SECTION 1. SHORT TITLE AND TABLE OF CONTENTS.
(a) SHORT TITLE.—This Act may be cited as the
‘‘Ticket to Work and Self-Sufficiency Act of 1999’’.
(b) TABLE OF CONTENTS.—The table of contents is
as follows:
Sec. 1. Short title and table of contents.
TITLE I—EXPANDED AVAILABILITY OF HEALTH CARE SERVICES
Sec. 101. Expanding State options under Medicaid for workers with disabilities.
Sec. 102. Extending Medicare coverage for OASDI disability benefit recipients
who are using tickets to work and self-sufficiency.
Sec. 103. Grants to develop and establish State infrastructures to support
working individuals with disabilities.
Sec. 104. Demonstration of coverage of workers with potentially severe disabil-
ities.
TITLE II—TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM
Sec. 201. Establishment of the Ticket to Work and Self-Sufficiency Program.
Sec. 202. Effective date.
Sec. 203. Graduated implementation of Program.
Sec. 204. The Ticket to Work and Self-Sufficiency Advisory Panel.
Sec. 205. Demonstration projects and studies.
TITLE III—TECHNICAL AMENDMENTS
Sec. 301. Technical amendments relating to drug addicts and alcoholics.
Sec. 302. Treatment of prisoners.
Sec. 303. Revocation by members of the clergy of exemption from social secu-
rity coverage.
Sec. 304. Additional technical amendment relating to cooperative research or
demonstration projects under titles II and XVI.
Sec. 305. Authorization for State to permit annual wage reports.
TITLE I—EXPANDED AVAILABIL-
ITY OF HEALTH CARE SERV-
ICES
SEC. 101. EXPANDING STATE OPTIONS UNDER MEDICAID
FOR WORKERS WITH DISABILITIES.
(a) STATE OPTION TO ELIMINATE INCOME, ASSETS,
AND RESOURCE LIMITATIONS FOR WORKERS WITH DIS-
ABILITIES
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—
(1) in subclause (XIII), by striking ‘‘or’’ at the
end;
(2) in subclause (XIV), by adding ‘‘or’’ at the
end; and
(3) by adding at the end the following:
‘‘(XV) who, but for earnings in
excess of the limit established under
section 1905(q)(2)(B), and subject to
limitations on assets, resources, or un-
earned income that may be set by the
State, would be considered to be re-
ceiving supplemental security income
(subject, 
notwithstanding 
section
1916, to payment of premiums or
other cost-sharing charges (set on a
sliding scale based on income that the
State may determine and that may re-
quire an individual with income that
exceeds 250 percent of the income of-
ficial poverty line (as defined by the
Office of Management and Budget,
and revised annually in accordance
with section 673(2) of the Omnibus
Budget Reconciliation Act of 1981)
applicable to a family of the size in-
volved to pay an amount equal to 100
percent of the premium cost for pro-
viding medical assistance to the indi-
vidual), so long as any such premiums
or other cost-sharing charges are the
same as any premiums or other cost-
sharing charges imposed for individ-
uals described in subclause (XVI));’’.
(b) STATE OPTION TO EXPAND OPPORTUNITIES FOR
WORKERS WITH DISABILITIES TO BUY INTO MEDIC-
AID.—
(1) ELIGIBILITY.—Section 1902(a)(10)(A)(ii)
of 
the 
Social 
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)), as amended by subsection (a),
is amended—
(A) in subclause (XIV), by striking ‘‘or’’ at
the end;
(B) in subclause (XV), by adding ‘‘or’’ at
the end; and
(C) by adding at the end the following:
‘‘(XVI) who are working individ-
uals with disabilities described in sec-
tion 1905(v) (subject, notwithstanding
section 1916, to payment of premiums
or other cost-sharing charges (set on
a sliding scale based on income) that
the State may determine so long as
any such premiums or other cost-shar-
ing charges are the same as any pre-
miums or other cost-sharing charges
imposed for individuals described in
subclause (XV)), but only if the State
provides medical assistance to individ-
uals described in subclause (XV);’’.
(2) DEFINITION
OF
WORKING
INDIVIDUALS
WITH DISABILITIES.—Section 1905 of the Social Se-
curity Act (42 U.S.C. 1396d) is amended by adding
at the end the following:
‘‘(v)(1) The term ‘working individuals with disabil-
ities’ means individuals ages 16 through 64 who—
‘‘(A) by reason of medical improvement, cease
to be eligible for benefits under section 223(d) or
1614(a)(3) at the time of a regularly scheduled con-
tinuing disability review but who continue to have a
severe medically determinable impairment; and
‘‘(B) are employed.
‘‘(2) 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
substantial and reasonable threshold criteria for
hours of work, wages, or other measures, as defined
by the State and approved by the Secretary.’’.
(3) 
CONFORMING
AMENDMENT.—Section
1905(a) of the Social Security Act (42 U.S.C.
1396d(a)) is amended in the matter preceding para-
graph (1)—
(A) in clause (x), by striking ‘‘or’’ at the
end;
(B) in clause (xi), by adding ‘‘or’’ at the
end; and
(C) by inserting after clause (xi), the fol-
lowing:
‘‘(xii) individuals described in subsection (v),’’.
(c) PROHIBITION
AGAINST
SUPPLANTATION
OF
STATE FUNDS; MAINTENANCE
OF EFFORT REQUIRE-
MENT; CONDITION
FOR APPROVAL
OF STATE PLAN
AMENDMENT.—
(1) NO SUPPLANTATION OF STATE FUNDS.—
Federal funds paid to a State for medical assistance
provided to an individual described in subclause
(XV) or (XVI) of section 1902(a)(10)(A)(ii) of the
Social Security Act (42 U.S.C. 1396a(a)(10)(A)(ii))
must be used to supplement but not supplant the
level of State funds expended as of October 1, 1998
for programs to enable working individuals with dis-
abilities to work.
(2) MAINTENANCE OF EFFORT.—With respect
to a fiscal year quarter, no Federal funds may be
paid to a State for medical assistance provided to an
individual described in subclause (XV) or (XVI) of
section 1902(a)(10)(A)(ii) of the Social Security Act
(42 U.S.C. 1396a(a)(10)(A)(ii)) for such fiscal year
quarter if the Secretary of Health and Human Serv-
ices determines that the total of the State expendi-
tures for programs to enable working individuals
with disabilities to work for the preceding fiscal year
quarter is less than the total of such expenditures
for the same fiscal year quarter of the preceding fis-
cal year.
(3) CONDITION FOR APPROVAL OF STATE PLAN
AMENDMENTS.—No State plan amendment that pro-
poses to provide medical assistance to an individual
described in subclause (XV) or (XVI) of section
1902(a)(10)(A)(ii) of the Social Security Act (42
U.S.C. 1396a(a)(10)(A)(ii)) may be approved unless
the chief executive officer of the State certifies to
the Secretary of Health and Human Services that
the plan, as so amended, will satisfy the require-
ments of paragraphs (1) and (2) of this subsection.
(d) EFFECTIVE DATE.—
(1) IN GENERAL.—The amendments made by
this section shall apply on and after October 1,
1999.
(2) EXTENSION
OF
EFFECTIVE
DATE
FOR
STATE LAW AMENDMENT.—In the case of a State
plan under title XIX of the Social Security Act
which the Secretary of Health and Human Services
determines requires State legislation in order for the
plan to meet the additional requirements imposed by
the amendments made by this section, the State
plan shall not be regarded as failing to comply with
the requirements of this section solely on the basis
of its failure to meet these additional requirements
before the first day of the first calendar quarter be-
ginning after the close of the first regular session of
the State legislature that begins after the date of en-
actment of this Act. For purposes of the previous
sentence, in the case of a State that has a 2-year
legislative session, each year of the session is consid-
ered to be a separate regular session of the State
legislature.
SEC. 102. EXTENDING MEDICARE COVERAGE FOR OASDI
DISABILITY BENEFIT RECIPIENTS WHO ARE
USING TICKETS TO WORK AND SELF-SUFFI-
CIENCY.
(a) IN GENERAL.—The next to last sentence of sec-
tion 226(b) of the Social Security Act (42 U.S.C. 426)
is amended—
(1) by striking ‘‘throughout all of which’’ and
inserting ‘‘throughout the first 24 months of which’’;
and
(2) by inserting after ‘‘but not in excess of 24
such months’’ the following: ‘‘(plus 24 additional
such months in the case of an individual who the
Commissioner determines is using a ticket to work
and self-sufficiency issued under section 1148, but
only for additional months that occur in the 7-year
period beginning on the date of the enactment of the
Ticket to Work and Self-Sufficiency Act of 1999)’’.
(b) REPORT.—Not later than 6 months prior to the
end of the 7-year period beginning on the date of the en-
actment of this Act, the Secretary of Health and Human
Services and the Commissioner of Social Security shall
submit in writing to each House of the Congress their rec-
ommendations for further legislative action with respect
to the amendments made by subsection (a), taking into
account experience derived from efforts to achieve full im-
plementation of the Ticket to Work and Self Sufficiency
Program under section 1148 of the Social Security Act.
SEC. 103. 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
provide items and services to support working indi-
viduals with disabilities. A State may submit an ap-
plication for a grant authorized under this section at
such time, in such manner, and containing such in-
formation as the Secretary may determine.
(2) 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 Commonwealth of the Northern Mariana Is-
lands.
(b) GRANTS
FOR
INFRASTRUCTURE
AND
OUT-
REACH.—
(1) IN
GENERAL.—Out of the funds appro-
priated under subsection (e), the Secretary shall
award grants to States to—
(A) support the establishment, implemen-
tation, and operation of the State infrastruc-
tures 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—
(i) the State has an approved amend-
ment to the State plan under title XIX of
the Social Security Act (42 U.S.C. 1396 et
seq.) that—
(I) provides medical assistance
under such plan to individuals de-
scribed 
in 
section
1902(a)(10)(A)(ii)(XV) of the Social
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)(XV)); or
(II) provides medical assistance
under such plan to individuals de-
scribed in subclauses (XV) and (XVI)
of section 1902(a)(10)(A)(ii) of the
Social 
Security 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)); and
(ii) the State demonstrates to the sat-
isfaction of the Secretary that the State
makes personal assistance services avail-
able 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 subclause (I) or
(II) of clause (i) to remain employed (as
determined under section 1905(v)(2) of the
Social 
Security 
Act 
(42 
U.S.C.
1396d(v)(2)).
(B) DEFINITION
OF
PERSONAL
ASSIST-
ANCE SERVICES.—In this paragraph, the term
‘‘personal assistance services’’ means a range of
services, provided by 1 or more persons, de-
signed to assist an individual with a disability
to perform daily activities on and off the job
that the individual would typically perform if
the individual did not have a disability. Such
services shall be designed to increase the indi-
vidual’s control in life and ability to perform ev-
eryday activities on or off the job.
(3) DETERMINATION OF AWARDS.—
(A) IN
GENERAL.—Subject to subpara-
graph (B), the Secretary shall determine a for-
mula for awarding grants to States under this
section that provides special consideration to
States that provide medical assistance under
title XIX of the Social Security Act to individ-
uals 
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.—No State that
submits an approved application for fund-
ing under this section shall receive a grant
for a fiscal year that is less than $500,000.
(ii) MAXIMUM
AWARDS.—No State
that submits an approved application for
funding under this section shall receive a
grant for a fiscal year that exceeds 15 per-
cent of the total expenditures by the State
(including the reimbursed Federal share of
such expenditures) for medical assistance
for individuals eligible under subclause
(e) APPROPRIATION.—Out of any funds in the Treas-
ury not otherwise appropriated, there is authorized to be
appropriated and there is appropriated to make grants
under 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 fiscal years 2005 through 2010, the
amount appropriated for the preceding fiscal year
increased by the percentage increase (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 of Health and Human Services, in
consultation with the Ticket to Work and Self-Sufficiency
Advisory Panel established under section 202, shall submit
a recommendation to the Committee on Commerce and the
Committee on Ways and Means of the House of Rep-
resentatives 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. 104. DEMONSTRATION OF COVERAGE OF WORKERS
WITH POTENTIALLY 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 dem-
onstration project (in this section referred to as a ‘‘dem-
onstration project’’) under which up to a specified maxi-
mum number of individuals who are workers with a poten-
tially severe disability (as defined in subsection (b)(1)) are
provided medical assistance equal to that provided under
section 1905(a) of the Social Security Act (42 U.S.C.
1396d(a)) 
to 
individuals 
described 
in 
section
1902(a)(10)(A)(ii)(XV) 
of 
that 
Act 
(42 
U.S.C.
1396a(a)(10)(A)(ii)(XV)).
(b) WORKER WITH A POTENTIALLY SEVERE DIS-
ABILITY DEFINED.—For purposes of this section—
(1) IN GENERAL.—The term ‘‘worker with a
potentially severe disability’’ means, with respect to
a demonstration project, an individual who—
(A) is at least 16, but less than 65, years
of age;
(B) has a specific physical or mental im-
pairment that, as defined by the State under
the demonstration project, is reasonably ex-
pected, but for the receipt of items and services
described in section 1905(a) of the Social Secu-
rity Act, to become blind or disabled (as defined
under section 1614(a) of the Social Security
Act); and
(C) is employed (as defined in paragraph
(2)).
(2) DEFINITION OF EMPLOYED.—An individual
is considered to be ‘‘employed’’ if the individual—
(A) is earning at least the applicable mini-
mum 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
substantial and reasonable threshold criteria for
hours of work, wages, or other measures, as de-
fined under the demonstration project and ap-
proved by the Secretary.
(c) APPROVAL OF DEMONSTRATION PROJECTS.—
(1) IN GENERAL.—Subject to paragraph (3),
the Secretary shall approve applications under sub-
section (a) that meet the requirements of paragraph
(2) and such additional terms and conditions as the
Secretary may require. The Secretary may waive the
requirement of section 1902(a)(1) of the Social Se-
curity Act (42 U.S.C. 1396a(a)(1)) to allow for sub-
State demonstrations.
(2) TERMS AND CONDITIONS OF DEMONSTRA-
TION PROJECTS.—The Secretary may not approve a
demonstration project under this section unless the
State provides assurances satisfactory to the Sec-
retary that the following conditions are or will be
met:
(A) ELECTION OF OPTIONAL CATEGORY.—
The State has elected to provide coverage under
its plan under title XIX of the Social Security
Act 
of 
individuals 
described 
in 
section
1902(a)(10)(A)(ii)(XV) of the Social Security
Act.
(B) MAINTENANCE OF STATE EFFORT.—
Federal funds paid to a State pursuant to this
section must be used to supplement, but not
supplant, the level of State funds expended for
workers with potentially severe disabilities
under programs in effect for such individuals at
the time the demonstration project is approved
under this section.
(C) 
INDEPENDENT
EVALUATION.—The
State provides for an independent evaluation of
the project.
(3) LIMITATIONS ON FEDERAL FUNDING.—
(A) APPROPRIATION.—Out of any funds in
the Treasury not otherwise appropriated, there
is authorized to be appropriated and there is
appropriated to carry out this section—
(i) for fiscal year 2000, $70,000,000;
(ii) for fiscal year 2001, $73,000,000;
(iii) for fiscal year 2002, $77,000,000;
and
(iv) for fiscal year 2003, $80,000,000.
(B) LIMITATION
ON
PAYMENTS.—In no
case may—
(i) the aggregate amount of payment
made by the Secretary to States under this
section exceed $300,000,000; or
(ii) payment be provided by the Sec-
retary for a fiscal year after fiscal year
2005.
(C) FUNDS ALLOCATED TO STATES.—The
Secretary shall allocate funds to States based
on their applications and the availability of
funds. Funds allocated to a State under a grant
made under this section for a fiscal year shall
remain available until expended.
(D) FUNDS NOT ALLOCATED TO STATES.—
Funds not allocated to States in the fiscal year
for which they are appropriated shall remain
available in succeeding fiscal years for alloca-
tion by the Secretary using the allocation for-
mula established under this section.
(E) PAYMENTS
TO
STATES.—Subject to
the succeeding provisions of this section, the
Secretary shall pay to each State with a dem-
onstration project approved under this section,
from its allocation under subparagraph (C), an
amount for each quarter equal to the Federal
medical assistance percentage (as defined in
section 1905(b) of the Social Security Act (42
U.S.C. 1395d(b)) of expenditures in the quarter
for medical assistance provided to workers with
a potentially severe disability.
(d) STATE DEFINED.—In this section, the term
‘‘State’’ has the meaning given such term for purposes of
title XIX of the Social Security Act.
TITLE II—TICKET TO WORK AND
SELF-SUFFICIENCY PROGRAM
SEC. 201. ESTABLISHMENT OF THE TICKET TO WORK AND
SELF-SUFFICIENCY PROGRAM.
(a) IN GENERAL.—Part A of title XI of the Social
Security Act (42 U.S.C. 1301 et seq.) is amended by add-
ing at the end the following new section:
‘‘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 bene-
ficiary may use a ticket to work and self-sufficiency issued
by the Commissioner in accordance with this section to
obtain employment services, vocational rehabilitation serv-
ices, or other support services from an employment net-
work which is of the beneficiary’s choice and which is will-
ing to provide such services to such beneficiary.
‘‘(b) TICKET SYSTEM.—
‘‘(1) DISTRIBUTION
OF
TICKETS.—The Com-
missioner of Social Security may issue a ticket to
work and self-sufficiency to disabled beneficiaries for
participation in the Program.
‘‘(2) ASSIGNMENT
OF
TICKETS.—A disabled
beneficiary holding a ticket to work and self-suffi-
ciency may assign the ticket to any employment net-
work of the beneficiary’s choice which is serving
under the Program and is willing to accept the as-
signment.
‘‘(3) TICKET
TERMS.—A ticket issued under
paragraph (1) shall consist of a document which evi-
dences the Commissioner’s agreement to pay (as
provided in paragraph (4)) an employment network,
which is serving under the Program and to which
such ticket is assigned by the beneficiary, for such
employment services, vocational rehabilitation serv-
ices, and other support services as the employment
network may provide to the beneficiary.
‘‘(4) 
PAYMENTS
TO
EMPLOYMENT
NET-
WORKS.—The Commissioner shall pay an employ-
ment network under the Program in accordance with
the outcome payment system under subsection
(h)(2) or under the outcome-milestone payment sys-
tem under subsection (h)(3) (whichever is elected
pursuant to subsection (h)(1)). An employment net-
work may not request or receive compensation for
such services from the beneficiary.
‘‘(c) STATE PARTICIPATION.—
‘‘(1) PERIODIC ELECTIONS.—Each State agen-
cy administering or supervising the administration
of the State plan approved under title I of the Reha-
bilitation act of 1973 may elect to participate in the
Program (or to revoke any such election) as an em-
ployment network. The Commissioner shall provide
for periodic opportunities for exercising such elec-
tions (and revocations).
‘‘(2) TREATMENT OF STATE AGENCIES.—Any
such election (or revocation) by a State agency de-
scribed in paragraph (1) taking effect during any
period for which an individual residing in the State
is a disabled beneficiary and a client of the State
agency shall not be effective with respect to such in-
dividual to the extent that such election (or revoca-
tion) would result in any change in the method of
payment to the State agency with respect to the in-
dividual from the method of payment to the State
agency with respect to the individual in effect imme-
diately before such election (or revocation).
‘‘(3) EFFECT
OF
PARTICIPATION
BY
STATE
AGENCY.—
‘‘(A) STATE AGENCIES PARTICIPATING.—
In any case in which a State agency described
in paragraph (1) elects under paragraph (1) to
participate in the Program—
‘‘(i) the employment services, voca-
tional 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 acting as an employment net-
work shall be governed by plans for voca-
tional 
rehabilitation 
services 
approved
under title I of the Rehabilitation Act of
1973; and
‘‘(ii) the provisions of section 222(d)
and the provisions of subsections (d) and
(e) of section 1615 shall not apply with re-
spect to such State.
‘‘(B) STATE
AGENCIES
ADMINISTERING
MATERNAL AND CHILD HEALTH SERVICES PRO-
GRAMS.—Subparagraph (A) shall not apply
with respect to any State agency administering
a program under title V of this Act.
‘‘(4) SPECIAL REQUIREMENTS APPLICABLE TO
CROSS-REFERRAL TO CERTAIN STATE AGENCIES.—
‘‘(A) IN GENERAL.—In any case in which
an employment network has been assigned a
ticket to work and self-sufficiency by a disabled
beneficiary, no State agency shall be deemed re-
quired, under this section, title I of the Reha-
bilitation Act of 1973, or a State plan approved
under such title, to accept any referral of such
disabled beneficiary from such employment net-
work unless such employment network and such
State agency have entered into a written agree-
ment that meets the requirements of subpara-
graph (B).
‘‘(B) TERMS OF AGREEMENT.—An agree-
ment required by subparagraph (A) shall speci-
fy, in accordance with regulations prescribed
pursuant to subparagraph (C)—
‘‘(i) the extent (if any) to which the
employment network holding the ticket will
provide to the State agency—
‘‘(I) reimbursement for costs in-
curred in providing services described
in subparagraph (A) to the disabled
beneficiary; and
‘‘(II) other amounts from pay-
ments made by the Commissioner to
the employment network pursuant to
subsection (h); and
‘‘(ii) any other conditions that may be
required by such regulations.
‘‘(C) REGULATIONS.—The Commissioner
of Social Security and the Secretary of Edu-
cation shall jointly prescribe regulations specify-
ing the terms of agreements required by sub-
paragraph (A) and otherwise necessary to carry
out the provisions of this paragraph.
‘‘(D) PENALTY.—No payment may be
made to an employment network pursuant to
subsection (h) in connection with services pro-
vided to any disabled beneficiary if such em-
ployment network makes referrals described in
subparagraph (A) in violation of the terms of
the contract required under subparagraph (A)
or without having entered into such a contract.
‘‘(d) RESPONSIBILITIES OF THE COMMISSIONER OF
SOCIAL SECURITY.—
‘‘(1) SELECTION AND QUALIFICATIONS OF PRO-
GRAM MANAGERS.—The Commissioner of Social Se-
curity shall enter into agreements with one or more
organizations in the private or public sector for serv-
ice as a program manager to assist the Commis-
sioner in administering the Program. Any such pro-
gram manager shall be selected by means of a com-
petitive bidding process, from among organizations
in the private or public sector with available exper-
tise and experience in the field of vocational rehabili-
tation or employment services.
‘‘(2) TENURE, RENEWAL, AND EARLY TERMI-
NATION.—Each agreement entered into under para-
graph (1) shall provide for early termination upon
failure to meet performance standards which shall be
specified in the agreement and which shall be
weighted to take into account any performance in
prior terms. Such performance standards shall in-
clude (but are not limited to)—
‘‘(A) measures for ease of access by bene-
ficiaries to services; and
‘‘(B) measures for determining the extent
to which failures in obtaining services for bene-
ficiaries fall within acceptable parameters, as
determined by the Commissioner.
‘‘(3) PRECLUSION
FROM
DIRECT
PARTICIPA-
TION IN DELIVERY OF SERVICES IN OWN SERVICE
AREA.—Agreements under paragraph (1) shall
preclude—
‘‘(A) direct participation by a program
manager in the delivery of employment services,
vocational rehabilitation services, or other sup-
port services to beneficiaries in the service area
covered by the program manager’s agreement;
and
‘‘(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
manager’s agreement.
‘‘(4) 
SELECTION
OF
EMPLOYMENT
NET-
WORKS.—The Commissioner shall select and enter
into agreements with employment networks for serv-
ice under the Program. Such employment networks
shall be in addition to State agencies serving as em-
ployment networks pursuant to elections under sub-
section (c).
‘‘(5) TERMINATION OF AGREEMENTS WITH EM-
PLOYMENT
NETWORKS.—The Commissioner shall
terminate agreements with employment networks for
inadequate performance, as determined by the Com-
missioner.
‘‘(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 take into account the views
of consumers and the program manager under which
the employment networks serve and shall consult
with providers of services to develop performance
measurements. The Commissioner shall ensure that
the results of the periodic reviews are made available
to beneficiaries who are prospective service recipients
as they select employment networks. The Commis-
sioner shall ensure the performance of periodic sur-
veys of beneficiaries receiving services under the
Program designed to measure customer service satis-
faction.
‘‘(7) DISPUTE
RESOLUTION.—The Commis-
sioner shall provide for a mechanism for resolving
disputes between beneficiaries and employment net-
works and between program managers and employ-
ment networks. 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 Commis-
sioner in carrying out the Commissioner’s duties in
administering 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
appropriate to ensure that adequate choices of serv-
ices are made available to beneficiaries. Employment
networks may serve under the Program only pursu-
ant to an agreement entered into with the Commis-
sioner under the Program incorporating the applica-
ble provisions of this section and regulations there-
under, and the program manager shall provide and
maintain assurances to the Commissioner that pay-
ment by the Commissioner to employment networks
pursuant to this section is warranted based on com-
pliance by such employment networks with the terms
of such agreement and this section. The program
manager shall not impose numerical limits on the
number of employment networks to be recommended
pursuant to this paragraph.
‘‘(3) FACILITATION
OF
ACCESS
BY
BENE-
FICIARIES
TO
EMPLOYMENT
NETWORKS.—A pro-
gram manager shall facilitate access by beneficiaries
to employment networks. The program manager
shall ensure that each beneficiary is allowed changes
in employment networks for good cause, as deter-
mined by the Commissioner, without being deemed
to have rejected services under the Program. 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
information provided to disabled beneficiaries pursu-
ant to this paragraph is provided in accessible for-
mat.
‘‘(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
beneficiaries 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 ac-
cess to employment services, vocational rehabilitation
services, and other support services. Such services
may include case management, benefits counseling,
supported employment, career planning, career plan
development, vocational assessment, job training,
placement, follow-up services, and such other serv-
ices as may be specified by the Commissioner under
the Program. The program manager shall ensure
that such services are coordinated.
‘‘(f) EMPLOYMENT NETWORKS.—
‘‘(1) QUALIFICATIONS FOR EMPLOYMENT NET-
WORKS.—Each employment network serving under
the Program shall consist of an agency or instru-
mentality of a State (or a political subdivision there-
of) or a private entity, which assumes responsibility
for the coordination and delivery of services under
the Program to individuals assigning to the employ-
ment network tickets to work and self-sufficiency
issued under subsection (b). No employment network
may serve under the Program unless it demonstrates
to the Commissioner substantial expertise and expe-
rience in the field of employment services, vocational
rehabilitation services, or other support services for
individuals with disabilities and provides an array of
such services. An employment network shall consist
of either a single provider of such services or of an
association of such providers organized so as to com-
bine their resources into a single entity. An employ-
ment network may meet the requirements of sub-
section (e)(4) by providing services directly, or by
entering into agreements with other individuals or
entities providing appropriate employment services,
vocational rehabilitation 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;
‘‘(B) meet, and maintain compliance with,
both general selection criteria (such as profes-
sional and governmental certification and edu-
cational credentials) and specific selection cri-
teria (such as the extent of work experience by
the provider with specific populations); and
‘‘(C) take such measures as are necessary
to ensure that employment services, vocational
rehabilitation services, and other support serv-
ices provided under the Program by, or under
agreements entered into with, the employment
network are provided under appropriate individ-
ual work plans meeting the requirements of
subsection (g).
‘‘(3) ANNUAL
FINANCIAL
REPORTING.—Each
employment network shall meet financial reporting
requirements 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
specific services provided by the employment net-
work. Such reports shall conform to a national
model prescribed under this section. Each employ-
ment network shall provide a copy of the latest re-
port issued by the employment network pursuant to
this paragraph to each beneficiary upon enrollment
under the Program for services to be received
through such employment network. Upon issuance of
each report to each beneficiary, a copy of the report
shall be maintained in the files of the employment
network pertaining to the beneficiary. The program
manager shall ensure that copies of all such reports
issued under this paragraph are made available to
the public under reasonable terms.
‘‘(g) INDIVIDUAL WORK PLANS.—
‘‘(1) IN GENERAL.—Each employment network
shall—
‘‘(A) take such measures as are necessary
to ensure that employment services, vocational
rehabilitation services, and other support serv-
ices provided under the Program by, or under
agreements entered into with, the employment
network are provided under appropriate individ-
ual work plans as defined by the Commissioner;
and
‘‘(B) develop and implement each such in-
dividual work plan, in the case of each bene-
ficiary receiving such services, in a manner that
affords such beneficiary the opportunity to ex-
ercise informed choice in selecting an employ-
ment goal and specific services needed to
achieve that employment goal.
A beneficiary’s individual work plan shall take effect
upon approval by the beneficiary.
‘‘(2) VOCATIONAL
EVALUATION.—In devising
the work plan, the employment network shall under-
take a vocational evaluation with respect to the ben-
eficiary. Each vocational evaluation shall set forth in
writing such elements and shall be in such format as
the Commissioner shall prescribe. The Commissioner
may provide for waiver by the beneficiary of such a
vocational evaluation, subject to regulations which
shall be prescribed by the Commissioner providing
for the permissible timing of, and the circumstances
permitting, such a waiver.
‘‘(h) EMPLOYMENT NETWORK PAYMENT SYSTEMS.—
‘‘(1) ELECTION OF PAYMENT SYSTEM BY EM-
PLOYMENT NETWORKS.—
‘‘(A) IN
GENERAL.—The Program shall
provide 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
utilized exclusively in connection with such em-
ployment network (except as provided in sub-
paragraph (B)).
‘‘(B) METHOD OF PAYMENT TO EMPLOY-
MENT
NETWORKS.—Any such election by an
employment network taking effect during any
period for which a disabled beneficiary is receiv-
ing services from such employment network
shall not be effective with respect to such bene-
ficiary to the extent that such election would re-
sult in any change in the method of payment to
the employment network with respect to serv-
ices provided to such beneficiary from the meth-
od of payment to the employment network with
respect to services provided to such beneficiary
as of immediately before such election.
‘‘(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
requirements 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 pay-
ment period, for which benefits (described in
paragraphs (2) and (3) of subsection (k)) are
not payable to such individual.
‘‘(C) COMPUTATION OF PAYMENTS TO EM-
PLOYMENT NETWORK.—The payment schedule
of the outcome payment system shall be de-
signed so that—
‘‘(i) the payment for each of the 60
months during the outcome payment pe-
riod for which benefits (described in para-
graphs (2) and (3) of subsection (k)) are
not payable is equal to a fixed percentage
of the payment calculation base for the cal-
endar year in which such month occurs;
and
‘‘(ii) such fixed percentage is set at a
percentage which does not exceed 40 per-
cent.
‘‘(3) 
OUTCOME-MILESTONE
PAYMENT
SYS-
TEM.—
‘‘(A) IN
GENERAL.—The outcome-mile-
stone payment system shall consist of a pay-
ment structure governing employment networks
electing such system under paragraph (1)(A)
which meets the requirements of this para-
graph.
‘‘(B) EARLY
PAYMENTS
UPON
ATTAIN-
MENT OF MILESTONES IN ADVANCE OF OUT-
COME PAYMENT PERIODS.—The outcome-mile-
stone payment system shall provide for one or
more milestones, with respect to beneficiaries
receiving services from an employment network
under the Program, which are directed toward
the goal of permanent employment. Such mile-
stones shall form a part of a payment structure
which provides, in addition to payments made
during outcome payment periods, payments
made prior to outcome payment periods in
amounts based on the attainment of such mile-
stones.
‘‘(C) LIMITATION ON TOTAL PAYMENTS TO
EMPLOYMENT NETWORK.—The payment sched-
ule of the outcome milestone payment system
shall be designed so that the total of the pay-
ments to the employment network with respect
to each beneficiary is less than, on a net
present value basis (using an interest rate de-
termined by the Commissioner that appro-
priately reflects the cost of funds faced by pro-
viders), 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 outcome payment
system.
‘‘(4) DEFINITIONS.—For purposes of 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 sup-
plementation) for months during the pre-
ceding calendar year to all beneficiaries
who have attained at least 18 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
(2) and (3) of subsection (k)) are not pay-
able to such individual by reason of en-
gagement in work activity; and
‘‘(ii) ending with the 60th month
(consecutive or otherwise), ending after
such date, for which such benefits are not
payable to such individual by reason of en-
gagement in work activity.
‘‘(5) PERIODIC REVIEW AND ALTERATIONS OF
PRESCRIBED SCHEDULES.—
‘‘(A) PERCENTAGES
AND
PERIODS.—The
Commissioner of Social Security shall periodi-
cally review the percentage specified in para-
graph (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 pay-
ments, and such period provide an adequate in-
centive for employment networks to assist bene-
ficiaries to enter the workforce, while providing
for appropriate economies. The Commissioner
may alter such percentage, such total permis-
sible payments, or such period of time to the
extent that the Commissioner determines, on
the basis of the Commissioner’s review under
this paragraph, that such an alteration would
better provide the incentive and economies de-
scribed in the preceding sentence.
‘‘(B) NUMBER
AND
AMOUNT
OF
MILE-
STONE
PAYMENTS.—The Commissioner shall
periodically review the number and amounts of
milestone payments established by the Commis-
sioner pursuant to this section to determine
whether they provide an adequate incentive for
employment networks to assist beneficiaries to
enter the workforce, taking into account infor-
mation provided to the Commissioner by pro-
gram managers, the Ticket to Work and Self-
Sufficiency Advisory Panel, and other reliable
sources. The Commissioner may from time to
time alter the number and amounts of mile-
stone payments initially established by the
Commissioner pursuant to this section to the
extent that the Commissioner determines that
such an alteration would allow an adequate in-
centive for employment networks to assist bene-
ficiaries to enter the workforce. Such alteration
shall be based on information provided to the
Commissioner by program managers, the Ticket
to Work and Self-Sufficiency Advisory Panel, or
other reliable sources.
‘‘(i) SUSPENSION OF DISABILITY REVIEWS.—During
any period for which an individual is using a ticket to work
and self-sufficiency issued under this section, the Commis-
sioner (and any applicable State agency) may not initiate
a continuing disability 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) TITLE
II
DISABILITY
BENEFICIARIES.—
There are authorized to be transferred from the
Federal Old-Age and Survivors Insurance Trust
Fund and the Federal Disability Insurance Trust
Fund each fiscal year such sums as may be nec-
essary to carry out the provisions of this section
with respect to title II disability beneficiaries. Money
paid from the Trust Funds under this section with
respect to title II disability beneficiaries who are en-
titled to benefits under section 223 or who are enti-
tled to benefits under section 202(d) on the basis of
the wages and self-employment income of such bene-
ficiaries, 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 Insur-
ance Trust Fund. The Commissioner of Social Secu-
rity shall determine according to such methods and
procedures as shall be prescribed under this
section—
‘‘(A) the total amount to be paid to pro-
gram managers and employment networks
under this section; and
‘‘(B) subject to the provisions of the pre-
ceding sentence, the amount which should be
charged to each of the Trust Funds.
‘‘(2) TITLE XVI DISABILITY BENEFICIARIES.—
Amounts authorized to be appropriated 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.
‘‘(k) DEFINITIONS.—For purposes of this section—
‘‘(1) DISABLED BENEFICIARY.—The term ‘dis-
abled beneficiary’ means a title II disability bene-
ficiary or a title XVI disability beneficiary.
‘‘(2) TITLE II DISABILITY BENEFICIARY.—The
term ‘title II disability beneficiary’ means an individ-
ual 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.
‘‘(3) TITLE
XVI
DISABILITY
BENEFICIARY.—
The term ‘title XVI disability beneficiary’ means an
individual eligible for supplemental security income
benefits under title XVI on the basis of blindness
(within the meaning of section 1614(a)(2)) or dis-
ability (within the meaning of section 1614(a)(3)).
An individual is a title XVI disability beneficiary for
each month for which such individual is eligible for
such benefits.
‘‘(4) SUPPLEMENTAL SECURITY INCOME BENE-
FIT.—The term ‘supplemental security income bene-
fit 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.—The Commissioner of Social Se-
curity shall prescribe such regulations as are necessary to
carry out the provisions of this section.’’.
(b) CONFORMING AMENDMENTS.—
(1) AMENDMENTS TO TITLE II.—
(A) Section 221(c) of such Act (42 U.S.C.
421(c)) is amended by adding at the end the
following new paragraph:
‘‘(4) 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
program of vocational rehabilitation services’’
and inserting ‘‘a program consisting of the
Ticket to Work and Self-Sufficiency Program
under section 1148 or another program of voca-
tional rehabilitation services, employment serv-
ices, 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 serv-
ices’’ and inserting ‘‘a program consisting of
the Ticket to Work and Self-Sufficiency Pro-
gram 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
new paragraph:
‘‘(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) 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
REGULATIONS.—The matters which shall be ad-
dressed in such regulations shall include (but are not
limited to)—
(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 such Act;
(B) the format and wording of such tick-
ets, which shall incorporate by reference any
contractual terms governing service by employ-
ment networks under the Program;
(C) the form and manner in which State
agencies may elect participation in the Ticket to
Work and Self-Sufficiency Program (and revoke
such 
an 
election) 
pursuant 
to 
section
1148(c)(1) of such Act and provision for peri-
odic opportunities for exercising such elections
(and revocations);
(D) the status of State agencies under sec-
tion 1148(c)(2) at the time that State agencies
exercise elections (and revocations) under such
section 1148(c)(1);
(E) the terms of agreements to be entered
into with program managers pursuant to sec-
tion 1148(d) of such Act, including (but not
limited to)—
(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) and
methods of recruitment of employment net-
works utilized pursuant to paragraph (2)
of section 1148(e); and
(iii) the format under which dispute
resolution 
will 
operate 
under 
section
1148(d)(7).
(F) the terms of agreements to be entered
into with employment networks pursuant to sec-
tion 1148(d)(4) of such Act, including (but not
limited to)—
(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
section 1148(f)(2)(B) of such Act in select-
ing 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
networks 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 (but not limited to)—
(i) the form and manner in which
elections by employment networks of pay-
ment systems are to be exercised pursuant
to section 1148(h)(1)(A);
(ii) the terms which must be met by
an outcome payment system under section
1148(h)(2);
(iii) the terms which must be met by
an outcome-milestone payment system
under section 1148(h)(3);
(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); 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.
(d) WORK INCENTIVE SPECIALISTS.—The Commis-
sioner shall establish a corps of trained, accessible, and
responsive work incentive specialists to specialize in title
II and title XVI disability work incentives for the purpose
of disseminating accurate information to disabled bene-
ficiaries (as defined in section 1148(k)(1) of the Social
Security Act as amended by this section) with respect to
inquiries and issues relating to work incentives.
SEC. 202. EFFECTIVE DATE.
Subject to section 203, the amendments made by sec-
tion 201 shall take effect with the first month following
one year after the date of the enactment of this Act.
SEC. 203. GRADUATED IMPLEMENTATION OF PROGRAM.
(a) IN GENERAL.—Not later than one year after the
date of the enactment of this Act, the Commissioner of
Social Security shall commence implementation of the
amendments made by section 201 (other than paragraphs
(1)(C) and (2)(B) of section 201(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 Ticket to Work and Self-Suffi-
ciency Program, the development and refinement of refer-
ral processes, payment systems, computer linkages, man-
agement information systems, and administrative proc-
esses necessary to provide for full implementation of such
amendments. Section 202 shall apply with respect to para-
graphs (1)(C) and (2)(B) of section 201(b) without regard
to this section.
(b) REQUIREMENTS.—Implementation of the Pro-
gram at each phase-in site shall be carried out on a wide
enough scale to permit a thorough evaluation of the alter-
native methods under consideration, so as to ensure that
the most efficacious methods are determined and in place
for full implementation of the Program on a timely basis.
(c) FULL
IMPLEMENTATION.—The Commissioner
shall ensure that the Program is fully implemented as
soon as practicable on or after the effective date specified
in section 202 but not later than six years after such date.
(d) ONGOING EVALUATION OF PROGRAM.—
(1) IN GENERAL.—The Commissioner shall de-
sign and conduct a series of evaluations to assess
the cost-effectiveness of activities carried out under
this title and the amendments made thereby, as well
as the effects of this title and the amendments made
thereby on work outcomes for beneficiaries receiving
tickets to work and self-sufficiency under the Pro-
gram.
(2) METHODOLOGY.—
(A) DESIGN AND IMPLEMENTATION.—The
Commissioner shall design the series of evalua-
tions after receiving relevant advice from ex-
perts in the fields of disability, vocational reha-
bilitation, and program evaluation and individ-
uals using tickets to work and self-sufficiency
under the Program. In designing and carrying
out such evaluations, the Commissioner shall
consult with the Comptroller General of the
United States and other agencies of the Federal
Government and with private organizations with
appropriate expertise. Before provision of serv-
ices begins under any phase of Program imple-
mentation, the Commissioner shall ensure that
plans for such evaluations and data collection
methods are in place and ready for implementa-
tion.
(B) SPECIFIC
MATTERS
TO
BE
AD-
DRESSED.—Each such evaluation shall address
(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 bene-
ficiaries in receipt of tickets under the Pro-
gram;
(iii) the types of employment services,
vocational rehabilitation services, and other
support services furnished 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 serv-
ices, vocational rehabilitation services, and
other support services furnished to bene-
ficiaries in receipt of tickets under the Pro-
gram who return to work and the duration
of such services furnished to those who do
not return to work and the cost to employ-
ment networks of furnishing such services;
(v) the employment outcomes, includ-
ing wages, occupations, benefits, and hours
worked, of beneficiaries who return to work
after receiving tickets under the Program
and those who return to work without re-
ceiving such tickets;
(vi) the characteristics of providers
whose services are provided within an em-
ployment network under the Program;
(vii) the extent (if any) to which em-
ployment networks display a greater will-
ingness to provide services to disabled
beneficiaries;
(viii) the characteristics (including
employment outcomes) of those bene-
ficiaries who receive services under the out-
come payment system and of those bene-
ficiaries who receive services under the out-
come-milestone payment system;
(ix) measures of satisfaction among
beneficiaries in receipt of tickets under the
Program; and
(x) reasons for (including comments
solicited from beneficiaries regarding) their
choice not to use their tickets or their in-
ability to return to work despite the use of
thier tickets.
(3) PERIODIC EVALUATION REPORTS.—Follow-
ing the close of the third and fifth fiscal years end-
ing after the effective date under section 202, 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 provisions of this section and the amend-
ments made thereby. Each such report shall set
forth the Commissioner’s evaluation of the extent to
which the Program has been successful and the
Commissioner’s conclusions on whether or how the
Program should be modified. Each such report shall
include such data, findings, materials, and rec-
ommendations as the Commissioner may consider
appropriate.
(e) EXTENT OF STATE’S RIGHT OF FIRST REFUSAL
IN ADVANCE
OF FULL IMPLEMENTATION
OF AMEND-
MENTS IN SUCH STATE.—
(1) IN GENERAL.—In the case of any State in
which the amendments made by section 201 have
not been fully implemented pursuant to this section,
the Commissioner shall determine by regulation the
extent to which—
(A) the requirement under section 222(a)
of the Social Security Act for prompt referrals
to a State agency; and
(B) the authority of the Commissioner
under section 222(d)(2) of such Act to provide
vocational rehabilitation services in such State
by agreement or contract with other public or
private agencies, organizations, institutions, or
individuals,
shall apply in such State.
(2) EXISTING AGREEMENTS.—Nothing in para-
graph (1) or the amendments made by section 201
shall be construed to limit, impede, or otherwise af-
fect 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 pursuant to such agreement to beneficiaries
receiving services under such agreement as of such
date, except with respect to services (if any) to be
provided after six years after the effective date pro-
vided in section 202.
SEC. 204. THE TICKET TO WORK AND SELF-SUFFICIENCY
ADVISORY PANEL.
(a) ESTABLISHMENT.—There is established in the ex-
ecutive branch a panel to be known as the ‘‘Ticket to Work
and Self-Sufficiency Advisory Panel’’ (in this section re-
ferred to as the ‘‘Panel’’).
(b) DUTIES OF PANEL.—It shall be the duty of the
Panel to—
(1) advise the Commissioner of Social Security
on establishing phase-in sites for the Ticket to Work
and Self-Sufficiency Program and on fully imple-
menting the Program thereafter;
(2) advise the Commissioner with respect to the
refinement of access of disabled beneficiaries to em-
ployment networks, payment systems, and manage-
ment information systems and advise the Commis-
sioner whether such measures are being taken to the
extent necessary to ensure the success of the Pro-
gram;
(3) advise the Commissioner regarding the most
effective designs for research and demonstration
projects associated with the Program or conducted
pursuant to section 205(a);
(4) advise the Commissioner on the develop-
ment of performance measurements relating to qual-
ity assurance under section 1148(d)(6) of the Social
Security Act; and
(5) furnish progress reports on the Program to
the President and each House of the Congress.
(c) MEMBERSHIP.—
(1) NUMBER AND APPOINTMENT.—The Panel
shall be composed of six members as follows:
(A) one member appointed by the Chair-
man of the Committee on Ways and Means of
the House of Representatives;
(B) one member appointed by the ranking
minority member of the Committee on Ways
and Means of the House of Representatives;
(C) one member appointed by the Chair-
man of the Committee on Finance of the Sen-
ate;
(D) one member appointed by the ranking
minority member of the Committee on Finance
of the Senate; and
(E) two members appointed by the Presi-
dent, who may not be of the same political
party.
(2) REPRESENTATION.—Of the members ap-
pointed under paragraph (1), at least four shall have
experience or expert knowledge as a recipient, pro-
vider, employer, or employee in the fields of, or re-
lated to, employment services, vocational rehabilita-
tion services, and other support services, of whom—
(A) at least one shall represent the inter-
ests of recipients of employment services, voca-
tional rehabilitation services, and other support
services;
(B) at least one shall represent the inter-
ests of providers of employment services, voca-
tional rehabilitation services, and other support
services;
(C) at least one shall represent the inter-
ests of private employers;
(D) at least one shall represent the inter-
ests of employees; and
(E) at least one shall be an individual who
is or has been a recipient of benefits under title
II or title XVI based on disability.
(3) TERMS.—
(A) IN GENERAL.—Each member shall be
appointed for a term of 4 years (or, if less, for
the remaining life of the Panel), except as pro-
vided in subparagraphs (B) and (C). The initial
members shall be appointed not later than 90
days after the date of the enactment of this
Act.
(B) TERMS OF INITIAL APPOINTEES.—As
designated by the President at the time of ap-
pointment, of the members first appointed—
(i) three of the members appointed
under paragraph (1) shall be appointed for
a term of 2 years; and
(ii) three of the members appointed
under paragraph (1) shall be appointed for
a term of 4 years.
(C) VACANCIES.—Any member appointed
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 expiration 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.
(4) BASIC PAY.—Members shall each be paid at
a rate equal to the daily equivalent of the rate of
basic pay for level 4 of the Senior Executive Service,
as in effect from time to time under section 5382 of
title 5, United States Code, for each day (including
travel time) during which they are engaged in the
actual performance of duties vested in the Panel.
(5) 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.
(6) QUORUM.—Four members of the Panel
shall constitute a quorum but a lesser number may
hold hearings.
(7) CHAIRPERSON.—The Chairperson of the
Panel shall be designated by the President. The
term of office of the Chairperson shall be 4 years.
(8) MEETINGS.—The Panel shall meet at least
quarterly and at other times at the call of the Chair-
person or a majority of its members.
(d) DIRECTOR AND STAFF OF PANEL; EXPERTS AND
CONSULTANTS.—
(1) DIRECTOR.—The Panel shall have a Direc-
tor who shall be appointed by the Panel. The Direc-
tor shall be paid at a rate not to exceed the maxi-
‘‘(I) the institution shall provide to the Com-
missioner, on a monthly basis and in a manner spec-
ified by the Commissioner, the names, Social Secu-
rity account numbers, dates of birth, confinement
commencement dates, and, to the extent available to
the institution, such other identifying information
concerning the individuals confined in the institution
as the Commissioner may require for the purpose of
carrying out paragraph (1); and
‘‘(II) the Commissioner shall pay to the institu-
tion, with respect to information described in sub-
clause (I) concerning each individual who is confined
therein as described in paragraph (1)(A), who re-
ceives a benefit under this title for the month pre-
ceding the first month of such confinement, and
whose benefit under this title is determined by the
Commissioner to be not payable by reason of con-
finement based on the information provided by the
institution, $400 (subject to reduction under clause
(ii)) if the institution furnishes the information to
the Commissioner within 30 days after the date such
individual’s confinement in such institution begins,
or $200 (subject to reduction under clause (ii)) if
the institution furnishes the information after 30