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106th CONGRESS
1st Session
H. R. 1180
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 19, 1999
Received
_______________________________________________________________________
AN ACT
To amend the Social Security Act to expand the availability of health
care coverage for working individuals with disabilities, to establish a
Ticket to Work and Self-Sufficiency Program in the Social Security
Administration to provide such individuals with meaningful
opportunities to work, and for other purposes.
Be it enacted by the Senate and House of Representatives 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 working 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 authority.
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. Prevention of fraud and abuse associated with certain
payments under the medicaid
program.Extension of authority of State
medicaid fraud control units.
Sec. 408. Extension of authority of State medicaid fraud control units.
Sec. 409. Special allowance adjustment for student loans.
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.
(a) In General.--Part A of title XI of the Social Security 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 following:
``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 employment 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 Commissioner 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-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 evidences 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 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 beneficiary.
``(c) State Participation.--
``(1) In general.--Each State agency administering or
supervising the administration of the State plan approved under
title I of the Rehabilitation Act of 1973 may elect to
participate in the Program 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 system or the
outcome-milestone payment system in accordance with subsection
(h)(1). With respect to a disabled 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
section 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 agency.--
``(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
acting 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 maternal and
child health services programs.--Subparagraph (A) shall
not apply with respect to any State agency
administering a program under title V of this Act.
``(3) Agreements between state agencies and employment
networks.--State agencies and employment networks shall enter
into agreements regarding the conditions under which services
will be provided when an individual is referred by an
employment network to a State agency for services. The
Commissioner of Social Security shall establish by regulations
the timeframe within which such agreements must be entered into
and the mechanisms for dispute resolution between State
agencies and employment networks with respect to such
agreements.
``(d) Responsibilities of the Commissioner of Social Security.--
``(1) Selection and qualifications of program managers.--
The Commissioner of Social Security shall enter into agreements
with 1 or more organizations in the private or public sector
for service as a program manager to assist the Commissioner in
administering 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 in the field of vocational
rehabilitation or employment services.
``(2) Tenure, renewal, and early termination.--Each
agreement entered into under paragraph (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 include--
``(A) measures for ease of access by beneficiaries
to services; and
``(B) measures for determining the extent to which
failures in obtaining services for beneficiaries fall
within acceptable parameters, as determined by the
Commissioner.
``(3) Preclusion from direct participation 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 support 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 networks.--
``(A) In general.--The Commissioner shall select
and enter into agreements with employment networks for
service under the Program. Such employment networks
shall be in addition to State agencies serving as
employment networks 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 the
enactment of this section and chooses to serve as an
employment network under the Program.
``(5) Termination of agreements with employment networks.--
The Commissioner shall terminate agreements with employment
networks for inadequate performance, as determined by the
Commissioner.
``(6) Quality assurance.--The Commissioner shall provide
for such periodic reviews as are necessary 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 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
Commissioner shall ensure that the periodic surveys of
beneficiaries receiving 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, between 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 administering the Program.
``(2) Recruitment of employment networks.--A program
manager shall recruit, and recommend for selection by the
Commissioner, employment networks for service under the
Program. The program manager shall carry out such recruitment
and provide such recommendations, and shall monitor 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 services are made available to beneficiaries.
Employment networks may serve under the Program only pursuant
to an agreement entered into with the Commissioner under the
Program incorporating the applicable provisions of this section
and regulations thereunder, and the program manager shall
provide and maintain assurances 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 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 beneficiaries to employment
networks.--A program manager shall facilitate access by
beneficiaries to employment networks. The program manager shall
ensure that each beneficiary is allowed changes in employment
networks without being deemed to have rejected 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
information 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 services, and other support services
are provided to beneficiaries throughout the geographic area
covered under the program manager's agreement, including rural
areas.
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