General
* Directs the Commissioner to establish a Ticket to Work
and Self-Sufficiency program (Program) which would provide
SSDI and SSI disability beneficiaries with a ticket they
may use to obtain vocational rehabilitation (VR) services,
employment services, and other support services from an
employment network of their choice.
Responsibilities of the Commissioner of Social Security*
Selects and enters into agreements with one or more organizations
in the public or private sector to serve as a program
manager(s) to assist the Commissioner in administering
the Program.
* Terminates agreements with program manager(s) who fail
to meet the performance standards specified in the agreements.
* Precludes program managers from direct participation
in the delivery of services to beneficiaries or from holding
a financial interest in an employment network in the service
area covered by the program managers' agreement.
* Selects, and enters into agreements with, employment
networks, including alternate participants who choose
to act as an employment network, to provide services under
the Program.
* Terminates agreements with employment networks whose
performance is inadequate.
* Provides for periodic reviews of employment networks
to ensure effective quality assurance in the provision
of services.
* Provides for a process to resolve disputes between beneficiaries
and employment networks, between program managers and
employment networks, and between program managers and
providers of services. Responsibilities of the Program
Manager(s)* Performs such tasks as assigned by the Commissioner.
* Recruits and recommends, for selection by the Commissioner,
employment networks which can provide services under the
Program.
* Monitors employment networks under its jurisdiction
to ensure that beneficiaries have adequate choices of
services and reasonable access to services, e.g., case
management, benefits counseling, supported employment,
job training, placement, and follow-up services.
* Ensures that employment networks comply with the terms
of their agreements with the Commissioner and that payment
by the Commissioner to an employment network is warranted.
* Ensures beneficiaries are allowed changes in employment
networks without being deemed to have rejected services
under the Program. Employment Network(s)* Assumes responsibility
for coordination and delivery of services under the Program
to an individual assigning his/her ticket to work and
self-sufficiency to an employment network.
* May consist of a one-stop delivery system established
under the Workforce Investment Act of 1998 or either a
single provider of such services or a group of providers
organized to combine their resources into a single entity.
* Provides services either directly or by entering into
agreements with other providers which can furnish appropriate
services.
* Serves prescribed service areas and takes measures to
ensure that services provided under the Program meet the
requirements of individual work plans.
* Meets the financial reporting requirements prescribed
by the Commissioner. Prepares periodic reports, on at
least an annual basis, itemizing specific outcomes achieved
with respect to services provided to beneficiaries.
* Develops and implements an individual work plan in partnership
with each beneficiary that includes a statement of the:
(1) beneficiary's vocational goal, (2) services and supports
necessary to accomplish that goal, (3) terms and conditions
related to the provision of those services and supports,
(4) rights and remedies available to the beneficiary,
and (5) beneficiary's right to modify his/her work plan
if needed. The individual work plan is effective upon
written approval by the beneficiary and a representative
of the employment network. Employment Network Payment
Systems* Authorizes the Commissioner to pay an employment
network under either an outcome payment system or an outcome-milestone
payment system. Each employment network will elect the
payment system under which it will be paid.
* Under the outcome payment system, an employment network
is paid a percentage, not to exceed 40 percent, of the
national average SSDI or SSI payment for each month that
a beneficiary does not receive a benefit payment due to
work activity for a period not to exceed 60 months.
* The outcome-milestone payment system combines outcome
payments with payments for achieving one or more milestones
directed toward assisting the beneficiary in achieving
permanent employment. However, the total amount of outcome-milestone
payments must be less than the total amount of payments
if the employment network is paid under the outcome payment
system.
* Requires the Commissioner to review periodically the
specifications of the payment system (percentage and total
payment) to ensure that the system provides an adequate
incentive for employment networks to assist beneficiaries
in entering the workforce.
* Allows the Commissioner to alter the percentage or total
permissible payments, as well as the number and amount
of milestone payments, to allow an adequate incentive
for employment networks.
* Requires the Commissioner to report within 36 months
of enactment on the adequacy of the payment system as
an incentive for providing services to individuals with
a need for ongoing support or services, high cost accommodations,
who earn a sub minimum wage, or who work and receive partial
benefits. State Agency Participation* Permits a State
VR agency to elect participation in the Program as an
employment network with respect to each disabled beneficiary
for whom it will provide services.
* State VR agencies participating in the Program will
provide services under plans approved under title I of
the Rehabilitation Act of 1973.
* Requires a written agreement between the State VR agency
and the employment network before a State VR agency can
accept any referral of a disabled beneficiary from an
employment network assigned a ticket to work by the disabled
beneficiary.
* Directs the Commissioner to prescribe regulations specifying
the terms of such agreements.
* Requires the Commissioner to establish in regulations
a dispute resolution mechanism when the State VR agency
and the employment network fail to reach an agreement
on cross-referring beneficiaries.
* Requires the Commissioner, if the amendments have not
been fully implemented in a State, to determine through
regulations the extent (1) to which the requirement concerning
prompt referral to the State VR agency applies, and (2)
of the Commissioner's authority to provide vocational
rehabilitation services by agreement or contract with
other public or private agencies in the State.
Continuing Disability Reviews
* Prohibits the Commissioner
from initiating continuing disability reviews during the
period that a beneficiary is using a ticket to work and
self-sufficiency.
Financing
*
Requires payments to employment networks to be made from
the Federal Old-Age, Survivors and Disability Insurance
(OASDI) Trust Funds in the case of SSDI beneficiaries
who return to work and from appropriations made available
for making SSI payments under title XVI. The costs for
administrative expenses would be authorized as appropriate
from amounts made available for the administration of
title II and title XVI of the Social Security Act (the
Act).
Regulations
*
Directs the Commissioner to prescribe regulations necessary
to implement the Ticket to Work and Self-Sufficiency Program
not later than 1 year after the date of enactment. Effective
Date of the Program
*
Effective with the first month following 1 year after
enactment. Scope of Program Implementation* Directs the
Commissioner to implement the amendments in graduated
phases at sites selected by the Commissioner to ensure
the refinement of the Program processes prior to full
implementation.
*
Requires the Commissioner to fully implement the Program
as soon as practicable, but not later than 3 years after
the effective date. Evaluation* Requires the Commissioner
(after consultation with the Advisory Panel, beneficiaries
using Tickets, the General Accounting Office (GAO), other
Federal agencies, and others with appropriate expertise)
to design and conduct a series of evaluations to assess
the cost-effectiveness of the Program and the work outcomes
for beneficiaries receiving a ticket to work and self
sufficiency under the Program. Also, requires the Commissioner
to provide for independent evaluations to assess the activities
carried out under the Program. Reports* Requires the Commissioner
to report following the close of the third and fifth fiscal
years and prior to the close of the seventh fiscal year
ending after the effective date. Reports should be submitted
to the House Committee on Ways and Means and the Senate
Committee on Finance on the Commissioner's evaluation
of the progress of activities, as well as the success
of the Program and the Commissioner's conclusions on whether
or how the Program should be modified. Work Incentives
Advisory Panel
*
Establishes a Work Incentives Advisory Panel within the
Social Security Administration. The Panel will be composed
of 12 members--4 appointed by the President; 2 each by
the Speaker and the Minority Leader of the House; and
2 each by the Majority and Minority Leaders of the Senate.
At least one-half of the members shall be individuals
with disabilities or representatives of individuals with
a disability, with consideration given to current and
former Social Security and Supplemental Security Income
disability beneficiaries. Requires that members be appointed
not later than 90 days after enactment.
*
Requires that all 12 members represent the interests of
recipients of service, providers of service, employers,
and employees (two each).
*
Duties include:
*
Advising the President, Congress, and the Commissioner
of Social Security on issues related to work incentive
programs, planning, and assistance for individuals with
disabilities, including work incentive provisions under
titles II, XI, XVI, XVIII, and XIX of the Act.
*
Advising the Commissioner with respect to the Ticket to
Work and Self-Sufficiency Program on the following:
*
phase-in sites for implementation of the Program;
*
access of disabled beneficiaries to employment networks,
payment systems, and management information systems to
ensure the success of the Program;
*
the most effective designs for research and demonstration
projects associated with the Program or conducted with
respect to the reduction in disability insurance benefits
based on earnings; and
*
development of performance measures for the employment
networks.
*
Furnishing progress reports on the Program to the Commissioner
and Congress.
*
Requires the Panel to submit interim reports at least
annually and transmit a final report which includes a
detailed statement of the findings and conclusions of
the Panel and its recommendations for legislation and
administrative actions, to the President and the Congress
not later than 8 years after the date of enactment.
*
Terminates the Panel 30 days after the date it submits
its final report.
*
The costs for the Panel shall be made from amounts available
for the administration of title II and title XVI, and
shall be allocated from those amounts as appropriate.
Elimination of Work DisincentivesWork Activity Standard
as a Basis for Review* Prohibits the use of work activity
as a basis for review for individuals who are entitled
to disability insurance benefits under section 223 of
the Act or monthly insurance benefits under section 202
of the Act based on disability and have received such
benefits for at least 24 months.
*
Allows for continuing disability reviews on a regularly
scheduled basis that are not triggered by work activity,
and termination of benefits if the individual has earnings
that exceed the level of earning established by the Commissioner
to represent substantial gainful activity (SGA).
*
Effective January 1, 2002. Expedited Reinstatement of
Benefits* Provides that individuals, whose prior entitlement
to disability and health care benefits had been terminated
as a result of earnings from work activity, may request
reinstatement of benefits without filing a new application.
*
Requires that such individuals (1) are unable to continue
working on account of their medical condition and (2)
file a reinstatement request during the 60-month period
following the month of termination.
*
Provides that, while SSA is making a determination (by
applying the medical improvement review standard) on the
reinstatement request, individuals are eligible for the
payment of provisional benefits for a period of not more
than 6 months.
*
Requires that, if SSA makes a favorable determination,
both the individual's prior entitlement to benefits and
the prior benefits of his dependents who continue to meet
the entitlement criteria would be reinstated.
*
Effective on the first day of the 13th month beginning
after the date of enactment. Work Incentives Planning,
Assistance, and OutreachWork Incentives Outreach Program*
Directs the Commissioner, in consultation with the Work
Incentives Advisory Panel, to establish a community-based
work incentives planning and assistance program for the
purpose of providing accurate information related to work
incentives to disabled beneficiaries.
*
Under the Program, the Commissioner is directed to:
*
establish a competitive program of grants, cooperative
agreements, or contracts to provide benefits planning
and assistance, including information on the availability
of protection and advocacy services, to disabled beneficiaries;
*
conduct directly, or through grants, cooperative agreements,
or contracts, ongoing outreach efforts; and
*
establish a corps of work incentive specialists within
the Social Security Administration who specialize in title
II and title XVI work incentives for the purpose of providing
accurate information.
*
Directs the Commissioner to award a grant, cooperative
agreement, or contract to an entity based on a percentage
of the population of disabled beneficiaries in the State
where the entity is located. No entity will receive a
grant, cooperative agreement, or contract for a fiscal
year that is less than $50,000 or more than $300,000.
The total amount of all grants, cooperative agreements,
and contracts awarded for a fiscal year may not exceed
$23 million.
*
Provides that the costs be paid from amounts made available
for the administration for title II and title XVI, and
that allocations be made from those amounts as appropriate.
*
Authorizes $23 million to be allocated for each of fiscal
years 2000 through 2004.
*
Effective upon enactment. Protection and Advocacy* Authorizes
the Commissioner to make payments to protection and advocacy
systems established in each state. Each system that receives
payment is required to submit an annual report to the
Commissioner and the Work Incentives Advisory Panel.
*
Provides that protection and advocacy systems are paid
the greater of $100,000 or 1/3 of 1 percent of the amount
available for payments for a fiscal year. Provides that
payments are made from amounts available for the administration
for title II and title XVI, and would be allocated from
those amounts as appropriate. Any amounts allotted for
payments to a protection and advocacy system would remain
available until the end of the succeeding fiscal year.
*
Authorizes $7 million to be appropriated for each of fiscal
years 2000 through 2004.
*
Effective upon enactment. Expanded Availability of Health
Care ServicesState Options under Medicaid* Expands, for
individuals who are at least 16, but less than 65, years
of age, the States' options and funding for the Medicaid
buy-in for workers with disabilities by permitting States
to: (1) liberalize limits on resources and income, and
(2) provide the opportunity for employed individuals with
medically determinable impairments, as determined by the
Secretary of Health and Human Services (HHS), to buy into
Medicaid even though they are no longer eligible for SSDI
or SSI disability benefits due to medical improvement.
For purposes of the Medicaid buy-in, the States are authorized
to require individuals to pay premiums, or other cost-sharing
charges, set on a sliding scale based on income.
*
Applicable with respect to medical assistance for items
and services furnished on or after October 1, 2000.
*
Requires GAO to report on these options not later than
3 years after enactment. Continuation of Medicare Coverage*
Extends premium-free Medicare Part A coverage for people
with disabilities who return to work for an additional
4 1/2-year period beyond the four years provided under
current law for SSDI beneficiaries.
Effective October 1, 2000.
*
Requires GAO (5 years after enactment) to examine the
effectiveness and cost of providing such premium-free
Medicare Part A coverage and to recommend whether such
coverage should be continued and to examine the viability
of employer buy-in to Medicare. Responsibilities of the
Secretary of Health and Human Services* Directs the Secretary
of HHS to:
*
provide grants to establish State infrastructures to support
working individuals with disabilities; and
*
create a demonstration of a Medicaid buy-in for people
whose disabilities have not yet gotten severe enough to
cause them to stop work and file for benefits.
*
Effective October 1, 2000. Election by Disabled Beneficiaries
to Suspend Medigap Insurance* Allows workers with disabilities
who have Medicare coverage and a Medigap policy to suspend
the premiums and benefits of the Medigap policy if they
have employer-sponsored coverage.
Applicable with respect to requests made after the date
of enactment.
Demonstration
Projects and StudiesDisability Insurance Program Demonstration
Project Authority* Authorizes section 505 of the Social
Security Disability Amendments of 1980 (Authority for
Demonstration Projects) for a 5-year period. Directs the
Commissioner to conduct demonstrations related to sliding
scale benefit offsets using variations in the amounts
of the offset as a proportion of earned income. Permits
presumptively eligible applicants to participate in demonstration
projects.
*
Directs the Commissioner to submit: (1) interim reports
on or before June 9 of each year on the progress of the
demonstration projects, and (2) a final report not later
than 90 days after the termination of any experiment or
demonstration project carried out under this provision.
*
Requires GAO to study and recommend as to whether the
authority should be permanent.
*
Effective upon enactment. Reduction in Disability Benefits
Based on Earnings* Directs the Commissioner to conduct
demonstration projects to evaluate the effects of a $1
for $2 withholding of SSDI payments for earnings over
a level specified by the Commissioner.
*
Provides that the demonstration projects should determine:
*
the effects, if any, of induced entry and reduced exit;
*
the extent, if any, to which the project being tested
is affected by whether it is being conducted in a locality
within an area under the administration of the Ticket
Program; and,
*
the savings to the Trust Funds and other Federal programs
as a result of the project.
*
Requires the Commissioner to determine the annual cost,
the reasons for the return to work of beneficiaries who
participate in the project, and the employment outcomes
of beneficiaries who return to work as a result of participation
in the project.
*
Permits the Commissioner to evaluate the merits of the
trial work period and the period of extended eligibility
as part of the projects.
*
Authorizes the Commissioner to waive compliance with the
title II benefit provisions and the Secretary of HHS to
waive compliance with the benefit requirements of title
XVIII, insofar as is necessary for a thorough evaluation
of the alternative methods under consideration.
*
Requires the Commissioner to submit a written report to
the House Committee on Ways and Means and the Senate Committee
on Finance 90 days prior to the start of a project. Also,
requires the Commissioner to submit periodic reports not
later than 2 years after the date of enactment, and annually
thereafter, on the progress of the project(s) and a final
report on all demonstration projects to the Congressional
committees not later than 1 year after their completion.
Funding
*
Provides that expenditures for the demonstration projects
be made from the Federal Disability Insurance Trust Fund
and the Federal Old-Age and Survivor's Insurance Trust
Fund as determined appropriate by the Commissioner of
Social Security, and from the Federal Hospital Insurance
Trust Fund and the Federal Supplementary Medical Insurance
Trust Fund as determined by the Secretary of Health and
Human Services, to the extent provided in advance in appropriation
Acts.
*
Effective upon enactment. Reports and Studies* Requires
GAO to study:
*
the extent to which existing tax credits and other employer
incentives under current law encourage employers to hire
and retain individuals with disabilities. A report is
due to the Committee on Ways and Means of the House of
Representatives and the Committee on Finance of the Senate
not later than 3 years after the date of enactment of
this Act;
*
the coordination of SSDI and SSI programs as they relate
to individuals who are eligible for benefits under both
programs, or whose eligibility changes from one program
to the other. The study should focus on the effectiveness
of work incentives and medical coverage for these individuals.
A report is due to the congressional committees not later
than 3 years after the date of enactment; and
*
the SGA levels applicable to disabled beneficiaries; whether
the levels serve as a disincentive for those returning
to work, the merits of increasing SGA levels, and the
rationale for not indexing the levels to inflation. A
report is due to the congressional committees not later
than 2 years after the date of enactment of this Act.
*
Directs the Commissioner to report to the House Ways and
Means Committee and the Senate Finance Committee, not
later than 90 days after enactment, on all income disregards
applicable to beneficiaries under SSDI and SSI programs.
The report should specify the most recent statutory or
regulatory change in each disregard; estimate the current
value of any disregard if the disregard had been indexed
for inflation; and recommend any further changes.
*
Effective upon enactment. Assessment on Attorneys who
Receive their Fees Via the Social Security Administration*
Allows the Commissioner to charge an assessment, not to
exceed 6.3 percent, to recover the costs for determining,
and certifying (processing, withholding, and distributing)
fees to attorneys.
*
Eliminates the requirement that the Commissioner may not
certify an attorney fee before the end of the 15-day waiting
period.
*
Requires GAO to study the costs of administering the attorney
fee provisions, the feasibility of a fixed fee for services
to an attorney, and make recommendations to improve or
modify the attorney fee payment process. A report would
be due to the congressional committees not later than
one year after the date of enactment.
Applicable in the case of any attorney with respect to
whom a fee for services is required to be certified for
payments from a claimant's past-due payments after the
later of December 31, 1999 or the last day of the first
month beginning after the month of enactment.
Extension
of Authority of State Medicaid Fraud Control Units
*
Extends the authority of State Medicaid fraud control
units to investigate and prosecute fraud in other Federal
health care programs.
*
Effective upon enactment. Schedule for SSI Supplementation
Payments
*
Effective for months after September 2009, requires a
State that has entered into an agreement with the Commissioner
for Federal administration of State supplementary payments
to remit the payments and fees required of them no later
than the business day preceding the SSI payment date.
(With respect to State supplementary payments paid for
the month which is the last month of the State's fiscal
year, the fifth business day following the SSI payment
date.)
*
Authorizes the Commissioner to charge a penalty equal
to 5 percent of the payment and fees if the remittance
is received after the required date.
*
Also provides that under extraordinary circumstances affecting
the State's ability to make payment, the Commissioner
may make the State supplementary payments on a reimbursable
basis.