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H.R. 1181 (ih) To lift the trade embargo on Cuba, and for other purposes. [Introduced in House] ...


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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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