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106-13R
December 3, 1999
Congress Passes the Ticket to Work and Work Incentives Improvement Act
of 1999
On November 18, 1999 the House of Representatives passed the conference
report accompanying H.R. 1180, the Ticket to Work and Work Incentives
Improvement Act of 1999, by a vote of 418-2. The Senate passed the
conference report, by a vote of 95-1, on November 19, 1999. The President
has indicated that he will sign the legislation. The bill contains the
following provisions of interest to SSA:
Ticket to Work and Self-Sufficiency Program
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 manager's
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 subminimum 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 Disincentives
Work 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 Outreach
Work 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 be 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 Services
State 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
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 Studies
Disability 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.
Technical Amendments
Drug Addicts and Alcoholics (DA&A)
Treatment of Prisoners
- Extends 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 for purpose of determining program eligibility.
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.
- Eliminates the OASDI requirement that confinement stem from a crime
punishable by imprisonment for more than 1 year. Benefits would be
suspended for any month during which the person was confined because of
a crime or finding of not guilty by reason of insanity except that no
monthly benefit would be suspended for any month falling within a period
of confinement that lasts for less than 30 days.
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.
- Provides 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.
Effective as if included in enactment of the Personal Responsibility
and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193).
- Prohibits 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.
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
Cooperative Research or Demonstration Projects Under Title II and
Title XVI
Authorization for State to Permit Annual Wage Reports
Assessment on Attorneys who Receive their Fees Via the Social Security
Administration
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.
* Denotes that the section has been revised.
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