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106-4
April 16, 1999
Senate Finance Committee Reports S. 331, the Work Incentives
Improvements Act of 1999
On March 26, 1999, the Senate Committee on Finance amended and
favorably reported S. 331, the Work Incentives Improvements Act of 1999,
to the full Senate. This bill addresses barriers to work for individuals
with disabilities. It 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. 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.
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
- Would prohibit the use of work activity as a basis for review for
individuals who are entitled to disability insurance benefits under
section 223 or monthly insurance benefits under section 202 based on
disability and have received such benefits for at least 24 months.
- Would allow 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). Would be effective upon enactment.
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
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
Miscellaneous
- The bill also contains several provisions related to the Internal
Revenue Code of 1986
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