFICIARY.—The
term ‘title XVI disability beneficiary’ means an indi-
vidual eligible for supplemental security income bene-
fits under title XVI on the basis of blindness (within
the meaning of section 1614(a)(2)) or disability
(within the meaning of section 1614(a)(3)). An indi-
vidual is a title XVI disability beneficiary for each
month for which such individual is eligible for such
benefits.
‘‘(5) SUPPLEMENTAL
SECURITY
INCOME
BEN-
EFIT.—The term ‘supplemental security income ben-
efit under title XVI’ means a cash benefit under sec-
tion 1611 or 1619(a), and does not include a State
supplementary payment, administered federally or
otherwise.
‘‘(l) REGULATIONS.—Not later than 1 year after the
date of the enactment of the Ticket to Work and Work Incen-
tives Improvement Act of 1999, the Commissioner shall pre-
scribe such regulations as are necessary to carry out the
provisions of this section.’’.
(b) CONFORMING AMENDMENTS.—
(1) AMENDMENTS TO TITLE II.—
(A) Section 221(i) of the Social Security
Act (42 U.S.C. 421(i)) is amended by adding at
the end the following:
‘‘(5) For suspension of reviews under this subsection
in the case of an individual using a ticket to work and
self-sufficiency, see section 1148(i).’’.
(B) Section 222(a) of such Act (42 U.S.C.
422(a)) is repealed.
(C) Section 222(b) of such Act (42 U.S.C.
422(b)) is repealed.
(D) Section 225(b)(1) of such Act (42
U.S.C. 425(b)(1)) is amended by striking ‘‘a pro-
gram of vocational rehabilitation services’’ and
inserting ‘‘a program consisting of the Ticket to
Work and Self-Sufficiency Program under sec-
tion 1148 or another program of vocational reha-
bilitation services, employment services, or other
support services’’.
(2) AMENDMENTS TO TITLE XVI.—
(A) Section 1615(a) of such Act (42 U.S.C.
1382d(a)) is amended to read as follows:
‘‘SEC. 1615. (a) In the case of any blind or disabled
individual who—
‘‘(1) has not attained age 16; and
‘‘(2) with respect to whom benefits are paid
under this title,
the Commissioner of Social Security shall make provision
for referral of such individual to the appropriate State
agency administering the State program under title V.’’.
(B) Section 1615(c) of such Act (42 U.S.C.
1382d(c)) is repealed.
(C) Section 1631(a)(6)(A) of such Act (42
U.S.C. 1383(a)(6)(A)) is amended by striking ‘‘a
program of vocational rehabilitation services’’
and inserting ‘‘a program consisting of the Tick-
et to Work and Self-Sufficiency Program under
section 1148 or another program of vocational
rehabilitation services, employment services, or
other support services’’.
(D) Section 1633(c) of such Act (42 U.S.C.
1383b(c)) is amended—
(i) by inserting ‘‘(1)’’ after ‘‘(c)’’; and
(ii) by adding at the end the following:
‘‘(2) For suspension of continuing disability reviews
and other reviews under this title similar to reviews under
section 221 in the case of an individual using a ticket to
work and self-sufficiency, see section 1148(i).’’.
(c) EFFECTIVE DATE.—Subject to subsection (d), the
amendments made by subsections (a) and (b) shall take ef-
fect with the first month following 1 year after the date
of the enactment of this Act.
(d) GRADUATED IMPLEMENTATION OF PROGRAM.—
(1) IN GENERAL.—Not later than 1 year after
the date of the enactment of this Act, the Commis-
sioner of Social Security shall commence implementa-
tion of the amendments made by this section (other
than paragraphs (1)(C) and (2)(B) of subsection (b))
in graduated phases at phase-in sites selected by the
Commissioner. Such phase-in sites shall be selected so
as to ensure, prior to full implementation of the Tick-
et to Work and Self-Sufficiency Program, the develop-
ment and refinement of referral processes, payment
systems, computer linkages, management information
systems, and administrative processes necessary to
provide for full implementation of such amendments.
Subsection (c) shall apply with respect to paragraphs
(1)(C) and (2)(B) of subsection (b) without regard to
this subsection.
(2) REQUIREMENTS.—Implementation of the
Program at each phase-in site shall be carried out on
a wide enough scale to permit a thorough evaluation
of the alternative methods under consideration, so as
to ensure that the most efficacious methods are deter-
mined and in place for full implementation of the
Program on a timely basis.
(3) FULL IMPLEMENTATION.—The Commissioner
shall ensure that ability to provide tickets and serv-
ices to individuals under the Program exists in every
State as soon as practicable on or after the effective
date specified in subsection (c) but not later than 3
years after such date.
(4) ONGOING EVALUATION OF PROGRAM.—
(A) IN GENERAL.—The Commissioner shall
design and conduct a series of evaluations to as-
sess the cost-effectiveness of activities carried out
under this section and the amendments made
thereby, as well as the effects of this section and
the amendments made thereby on work outcomes
for beneficiaries receiving tickets to work and
self-sufficiency under the Program.
(B) 
CONSULTATION.—The 
Commissioner
shall design and carry out the series of evalua-
tions after receiving relevant advice from experts
in the fields of disability, vocational rehabilita-
tion, and program evaluation and individuals
using tickets to work and self-sufficiency under
the Program and consulting with the Ticket to
Work and Work Incentives Advisory Panel estab-
lished under section 101(f), the Comptroller Gen-
eral of the United States, other agencies of the
Federal Government, and private organizations
with appropriate expertise.
(C) METHODOLOGY.—
(i) IMPLEMENTATION.—The Commis-
sioner, in consultation with the Ticket to
Work and Work Incentives Advisory Panel
established under section 101(f), shall ensure
that plans for evaluations and data collec-
tion methods under the Program are appro-
priately designed to obtain detailed employ-
ment information.
(ii) SPECIFIC
MATTERS
TO
BE
AD-
DRESSED.—Each such evaluation shall ad-
dress (but is not limited to)—
(I) the annual cost (including net
cost) of the Program and the annual
cost (including net cost) that would
have been incurred in the absence of
the Program;
(II) the determinants of return to
work, including the characteristics of
beneficiaries in receipt of tickets under
the Program;
(III) the types of employment
services, vocational rehabilitation serv-
ices, and other support services fur-
nished to beneficiaries in receipt of
tickets under the Program who return
to work and to those who do not return
to work;
(IV) the duration of employment
services, vocational rehabilitation serv-
ices, and other support services fur-
nished to beneficiaries in receipt of
tickets under the Program who return
to work and the duration of such serv-
ices furnished to those who do not re-
turn to work and the cost to employ-
ment networks of furnishing such serv-
ices;
(V) the employment outcomes, in-
cluding wages, occupations, benefits,
and hours worked, of beneficiaries who
return to work after receiving tickets
under the Program and those who re-
turn to work without receiving such
tickets;
(VI) the characteristics of individ-
uals in possession of tickets under the
Program who are not accepted for serv-
ices and, to the extent reasonably deter-
minable, the reasons for which such
beneficiaries were not accepted for serv-
ices;
(VII) the characteristics of pro-
viders whose services are provided
within an employment network under
the Program;
(VIII) the extent (if any) to which
employment networks display a greater
willingness to provide services to bene-
ficiaries with a range of disabilities;
(IX) the characteristics (including
employment outcomes) of those bene-
ficiaries who receive services under the
outcome payment system and of those
beneficiaries who receive services under
the outcome-milestone payment system;
(X) 
measures 
of 
satisfaction
among beneficiaries in receipt of tick-
ets under the Program; and
(XI) reasons for (including com-
ments solicited from beneficiaries re-
garding) their choice not to use their
tickets or their inability to return to
work despite the use of their tickets.
(D) PERIODIC EVALUATION REPORTS.—Fol-
lowing the close of the third and fifth fiscal years
ending after the effective date under subsection
(c), and prior to the close of the seventh fiscal
year ending after such date, the Commissioner
shall transmit to the Committee on Ways and
Means of the House of Representatives and the
Committee on Finance of the Senate a report
containing the Commissioner’s evaluation of the
progress of activities conducted under the provi-
sions of this section and the amendments made
thereby. Each such report shall set forth the
Commissioner’s evaluation of the extent to which
the Program has been successful and the Com-
missioner’s conclusions on whether or how the
Program should be modified. Each such report
shall include such data, findings, materials, and
recommendations as the Commissioner may con-
sider appropriate.
(5) EXTENT OF STATE’S RIGHT OF FIRST RE-
FUSAL
IN
ADVANCE
OF
FULL
IMPLEMENTATION
OF
AMENDMENTS IN SUCH STATE.—
(A) IN GENERAL.—In the case of any State
in which the amendments made by subsection (a)
have not been fully implemented pursuant to this
subsection, the Commissioner shall determine by
regulation the extent to which—
(i) the requirement under section
222(a) for prompt referrals to a State agen-
cy; and
(ii) the authority of the Commissioner
under section 222(d)(2) of the Social Secu-
rity Act to provide vocational rehabilitation
services in such State by agreement or con-
tract with other public or private agencies,
organizations, institutions, or individuals,
shall apply in such State.
(B) EXISTING
AGREEMENTS.—Nothing in
subparagraph (A) or the amendments made by
subsection (a) shall be construed to limit, im-
pede, or otherwise affect any agreement entered
into pursuant to section 222(d)(2) of the Social
Security Act before the date of the enactment of
this Act with respect to services provided pursu-
ant to such agreement to beneficiaries receiving
services under such agreement as of such date,
except with respect to services (if any) to be pro-
vided after 3 years after the effective date pro-
vided in subsection (c).
(e) SPECIFIC REGULATIONS REQUIRED.—
(1) IN GENERAL.—The Commissioner of Social
Security shall prescribe such regulations as are nec-
essary to implement the amendments made by this
section.
(2) SPECIFIC MATTERS TO BE INCLUDED IN REG-
ULATIONS.—The matters which shall be addressed in
such regulations shall include—
(A) the form and manner in which tickets
to work and self-sufficiency may be distributed to
beneficiaries pursuant to section 1148(b)(1) of
the Social Security Act;
(B) the format and wording of such tickets,
which shall incorporate by reference any contrac-
tual terms governing service by employment net-
works under the Program;
(C) the form and manner in which State
agencies may elect participation in the Ticket to
Work and Self-Sufficiency Program pursuant to
section 1148(c)(1) of such Act and provision for
periodic opportunities for exercising such elec-
tions;
(D) the status of State agencies under sec-
tion 1148(c)(1) of such Act at the time that State
agencies exercise elections under that section;
(E) the terms of agreements to be entered
into with program managers pursuant to section
1148(d) of such Act, including—
(i) the terms by which program man-
agers are precluded from direct participa-
tion in the delivery of services pursuant to
section 1148(d)(3) of such Act;
(ii) standards which must be met by
quality assurance measures referred to in
paragraph (6) of section 1148(d) of such
Act and methods of recruitment of employ-
ment networks utilized pursuant to para-
graph (2) of section 1148(e) of such Act;
and
(iii) the format under which dispute
resolution 
will 
operate 
under 
section
1148(d)(7) of such Act;
(F) the terms of agreements to be entered
into with employment networks pursuant to sec-
tion 1148(d)(4) of such Act, including—
(i) the manner in which service areas
are 
specified 
pursuant 
to 
section
1148(f)(2)(A) of such Act;
(ii) the general selection criteria and
the specific selection criteria which are ap-
plicable to employment networks under sec-
tion 1148(f)(1)(C) of such Act in selecting
service providers;
(iii) specific requirements relating to
annual financial reporting by employment
networks pursuant to section 1148(f)(3) of
such Act; and
(iv) the national model to which peri-
odic outcomes reporting by employment net-
works 
must 
conform 
under 
section
1148(f)(4) of such Act;
(G) standards which must be met by indi-
vidual work plans pursuant to section 1148(g) of
such Act;
(H) standards which must be met by pay-
ment systems required under section 1148(h) of
such Act, including—
(i) the form and manner in which elec-
tions by employment networks of payment
systems are to be exercised pursuant to sec-
tion 1148(h)(1)(A) of such Act;
(ii) the terms which must be met by an
outcome payment system under section
1148(h)(2) of such Act;
(iii) the terms which must be met by
an 
outcome-milestone 
payment 
system
under section 1148(h)(3) of such Act;
(iv) any revision of the percentage
specified in paragraph (2)(C) of section
1148(h) of such Act or the period of time
specified in paragraph (4)(B) of such sec-
tion 1148(h) of such Act; and
(v) annual oversight procedures for
such systems; and
(I) procedures for effective oversight of the
Program by the Commissioner of Social Secu-
rity, including periodic reviews and reporting
requirements.
(f) THE TICKET TO WORK AND WORK INCENTIVES AD-
VISORY PANEL.—
(1) ESTABLISHMENT.—There is established with-
in the Social Security Administration a panel to be
known as the ‘‘Ticket to Work and Work Incentives
Advisory Panel’’ (in this subsection referred to as the
‘‘Panel’’).
(2) DUTIES OF PANEL.—It shall be the duty of
the Panel to—
(A) advise the President, the Congress, and
the Commissioner of Social Security on issues
related to work incentives programs, planning,
and assistance for individuals with disabilities,
including work incentive provisions under titles
II, XI, XVI, XVIII, and XIX of the Social Secu-
rity Act (42 U.S.C. 401 et seq., 1301 et seq.,
1381 et seq., 1395 et seq., 1396 et seq.); and
(B) with respect to the Ticket to Work and
Self-Sufficiency Program established under sec-
tion 1148 of such Act—
(i) advise the Commissioner of Social
Security with respect to establishing phase-
in sites for such Program and fully imple-
menting the Program thereafter, the refine-
ment of access of disabled beneficiaries to
employment networks, payment systems,
and management information systems, and
advise the Commissioner whether such
measures are being taken to the extent nec-
essary to ensure the success of the Program;
(ii) advise the Commissioner regarding
the most effective designs for research and
demonstration projects associated with the
Program or conducted pursuant to section
302 of this Act;
(iii) advise the Commissioner on the
development of performance measurements
relating to quality assurance under section
1148(d)(6) of the Social Security Act; and
(iv) furnish progress reports on the
Program to the Commissioner and each
House of Congress.
(3) MEMBERSHIP.—
(A) 
NUMBER
AND
APPOINTMENT.—The
Panel shall be composed of 12 members as fol-
lows:
(i) 4 members appointed by the Presi-
dent, not more than 2 of whom may be of
the same political party;
(ii) 2 members appointed by the
Speaker of the House of Representatives, in
consultation with the Chairman of the Com-
mittee on Ways and Means of the House of
Representatives;
(iii) 2 members appointed by the mi-
nority leader of the House of Representa-
tives, in consultation with the ranking
member of the Committee on Ways and
Means of the House of Representatives;
(iv) 2 members appointed by the ma-
jority leader of the Senate, in consultation
with the Chairman of the Committee on Fi-
nance of the Senate; and
(v) 2 members appointed by the minor-
ity leader of the Senate, in consultation
with the ranking member of the Committee
on Finance of the Senate.
(B) REPRESENTATION.—Of the members
appointed under subparagraph (A), at least 8
shall have experience or expert knowledge as a
recipient, provider, employer, or employee in the
fields of, or related to, employment services, voca-
tional rehabilitation services, and other support
services, of whom—
(i) at least 2 shall represent the inter-
ests of recipients of employment services, vo-
cational rehabilitation services, and other
support services;
(ii) at least 2 shall represent the inter-
ests of providers of employment services, vo-
cational rehabilitation services, and other
support services;
(iii) at least 2 shall represent the inter-
ests of private employers; and
(iv) at least 2 shall represent the inter-
ests of employees.
At least 1⁄2 of the members described in each
clause of subparagraph (A) shall be individuals
with disabilities, or representatives of individ-
uals with disabilities, with consideration to cur-
rent or former title II disability beneficiaries or
title XVI disability beneficiaries (as such terms
are defined in section 1148(k) of the Social Secu-
rity Act (as added by subsection (a)).
(C) TERMS.—
(i) IN GENERAL.—Each member shall
be appointed for a term of 4 years (or, if
less, for the remaining life of the Panel), ex-
cept as provided in clauses (ii) and (iii).
The initial members shall be appointed not
later than 90 days after the date of the en-
actment of this Act.
(ii) TERMS OF INITIAL APPOINTEES.—
As designated by the President at the time
of appointment, of the members first
appointed—
(I) 1⁄2 of the members appointed
under subparagraph (A) shall be ap-
pointed for a term of 2 years; and
(II) the remaining members ap-
pointed under subparagraph (A) shall
be appointed for a term of 4 years.
(iii) VACANCIES.—Any member ap-
pointed to fill a vacancy occurring before
the expiration of the term for which the
member’s predecessor was appointed shall be
appointed only for the remainder of that
term. A member may serve after the expira-
tion of that member’s term until a successor
has taken office. A vacancy in the Panel
shall be filled in the manner in which the
original appointment was made.
(D) BASIC
PAY.—Members shall each be
paid at a rate, and in a manner, that is con-
sistent with guidelines established under section
7 of the Federal Advisory Committee Act (5
U.S.C. App.).
(E) TRAVEL
EXPENSES.—Each member
shall receive travel expenses, including per diem
in lieu of subsistence, in accordance with sections
5702 and 5703 of title 5, United States Code.
(F) QUORUM.—8 members of the Panel
shall constitute a quorum but a lesser number
may hold hearings.
(G) CHAIRPERSON.—The Chairperson of the
Panel shall be designated by the President. The
term of office of the Chairperson shall be 4 years.
(H) MEETINGS.—The Panel shall meet at
least quarterly and at other times at the call of
the Chairperson or a majority of its members.
(4) DIRECTOR AND STAFF OF PANEL; EXPERTS
AND CONSULTANTS.—
(A) DIRECTOR.—The Panel shall have a Di-
rector who shall be appointed by the Panel, and
paid at a rate, and in a manner, that is con-
sistent with guidelines established under section
7 of the Federal Advisory Committee Act (5
U.S.C. App.).
(B) STAFF.—Subject to rules prescribed by
the Commissioner of Social Security, the Direc-
tor may appoint and fix the pay of additional
personnel as the Director considers appropriate.
(C) EXPERTS AND CONSULTANTS.—Subject
to rules prescribed by the Commissioner of Social
Security, the Director may procure temporary
and intermittent services under section 3109(b)
of title 5, United States Code.
(D) STAFF OF FEDERAL AGENCIES.—Upon
request of the Panel, the head of any Federal de-
partment or agency may detail, on a reimburs-
able basis, any of the personnel of that depart-
ment or agency to the Panel to assist it in car-
rying out its duties under this Act.
(5) POWERS OF PANEL.—
(A) HEARINGS AND SESSIONS.—The Panel
may, for the purpose of carrying out its duties
under this subsection, hold such hearings, sit and
act at such times and places, and take such testi-
mony and evidence as the Panel considers appro-
priate.
(B) POWERS OF MEMBERS AND AGENTS.—
Any member or agent of the Panel may, if au-
thorized by the Panel, take any action which the
Panel is authorized to take by this section.
(C) MAILS.—The Panel may use the United
States mails in the same manner and under the
same conditions as other departments and agen-
cies of the United States.
(6) REPORTS.—
(A) INTERIM
REPORTS.—The Panel shall
submit to the President and the Congress interim
reports at least annually.
(B) FINAL REPORT.—The Panel shall trans-
mit a final report to the President and the Con-
gress not later than eight years after the date of
the enactment of this Act. The final report shall
contain a detailed statement of the findings and
conclusions of the Panel, together with its rec-
ommendations for legislation and administrative
actions which the Panel considers appropriate.
(7) TERMINATION.—The Panel shall terminate
30 days after the date of the submission of its final
report under paragraph (6)(B).
(8) AUTHORIZATION
OF
APPROPRIATIONS.—
There are authorized to be appropriated from the Fed-
eral Old-Age and Survivors Insurance Trust Fund,
the Federal Disability Insurance Trust Fund, and the
general fund of the Treasury, as appropriate, such
sums as are necessary to carry out this subsection.
Subtitle B—Elimination of Work
Disincentives
SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR RE-
VIEW OF AN INDIVIDUAL’S DISABLED STATUS.
(a) IN GENERAL.—Section 221 of the Social Security
Act (42 U.S.C. 421) is amended by adding at the end the
following:
‘‘(m)(1) In any case where an individual entitled to
disability insurance benefits under section 223 or to month-
ly insurance benefits under section 202 based on such indi-
vidual’s disability (as defined in section 223(d)) has re-
ceived such benefits for at least 24 months—
‘‘(A) no continuing disability review conducted
by the Commissioner may be scheduled for the indi-
vidual solely as a result of the individual’s work ac-
tivity;
‘‘(B) no work activity engaged in by the indi-
vidual may be used as evidence that the individual is
no longer disabled; and
‘‘(C) no cessation of work activity by the indi-
vidual may give rise to a presumption that the indi-
vidual is unable to engage in work.
‘‘(2) An individual to which paragraph (1) applies
shall continue to be subject to—
‘‘(A) continuing disability reviews on a regu-
larly scheduled basis that is not triggered by work;
and
‘‘(B) termination of benefits under this title in
the event that the individual has earnings that exceed
the level of earnings established by the Commissioner
to represent substantial gainful activity.’’.
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall take effect on January 1, 2003.
SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BEN-
EFITS.
(a) OASDI BENEFITS.—Section 223 of the Social Se-
curity Act (42 U.S.C. 423) is amended—
(1) by redesignating subsection (i) as subsection
(j); and
(2) by inserting after subsection (h) the fol-
lowing:
‘‘Reinstatement of Entitlement
‘‘(i)(1)(A) Entitlement to benefits described in sub-
paragraph (B)(i)(I) shall be reinstated in any case where
the Commissioner determines that an individual described
in subparagraph (B) has filed a request for reinstatement
meeting the requirements of paragraph (2)(A) during the
period prescribed in subparagraph (C). Reinstatement of
such entitlement shall be in accordance with the terms of
this subsection.
‘‘(B) An individual is described in this subparagraph
if—
‘‘(i) prior to the month in which the individual
files a request for reinstatement—
‘‘(I) the individual was entitled to benefits
under this section or section 202 on the basis of
disability pursuant to an application filed there-
for; and
‘‘(II) such entitlement terminated due to the
performance of substantial gainful activity;
‘‘(ii) the individual is under a disability and the
physical or mental impairment that is the basis for
the finding of disability is the same as (or related to)
the physical or mental impairment that was the basis
for the finding of disability that gave rise to the enti-
tlement described in clause (i); and
‘‘(iii) the individual’s disability renders the in-
dividual unable to perform substantial gainful activ-
ity.
‘‘(C)(i) Except as provided in clause (ii), the period
prescribed in this subparagraph with respect to an indi-
vidual is 60 consecutive months beginning with the month
following the most recent month for which the individual
was entitled to a benefit described in subparagraph
(B)(i)(I) prior to the entitlement termination described in
subparagraph (B)(i)(II).
‘‘(ii) In the case of an individual who fails to file a
reinstatement request within the period prescribed in clause
(i), the Commissioner may extend the period if the Commis-
sioner determines that the individual had good cause for
the failure to so file.
‘‘(2)(A)(i) A request for reinstatement shall be filed in
such form, and containing such information, as the Com-
missioner may prescribe.
‘‘(ii) A request for reinstatement shall include express
declarations by the individual that the individual meets the
requirements specified in clauses (ii) and (iii) of paragraph
(1)(B).
‘‘(B) A request for reinstatement filed in accordance
with subparagraph (A) may constitute an application for
benefits in the case of any individual who the Commissioner
determines is not entitled to reinstated benefits under this
subsection.
‘‘(3) In determining whether an individual meets the
requirements of paragraph (1)(B)(ii), the provisions of sub-
section (f) shall apply.
‘‘(4)(A)(i) Subject to clause (ii), entitlement to benefits
reinstated under this subsection shall commence with the
benefit payable for the month in which a request for rein-
statement is filed.
‘‘(ii) An individual whose entitlement to a benefit for
any month would have been reinstated under this subsection
had the individual filed a request for reinstatement before
the end of such month shall be entitled to such benefit for
such month if such request for reinstatement is filed before
the end of the twelfth month immediately succeeding such
month.
‘‘(B)(i) Subject to clauses (ii) and (iii), the amount
of the benefit payable for any month pursuant to the rein-
statement of entitlement under this subsection shall be deter-
mined in accordance with the provisions of this title.
‘‘(ii) For purposes of computing the primary insur-
ance amount of an individual whose entitlement to benefits
under this section is reinstated under this subsection, the
date of onset of the individual’s disability shall be the date
of onset used in determining the individual’s most recent
period of disability arising in connection with such benefits
payable on the basis of an application.
‘‘(iii) Benefits under this section or section 202 pay-
able for any month pursuant to a request for reinstatement
filed in accordance with paragraph (2) shall be reduced by
the amount of any provisional benefit paid to such indi-
vidual for such month under paragraph (7).
‘‘(C) No benefit shall be payable pursuant to an enti-
tlement reinstated under this subsection to an individual
for any month in which the individual engages in substan-
tial gainful activity.
‘‘(D) The entitlement of any individual that is rein-
stated under this subsection shall end with the benefits pay-
able for the month preceding whichever of the following
months is the earliest:
‘‘(i) The month in which the individual dies.
‘‘(ii) The month in which the individual attains
retirement age.
‘‘(iii) The third month following the month in
which the individual’s disability ceases.
‘‘(5) Whenever an individual’s entitlement to benefits
under this section is reinstated under this subsection, enti-
tlement to benefits payable on the basis of such individual’s
wages and self-employment income may be reinstated with
respect to any person previously entitled to such benefits
on the basis of an application if the Commissioner deter-
mines that such person satisfies all the requirements for en-
titlement to such benefits except requirements related to the
filing of an application. The provisions of paragraph (4)
shall apply to the reinstated entitlement of any such person
to the same extent that they apply to the reinstated entitle-
ment of such individual.
‘‘(6) An individual to whom benefits are payable under
this section or section 202 pursuant to a reinstatement of
entitlement under this subsection for 24 months (whether
or not consecutive) shall, with respect to benefits so payable
after such twenty-fourth month, be deemed for purposes of
paragraph (1)(B)(i)(I) and the determination, if appro-
priate, of the termination month in accordance with sub-
section (a)(1) of this section, or subsection (d)(1), (e)(1),
or (f)(1) of section 202, to be entitled to such benefits on
the basis of an application filed therefor.
‘‘(7)(A) An individual described in paragraph (1)(B)
who files a request for reinstatement in accordance with the
provisions of paragraph (2)(A) shall be entitled to provi-
sional benefits payable in accordance with this paragraph,
unless the Commissioner determines that the individual
does not meet the requirements of paragraph (1)(B)(i) or
that 
the 
individual’s 
declaration 
under 
paragraph
(2)(A)(ii) is false. Any such determination by the Commis-
sioner shall be final and not subject to review under sub-
section (b) or (g) of section 205.
‘‘(B) The amount of a provisional benefit for a month
shall equal the amount of the last monthly benefit payable
to the individual under this title on the basis of an applica-
tion increased by an amount equal to the amount, if any,
by which such last monthly benefit would have been in-
creased as a result of the operation of section 215(i).
‘‘(C)(i) Provisional benefits shall begin with the month
in which a request for reinstatement is filed in accordance
with paragraph (2)(A).
‘‘(ii) Provisional benefits shall end with the earliest
of—
‘‘(I) the month in which the Commissioner
makes a determination regarding the individual’s en-
titlement to reinstated benefits;
‘‘(II) the fifth month following the month de-
scribed in clause (i);
‘‘(III) the month in which the individual per-
forms substantial gainful activity; or
‘‘(IV) the month in which the Commissioner de-
termines that the individual does not meet the re-
quirements of paragraph (1)(B)(i) or that the indi-
vidual’s declaration made in accordance with para-
graph (2)(A)(ii) is false.
‘‘(D) In any case in which the Commissioner deter-
mines that an individual is not entitled to reinstated bene-
fits, any provisional benefits paid to the individual under
this paragraph shall not be subject to recovery as an over-
payment unless the Commissioner determines that the indi-
vidual knew or should have known that the individual did
not meet the requirements of paragraph (1)(B).’’.
(b) SSI BENEFITS.—
(1) IN GENERAL.—Section 1631 of the Social Se-
curity Act (42 U.S.C. 1383) is amended by adding at
the end the following:
‘‘Reinstatement of Eligibility on the Basis of Blindness or
Disability
‘‘(p)(1)(A) Eligibility for benefits under this title shall
be reinstated in any case where the Commissioner deter-
mines that an individual described in subparagraph (B)
has filed a request for reinstatement meeting the require-
ments of paragraph (2)(A) during the period prescribed in
subparagraph (C). Reinstatement of eligibility shall be in
accordance with the terms of this subsection.
‘‘(B) An individual is described in this subparagraph
if—
‘‘(i) prior to the month in which the individual
files a request for reinstatement—
‘‘(I) the individual was eligible for benefits
under this title on the basis of blindness or dis-
ability pursuant to an application filed therefor;
and
‘‘(II) the individual thereafter was ineligible
for such benefits due to earned income (or earned
and unearned income) for a period of 12 or more
consecutive months;
‘‘(ii) the individual is blind or disabled and the
physical or mental impairment that is the basis for
the finding of blindness or disability is the same as
(or related to) the physical or mental impairment
that was the basis for the finding of blindness or dis-
ability that gave rise to the eligibility described in
clause (i);
‘‘(iii) the individual’s blindness or disability
renders the individual unable to perform substantial
gainful activity; and
‘‘(iv) the individual satisfies the nonmedical re-
quirements for eligibility for benefits under this title.
‘‘(C)(i) Except as provided in clause (ii), the period
prescribed in this subparagraph with respect to an indi-
vidual is 60 consecutive months beginning with the month
following the most recent month for which the individual
was eligible for a benefit under this title (including section
1619) prior to the period of ineligibility described in sub-
paragraph (B)(i)(II).
‘‘(ii) In the case of an individual who fails to file a
reinstatement request within the period prescribed in clause
(i), the Commissioner may extend the period if the Commis-
sioner determines that the individual had good cause for
the failure to so file.
‘‘(2)(A)(i) A request for reinstatement shall be filed in
such form, and containing such information, as the Com-
missioner may prescribe.
‘‘(ii) A request for reinstatement shall include express
declarations by the individual that the individual meets the
requirements specified in clauses (ii) through (iv) of para-
graph (1)(B).
‘‘(B) A request for reinstatement filed in accordance
with subparagraph (A) may constitute an application for
benefits in the case of any individual who the Commissioner
determines is not eligible for reinstated benefits under this
subsection.
‘‘(3) In determining whether an individual meets the
requirements of paragraph (1)(B)(ii), the provisions of sec-
tion 1614(a)(4) shall apply.
‘‘(4)(A) Eligibility for benefits reinstated under this
subsection shall commence with the benefit payable for the
month following the month in which a request for reinstate-
ment is filed.
‘‘(B)(i) Subject to clause (ii), the amount of the benefit
payable for any month pursuant to the reinstatement of eli-
gibility under this subsection shall be determined in accord-
ance with the provisions of this title.
‘‘(ii) The benefit under this title payable for any
month pursuant to a request for reinstatement filed in ac-
cordance with paragraph (2) shall be reduced by the
amount of any provisional benefit paid to such individual
for such month under paragraph (7).
‘‘(C) Except as otherwise provided in this subsection,
eligibility for benefits under this title reinstated pursuant
to a request filed under paragraph (2) shall be subject to
the same terms and conditions as eligibility established pur-
suant to an application filed therefor.
‘‘(5) Whenever an individual’s eligibility for benefits
under this title is reinstated under this subsection, eligi-
bility for such benefits shall be reinstated with respect to
the individual’s spouse if such spouse was previously an
eligible spouse of the individual under this title and the
Commissioner determines that such spouse satisfies all the
requirements for eligibility for such benefits except require-
ments related to the filing of an application. The provisions
of paragraph (4) shall apply to the reinstated eligibility
of the spouse to the same extent that they apply to the rein-
stated eligibility of such individual.
‘‘(6) An individual to whom benefits are payable under
this title pursuant to a reinstatement of eligibility under
this subsection for twenty-four months (whether or not con-
secutive) shall, with respect to benefits so payable after such
twenty-fourth month, be deemed for purposes of paragraph
(1)(B)(i)(I) to be eligible for such benefits on the basis of
an application filed therefor.
‘‘(7)(A) An individual described in paragraph (1)(B)
who files a request for reinstatement in accordance with the
provisions of paragraph (2)(A) shall be eligible for provi-
sional benefits payable in accordance with this paragraph,
unless the Commissioner determines that the individual
does not meet the requirements of paragraph (1)(B)(i) or
that 
the 
individual’s 
declaration 
under 
paragraph
(2)(A)(ii) is false. Any such determination by the Commis-
sioner shall be final and not subject to review under para-
graph (1) or (3) of subsection (c).
‘‘(B)(i) Except as otherwise provided in clause (ii), the
amount of a provisional benefit for a month shall equal the
amount of the monthly benefit that would be payable to an
eligible individual under this title with the same kind and
amount of income.
‘‘(ii) If the individual has a spouse who was previously
an eligible spouse of the individual under this title and the
Commissioner determines that such spouse satisfies all the
requirements of section 1614(b) except requirements related
to the filing of an application, the amount of a provisional
benefit for a month shall equal the amount of the monthly
benefit that would be payable to an eligible individual and
eligible spouse under this title with the same kind and
amount of income.
‘‘(C)(i) Provisional benefits shall begin with the month
following the month in which a request for reinstatement
is filed in accordance with paragraph (2)(A).
‘‘(ii) Provisional benefits shall end with the earliest
of—
‘‘(I) the month in which the Commissioner
makes a determination regarding the individual’s eli-
gibility for reinstated benefits;
‘‘(II) the fifth month following the month for
which provisional benefits are first payable under
clause (i); or
‘‘(III) the month in which the Commissioner de-
termines that the individual does not meet the re-
quirements of paragraph (1)(B)(i) or that the indi-
vidual’s declaration made in accordance with para-
graph (2)(A)(ii) is false.
‘‘(D) In any case in which the Commissioner deter-
mines that an individual is not eligible for reinstated bene-
fits, any provisional benefits paid to the individual under
this paragraph shall not be subject to recovery as an over-
payment unless the Commissioner determines that the indi-
vidual knew or should have known that the individual did
not meet the requirements of paragraph (1)(B).
‘‘(8) For purposes of this subsection other than para-
graph (7), the term ‘benefits under this title’ includes State
supplementary payments made pursuant to an agreement
under section 1616(a) of this Act or section 212(b) of Public
Law 93–66.’’.
(2) CONFORMING AMENDMENTS.—
(A) Section 1631(j)(1) of such Act (42
U.S.C. 1383(j)(1)) is amended by striking the pe-
riod and inserting ‘‘, or has filed a request for
reinstatement of eligibility under subsection
(p)(2) and been determined to be eligible for re-
instatement.’’.
(B) Section 1631(j)(2)(A)(i)(I) of such Act
(42 U.S.C. 1383(j)(2)(A)(i)(I)) is amended by
inserting ‘‘(other than pursuant to a request for
reinstatement under subsection (p))’’ after ‘‘eligi-
ble’’.
(c) EFFECTIVE DATE.—
(1) IN
GENERAL.—The amendments made by
this section shall take effect on the first day of the
thirteenth month beginning after the date of enact-
ment of this Act.
(2) LIMITATION.—No benefit shall be payable
under title II or XVI on the basis of a request for re-
instatement filed under section 223(i) or 1631(p) of
the Social Security Act before the effective date de-
scribed in paragraph (1).
Subtitle C—Work Incentives Plan-
ning, Assistance, and Outreach
SEC. 121. WORK INCENTIVES OUTREACH PROGRAM.
Part A of title XI of the Social Security Act (42 U.S.C.
1301 et seq.), as amended by section 101, is amended by
adding after section 1148 the following:
‘‘WORK INCENTIVES OUTREACH PROGRAM
‘‘SEC. 1149. (a) ESTABLISHMENT.—
‘‘(1) IN GENERAL.—The Commissioner, in con-
sultation with the Ticket to Work and Work Incen-
tives Advisory Panel established under section 101(f)
of the Ticket to Work and Work Incentives Improve-
ment Act of 1999, shall establish a community-based
work incentives planning and assistance program for
the purpose of disseminating accurate information to
disabled beneficiaries on work incentives programs
and issues related to such programs.
‘‘(2) GRANTS, COOPERATIVE AGREEMENTS, CON-
TRACTS, AND OUTREACH.—Under the program estab-
lished under this section, the Commissioner shall—
‘‘(A) establish a competitive program of
grants, cooperative agreements, or contracts to
provide benefits planning and assistance, includ-
ing information on the availability of protection
and advocacy services, to disabled beneficiaries,
including individuals participating in the Ticket
to Work and Self-Sufficiency Program estab-
lished under section 1148, the program estab-
lished under section 1619, and other programs
that are designed to encourage disabled bene-
ficiaries to work;
‘‘(B) conduct directly, or through grants, co-
operative agreements, or contracts, ongoing out-
reach efforts to disabled beneficiaries (and to the
families of such beneficiaries) who are poten-
tially eligible to participate in Federal or State
work incentive programs that are designed to as-
sist disabled beneficiaries to work, including—
‘‘(i) preparing and disseminating in-
formation explaining such programs; and
‘‘(ii) working in cooperation with other
Federal, State, and private agencies and
nonprofit organizations that serve disabled
beneficiaries, and with agencies and organi-
zations that focus on vocational rehabilita-
tion and work-related training and coun-
seling;
‘‘(C) establish a corps of trained, accessible,
and responsive work incentives specialists within
the Social Security Administration who will spe-
cialize in disability work incentives under titles
II and XVI for the purpose of disseminating ac-
curate information with respect to inquiries and
issues relating to work incentives to—
‘‘(i) disabled beneficiaries;
‘‘(ii) benefit applicants under titles II
and XVI; and
‘‘(iii) individuals or entities awarded
grants under subparagraphs (A) or (B);
and
‘‘(D) provide—
‘‘(i) training for work incentives spe-
cialists and individuals providing planning
assistance described in subparagraph (C);
and
‘‘(ii) technical assistance to organiza-
tions and entities that are designed to en-
courage disabled beneficiaries to return to
work.
‘‘(3) COORDINATION WITH OTHER PROGRAMS.—
The responsibilities of the Commissioner established
under this section shall be coordinated with other
public and private programs that provide informa-
tion and assistance regarding rehabilitation services
and independent living supports and benefits plan-
ning for disabled beneficiaries including the program
under section 1619, the plans for achieving self-sup-
port program (PASS), and any other Federal or
State work incentives programs that are designed to
assist disabled beneficiaries, including educational
agencies that provide information and assistance re-
garding rehabilitation, school-to-work programs, tran-
sition services (as defined in, and provided in accord-
ance with, the Individuals with Disabilities Edu-
cation Act (20 U.S.C. 1400 et seq.)), a one-stop deliv-
ery system established under subtitle B of title I of the
Workforce Investment Act of 1998, and other services.
‘‘(b) CONDITIONS.—
‘‘(1) SELECTION OF ENTITIES.—
‘‘(A) APPLICATION.—An entity shall submit
an application for a grant, cooperative agree-
ment, or contract to provide benefits planning
and assistance to the Commissioner at such time,
in such manner, and containing such informa-
tion as the Commissioner may determine is nec-
essary to meet the requirements of this section.
‘‘(B) STATEWIDENESS.—The Commissioner
shall ensure that the planning, assistance, and
information described in paragraph (2) shall be
available on a statewide basis.
‘‘(C) ELIGIBILITY OF STATES AND PRIVATE
ORGANIZATIONS.—
‘‘(i) IN GENERAL.—The Commissioner
may award a grant, cooperative agreement,
or contract under this section to a State or
a private agency or organization (other
than Social Security Administration Field
Offices and the State agency administering
the State medicaid program under title
XIX, including any agency or entity de-
scribed in clause (ii), that the Commissioner
determines is qualified to provide the plan-
ning, assistance, and information described
in paragraph (2)).
‘‘(ii) AGENCIES
AND
ENTITIES
DE-
SCRIBED.—The agencies and entities de-
scribed in this clause are the following:
‘‘(I) Any public or private agency
or organization (including Centers for
Independent Living established under
title VII of the Rehabilitation Act of
1973, protection and advocacy organi-
zations, client assistance programs es-
tablished in accordance with section
112 of the Rehabilitation Act of 1973,
and State Developmental Disabilities
Councils established in accordance
with section 124 of the Developmental
Disabilities Assistance and Bill of
Rights Act (42 U.S.C. 6024)) that the
Commissioner determines satisfies the
requirements of this section.
‘‘(II) The State agency admin-
istering the State program funded
under part A of title IV.
‘‘(D) EXCLUSION FOR CONFLICT OF INTER-
EST.—The Commissioner may not award a
grant, cooperative agreement, or contract under
this section to any entity that the Commissioner
determines would have a conflict of interest if the
entity were to receive a grant, cooperative agree-
ment, or contract under this section.
‘‘(2) SERVICES
PROVIDED.—A recipient of a
grant, cooperative agreement, or contract to provide
benefits planning and assistance shall select individ-
uals who will act as planners and provide informa-
tion, guidance, and planning to disabled beneficiaries
on the—
‘‘(A) availability and interrelation of any
Federal or State work incentives programs de-
signed to assist disabled beneficiaries that the in-
dividual may be eligible to participate in;
‘‘(B) adequacy of any health benefits cov-
erage that may be offered by an employer of the
individual and the extent to which other health
benefits coverage may be available to the indi-
vidual; and
‘‘(C) availability of protection and advocacy
services for disabled beneficiaries and how to ac-
cess such services.
‘‘(3) AMOUNT OF GRANTS, COOPERATIVE AGREE-
MENTS, OR CONTRACTS.—
‘‘(A) BASED ON POPULATION OF DISABLED
BENEFICIARIES.—Subject to subparagraph (B),
the Commissioner shall award a grant, coopera-
tive agreement, or contract under this section to
an entity based on the percentage of the popu-
lation of the State where the entity is located
who are disabled beneficiaries.
‘‘(B) LIMITATIONS.—
‘‘(i) PER GRANT.—No entity shall re-
ceive a grant, cooperative agreement, or
contract under this section for a fiscal year
that is less than $50,000 or more than
$300,000.
‘‘(ii) TOTAL AMOUNT FOR ALL GRANTS,
COOPERATIVE
AGREEMENTS, 
AND
CON-
TRACTS.—The total amount of all grants,
cooperative 
agreements, 
and 
contracts
awarded under this section for a fiscal year
may not exceed $23,000,000.
‘‘(4) ALLOCATION OF COSTS.—The costs of car-
rying out this section shall be paid from amounts
made available for the administration of title II and
amounts made available for the administration of
title XVI, and shall be allocated among those amounts
as appropriate.
‘‘(c) DEFINITIONS.—In this section:
‘‘(1) COMMISSIONER.—The term ‘Commissioner’
means the Commissioner of Social Security.
‘‘(2) DISABLED
BENEFICIARY.—The term ‘dis-
abled beneficiary’ has the meaning given that term in
section 1148(k)(2).
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section
$23,000,000 for each of the fiscal years 2000 through
2004.’’.
SEC. 122. STATE GRANTS FOR WORK INCENTIVES ASSIST-
ANCE TO DISABLED BENEFICIARIES.
Part A of title XI of the Social Security Act (42 U.S.C.
1301 et seq.), as amended by section 121, is amended by
adding after section 1149 the following:
‘‘STATE GRANTS FOR WORK INCENTIVES ASSISTANCE TO
DISABLED BENEFICIARIES
‘‘SEC. 1150. (a) IN GENERAL.—Subject to subsection
(c), the Commissioner may make payments in each State
to the protection and advocacy system established pursuant
to part C of title I of the Developmental Disabilities Assist-
ance and Bill of Rights Act (42 U.S.C. 6041 et seq.) for
the purpose of providing services to disabled beneficiaries.
‘‘(b) SERVICES PROVIDED.—Services provided to dis-
abled beneficiaries pursuant to a payment made under this
section may include—
‘‘(1) information and advice about obtaining vo-
cational rehabilitation and employment services; and
‘‘(2) advocacy or other services that a disabled
beneficiary may need to secure or regain gainful em-
ployment.
‘‘(c) APPLICATION.—In order to receive payments
under this section, a protection and advocacy system shall
submit an application to the Commissioner, at such time,
in such form and manner, and accompanied by such infor-
mation and assurances as the Commissioner may require.
‘‘(d) AMOUNT OF PAYMENTS.—
‘‘(1) IN GENERAL.—Subject to the amount ap-
propriated for a fiscal year for making payments
under this section, a protection and advocacy system
shall not be paid an amount that is less than—
‘‘(A) in the case of a protection and advo-
cacy system located in a State (including the
District of Columbia and Puerto Rico) other
than Guam, American Samoa, the United States
Virgin Islands, and the Commonwealth of the
Northern Mariana Islands, the greater of—
‘‘(i) $100,000; or
‘‘(ii) 1⁄3 of 1 percent of the amount
available for payments under this section;
and
‘‘(B) in the case of a protection and advo-
cacy system located in Guam, American Samoa,
the United States Virgin Islands, and the Com-
monwealth of the Northern Mariana Islands,
$50,000.
‘‘(2) INFLATION ADJUSTMENT.—For each fiscal
year in which the total amount appropriated to carry
out this section exceeds the total amount appropriated
to carry out this section in the preceding fiscal year,
the Commissioner shall increase each minimum pay-
ment under subparagraphs (A) and (B) of paragraph
(1) by a percentage equal to the percentage increase
in the total amount so appropriated to carry out this
section.
‘‘(e) ANNUAL REPORT.—Each protection and advocacy
system that receives a payment under this section shall sub-
mit an annual report to the Commissioner and the Ticket
to Work and Work Incentives Advisory Panel established
under section 101(f) of the Ticket to Work and Work Incen-
tives Improvement Act of 1999 on the services provided to
individuals by the system.
‘‘(f) FUNDING.—
‘‘(1) ALLOCATION
OF
PAYMENTS.—Payments
under this section shall be made from amounts made
available for the administration of title II and
amounts made available for the administration of
title XVI, and shall be allocated among those amounts
as appropriate.
‘‘(2) CARRYOVER.—Any amounts allotted for
payment to a protection and advocacy system under
this section for a fiscal year shall remain available
for payment to or on behalf of the protection and ad-
vocacy system until the end of the succeeding fiscal
year.
‘‘(g) DEFINITIONS.—In this section:
‘‘(1) COMMISSIONER.—The term ‘Commissioner’
means the Commissioner of Social Security.
‘‘(2) DISABLED
BENEFICIARY.—The term ‘dis-
abled beneficiary’ has the meaning given that term in
section 1148(k)(2).
‘‘(3) PROTECTION AND ADVOCACY SYSTEM.—The
term ‘protection and advocacy system’ means a pro-
tection and advocacy system established pursuant to
part C of title I of the Developmental Disabilities As-
sistance and Bill of Rights Act (42 U.S.C. 6041 et
seq.).
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section
$7,000,000 for each of the fiscal years 2000 through 2004.’’.
TITLE 
II—EXPANDED 
AVAIL-
ABILITY 
OF 
HEALTH 
CARE
SERVICES
SEC. 201. EXPANDING STATE OPTIONS UNDER THE MED-
ICAID PROGRAM FOR WORKERS WITH DIS-
ABILITIES.
(a) IN GENERAL.—
(1) STATE OPTION TO ELIMINATE INCOME, AS-
SETS, AND
RESOURCE
LIMITATIONS
FOR
WORKERS
WITH DISABILITIES BUYING INTO MEDICAID.—Section
1902(a)(10)(A)(ii) of the Social Security Act (42
U.S.C. 1396a(a)(10)(A)(ii)) is amended—
(A) in subclause (XIII), by striking ‘‘or’’ at
the end;
(B) in subclause (XIV), by adding ‘‘or’’ at
the end; and
(C) by adding at the end the following:
‘‘(XV) who, but for earnings in
excess of the limit established under
section 1905(q)(2)(B), would be consid-
ered to be receiving supplemental secu-
rity income, who is at least 16, but less
than 65, years of age, and whose assets,
resources, and earned or unearned in-
come (or both) do not exceed such limi-
tations (if any) as the State may es-
tablish;’’.
(2) STATE
OPTION
TO
PROVIDE
OPPORTUNITY
FOR EMPLOYED INDIVIDUALS WITH A MEDICALLY IM-
PROVED DISABILITY TO BUY INTO MEDICAID.—
(A) 
ELIGIBILITY.—Section
1902(a)(10)(A)(ii) of the Social Security Act (42
U.S.C. 1396a(a)(10)(A)(ii)), as amended by
paragraph (1), is amended—
(i) in subclause (XIV), by striking ‘‘or’’
at the end;
(ii) in subclause (XV), by adding ‘‘or’’
at the end; and
(iii) by adding at the end the fol-
lowing:
‘‘(XVI) who are employed individ-
uals with a medically improved dis-
ability described in section 1905(v)(1)
and whose assets, resources, and earned
or unearned income (or both) do not
exceed such limitations (if any) as the
State may establish, but only if the
State provides medical assistance to
individuals 
described 
in 
subclause
(XV);’’.
(B) DEFINITION OF EMPLOYED INDIVIDUALS
WITH A MEDICALLY IMPROVED DISABILITY.—Sec-
tion 1905 of the Social Security Act (42 U.S.C.
1396d) is amended by adding at the end the fol-
lowing:
‘‘(v)(1) The term ‘employed individual with a medi-
cally improved disability’ means an individual who—
‘‘(A) is at least 16, but less than 65, years of age;
‘‘(B) is employed (as defined in paragraph (2));
‘‘(C) ceases to be eligible for medical assistance
under section 1902(a)(10)(A)(ii)(XV) because the in-
dividual, by reason of medical improvement, is deter-
mined at the time of a regularly scheduled continuing
disability review to no longer be eligible for benefits
under section 223(d) or 1614(a)(3); and
‘‘(D) continues to have a severe medically deter-
minable impairment, as determined under regulations
of the Secretary.
‘‘(2) For purposes of paragraph (1), an individual is
considered to be ‘employed’ if the individual—
‘‘(A) is earning at least the applicable minimum
wage requirement under section 6 of the Fair Labor
Standards Act (29 U.S.C. 206) and working at least
40 hours per month; or
‘‘(B) is engaged in a work effort that meets sub-
stantial and reasonable threshold criteria for hours of
work, wages, or other measures, as defined by the
State and approved by the Secretary.’’.
(C) 
CONFORMING
AMENDMENT.—Section
1905(a) of such Act (42 U.S.C. 1396d(a)) is
amended in the matter preceding paragraph
(1)—
(i) in clause (x), by striking ‘‘or’’ at
the end;
(ii) in clause (xi), by adding ‘‘or’’ at
the end; and
(iii) by inserting after clause (xi), the
following:
‘‘(xii) employed individuals with a medically
improved disability (as defined in subsection (v)),’’.
(3) STATE AUTHORITY TO IMPOSE INCOME-RE-
LATED PREMIUMS AND COST-SHARING.—Section 1916
of such Act (42 U.S.C. 1396o) is amended—
(A) in subsection (a), by striking ‘‘The
State plan’’ and inserting ‘‘Subject to subsection
(g), the State plan’’; and
(B) by adding at the end the following:
‘‘(g) With respect to individuals provided medical as-
sistance only under subclause (XV) or (XVI) of section
1902(a)(10)(A)(ii)—
‘‘(1) a State may (in a uniform manner for in-
dividuals described in either such subclause)—
‘‘(A) require such individuals to pay pre-
miums or other cost-sharing charges set on a
sliding scale based on income that the State may
determine; and
‘‘(B) require payment of 100 percent of such
premiums or charges for a year in the case of
such an individual who has income for such year
that exceeds 250 percent of the income official
poverty line (referred to in subsection (c)(1)) ap-
plicable to a family of the size involved, except
that, in the case of such an individual who has
income for a year that does not exceed 450 per-
cent of such poverty line, such requirement may
apply only to the extent that such premiums do
not exceed 7.5 percent of such income; and
‘‘(2) a State shall require payment of 100 per-
cent of such premium for a year by such an indi-
vidual whose adjusted gross income (as defined in sec-
tion 62 of the Internal Revenue Code of 1986) for
such year exceeds $75,000, except that a State may
choose to subsidize such premium by using State
funds which may not be federally matched under this
title.
The Secretary shall adjust annually (after 2000) the dollar
amount set forth in paragraph (2) under procedures pro-
viding for adjustments in the same manner and to the same
extent as adjustments are provided for under the procedures
used to adjust benefit amounts under section 215(i)(2)(A),
except that any amount so adjusted that is not a multiple
of $1.00 shall be rounded to the nearest multiple of $1.00.’’.
(4) PROHIBITION
AGAINST
SUPPLANTATION
OF
STATE FUNDS AND STATE FAILURE TO MAINTAIN EF-
FORT.—Section 1903(i) of such Act (42 U.S.C.
1396b(i)) is amended—
(A) by striking the period at the end of
paragraph (18) and inserting ‘‘; or’’; and
(B) by inserting after such paragraph the
following:
‘‘(19) with respect to amounts expended for med-
ical assistance provided to an individual described in
subclause (XV) or (XVI) of section 1902(a)(10)(A)(ii)
for a fiscal year unless the State demonstrates to the
satisfaction of the Secretary that the level of State
funds expended for such fiscal year for programs to
enable working individuals with disabilities to work
(other than for such medical assistance) is not less
than the level expended for such programs during the
most recent State fiscal year ending before the date of
enactment of this paragraph.’’.
(b) CONFORMING AMENDMENTS.—
(1) Section 1903(f)(4) of the Social Security Act
(42 U.S.C. 1396b(f)(4)) is amended in the matter pre-
ceding 
subparagraph 
(A) 
by 
inserting
‘‘1902(a)(10)(A)(ii)(XV), 
1902(a)(10)(A)(ii)(XVI)’’
after ‘‘1902(a)(10)(A)(ii)(X),’’.
(2) Section 1903(f)(4) of such Act, as amended
by 
paragraph 
(1), 
is 
amended 
by 
inserting
‘‘1902(a)(10)(A)(ii)(XIII),’’ 
before
‘‘1902(a)(10)(A)(ii)(XV)’’.
(c) GAO REPORT.—Not later than 3 years after the
date of enactment of this Act, the Comptroller General of
the United States shall submit a report to Congress regard-
ing the amendments made by this section that examines—
(1) the extent to which higher health care costs
for individuals with disabilities at higher income lev-
els deter employment or progress with employment;
(2) whether such individuals have health insur-
ance coverage or could benefit from the State option
established under such amendments to provide a med-
icaid buy-in; and
(3) how the States are exercising such option,
including—
(A) how such States are exercising the flexi-
bility afforded them with regard to income dis-
regards;
(B) what income and premium levels have
been set;
(C) the degree to which States are sub-
sidizing premiums above the dollar amount spec-
ified in section 1916(g)(2) of the Social Security
Act (42 U.S.C. 1396o(g)(2)); and
(D) the extent to which there exists any
crowd-out effect.
(d) EFFECTIVE DATE.—
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by this section
apply to medical assistance for items and services
furnished on or after October 1, 1999.
(2) RETROACTIVITY
OF
CONFORMING
AMEND-
MENT.—The amendment made by subsection (b)(2)
takes effect as if included in the enactment of the Bal-
anced Budget Act of 1997.
SEC. 202. EXTENDING MEDICARE COVERAGE FOR OASDI
DISABILITY BENEFIT RECIPIENTS.
(a) IN GENERAL.—The next to last sentence of section
226(b) of the Social Security Act (42 U.S.C. 426) is amend-
ed by striking ‘‘24’’ and inserting ‘‘96’’.
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall be effective on and after October 1, 2000.
(c) GAO REPORT.—Not later than 5 years after the
date of the enactment of this Act, the Comptroller General
of the United States shall submit a report to the Congress
that—
(1) examines the effectiveness and cost of the
amendment made by subsection (a);
(2) examines the necessity and effectiveness of
providing continuation of medicare coverage under
section 226(b) of the Social Security Act to individ-
uals whose annual income exceeds the contribution
and benefit base (as determined under section 230 of
such Act);
(3) examines the viability of providing the con-
tinuation of medicare coverage under such section
226(b) based on a sliding scale premium for individ-
uals whose annual income exceeds such contribution
and benefit base;
(4) examines the viability of providing the con-
tinuation of medicare coverage under such section
226(b) based on a premium buy-in by the bene-
ficiary’s employer in lieu of coverage under private
health insurance;
(5) examines the interrelation between the use of
the continuation of medicare coverage under such sec-
tion 226(b) and the use of private health insurance
coverage by individuals during the extended period;
and
(6) recommends such legislative or administra-
tive changes relating to the continuation of medicare
coverage for recipients of social security disability
benefits as the Comptroller General determines are
appropriate.
SEC. 203. GRANTS TO DEVELOP AND ESTABLISH STATE IN-
FRASTRUCTURES TO SUPPORT WORKING IN-
DIVIDUALS WITH DISABILITIES.
(a) ESTABLISHMENT.—
(1) IN GENERAL.—The Secretary of Health and
Human Services (in this section referred to as the
‘‘Secretary’’) shall award grants described in sub-
section (b) to States to support the design, establish-
ment, and operation of State infrastructures that pro-
vide items and services to support working individ-
uals with disabilities.
(2) APPLICATION.—In order to be eligible for an
award of a grant under this section, a State shall
submit an application to the Secretary at such time,
in such manner, and containing such information as
the Secretary shall require.
(3) DEFINITION OF STATE.—In this section, the
term ‘‘State’’ means each of the 50 States, the District
of Columbia, Puerto Rico, Guam, the United States
Virgin Islands, American Samoa, and the Common-
wealth of the Northern Mariana Islands.
(b) GRANTS FOR INFRASTRUCTURE AND OUTREACH.—
(1) IN GENERAL.—Out of the funds appropriated
under subsection (e), the Secretary shall award grants
to States to—
(A) support the establishment, implementa-
tion, and operation of the State infrastructures
described in subsection (a); and
(B) conduct outreach campaigns regarding
the existence of such infrastructures.
(2) ELIGIBILITY FOR GRANTS.—
(A) IN GENERAL.—No State may receive a
grant under this subsection unless the State—
(i) has an approved amendment to the
State plan under title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) that pro-
vides medical assistance under such plan to
individuals 
described 
in 
section
1902(a)(10)(A)(ii)(XV) of the Social Secu-
rity 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)(XV)); and
(ii) demonstrates to the satisfaction of
the Secretary that the State makes personal
assistance services available under the State
plan under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.) to the extent
necessary to enable individuals described in
clause (i) to remain employed (as deter-
mined under section 1905(v)(2) of the So-
cial Security Act (42 U.S.C. 1396d(v)(2)).
(B) DEFINITION OF PERSONAL ASSISTANCE
SERVICES.—In this paragraph, the term ‘‘per-
sonal assistance services’’ means a range of serv-
ices, provided by 1 or more persons, designed to
assist an individual with a disability to perform
daily activities on and off the job that the indi-
vidual would typically perform if the individual
did not have a disability. Such services shall be
designed to increase the individual’s control in
life and ability to perform everyday activities on
or off the job.
(3) DETERMINATION OF AWARDS.—
(A) IN GENERAL.—Subject to subparagraph
(B), the Secretary shall determine a formula for
awarding grants to States under this section that
provides special consideration to States that pro-
vide medical assistance under title XIX of the
Social Security Act to individuals described in
section 1902(a)(10)(A)(ii)(XVI) of that Act (42
U.S.C. 1396a(a)(10)(A)(ii)(XVI)).
(B) AWARD LIMITS.—
(i) MINIMUM AWARDS.—
(I) IN GENERAL.—Subject to sub-
clause (II), no State with an approved
application under this section shall re-
ceive a grant for a fiscal year that is
less than $500,000.
(II) PRO RATA REDUCTIONS.—If
the funds appropriated under sub-
section (e) for a fiscal year are not suf-
ficient to pay each State with an ap-
plication approved under this section
the minimum amount described in
subclause (I), the Secretary shall pay
each such State an amount equal to the
pro rata share of the amount made
available.
(ii) MAXIMUM
AWARDS.—No State
with an application that has been approved
under this section shall receive a grant for
a fiscal year that exceeds 15 percent of the
total expenditures by the State (including
the reimbursed Federal share of such ex-
penditures) for medical assistance for indi-
viduals eligible under subclause (XV) and
(XVI) of section 1902(a)(10)(A)(ii) of the
Social 
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)), as estimated by the
State and approved by the Secretary.
(c) AVAILABILITY OF FUNDS.—
(1) 
FUNDS
AWARDED
TO
STATES.—Funds
awarded to a State under a grant made under this
section for a fiscal year shall remain available until
expended.
(2) FUNDS NOT AWARDED TO STATES.—Funds
not awarded to States in the fiscal year for which
they are appropriated shall remain available in suc-
ceeding fiscal years for awarding by the Secretary.
(d) ANNUAL REPORT.—A State that is awarded a
grant under this section shall submit an annual report to
the Secretary on the use of funds provided under the grant.
Each report shall include the percentage increase in the
number of title II disability beneficiaries, as defined in sec-
tion 1148(k)(3) of the Social Security Act (as amended by
section 201) in the State, and title XVI disability bene-
ficiaries, as defined in section 1148(k)(4) of the Social Secu-
rity Act (as so amended) in the State who return to work.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section—
(1) for fiscal year 2000, $20,000,000;
(2) for fiscal year 2001, $25,000,000;
(3) for fiscal year 2002, $30,000,000;
(4) for fiscal year 2003, $35,000,000;
(5) for fiscal year 2004, $40,000,000; and
(6) for each of fiscal years 2005 through 2010,
the amount appropriated for the preceding fiscal year
under this subsection increased by the percentage in-
crease (if any) in the Consumer Price Index for All
Urban Consumers (United States city average) for the
preceding fiscal year.
(f) RECOMMENDATION.—Not later than October 1,
2009, the Secretary, in consultation with the Ticket to Work
and Work Incentives Advisory Panel established under sec-
tion 101(f), shall submit a recommendation to the Com-
mittee on Commerce of the House of Representatives and
the Committee on Finance of the Senate regarding whether
the grant program established under this section should be
continued after fiscal year 2010.
SEC. 204. DEMONSTRATION OF COVERAGE UNDER THE
MEDICAID PROGRAM OF WORKERS WITH PO-
TENTIALLY SEVERE DISABILITIES.
(a) STATE APPLICATION.—A State may apply to the
Secretary of Health and Human Services (in this section
referred to as the ‘‘Secretary’’) for approval of a demonstra-
tion project (in this section referred to as a ‘‘demonstration
project’’) under which up to a specified maximum number
of individuals who are workers with a potentially severe