106-7 May 28, 1999
House Committee on Commerce Approves H.R. 1180, the Work
Incentives Improvement Act of 1999 On May 19, 1999, the
House Committee on Commerce favorably reported, by voice vote,
H.R.1180, as previously amended by the Subcommittee on Health and
Environment.
H.R. 1180 is similar to Senate bill, S. 331 ("Work Incentives
Improvement Act of 1999"), which has been reported by the Senate
Committee on Finance and is awaiting action by the full Senate (see Legislative Bulletin
106-4). However, S.331 does not include the amendments in the
Commerce Committee reported bill. These bills address barriers to
work for individuals with disabilities. They would: expand the
availability of health care coverage for working individuals with
disabilities; establish a Ticket to Work and Self-Sufficiency
Program; and provide such individuals with meaningful opportunities
to work.
H.R. 1180, as reported by the House Committee on Commerce, is
still subject to change because the House Committee on Ways and
Means has not yet considered the bill.
The bill contains the following provisions:
Expanded Availability of Health Care Services
State Options under Medicaid
Continuation of Medicare Coverage
Responsibilities of the Secretary of Health and Human
Services
- Would direct 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.
Would be effective upon
enactment.
Election by Disabled Beneficiaries to Suspend Medigap
Insurance
Ticket to Work and Self-Sufficiency Program
General
- Would direct the Commissioner to establish a Ticket to Work
and Self- Sufficiency Program (Program) which would provide SSDI
beneficiaries and SSI disability recipients with a ticket they may
use to obtain vocational rehabilitation (VR) services, employment
services, or other support services from an employment network of
their choice.
Responsibilities of the Commissioner of Social Security
- Would select and enter 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.
- Would terminate agreements with program manager(s) who fail to
meet the performance standards specified in the agreements.
- Would preclude 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 manager's agreement.
- Would select, and enter into agreements with, employment
networks, including alternate participants who choose to act as an
employment network, to provide services under the Program.
- Would terminate agreements with employment networks whose
performance is inadequate.
- Would provide for periodic reviews of employment networks to
ensure effective quality assurance in the provision of services.
- Would provide 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)
- Would perform such tasks as assigned by the Commissioner.
- Would recruit, and recommend for selection by the
Commissioner, employment networks which can provide services under
the Program.
- Would monitor 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.
- Would ensure 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.
- Would ensure beneficiaries are allowed changes in employment
networks for good cause without being deemed to have rejected
services under the Program.
Employment Network(s)
- Would assume 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.
- Would provide services either directly or by entering into
agreements with other providers which can furnish appropriate
services.
- Would serve prescribed service areas and take measures to
ensure that services provided under the Program meet the
requirements of individual work plans.
- Would meet 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.
- Would develop and implement 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
- Would authorize 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
would be 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 would combine 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 were paid under the outcome payment system.
- Would require 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.
- Would allow 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.
State Agency Participation
- Would permit 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 would provide
services under plans approved under title I of the Rehabilitation
Act of 1973.
- Would require 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.
- Would direct the Commissioner and the Secretary of Education
jointly to prescribe regulations specifying the terms of such
agreements.
- Would prohibit payment to an employment network if the
employment network makes referrals to the State VR agency
without entering into a written agreement with such State VR
agency or in violation of the terms of the written agreement.
- Would require 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
- Would prohibit the Commissioner from initiating continuing
disability reviews during the period that a beneficiary is using a
ticket to work and self-sufficiency.
Financing
- Would require payments to employment networks to be made from
the Federal Old-Age, Survivors and Disability Insurance Trust
Funds (OASDI) in the case of title II disability beneficiaries who
return to work and from appropriations made available for making
SSI payments under title XVI. The costs for administrative
expenses must be allocated as appropriate from amounts made
available for the administration of title II and title XVI.
Regulations
Reauthorization of Program
Scope of Program Implementation
- Would direct 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.
- Would require the Commissioner to fully implement the Program
as soon as practicable, but not later than 3 years after the
effective date.
Evaluation
- Would require the Commissioner 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.
- Would require the Commissioner to design and conduct a series
of evaluations after consultation with work incentive experts, the
Advisory Panel, GAO, other Federal agencies and private
organizations with appropriate expertise.
Reports
- Would require 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 would
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
- Would establish a Work Incentives Advisory Panel within the
Social Security Administration. The Panel would be composed of 12
members appointed by the Commissioner in consultation with the
Speaker and the Minority Leader of the House of Representatives
and the Majority and Minority Leader of the Senate; at least 7
members should be individuals with disabilities or representatives
of individuals with disability, and at least 5 of those 7 members
should be current or former title II or title XVI disability
beneficiaries. Would require that members be appointed not later
than 90 days after enactment.
Duties would include:
- Advising the Secretary of HHS, the Secretary of Labor, the
Secretary of Education, 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 Social Security Act.
- Advising the Commissioner with respect to the Ticket to Work
and Self- Sufficiency 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;
- development of performance measures for the employment
networks; and
- furnishing progress reports on the Program to the
Commissioner and Congress.
- Would require 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.
- Would terminate 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 Disincentives
Work Activity Standard as a Basis for Review
Expedited Reinstatement
Work Incentives Planning, Assistance, and Outreach
Work Incentive Outreach Program
Protection and Advocacy
Demonstration Projects and Studies
Permanent Disability Insurance Program Demonstration Project
Authority
Reduction in Disability Benefits Based on Earnings
- Would direct 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.
- Would provide that the demonstration projects should
determine:
- the effects, if any, of induced entry and reduced exit;
- the effect, if any, on a project being conducted in a
locality under the administration of the Ticket to Work and
Self-Sufficiency Program; and,
- the savings to the Trust Funds and other Federal programs as
a result of the project.
- Would require the Commissioner to determine the annual cost,
the reasons for the return to work of beneficiaries who
participate in the project, the employment outcomes, the merits of
trial work periods and periods of extended eligibility for each
project.
- Would authorize the Commissioner to waive compliance with the
title II benefit provisions and the Secretary of Health and Human
Services to waive compliance with the benefit requirements of
title XVIII, insofar as is necessary for a thorough evaluation of
the alternative methods under consideration.
- Would require 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, would
require 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
Reports and Studies
Technical Amendments
Drug Addicts and Alcoholics (DA&A)
Treatment of Prisoners
- Would extend the incentive payment provisions now in effect
for SSI prisoners to OASDI, and would authorize the Commissioner
to provide, on a reimbursable basis, this reported information to
any agency administering a Federal or federally assisted cash,
food, or medical assistance program.
Would be applicable to individuals whose period of confinement
in an institution begins on or after the first day of the fourth
month beginning after the month of enactment.
- Would eliminate the OASDI requirement that confinement stem
from a crime punishable by imprisonment for more than 1 year--like
SSI, benefits would be suspended for any month throughout which
the person was confined because of a crime or finding of not
guilty by reason of insanity. Would be applicable to individuals
whose period of confinement in an institution begins on or after
the first day of the fourth month beginning after the month of
enactment.
- Would provide that an institution does not get two incentive
payments when the reported prisoner is a concurrent OASDI/SSI
beneficiary--the programs would split the cost of the payment.
Would be effective as if included in enactment of the Personal
Responsibility and Work Opportunity Reconciliation Act of 1996
(P.L. 104-193).
- Would prohibit the payment of monthly benefits to any title II
beneficiary who upon completion of a prison term remains confined
by court order to a public institution based on a finding that the
individual is a sexually dangerous person or a sexual predator.
Would be effective with respect to benefits for months ending
after the date of enactment.
Revocation by Members of the Clergy of Exemption from Social
Security Coverage
- Would create a 2-year window of opportunity to allow members
of the clergy who applied for and received an exemption from
Social Security coverage to revoke the exemption. The application
for revocation would have to be filed before the due date for the
income tax return for the applicants second taxable year beginning
after 12/31/99. The revocation would be effective, at the
applicant's option, beginning with either the first or second
taxable year beginning after 12/31/99.
Cooperative Research or Demonstration Projects Under Title II
and Title XVI
Authorization for State to Permit Annual Wage Reports
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