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TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999
(House of Representatives - October 19, 1999)

Text of this article available as: TXT PDF [Pages H10241-H10266] TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999 Mr. ARCHER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1180) 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, as amended. The Clerk read as follows: H.R. 1180 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 [[Page H10242]] 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 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. ``(5) Reasonable access to services.--The program manager shall take such measures as are necessary to ensure that sufficient employment networks are available and that each beneficiary receiving services under the Program has reasonable access to employment services, vocational rehabilitation services, and other support services. Services provided under the Program may include case management, work incentives planning, supported employment, career planning, career plan development, vocational assessment, job training, placement, follow-up services, and such other services as may be specified by the Commissioner under the Program. The program manager shall ensure that such services are available in each service area. ``(f) Employment Networks.-- ``(1) Qualifications for employment networks.-- ``(A) In general.--Each employment network serving under the Program shall consist of an agency or instrumentality of a State (or a political subdivision thereof) or a private entity, that assumes responsibility for the coordination and delivery of services under the Program to individuals assigning to the employment network tickets to work and self- sufficiency issued under subsection (b). ``(B) One-stop delivery systems.--An employment network serving under the Program may consist of a one-stop delivery system established under subtitle B of title I of the Workforce Investment Act of 1998. ``(C) Compliance with selection criteria.--No employment network may serve under the Program unless it meets and maintains compliance with both general selection criteria (such as professional and educational qualifications, where applicable) and specific selection criteria (such as substantial expertise and experience in providing relevant employment services and supports). ``(D) Single or associated providers allowed.--An employment network shall consist of either a single provider of such services or of an association of such providers organized so as to combine their resources into a single entity. An employment network may meet the requirements of subsection (e)(4) by providing services directly, or by entering into agreements with other individuals or entities providing appropriate employment services, vocational rehabilitation services, or other support services. ``(2) Requirements relating to provision of services.--Each employment network serving under the Program shall be required under the terms of its agreement with the Commissioner to-- ``(A) serve prescribed service areas; and ``(B) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans meeting the requirements of subsection (g). ``(3) Annual financial reporting.--Each employment network shall meet financial reporting requirements as prescribed by the Commissioner. ``(4) Periodic outcomes reporting.--Each employment network shall prepare periodic reports, on at least an annual basis, itemizing for the covered period specific outcomes achieved with respect to specific services provided by the employment network. Such reports shall conform to a national model prescribed under this section. Each employment network shall provide a copy of the latest report issued by the employment network pursuant to this paragraph to each beneficiary upon enrollment under the Program for services to be received through such employment network. Upon issuance of each report to each beneficiary, a copy of the report shall be maintained in the files of the employment network. The program manager shall ensure that copies of all such reports issued under this paragraph are made available to the public under reasonable terms. ``(g) Individual Work Plans.-- ``(1) Requirements.--Each employment network shall-- ``(A) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subparagraph (C); ``(B) develop and implement each such individual work plan, in partnership with each beneficiary receiving such services, in a manner that affords such beneficiary the opportunity to exercise informed choice in selecting an employment goal and specific services needed to achieve that employment goal; ``(C) ensure that each individual work plan includes at least-- ``(i) a statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement; ``(ii) a statement of the services and supports that have been deemed necessary for the beneficiary to accomplish that goal; [[Page H10243]] ``(iii) a statement of any terms and conditions related to the provision of such services and supports; and ``(iv) a statement of understanding regarding the beneficiary's rights under the Program (such as the right to retrieve the ticket to work and self-sufficiency if the beneficiary is dissatisfied with the services being provided by the employment network) and remedies available to the individual, including information on the availability of advocacy services and assistance in resolving disputes through the State grant program authorized under section 1150; ``(D) provide a beneficiary the opportunity to amend the individual work plan if a change in circumstances necessitates a change in the plan; and ``(E) make each beneficiary's individual work plan available to the beneficiary in, as appropriate, an accessible format chosen by the beneficiary. ``(2) Effective upon written approval.--A beneficiary's individual work plan shall take effect upon written approval by the beneficiary or a representative of the beneficiary and a representative of the employment network that, in providing such written approval, acknowledges assignment of the beneficiary's ticket to work and self-sufficiency. ``(h) Employment Network Payment Systems.-- ``(1) Election of payment system by employment networks.-- ``(A) In general.--The Program shall provide for payment authorized by the Commissioner to employment networks under either an outcome payment system or an outcome-milestone payment system. Each employment network shall elect which payment system will be utilized by the employment network, and, for such period of time as such election remains in effect, the payment system so elected shall be utilized exclusively in connection with such employment network (except as provided in subparagraph (B)). ``(B) No change in method of payment for beneficiaries with tickets already assigned to the employment networks.--Any election of a payment system by an employment network that would result in a change in the method of payment to the employment network for services provided to a beneficiary who is receiving services from the employment network at the time of the election shall not be effective with respect to payment for services provided to that beneficiary and the method of payment previously selected shall continue to apply with respect to such services. ``(2) Outcome payment system.-- ``(A) In general.--The outcome payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Payments made during outcome payment period.--The outcome payment system shall provide for a schedule of payments to an employment network, in connection with each individual who is a beneficiary, for each month, during the individual's outcome payment period, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual because of work or earnings. ``(C) Computation of payments to employment network.--The payment schedule of the outcome payment system shall be designed so that-- ``(i) the payment for each month during the outcome payment period for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable is equal to a fixed percentage of the payment calculation base for the calendar year in which such month occurs; and ``(ii) such fixed percentage is set at a percentage which does not exceed 40 percent. ``(3) Outcome-milestone payment system.-- ``(A) In general.--The outcome-milestone payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Early payments upon attainment of milestones in advance of outcome payment periods.--The outcome-milestone payment system shall provide for 1 or more milestones, with respect to beneficiaries receiving services from an employment network under the Program, that are directed toward the goal of permanent employment. Such milestones shall form a part of a payment structure that provides, in addition to payments made during outcome payment periods, payments made prior to outcome payment periods in amounts based on the attainment of such milestones. ``(C) Limitation on total payments to employment network.-- The payment schedule of the outcome milestone payment system shall be designed so that the total of the payments to the employment network with respect to each beneficiary is less than, on a net present value basis (using an interest rate determined by the Commissioner that appropriately reflects the cost of funds faced by providers), the total amount to which payments to the employment network with respect to the beneficiary would be limited if the employment network were paid under the outcome payment system. ``(4) Definitions.--In this subsection: ``(A) Payment calculation base.--The term `payment calculation base' means, for any calendar year-- ``(i) in connection with a title II disability beneficiary, the average disability insurance benefit payable under section 223 for all beneficiaries for months during the preceding calendar year; and ``(ii) in connection with a title XVI disability beneficiary (who is not concurrently a title II disability beneficiary), the average payment of supplemental security income benefits based on disability payable under title XVI (excluding State supplementation) for months during the preceding calendar year to all beneficiaries who have attained 18 years of age but have not attained 65 years of age. ``(B) Outcome payment period.--The term `outcome payment period' means, in connection with any individual who had assigned a ticket to work and self-sufficiency to an employment network under the Program, a period-- ``(i) beginning with the first month, ending after the date on which such ticket was assigned to the employment network, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity; and ``(ii) ending with the 60th month (consecutive or otherwise), ending after such date, for which such benefits are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity. ``(5) Periodic review and alterations of prescribed schedules.-- ``(A) Percentages and periods.--The Commissioner shall periodically review the percentage specified in paragraph (2)(C), the total payments permissible under paragraph (3)(C), and the period of time specified in paragraph (4)(B) to determine whether such percentages, such permissible payments, and such period provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, while providing for appropriate economies. The Commissioner may alter such percentage, such total permissible payments, or such period of time to the extent that the Commissioner determines, on the basis of the Commissioner's review under this paragraph, that such an alteration would better provide the incentive and economies described in the preceding sentence. ``(B) Number and amount of milestone payments.--The Commissioner shall periodically review the number and amounts of milestone payments established by the Commissioner pursuant to this section to determine whether they provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, taking into account information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, and other reliable sources. The Commissioner may from time to time alter the number and amounts of milestone payments initially established by the Commissioner pursuant to this section to the extent that the Commissioner determines that such an alteration would allow an adequate incentive for employment networks to assist beneficiaries to enter the workforce. Such alteration shall be based on information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, or other reliable sources. ``(C) Report on the adequacy of incentives.--The Commissioner shall submit to Congress not later than 36 months after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999 a report with recommendations for a method or methods to adjust payment rates under subparagraphs (A) and (B), that would ensure adequate incentives for the provision of services by employment networks of-- ``(i) individuals with a need for ongoing support and services; ``(ii) individuals with a need for high-cost accommodations; ``(iii) individuals who earn a subminimum wage; and ``(iv) individuals who work and receive partial cash benefits. The Commissioner shall consult with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999 during the development and evaluation of the study. The Commissioner shall implement the necessary adjusted payment rates prior to full implementation of the Ticket to Work and Self-Sufficiency Program. ``(i) Suspension of Disability Reviews.--During any period for which an individual is using, as defined by the Commissioner, a ticket to work and self-sufficiency issued under this section, the Commissioner (and any applicable State agency) may not initiate a continuing disability review or other review under section 221 of whether the individual is or is not under a disability or a review under title XVI similar to any such review under section 221. ``(j) Authorizations.-- ``(1) Payments to employment networks.-- ``(A) Title ii disability beneficiaries.--There are authorized to be transferred from the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund each fiscal year such sums [[Page H10244]] as may be necessary to make payments to employment networks under this section. Money paid from the Trust Funds under this section with respect to title II disability beneficiaries who are entitled to benefits under section 223 or who are entitled to benefits under section 202(d) on the basis of the wages and self-employment income of such beneficiaries, shall be charged to the Federal Disability Insurance Trust Fund, and all other money paid from the Trust Funds under this section shall be charged to the Federal Old- Age and Survivors Insurance Trust Fund. ``(B) Title xvi disability beneficiaries.--Amounts authorized to be appropriated to the Social Security Administration under section 1601 (as in effect pursuant to the amendments made by section 301 of the Social Security Amendments of 1972) shall include amounts necessary to carry out the provisions of this section with respect to title XVI disability beneficiaries. ``(2) Administrative expenses.--The costs of administering this section (other than payments to employment networks) shall be paid from amounts made available for the administration of title II and amounts made available for the administration of title XVI, and shall be allocated among such amounts as appropriate. ``(k) Definitions.--In this section: ``(1) Commissioner.--The term `Commissioner' means the Commissioner of Social Security. ``(2) Disabled beneficiary.--The term `disabled beneficiary' means a title II disability beneficiary or a title XVI disability beneficiary. ``(3) Title ii disability beneficiary.--The term `title II disability beneficiary' means an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)). An individual is a title II disability beneficiary for each month for which such individual is entitled to such benefits. ``(4) Title xvi disability beneficiary.--The term `title XVI disability beneficiary' means an individual eligible for supplemental security income benefits under title XVI on the basis of blindness (within the meaning of section 1614(a)(2)) or disability (within the meaning of section 1614(a)(3)). An individual is a title XVI disability beneficiary for each month for which such individual is eligible for such benefits. ``(5) Supplemental security income benefit.--The term `supplemental security income benefit under title XVI' means a cash benefit under section 1611 or 1619(a), and does not include a State supplementary payment, administered federally or otherwise. ``(l) Regulations.--Not later than 1 year after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999, the Commissioner shall prescribe such regulations as are necessary to carry out the provisions of this section.''. (b) Conforming Amendments.-- (1) Amendments to title ii.-- (A) Section 221(i) of the Social Security Act (42 U.S.C. 421(i)) is amended by adding at the end the following: ``(5) For suspension of reviews under this subsection in the case of an individual using a ticket to work and self- sufficiency, see section 1148(i).''. (B) Section 222(a) of such Act (42 U.S.C. 422(a)) is repealed. (C) Section 222(b) of such Act (42 U.S.C. 422(b)) is repealed. (D) Section 225(b)(1) of such Act (42 U.S.C. 425(b)(1)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (2) Amendments to title xvi.-- (A) Section 1615(a) of such Act (42 U.S.C. 1382d(a)) is amended to read as follows: ``Sec. 1615. (a) In the case of any blind or disabled individual who-- ``(1) has not attained age 16; and ``(2) with respect to whom benefits are paid under this title, the Commissioner of Social Security shall make provision for referral of such individual to the appropriate State agency administering the State program under title V.''. (B) Section 1615(c) of such Act (42 U.S.C. 1382d(c)) is repealed. (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 1383(a)(6)(A)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (D) Section 1633(c) of such Act (42 U.S.C. 1383b(c)) is amended-- (i) by inserting ``(1)'' after ``(c)''; and (ii) by adding at the end the following: ``(2) For suspension of continuing disability reviews and other reviews under this title similar to reviews under section 221 in the case of an individual using a ticket to work and self-sufficiency, see section 1148(i).''. (c) Effective Date.--Subject to subsection (d), the amendments made by subsections (a) and (b) shall take effect with the first month following 1 year after the date of the enactment of this Act. (d) Graduated Implementation of Program.-- (1) In general.--Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall commence implementation of the amendments made by this section (other than paragraphs (1)(C) and (2)(B) of subsection (b)) in graduated phases at phase-in sites selected by the Commissioner. Such phase-in sites shall be selected so as to ensure, prior to full implementation of the Ticket to Work and Self-Sufficiency Program, the development and refinement of referral processes, payment systems, computer linkages, management information systems, and administrative processes necessary to provide for full implementation of such amendments. Subsection (c) shall apply with respect to paragraphs (1)(C) and (2)(B) of subsection (b) without regard to this subsection. (2) Requirements.--Implementation of the Program at each phase-in site shall be carried out on a wide enough scale to permit a thorough evaluation of the alternative methods under consideration, so as to ensure that the most efficacious methods are determined and in place for full implementation of the Program on a timely basis. (3) Full implementation.--The Commissioner shall ensure that ability to provide tickets and services to individuals under the Program exists in every State as soon as practicable on or after the effective date specified in subsection (c) but not later than 3 years after such date. (4) Ongoing evaluation of program.-- (A) In general.--The Commissioner shall design and conduct a series of evaluations to assess the cost-effectiveness of activities carried out under this section and the amendments made thereby, as well as the effects of this section and the amendments made thereby on work outcomes for beneficiaries receiving tickets to work and self-sufficiency under the Program. (B) Consultation.--The Commissioner shall design and carry out the series of evaluations after receiving relevant advice from experts in the fields of disability, vocational rehabilitation, and program evaluation and individuals using tickets to work and self-sufficiency under the Program and consulting with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), the Comptroller General of the United States, other agencies of the Federal Government, and private organizations with appropriate expertise. (C) Methodology.-- (i) Implementation.--The Commissioner, in consultation with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), shall ensure that plans for evaluations and data collection methods under the Program are appropriately designed to obtain detailed employment information. (ii) Specific matters to be addressed.--Each such evaluation shall address (but is not limited to)-- (I) the annual cost (including net cost) of the Program and the annual cost (including net cost) that would have been incurred in the absence of the Program; (II) the determinants of return to work, including the characteristics of beneficiaries in receipt of tickets under the Program; (III) the types of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and to those who do not return to work; (IV) the duration of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and the duration of such services furnished to those who do not return to work and the cost to employment networks of furnishing such services; (V) the employment outcomes, including wages, occupations, benefits, and hours worked, of beneficiaries who return to work after receiving tickets under the Program and those who return to work without receiving such tickets; (VI) the characteristics of individuals in possession of tickets under the Program who are not accepted for services and, to the extent reasonably determinable, the reasons for which such beneficiaries were not accepted for services; (VII) the characteristics of providers whose services are provided within an employment network under the Program; (VIII) the extent (if any) to which employment networks display a greater willingness to provide services to beneficiaries with a range of disabilities; (IX) the characteristics (including employment outcomes) of those beneficiaries who receive services under the outcome payment system and of those beneficiaries who receive services under the outcome-milestone payment system; (X) measures of satisfaction among beneficiaries in receipt of tickets under the Program; and (XI) reasons for (including comments solicited from beneficiaries regarding) their choice not to use their tickets or their inability to return to work despite the use of their tickets. (D) Periodic evaluation reports.--Following the close of the third and fifth fiscal years ending after the effective date under subsection (c), and prior to the close of the seventh fiscal year ending after such date, the Commissioner shall transmit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report containing the [[Page H10245]] Commissioner's evaluation of the progress of activities conducted under the provisions of this section and the amendments made thereby. Each such report shall set forth the Commissioner's evaluation of the extent to which the Program has been successful and the Commissioner's conclusions on whether or how the Program should be modified. Each such report shall include such data, findings, materials, and recommendations as the Commissioner may consider appropriate. (5) Extent of state's right of first refusal in advance of full implementation of amendments in such state.-- (A) In general.--In the case of any State in which the amendments made by subsection (a) have not been fully implemented pursuant to this subsection, the Commissioner shall determine by regulation the extent to which-- (i) the requirement under section 222(a) for prompt referrals to a State agency; and (ii) the authority of the Commissioner under section 222(d)(2) of the Social Security Act to provide vocational rehabilitation services in such State by agreement or contract with other public or private agencies, organizations, institutions, or individuals, shall apply in such State. (B) Existing agreements.--Nothing in subparagraph (A) or the amendments made by subsection (a) shall be construed to limit, impede, or otherwise affect any agreement entered into pursuant to section 222(d)(2) of the Social Security Act before the date of the enactment of this Act with respect to services provided pursuant to such agreement to beneficiaries receiving services under such agreement as of such date, except with respect to services (if any) to be provided after 3 years after the effective date provided in subsection (c). (e) Specific Regulations Required.-- (1) In general.--The Commissioner of Social Security shall prescribe such regulations as are necessary to implement the amendments made by this section. (2) Specific matters to be included in regulations.--The matters which shall be addressed in such regulations shall include-- (A) the form and manner in which tickets to work and self- sufficiency may be distributed to beneficiaries pursuant to section 1148(b)(1) of the Social Security Act; (B) the format and wording of such tickets, which shall incorporate by reference any contractual terms governing service by employment networks under the Program; (C) the form and manner in which State agencies may elect participation in the Ticket to Work and Self-Sufficiency Program pursuant to section 1148(c)(1) of such Act and provision for periodic opportunities for exercising such elections; (D) the status of State agencies under section 1148(c)(1) of such Act at the time that State agencies exercise elections under that section; (E) the terms of agreements to be entered into with program managers pursuant to section 1148(d) of such Act, including-- (i) the terms by which program managers are precluded from direct participation in the delivery of services pursuant to section 1148(d)(3) of such Act; (ii) standards which must be met by quality assurance measures referred to in paragraph (6) of section 1148(d) of such Act and methods of recruitment of employment networks utilized pursuant to paragraph (2) of section 1148(e) of such Act; and (iii) the format under which dispute resolution will operate under section 1148(d)(7) of such Act; (F) the terms of agreements to be entered into with employment networks pursuant to section 1148(d)(4) of such Act, including-- (i) the manner in which service areas are specified pursuant to section 1148(f)(2)(A) of such Act; (ii) the general selection criteria and the specific selection criteria which are applicable to employment networks under section 1148(f)(1)(C) of such Act in selecting service providers; (iii) specific requirements relating to annual financial reporting by employment networks pursuant to section 1148(f)(3) of such Act; and (iv) the national model to which periodic outcomes reporting by employment networks must conform under section 1148(f)(4) of such Act; (G) standards which must be met by individual work plans pursuant to section 1148(g) of such Act; (H) standards which must be met by payment systems required under section 1148(h) of such Act, including-- (i) the form and manner in which elections by employment networks of payment systems are to be exercised pursuant to section 1148(h)(1)(A) of such Act; (ii) the terms which must be met by an outcome payment system under section 1148(h)(2) of such Act; (iii) the terms which must be met by an outcome-milestone payment system under section 1148(h)(3) of such Act; (iv) any revision of the percentage specified in paragraph (2)(C) of section 1148(h) of such Act or the period of time specified in paragraph (4)(B) of such section 1148(h) of such Act; and (v) annual oversight procedures for such systems; and (I) procedures for effective oversight of the Program by the Commissioner of Social Security, including periodic reviews and reporting requirements. (f) The Ticket to Work and Work Incentives Advisory Panel.-- (1) Establishment.--There is established within the Social Security Administration a panel to be known as the ``Ticket to Work and Work Incentives Advisory Panel'' (in this subsection referred to as the ``Panel''). (2) Duties of panel.--It shall be the duty of the Panel to-- (A) advise the President, the Congress, and the Commissioner of Social Security on issues related to work incentives 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 (42 U.S.C. 401 et seq., 1301 et seq., 1381 et seq., 1395 et seq., 1396 et seq.); and (B) with respect to the Ticket to Work and Self-Sufficiency Program established under section 1148 of such Act-- (i) advise the Commissioner of Social Security with respect to establishing phase-in sites for such Program and fully implementing the Program thereafter, the refinement of access of disabled beneficiaries to employment networks, payment systems, and management information systems, and advise the Commissioner whether such measures are being taken to the extent necessary to ensure the success of the Program; (ii) advise the Commissioner regarding the most effective designs for research and demonstration projects associated with the Program or conducted pursuant to section 302 of this Act; (iii) advise the Commissioner on the development of performance measurements relating to quality assurance under section 1148(d)(6) of the Social Security Act; and (iv) furnish progress reports on the Program to the Commissioner and each House of Congress. (3) Membership.-- (A) Number and appointment.--The Panel shall be composed of 12 members as follows: (i) 4 members appointed by the President, not more than 2 of whom may be of the same political party; (ii) 2 members appointed by the Speaker of the House of Representatives, in consultation with the Chairman of the Committee on Ways and Means of the House of Representatives; (iii) 2 members appointed by the minority leader of the House of Representatives, in consultation with the ranking member of the Committee on Ways and Means of the House of Representatives; (iv) 2 members appointed by the majority leader of the Senate, in consultation with the Chairman of the Committee on Finance of the Senate; and (v) 2 members appointed by the minority leader of the Senate, in consultation with the ranking member of the Committee on Finance of the Senate. (B) Representation.--Of the members appointed under subparagraph (A), at least 8 shall have experience or expert knowledge as a recipient, provider, employer, or employee in the fields of, or related to, employment services, vocational rehabilitation services, and other support services, of whom-- (i) at least 2 shall represent the interests of recipients of employment services, vocational rehabilitation services, and other support services; (ii) at least 2 shall represent the interests of providers of employment services, vocational rehabilitation services, and other support services; (iii) at least 2 shall represent the interests of private employers; and (iv) at least 2 shall represent the interests of employees. At least \1/2\ of the members described in each clause of subparagraph (A) shall be individuals with disabilities, or representatives of individuals with disabilities, with consideration to current or former title II disability beneficiaries or title XVI disability beneficiaries (as such terms are defined in section 1148(k) of the Social Security Act (as added by subsection (a)). (C) Terms.-- (i) In general.--Each member shall be appointed for a term of 4 years (or, if less, for the remaining life of the Panel), except as provided in clauses (ii) and (iii). The initial members shall be appointed not later than 90 days after the date of the enactment of this Act. (ii) Terms of initial appointees.--As designated by the President at the time of appointment, of the members first appointed-- (I) \1/2\ of the members appointed under subparagraph (A) shall be appointed for a term of 2 years; and (II) the remaining members appointed under subparagraph (A) shall be appointed for a term of 4 years. (iii) Vacancies.--Any member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member's term until a successor has taken office. A vacancy in the Panel shall be filled in the manner in which the original appointment was made. (D) Basic pay.--Members shall each be paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (E) Travel expenses.--Each member shall receive travel expenses, including per diem in lieu of subsistence, in accordance with sections 5702 and 5703 of title 5, United States Code. [[Page H10246]] (F) Quorum.--8 members of the Panel shall constitute a quorum but a lesser number may hold hearings. (G) Chairperson.--The Chairperson of the Panel shall be designated by the President. The term of office of the Chairperson shall be 4 years. (H) Meetings.--The Panel shall meet at least quarterly and at other times at the call of the Chairperson or a majority of its members. (4) Director and staff of panel; experts and consultants.-- (A) Director.--The Panel shall have a Director who shall be appointed by the Panel, and paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (B) Staff.--Subject to rules prescribed by the Commissioner of Social Security, the Director may appoint and fix the pay of additional personnel as the Director considers appropriate. (C) Experts and consultants.--Subject to rules prescribed by the Commissioner of Social Security, the Director may procure temporary and intermittent services under section 3109(b) of title 5, United States Code. (D) Staff of federal agencies.--Upon request of the Panel, the head of any Federal department or agency may detail, on a reimbursable basis, any of the personnel of that department or agency to the Panel to assist it in carrying out its duties under this Act. (5) Powers of panel.-- (A) Hearings and sessions.--The Panel may, for the purpose of carrying out its duties under this subsection, hold such hearings, sit and act at such times and places, and take such testimony and evidence as the Panel considers appropriate. (B) Powers of members and agents.--Any member or agent of the Panel may, if authorized by the Panel, take any action which the Panel is authorized to take by this section. (C) Mails.--The Panel may use the United States mails in the same manner and under the same conditions as other departments and agencies of the United States. (6) Reports.-- (A) Interim reports.--The Panel shall submit to the President and the Congress interim reports at least annually. (B) Final report.--The Panel shall transmit a final report to the President and the Congress not later than eight years after the date of the enactment of this Act. The final report shall contain a detailed statement of the findings and conclusions of the Panel, together with its recommendations for legislation and administrative actions which the Panel considers appropriate. (7) Termination.--The Panel shall terminate 30 days after the date of the submission of its final report under paragraph (6)(B). (8) Authorization of appropriations.--There are authorized to be appropriated from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the general fund of the Treasury, as appropriate, such sums as are necessary to carry out this subsection. Subtitle B--Elimination of Work Disincentives SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN INDIVIDUAL'S DISABLED STATUS. (a) In General.--Section 221 of the Social Security Act (42 U.S.C. 421) is amended by adding at the end the following: ``(m)(1) In any case where an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)) has received such benefits for at least 24 months-- ``(A) no continuing disability review conducted by the Commissioner may be scheduled for the individual solely as a result of the individual's work activity; ``(B) no work activity engaged in by the individual may be used as evidence that the individual is no longer disabled; and ``(C) no cessation of work activity by the individual may give rise to a presumption that the individual is unable to engage in work. ``(2) An individual to which paragraph (1) applies shall continue to be subject to-- ``(A) continuing disability reviews on a regularly scheduled basis that is not triggered by work; and ``(B) termination of benefits under this title in the event that the individual has earnings that exceed the level of earnings established by the Commissioner to represent substantial gainful activity.''. (b) Effective Date.--The amendment made by subsection (a) shall take effect on January 1, 2003. SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS. (a) OASDI Benefits.--Section 223 of the Social Security Act (42 U.S.C. 423) is amended-- (1) by redesignating subsection (i) as subsection (j); and (2) by inserting after subsection (h) the following: ``Reinstatement of Entitlement ``(i)(1)(A) Entitlement to benefits described in subparagraph (B)(i)(I) shall be reinstated in any case where the Commissioner determines that an individual described in subparagraph (B) has filed a request for reinstatement meeting the requirements of paragraph (2)(A) during the period prescribed in subparagraph (C). Reinstatement of such entitlement shall be in accordance with the terms of this subsection. ``(B) An individual is described in this subparagraph if-- ``(i) prior to the month in which the individual files a request for reinstatement-- ``(I) the individual was entitled to benefits under this section or section 202 on the basis of disability pursuant to an application filed therefor; and ``(II) such entitlement terminated due to the performance of substantial gainful activity; ``(ii) the individual is under a disability and the physical or mental impairment that is the basis for the finding of disability is the same as (or related to) the physical or mental impairment that was the basis for the finding of disability that gave rise to the entitlement described in clause (i); and ``(iii) the individual's disability renders the individual unable to perform substantial gainful activity. ``(C)(i) Except as provided in clause (ii), the period prescribed in this subparagraph with respect to an individual is 60 consecutive months beginning with the month following the most recent month for which the individual was entitled to a benefit described in subparagraph (B)(i)(I) prior to the entitlement termination described in subparagraph (B)(i)(II). ``(ii) In the case of an individual who fails to file a reinstatement request within the period prescribed in clause (i), the Commissioner may extend the period if the Commissioner determines that the individual had good cause for the failure to so file. ``(2)(A)(i) A request for reinstatement shall be filed in such form, and containing such information, as the Commissioner may prescribe. ``(ii) A request for reinstatement shall include express declarations by the individual that the individual meets the requirements specified in clauses (ii) and (iii) of paragraph (1)(B). ``(B) A request for reinstatement filed in accordance with subparagraph (A) may constitute an application for benefits in the case of any individual who the Commissioner determines is not entitled to reinstated benefits under this subsection. ``(3) In determining whether an individual meets the requirements of paragraph (1)(B)(ii), the provisions of subsection (f) shall apply. ``(4)(A)(i) Subject to clause (ii), entitlement to benefits reinstated under this subsection shall commence with the benefit payable for the month in which a request for reinstatement is filed. ``(ii) An individual whose entitlement to a benefit for any

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TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999
(House of Representatives - October 19, 1999)

Text of this article available as: TXT PDF [Pages H10241-H10266] TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999 Mr. ARCHER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1180) 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, as amended. The Clerk read as follows: H.R. 1180 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 [[Page H10242]] 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 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. ``(5) Reasonable access to services.--The program manager shall take such measures as are necessary to ensure that sufficient employment networks are available and that each beneficiary receiving services under the Program has reasonable access to employment services, vocational rehabilitation services, and other support services. Services provided under the Program may include case management, work incentives planning, supported employment, career planning, career plan development, vocational assessment, job training, placement, follow-up services, and such other services as may be specified by the Commissioner under the Program. The program manager shall ensure that such services are available in each service area. ``(f) Employment Networks.-- ``(1) Qualifications for employment networks.-- ``(A) In general.--Each employment network serving under the Program shall consist of an agency or instrumentality of a State (or a political subdivision thereof) or a private entity, that assumes responsibility for the coordination and delivery of services under the Program to individuals assigning to the employment network tickets to work and self- sufficiency issued under subsection (b). ``(B) One-stop delivery systems.--An employment network serving under the Program may consist of a one-stop delivery system established under subtitle B of title I of the Workforce Investment Act of 1998. ``(C) Compliance with selection criteria.--No employment network may serve under the Program unless it meets and maintains compliance with both general selection criteria (such as professional and educational qualifications, where applicable) and specific selection criteria (such as substantial expertise and experience in providing relevant employment services and supports). ``(D) Single or associated providers allowed.--An employment network shall consist of either a single provider of such services or of an association of such providers organized so as to combine their resources into a single entity. An employment network may meet the requirements of subsection (e)(4) by providing services directly, or by entering into agreements with other individuals or entities providing appropriate employment services, vocational rehabilitation services, or other support services. ``(2) Requirements relating to provision of services.--Each employment network serving under the Program shall be required under the terms of its agreement with the Commissioner to-- ``(A) serve prescribed service areas; and ``(B) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans meeting the requirements of subsection (g). ``(3) Annual financial reporting.--Each employment network shall meet financial reporting requirements as prescribed by the Commissioner. ``(4) Periodic outcomes reporting.--Each employment network shall prepare periodic reports, on at least an annual basis, itemizing for the covered period specific outcomes achieved with respect to specific services provided by the employment network. Such reports shall conform to a national model prescribed under this section. Each employment network shall provide a copy of the latest report issued by the employment network pursuant to this paragraph to each beneficiary upon enrollment under the Program for services to be received through such employment network. Upon issuance of each report to each beneficiary, a copy of the report shall be maintained in the files of the employment network. The program manager shall ensure that copies of all such reports issued under this paragraph are made available to the public under reasonable terms. ``(g) Individual Work Plans.-- ``(1) Requirements.--Each employment network shall-- ``(A) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subparagraph (C); ``(B) develop and implement each such individual work plan, in partnership with each beneficiary receiving such services, in a manner that affords such beneficiary the opportunity to exercise informed choice in selecting an employment goal and specific services needed to achieve that employment goal; ``(C) ensure that each individual work plan includes at least-- ``(i) a statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement; ``(ii) a statement of the services and supports that have been deemed necessary for the beneficiary to accomplish that goal; [[Page H10243]] ``(iii) a statement of any terms and conditions related to the provision of such services and supports; and ``(iv) a statement of understanding regarding the beneficiary's rights under the Program (such as the right to retrieve the ticket to work and self-sufficiency if the beneficiary is dissatisfied with the services being provided by the employment network) and remedies available to the individual, including information on the availability of advocacy services and assistance in resolving disputes through the State grant program authorized under section 1150; ``(D) provide a beneficiary the opportunity to amend the individual work plan if a change in circumstances necessitates a change in the plan; and ``(E) make each beneficiary's individual work plan available to the beneficiary in, as appropriate, an accessible format chosen by the beneficiary. ``(2) Effective upon written approval.--A beneficiary's individual work plan shall take effect upon written approval by the beneficiary or a representative of the beneficiary and a representative of the employment network that, in providing such written approval, acknowledges assignment of the beneficiary's ticket to work and self-sufficiency. ``(h) Employment Network Payment Systems.-- ``(1) Election of payment system by employment networks.-- ``(A) In general.--The Program shall provide for payment authorized by the Commissioner to employment networks under either an outcome payment system or an outcome-milestone payment system. Each employment network shall elect which payment system will be utilized by the employment network, and, for such period of time as such election remains in effect, the payment system so elected shall be utilized exclusively in connection with such employment network (except as provided in subparagraph (B)). ``(B) No change in method of payment for beneficiaries with tickets already assigned to the employment networks.--Any election of a payment system by an employment network that would result in a change in the method of payment to the employment network for services provided to a beneficiary who is receiving services from the employment network at the time of the election shall not be effective with respect to payment for services provided to that beneficiary and the method of payment previously selected shall continue to apply with respect to such services. ``(2) Outcome payment system.-- ``(A) In general.--The outcome payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Payments made during outcome payment period.--The outcome payment system shall provide for a schedule of payments to an employment network, in connection with each individual who is a beneficiary, for each month, during the individual's outcome payment period, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual because of work or earnings. ``(C) Computation of payments to employment network.--The payment schedule of the outcome payment system shall be designed so that-- ``(i) the payment for each month during the outcome payment period for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable is equal to a fixed percentage of the payment calculation base for the calendar year in which such month occurs; and ``(ii) such fixed percentage is set at a percentage which does not exceed 40 percent. ``(3) Outcome-milestone payment system.-- ``(A) In general.--The outcome-milestone payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Early payments upon attainment of milestones in advance of outcome payment periods.--The outcome-milestone payment system shall provide for 1 or more milestones, with respect to beneficiaries receiving services from an employment network under the Program, that are directed toward the goal of permanent employment. Such milestones shall form a part of a payment structure that provides, in addition to payments made during outcome payment periods, payments made prior to outcome payment periods in amounts based on the attainment of such milestones. ``(C) Limitation on total payments to employment network.-- The payment schedule of the outcome milestone payment system shall be designed so that the total of the payments to the employment network with respect to each beneficiary is less than, on a net present value basis (using an interest rate determined by the Commissioner that appropriately reflects the cost of funds faced by providers), the total amount to which payments to the employment network with respect to the beneficiary would be limited if the employment network were paid under the outcome payment system. ``(4) Definitions.--In this subsection: ``(A) Payment calculation base.--The term `payment calculation base' means, for any calendar year-- ``(i) in connection with a title II disability beneficiary, the average disability insurance benefit payable under section 223 for all beneficiaries for months during the preceding calendar year; and ``(ii) in connection with a title XVI disability beneficiary (who is not concurrently a title II disability beneficiary), the average payment of supplemental security income benefits based on disability payable under title XVI (excluding State supplementation) for months during the preceding calendar year to all beneficiaries who have attained 18 years of age but have not attained 65 years of age. ``(B) Outcome payment period.--The term `outcome payment period' means, in connection with any individual who had assigned a ticket to work and self-sufficiency to an employment network under the Program, a period-- ``(i) beginning with the first month, ending after the date on which such ticket was assigned to the employment network, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity; and ``(ii) ending with the 60th month (consecutive or otherwise), ending after such date, for which such benefits are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity. ``(5) Periodic review and alterations of prescribed schedules.-- ``(A) Percentages and periods.--The Commissioner shall periodically review the percentage specified in paragraph (2)(C), the total payments permissible under paragraph (3)(C), and the period of time specified in paragraph (4)(B) to determine whether such percentages, such permissible payments, and such period provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, while providing for appropriate economies. The Commissioner may alter such percentage, such total permissible payments, or such period of time to the extent that the Commissioner determines, on the basis of the Commissioner's review under this paragraph, that such an alteration would better provide the incentive and economies described in the preceding sentence. ``(B) Number and amount of milestone payments.--The Commissioner shall periodically review the number and amounts of milestone payments established by the Commissioner pursuant to this section to determine whether they provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, taking into account information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, and other reliable sources. The Commissioner may from time to time alter the number and amounts of milestone payments initially established by the Commissioner pursuant to this section to the extent that the Commissioner determines that such an alteration would allow an adequate incentive for employment networks to assist beneficiaries to enter the workforce. Such alteration shall be based on information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, or other reliable sources. ``(C) Report on the adequacy of incentives.--The Commissioner shall submit to Congress not later than 36 months after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999 a report with recommendations for a method or methods to adjust payment rates under subparagraphs (A) and (B), that would ensure adequate incentives for the provision of services by employment networks of-- ``(i) individuals with a need for ongoing support and services; ``(ii) individuals with a need for high-cost accommodations; ``(iii) individuals who earn a subminimum wage; and ``(iv) individuals who work and receive partial cash benefits. The Commissioner shall consult with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999 during the development and evaluation of the study. The Commissioner shall implement the necessary adjusted payment rates prior to full implementation of the Ticket to Work and Self-Sufficiency Program. ``(i) Suspension of Disability Reviews.--During any period for which an individual is using, as defined by the Commissioner, a ticket to work and self-sufficiency issued under this section, the Commissioner (and any applicable State agency) may not initiate a continuing disability review or other review under section 221 of whether the individual is or is not under a disability or a review under title XVI similar to any such review under section 221. ``(j) Authorizations.-- ``(1) Payments to employment networks.-- ``(A) Title ii disability beneficiaries.--There are authorized to be transferred from the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund each fiscal year such sums [[Page H10244]] as may be necessary to make payments to employment networks under this section. Money paid from the Trust Funds under this section with respect to title II disability beneficiaries who are entitled to benefits under section 223 or who are entitled to benefits under section 202(d) on the basis of the wages and self-employment income of such beneficiaries, shall be charged to the Federal Disability Insurance Trust Fund, and all other money paid from the Trust Funds under this section shall be charged to the Federal Old- Age and Survivors Insurance Trust Fund. ``(B) Title xvi disability beneficiaries.--Amounts authorized to be appropriated to the Social Security Administration under section 1601 (as in effect pursuant to the amendments made by section 301 of the Social Security Amendments of 1972) shall include amounts necessary to carry out the provisions of this section with respect to title XVI disability beneficiaries. ``(2) Administrative expenses.--The costs of administering this section (other than payments to employment networks) shall be paid from amounts made available for the administration of title II and amounts made available for the administration of title XVI, and shall be allocated among such amounts as appropriate. ``(k) Definitions.--In this section: ``(1) Commissioner.--The term `Commissioner' means the Commissioner of Social Security. ``(2) Disabled beneficiary.--The term `disabled beneficiary' means a title II disability beneficiary or a title XVI disability beneficiary. ``(3) Title ii disability beneficiary.--The term `title II disability beneficiary' means an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)). An individual is a title II disability beneficiary for each month for which such individual is entitled to such benefits. ``(4) Title xvi disability beneficiary.--The term `title XVI disability beneficiary' means an individual eligible for supplemental security income benefits under title XVI on the basis of blindness (within the meaning of section 1614(a)(2)) or disability (within the meaning of section 1614(a)(3)). An individual is a title XVI disability beneficiary for each month for which such individual is eligible for such benefits. ``(5) Supplemental security income benefit.--The term `supplemental security income benefit under title XVI' means a cash benefit under section 1611 or 1619(a), and does not include a State supplementary payment, administered federally or otherwise. ``(l) Regulations.--Not later than 1 year after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999, the Commissioner shall prescribe such regulations as are necessary to carry out the provisions of this section.''. (b) Conforming Amendments.-- (1) Amendments to title ii.-- (A) Section 221(i) of the Social Security Act (42 U.S.C. 421(i)) is amended by adding at the end the following: ``(5) For suspension of reviews under this subsection in the case of an individual using a ticket to work and self- sufficiency, see section 1148(i).''. (B) Section 222(a) of such Act (42 U.S.C. 422(a)) is repealed. (C) Section 222(b) of such Act (42 U.S.C. 422(b)) is repealed. (D) Section 225(b)(1) of such Act (42 U.S.C. 425(b)(1)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (2) Amendments to title xvi.-- (A) Section 1615(a) of such Act (42 U.S.C. 1382d(a)) is amended to read as follows: ``Sec. 1615. (a) In the case of any blind or disabled individual who-- ``(1) has not attained age 16; and ``(2) with respect to whom benefits are paid under this title, the Commissioner of Social Security shall make provision for referral of such individual to the appropriate State agency administering the State program under title V.''. (B) Section 1615(c) of such Act (42 U.S.C. 1382d(c)) is repealed. (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 1383(a)(6)(A)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (D) Section 1633(c) of such Act (42 U.S.C. 1383b(c)) is amended-- (i) by inserting ``(1)'' after ``(c)''; and (ii) by adding at the end the following: ``(2) For suspension of continuing disability reviews and other reviews under this title similar to reviews under section 221 in the case of an individual using a ticket to work and self-sufficiency, see section 1148(i).''. (c) Effective Date.--Subject to subsection (d), the amendments made by subsections (a) and (b) shall take effect with the first month following 1 year after the date of the enactment of this Act. (d) Graduated Implementation of Program.-- (1) In general.--Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall commence implementation of the amendments made by this section (other than paragraphs (1)(C) and (2)(B) of subsection (b)) in graduated phases at phase-in sites selected by the Commissioner. Such phase-in sites shall be selected so as to ensure, prior to full implementation of the Ticket to Work and Self-Sufficiency Program, the development and refinement of referral processes, payment systems, computer linkages, management information systems, and administrative processes necessary to provide for full implementation of such amendments. Subsection (c) shall apply with respect to paragraphs (1)(C) and (2)(B) of subsection (b) without regard to this subsection. (2) Requirements.--Implementation of the Program at each phase-in site shall be carried out on a wide enough scale to permit a thorough evaluation of the alternative methods under consideration, so as to ensure that the most efficacious methods are determined and in place for full implementation of the Program on a timely basis. (3) Full implementation.--The Commissioner shall ensure that ability to provide tickets and services to individuals under the Program exists in every State as soon as practicable on or after the effective date specified in subsection (c) but not later than 3 years after such date. (4) Ongoing evaluation of program.-- (A) In general.--The Commissioner shall design and conduct a series of evaluations to assess the cost-effectiveness of activities carried out under this section and the amendments made thereby, as well as the effects of this section and the amendments made thereby on work outcomes for beneficiaries receiving tickets to work and self-sufficiency under the Program. (B) Consultation.--The Commissioner shall design and carry out the series of evaluations after receiving relevant advice from experts in the fields of disability, vocational rehabilitation, and program evaluation and individuals using tickets to work and self-sufficiency under the Program and consulting with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), the Comptroller General of the United States, other agencies of the Federal Government, and private organizations with appropriate expertise. (C) Methodology.-- (i) Implementation.--The Commissioner, in consultation with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), shall ensure that plans for evaluations and data collection methods under the Program are appropriately designed to obtain detailed employment information. (ii) Specific matters to be addressed.--Each such evaluation shall address (but is not limited to)-- (I) the annual cost (including net cost) of the Program and the annual cost (including net cost) that would have been incurred in the absence of the Program; (II) the determinants of return to work, including the characteristics of beneficiaries in receipt of tickets under the Program; (III) the types of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and to those who do not return to work; (IV) the duration of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and the duration of such services furnished to those who do not return to work and the cost to employment networks of furnishing such services; (V) the employment outcomes, including wages, occupations, benefits, and hours worked, of beneficiaries who return to work after receiving tickets under the Program and those who return to work without receiving such tickets; (VI) the characteristics of individuals in possession of tickets under the Program who are not accepted for services and, to the extent reasonably determinable, the reasons for which such beneficiaries were not accepted for services; (VII) the characteristics of providers whose services are provided within an employment network under the Program; (VIII) the extent (if any) to which employment networks display a greater willingness to provide services to beneficiaries with a range of disabilities; (IX) the characteristics (including employment outcomes) of those beneficiaries who receive services under the outcome payment system and of those beneficiaries who receive services under the outcome-milestone payment system; (X) measures of satisfaction among beneficiaries in receipt of tickets under the Program; and (XI) reasons for (including comments solicited from beneficiaries regarding) their choice not to use their tickets or their inability to return to work despite the use of their tickets. (D) Periodic evaluation reports.--Following the close of the third and fifth fiscal years ending after the effective date under subsection (c), and prior to the close of the seventh fiscal year ending after such date, the Commissioner shall transmit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report containing the [[Page H10245]] Commissioner's evaluation of the progress of activities conducted under the provisions of this section and the amendments made thereby. Each such report shall set forth the Commissioner's evaluation of the extent to which the Program has been successful and the Commissioner's conclusions on whether or how the Program should be modified. Each such report shall include such data, findings, materials, and recommendations as the Commissioner may consider appropriate. (5) Extent of state's right of first refusal in advance of full implementation of amendments in such state.-- (A) In general.--In the case of any State in which the amendments made by subsection (a) have not been fully implemented pursuant to this subsection, the Commissioner shall determine by regulation the extent to which-- (i) the requirement under section 222(a) for prompt referrals to a State agency; and (ii) the authority of the Commissioner under section 222(d)(2) of the Social Security Act to provide vocational rehabilitation services in such State by agreement or contract with other public or private agencies, organizations, institutions, or individuals, shall apply in such State. (B) Existing agreements.--Nothing in subparagraph (A) or the amendments made by subsection (a) shall be construed to limit, impede, or otherwise affect any agreement entered into pursuant to section 222(d)(2) of the Social Security Act before the date of the enactment of this Act with respect to services provided pursuant to such agreement to beneficiaries receiving services under such agreement as of such date, except with respect to services (if any) to be provided after 3 years after the effective date provided in subsection (c). (e) Specific Regulations Required.-- (1) In general.--The Commissioner of Social Security shall prescribe such regulations as are necessary to implement the amendments made by this section. (2) Specific matters to be included in regulations.--The matters which shall be addressed in such regulations shall include-- (A) the form and manner in which tickets to work and self- sufficiency may be distributed to beneficiaries pursuant to section 1148(b)(1) of the Social Security Act; (B) the format and wording of such tickets, which shall incorporate by reference any contractual terms governing service by employment networks under the Program; (C) the form and manner in which State agencies may elect participation in the Ticket to Work and Self-Sufficiency Program pursuant to section 1148(c)(1) of such Act and provision for periodic opportunities for exercising such elections; (D) the status of State agencies under section 1148(c)(1) of such Act at the time that State agencies exercise elections under that section; (E) the terms of agreements to be entered into with program managers pursuant to section 1148(d) of such Act, including-- (i) the terms by which program managers are precluded from direct participation in the delivery of services pursuant to section 1148(d)(3) of such Act; (ii) standards which must be met by quality assurance measures referred to in paragraph (6) of section 1148(d) of such Act and methods of recruitment of employment networks utilized pursuant to paragraph (2) of section 1148(e) of such Act; and (iii) the format under which dispute resolution will operate under section 1148(d)(7) of such Act; (F) the terms of agreements to be entered into with employment networks pursuant to section 1148(d)(4) of such Act, including-- (i) the manner in which service areas are specified pursuant to section 1148(f)(2)(A) of such Act; (ii) the general selection criteria and the specific selection criteria which are applicable to employment networks under section 1148(f)(1)(C) of such Act in selecting service providers; (iii) specific requirements relating to annual financial reporting by employment networks pursuant to section 1148(f)(3) of such Act; and (iv) the national model to which periodic outcomes reporting by employment networks must conform under section 1148(f)(4) of such Act; (G) standards which must be met by individual work plans pursuant to section 1148(g) of such Act; (H) standards which must be met by payment systems required under section 1148(h) of such Act, including-- (i) the form and manner in which elections by employment networks of payment systems are to be exercised pursuant to section 1148(h)(1)(A) of such Act; (ii) the terms which must be met by an outcome payment system under section 1148(h)(2) of such Act; (iii) the terms which must be met by an outcome-milestone payment system under section 1148(h)(3) of such Act; (iv) any revision of the percentage specified in paragraph (2)(C) of section 1148(h) of such Act or the period of time specified in paragraph (4)(B) of such section 1148(h) of such Act; and (v) annual oversight procedures for such systems; and (I) procedures for effective oversight of the Program by the Commissioner of Social Security, including periodic reviews and reporting requirements. (f) The Ticket to Work and Work Incentives Advisory Panel.-- (1) Establishment.--There is established within the Social Security Administration a panel to be known as the ``Ticket to Work and Work Incentives Advisory Panel'' (in this subsection referred to as the ``Panel''). (2) Duties of panel.--It shall be the duty of the Panel to-- (A) advise the President, the Congress, and the Commissioner of Social Security on issues related to work incentives 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 (42 U.S.C. 401 et seq., 1301 et seq., 1381 et seq., 1395 et seq., 1396 et seq.); and (B) with respect to the Ticket to Work and Self-Sufficiency Program established under section 1148 of such Act-- (i) advise the Commissioner of Social Security with respect to establishing phase-in sites for such Program and fully implementing the Program thereafter, the refinement of access of disabled beneficiaries to employment networks, payment systems, and management information systems, and advise the Commissioner whether such measures are being taken to the extent necessary to ensure the success of the Program; (ii) advise the Commissioner regarding the most effective designs for research and demonstration projects associated with the Program or conducted pursuant to section 302 of this Act; (iii) advise the Commissioner on the development of performance measurements relating to quality assurance under section 1148(d)(6) of the Social Security Act; and (iv) furnish progress reports on the Program to the Commissioner and each House of Congress. (3) Membership.-- (A) Number and appointment.--The Panel shall be composed of 12 members as follows: (i) 4 members appointed by the President, not more than 2 of whom may be of the same political party; (ii) 2 members appointed by the Speaker of the House of Representatives, in consultation with the Chairman of the Committee on Ways and Means of the House of Representatives; (iii) 2 members appointed by the minority leader of the House of Representatives, in consultation with the ranking member of the Committee on Ways and Means of the House of Representatives; (iv) 2 members appointed by the majority leader of the Senate, in consultation with the Chairman of the Committee on Finance of the Senate; and (v) 2 members appointed by the minority leader of the Senate, in consultation with the ranking member of the Committee on Finance of the Senate. (B) Representation.--Of the members appointed under subparagraph (A), at least 8 shall have experience or expert knowledge as a recipient, provider, employer, or employee in the fields of, or related to, employment services, vocational rehabilitation services, and other support services, of whom-- (i) at least 2 shall represent the interests of recipients of employment services, vocational rehabilitation services, and other support services; (ii) at least 2 shall represent the interests of providers of employment services, vocational rehabilitation services, and other support services; (iii) at least 2 shall represent the interests of private employers; and (iv) at least 2 shall represent the interests of employees. At least \1/2\ of the members described in each clause of subparagraph (A) shall be individuals with disabilities, or representatives of individuals with disabilities, with consideration to current or former title II disability beneficiaries or title XVI disability beneficiaries (as such terms are defined in section 1148(k) of the Social Security Act (as added by subsection (a)). (C) Terms.-- (i) In general.--Each member shall be appointed for a term of 4 years (or, if less, for the remaining life of the Panel), except as provided in clauses (ii) and (iii). The initial members shall be appointed not later than 90 days after the date of the enactment of this Act. (ii) Terms of initial appointees.--As designated by the President at the time of appointment, of the members first appointed-- (I) \1/2\ of the members appointed under subparagraph (A) shall be appointed for a term of 2 years; and (II) the remaining members appointed under subparagraph (A) shall be appointed for a term of 4 years. (iii) Vacancies.--Any member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member's term until a successor has taken office. A vacancy in the Panel shall be filled in the manner in which the original appointment was made. (D) Basic pay.--Members shall each be paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (E) Travel expenses.--Each member shall receive travel expenses, including per diem in lieu of subsistence, in accordance with sections 5702 and 5703 of title 5, United States Code. [[Page H10246]] (F) Quorum.--8 members of the Panel shall constitute a quorum but a lesser number may hold hearings. (G) Chairperson.--The Chairperson of the Panel shall be designated by the President. The term of office of the Chairperson shall be 4 years. (H) Meetings.--The Panel shall meet at least quarterly and at other times at the call of the Chairperson or a majority of its members. (4) Director and staff of panel; experts and consultants.-- (A) Director.--The Panel shall have a Director who shall be appointed by the Panel, and paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (B) Staff.--Subject to rules prescribed by the Commissioner of Social Security, the Director may appoint and fix the pay of additional personnel as the Director considers appropriate. (C) Experts and consultants.--Subject to rules prescribed by the Commissioner of Social Security, the Director may procure temporary and intermittent services under section 3109(b) of title 5, United States Code. (D) Staff of federal agencies.--Upon request of the Panel, the head of any Federal department or agency may detail, on a reimbursable basis, any of the personnel of that department or agency to the Panel to assist it in carrying out its duties under this Act. (5) Powers of panel.-- (A) Hearings and sessions.--The Panel may, for the purpose of carrying out its duties under this subsection, hold such hearings, sit and act at such times and places, and take such testimony and evidence as the Panel considers appropriate. (B) Powers of members and agents.--Any member or agent of the Panel may, if authorized by the Panel, take any action which the Panel is authorized to take by this section. (C) Mails.--The Panel may use the United States mails in the same manner and under the same conditions as other departments and agencies of the United States. (6) Reports.-- (A) Interim reports.--The Panel shall submit to the President and the Congress interim reports at least annually. (B) Final report.--The Panel shall transmit a final report to the President and the Congress not later than eight years after the date of the enactment of this Act. The final report shall contain a detailed statement of the findings and conclusions of the Panel, together with its recommendations for legislation and administrative actions which the Panel considers appropriate. (7) Termination.--The Panel shall terminate 30 days after the date of the submission of its final report under paragraph (6)(B). (8) Authorization of appropriations.--There are authorized to be appropriated from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the general fund of the Treasury, as appropriate, such sums as are necessary to carry out this subsection. Subtitle B--Elimination of Work Disincentives SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN INDIVIDUAL'S DISABLED STATUS. (a) In General.--Section 221 of the Social Security Act (42 U.S.C. 421) is amended by adding at the end the following: ``(m)(1) In any case where an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)) has received such benefits for at least 24 months-- ``(A) no continuing disability review conducted by the Commissioner may be scheduled for the individual solely as a result of the individual's work activity; ``(B) no work activity engaged in by the individual may be used as evidence that the individual is no longer disabled; and ``(C) no cessation of work activity by the individual may give rise to a presumption that the individual is unable to engage in work. ``(2) An individual to which paragraph (1) applies shall continue to be subject to-- ``(A) continuing disability reviews on a regularly scheduled basis that is not triggered by work; and ``(B) termination of benefits under this title in the event that the individual has earnings that exceed the level of earnings established by the Commissioner to represent substantial gainful activity.''. (b) Effective Date.--The amendment made by subsection (a) shall take effect on January 1, 2003. SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS. (a) OASDI Benefits.--Section 223 of the Social Security Act (42 U.S.C. 423) is amended-- (1) by redesignating subsection (i) as subsection (j); and (2) by inserting after subsection (h) the following: ``Reinstatement of Entitlement ``(i)(1)(A) Entitlement to benefits described in subparagraph (B)(i)(I) shall be reinstated in any case where the Commissioner determines that an individual described in subparagraph (B) has filed a request for reinstatement meeting the requirements of paragraph (2)(A) during the period prescribed in subparagraph (C). Reinstatement of such entitlement shall be in accordance with the terms of this subsection. ``(B) An individual is described in this subparagraph if-- ``(i) prior to the month in which the individual files a request for reinstatement-- ``(I) the individual was entitled to benefits under this section or section 202 on the basis of disability pursuant to an application filed therefor; and ``(II) such entitlement terminated due to the performance of substantial gainful activity; ``(ii) the individual is under a disability and the physical or mental impairment that is the basis for the finding of disability is the same as (or related to) the physical or mental impairment that was the basis for the finding of disability that gave rise to the entitlement described in clause (i); and ``(iii) the individual's disability renders the individual unable to perform substantial gainful activity. ``(C)(i) Except as provided in clause (ii), the period prescribed in this subparagraph with respect to an individual is 60 consecutive months beginning with the month following the most recent month for which the individual was entitled to a benefit described in subparagraph (B)(i)(I) prior to the entitlement termination described in subparagraph (B)(i)(II). ``(ii) In the case of an individual who fails to file a reinstatement request within the period prescribed in clause (i), the Commissioner may extend the period if the Commissioner determines that the individual had good cause for the failure to so file. ``(2)(A)(i) A request for reinstatement shall be filed in such form, and containing such information, as the Commissioner may prescribe. ``(ii) A request for reinstatement shall include express declarations by the individual that the individual meets the requirements specified in clauses (ii) and (iii) of paragraph (1)(B). ``(B) A request for reinstatement filed in accordance with subparagraph (A) may constitute an application for benefits in the case of any individual who the Commissioner determines is not entitled to reinstated benefits under this subsection. ``(3) In determining whether an individual meets the requirements of paragraph (1)(B)(ii), the provisions of subsection (f) shall apply. ``(4)(A)(i) Subject to clause (ii), entitlement to benefits reinstated under this subsection shall commence with the benefit payable for the month in which a request for reinstatement is filed. ``(ii) An individual whose entitlement to a benef

Summary:

All articles in House section

TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999
(House of Representatives - October 19, 1999)

Text of this article available as: TXT PDF [Pages H10241-H10266] TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999 Mr. ARCHER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1180) 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, as amended. The Clerk read as follows: H.R. 1180 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 [[Page H10242]] 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 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. ``(5) Reasonable access to services.--The program manager shall take such measures as are necessary to ensure that sufficient employment networks are available and that each beneficiary receiving services under the Program has reasonable access to employment services, vocational rehabilitation services, and other support services. Services provided under the Program may include case management, work incentives planning, supported employment, career planning, career plan development, vocational assessment, job training, placement, follow-up services, and such other services as may be specified by the Commissioner under the Program. The program manager shall ensure that such services are available in each service area. ``(f) Employment Networks.-- ``(1) Qualifications for employment networks.-- ``(A) In general.--Each employment network serving under the Program shall consist of an agency or instrumentality of a State (or a political subdivision thereof) or a private entity, that assumes responsibility for the coordination and delivery of services under the Program to individuals assigning to the employment network tickets to work and self- sufficiency issued under subsection (b). ``(B) One-stop delivery systems.--An employment network serving under the Program may consist of a one-stop delivery system established under subtitle B of title I of the Workforce Investment Act of 1998. ``(C) Compliance with selection criteria.--No employment network may serve under the Program unless it meets and maintains compliance with both general selection criteria (such as professional and educational qualifications, where applicable) and specific selection criteria (such as substantial expertise and experience in providing relevant employment services and supports). ``(D) Single or associated providers allowed.--An employment network shall consist of either a single provider of such services or of an association of such providers organized so as to combine their resources into a single entity. An employment network may meet the requirements of subsection (e)(4) by providing services directly, or by entering into agreements with other individuals or entities providing appropriate employment services, vocational rehabilitation services, or other support services. ``(2) Requirements relating to provision of services.--Each employment network serving under the Program shall be required under the terms of its agreement with the Commissioner to-- ``(A) serve prescribed service areas; and ``(B) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans meeting the requirements of subsection (g). ``(3) Annual financial reporting.--Each employment network shall meet financial reporting requirements as prescribed by the Commissioner. ``(4) Periodic outcomes reporting.--Each employment network shall prepare periodic reports, on at least an annual basis, itemizing for the covered period specific outcomes achieved with respect to specific services provided by the employment network. Such reports shall conform to a national model prescribed under this section. Each employment network shall provide a copy of the latest report issued by the employment network pursuant to this paragraph to each beneficiary upon enrollment under the Program for services to be received through such employment network. Upon issuance of each report to each beneficiary, a copy of the report shall be maintained in the files of the employment network. The program manager shall ensure that copies of all such reports issued under this paragraph are made available to the public under reasonable terms. ``(g) Individual Work Plans.-- ``(1) Requirements.--Each employment network shall-- ``(A) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subparagraph (C); ``(B) develop and implement each such individual work plan, in partnership with each beneficiary receiving such services, in a manner that affords such beneficiary the opportunity to exercise informed choice in selecting an employment goal and specific services needed to achieve that employment goal; ``(C) ensure that each individual work plan includes at least-- ``(i) a statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement; ``(ii) a statement of the services and supports that have been deemed necessary for the beneficiary to accomplish that goal; [[Page H10243]] ``(iii) a statement of any terms and conditions related to the provision of such services and supports; and ``(iv) a statement of understanding regarding the beneficiary's rights under the Program (such as the right to retrieve the ticket to work and self-sufficiency if the beneficiary is dissatisfied with the services being provided by the employment network) and remedies available to the individual, including information on the availability of advocacy services and assistance in resolving disputes through the State grant program authorized under section 1150; ``(D) provide a beneficiary the opportunity to amend the individual work plan if a change in circumstances necessitates a change in the plan; and ``(E) make each beneficiary's individual work plan available to the beneficiary in, as appropriate, an accessible format chosen by the beneficiary. ``(2) Effective upon written approval.--A beneficiary's individual work plan shall take effect upon written approval by the beneficiary or a representative of the beneficiary and a representative of the employment network that, in providing such written approval, acknowledges assignment of the beneficiary's ticket to work and self-sufficiency. ``(h) Employment Network Payment Systems.-- ``(1) Election of payment system by employment networks.-- ``(A) In general.--The Program shall provide for payment authorized by the Commissioner to employment networks under either an outcome payment system or an outcome-milestone payment system. Each employment network shall elect which payment system will be utilized by the employment network, and, for such period of time as such election remains in effect, the payment system so elected shall be utilized exclusively in connection with such employment network (except as provided in subparagraph (B)). ``(B) No change in method of payment for beneficiaries with tickets already assigned to the employment networks.--Any election of a payment system by an employment network that would result in a change in the method of payment to the employment network for services provided to a beneficiary who is receiving services from the employment network at the time of the election shall not be effective with respect to payment for services provided to that beneficiary and the method of payment previously selected shall continue to apply with respect to such services. ``(2) Outcome payment system.-- ``(A) In general.--The outcome payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Payments made during outcome payment period.--The outcome payment system shall provide for a schedule of payments to an employment network, in connection with each individual who is a beneficiary, for each month, during the individual's outcome payment period, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual because of work or earnings. ``(C) Computation of payments to employment network.--The payment schedule of the outcome payment system shall be designed so that-- ``(i) the payment for each month during the outcome payment period for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable is equal to a fixed percentage of the payment calculation base for the calendar year in which such month occurs; and ``(ii) such fixed percentage is set at a percentage which does not exceed 40 percent. ``(3) Outcome-milestone payment system.-- ``(A) In general.--The outcome-milestone payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Early payments upon attainment of milestones in advance of outcome payment periods.--The outcome-milestone payment system shall provide for 1 or more milestones, with respect to beneficiaries receiving services from an employment network under the Program, that are directed toward the goal of permanent employment. Such milestones shall form a part of a payment structure that provides, in addition to payments made during outcome payment periods, payments made prior to outcome payment periods in amounts based on the attainment of such milestones. ``(C) Limitation on total payments to employment network.-- The payment schedule of the outcome milestone payment system shall be designed so that the total of the payments to the employment network with respect to each beneficiary is less than, on a net present value basis (using an interest rate determined by the Commissioner that appropriately reflects the cost of funds faced by providers), the total amount to which payments to the employment network with respect to the beneficiary would be limited if the employment network were paid under the outcome payment system. ``(4) Definitions.--In this subsection: ``(A) Payment calculation base.--The term `payment calculation base' means, for any calendar year-- ``(i) in connection with a title II disability beneficiary, the average disability insurance benefit payable under section 223 for all beneficiaries for months during the preceding calendar year; and ``(ii) in connection with a title XVI disability beneficiary (who is not concurrently a title II disability beneficiary), the average payment of supplemental security income benefits based on disability payable under title XVI (excluding State supplementation) for months during the preceding calendar year to all beneficiaries who have attained 18 years of age but have not attained 65 years of age. ``(B) Outcome payment period.--The term `outcome payment period' means, in connection with any individual who had assigned a ticket to work and self-sufficiency to an employment network under the Program, a period-- ``(i) beginning with the first month, ending after the date on which such ticket was assigned to the employment network, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity; and ``(ii) ending with the 60th month (consecutive or otherwise), ending after such date, for which such benefits are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity. ``(5) Periodic review and alterations of prescribed schedules.-- ``(A) Percentages and periods.--The Commissioner shall periodically review the percentage specified in paragraph (2)(C), the total payments permissible under paragraph (3)(C), and the period of time specified in paragraph (4)(B) to determine whether such percentages, such permissible payments, and such period provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, while providing for appropriate economies. The Commissioner may alter such percentage, such total permissible payments, or such period of time to the extent that the Commissioner determines, on the basis of the Commissioner's review under this paragraph, that such an alteration would better provide the incentive and economies described in the preceding sentence. ``(B) Number and amount of milestone payments.--The Commissioner shall periodically review the number and amounts of milestone payments established by the Commissioner pursuant to this section to determine whether they provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, taking into account information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, and other reliable sources. The Commissioner may from time to time alter the number and amounts of milestone payments initially established by the Commissioner pursuant to this section to the extent that the Commissioner determines that such an alteration would allow an adequate incentive for employment networks to assist beneficiaries to enter the workforce. Such alteration shall be based on information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, or other reliable sources. ``(C) Report on the adequacy of incentives.--The Commissioner shall submit to Congress not later than 36 months after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999 a report with recommendations for a method or methods to adjust payment rates under subparagraphs (A) and (B), that would ensure adequate incentives for the provision of services by employment networks of-- ``(i) individuals with a need for ongoing support and services; ``(ii) individuals with a need for high-cost accommodations; ``(iii) individuals who earn a subminimum wage; and ``(iv) individuals who work and receive partial cash benefits. The Commissioner shall consult with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999 during the development and evaluation of the study. The Commissioner shall implement the necessary adjusted payment rates prior to full implementation of the Ticket to Work and Self-Sufficiency Program. ``(i) Suspension of Disability Reviews.--During any period for which an individual is using, as defined by the Commissioner, a ticket to work and self-sufficiency issued under this section, the Commissioner (and any applicable State agency) may not initiate a continuing disability review or other review under section 221 of whether the individual is or is not under a disability or a review under title XVI similar to any such review under section 221. ``(j) Authorizations.-- ``(1) Payments to employment networks.-- ``(A) Title ii disability beneficiaries.--There are authorized to be transferred from the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund each fiscal year such sums [[Page H10244]] as may be necessary to make payments to employment networks under this section. Money paid from the Trust Funds under this section with respect to title II disability beneficiaries who are entitled to benefits under section 223 or who are entitled to benefits under section 202(d) on the basis of the wages and self-employment income of such beneficiaries, shall be charged to the Federal Disability Insurance Trust Fund, and all other money paid from the Trust Funds under this section shall be charged to the Federal Old- Age and Survivors Insurance Trust Fund. ``(B) Title xvi disability beneficiaries.--Amounts authorized to be appropriated to the Social Security Administration under section 1601 (as in effect pursuant to the amendments made by section 301 of the Social Security Amendments of 1972) shall include amounts necessary to carry out the provisions of this section with respect to title XVI disability beneficiaries. ``(2) Administrative expenses.--The costs of administering this section (other than payments to employment networks) shall be paid from amounts made available for the administration of title II and amounts made available for the administration of title XVI, and shall be allocated among such amounts as appropriate. ``(k) Definitions.--In this section: ``(1) Commissioner.--The term `Commissioner' means the Commissioner of Social Security. ``(2) Disabled beneficiary.--The term `disabled beneficiary' means a title II disability beneficiary or a title XVI disability beneficiary. ``(3) Title ii disability beneficiary.--The term `title II disability beneficiary' means an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)). An individual is a title II disability beneficiary for each month for which such individual is entitled to such benefits. ``(4) Title xvi disability beneficiary.--The term `title XVI disability beneficiary' means an individual eligible for supplemental security income benefits under title XVI on the basis of blindness (within the meaning of section 1614(a)(2)) or disability (within the meaning of section 1614(a)(3)). An individual is a title XVI disability beneficiary for each month for which such individual is eligible for such benefits. ``(5) Supplemental security income benefit.--The term `supplemental security income benefit under title XVI' means a cash benefit under section 1611 or 1619(a), and does not include a State supplementary payment, administered federally or otherwise. ``(l) Regulations.--Not later than 1 year after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999, the Commissioner shall prescribe such regulations as are necessary to carry out the provisions of this section.''. (b) Conforming Amendments.-- (1) Amendments to title ii.-- (A) Section 221(i) of the Social Security Act (42 U.S.C. 421(i)) is amended by adding at the end the following: ``(5) For suspension of reviews under this subsection in the case of an individual using a ticket to work and self- sufficiency, see section 1148(i).''. (B) Section 222(a) of such Act (42 U.S.C. 422(a)) is repealed. (C) Section 222(b) of such Act (42 U.S.C. 422(b)) is repealed. (D) Section 225(b)(1) of such Act (42 U.S.C. 425(b)(1)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (2) Amendments to title xvi.-- (A) Section 1615(a) of such Act (42 U.S.C. 1382d(a)) is amended to read as follows: ``Sec. 1615. (a) In the case of any blind or disabled individual who-- ``(1) has not attained age 16; and ``(2) with respect to whom benefits are paid under this title, the Commissioner of Social Security shall make provision for referral of such individual to the appropriate State agency administering the State program under title V.''. (B) Section 1615(c) of such Act (42 U.S.C. 1382d(c)) is repealed. (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 1383(a)(6)(A)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (D) Section 1633(c) of such Act (42 U.S.C. 1383b(c)) is amended-- (i) by inserting ``(1)'' after ``(c)''; and (ii) by adding at the end the following: ``(2) For suspension of continuing disability reviews and other reviews under this title similar to reviews under section 221 in the case of an individual using a ticket to work and self-sufficiency, see section 1148(i).''. (c) Effective Date.--Subject to subsection (d), the amendments made by subsections (a) and (b) shall take effect with the first month following 1 year after the date of the enactment of this Act. (d) Graduated Implementation of Program.-- (1) In general.--Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall commence implementation of the amendments made by this section (other than paragraphs (1)(C) and (2)(B) of subsection (b)) in graduated phases at phase-in sites selected by the Commissioner. Such phase-in sites shall be selected so as to ensure, prior to full implementation of the Ticket to Work and Self-Sufficiency Program, the development and refinement of referral processes, payment systems, computer linkages, management information systems, and administrative processes necessary to provide for full implementation of such amendments. Subsection (c) shall apply with respect to paragraphs (1)(C) and (2)(B) of subsection (b) without regard to this subsection. (2) Requirements.--Implementation of the Program at each phase-in site shall be carried out on a wide enough scale to permit a thorough evaluation of the alternative methods under consideration, so as to ensure that the most efficacious methods are determined and in place for full implementation of the Program on a timely basis. (3) Full implementation.--The Commissioner shall ensure that ability to provide tickets and services to individuals under the Program exists in every State as soon as practicable on or after the effective date specified in subsection (c) but not later than 3 years after such date. (4) Ongoing evaluation of program.-- (A) In general.--The Commissioner shall design and conduct a series of evaluations to assess the cost-effectiveness of activities carried out under this section and the amendments made thereby, as well as the effects of this section and the amendments made thereby on work outcomes for beneficiaries receiving tickets to work and self-sufficiency under the Program. (B) Consultation.--The Commissioner shall design and carry out the series of evaluations after receiving relevant advice from experts in the fields of disability, vocational rehabilitation, and program evaluation and individuals using tickets to work and self-sufficiency under the Program and consulting with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), the Comptroller General of the United States, other agencies of the Federal Government, and private organizations with appropriate expertise. (C) Methodology.-- (i) Implementation.--The Commissioner, in consultation with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), shall ensure that plans for evaluations and data collection methods under the Program are appropriately designed to obtain detailed employment information. (ii) Specific matters to be addressed.--Each such evaluation shall address (but is not limited to)-- (I) the annual cost (including net cost) of the Program and the annual cost (including net cost) that would have been incurred in the absence of the Program; (II) the determinants of return to work, including the characteristics of beneficiaries in receipt of tickets under the Program; (III) the types of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and to those who do not return to work; (IV) the duration of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and the duration of such services furnished to those who do not return to work and the cost to employment networks of furnishing such services; (V) the employment outcomes, including wages, occupations, benefits, and hours worked, of beneficiaries who return to work after receiving tickets under the Program and those who return to work without receiving such tickets; (VI) the characteristics of individuals in possession of tickets under the Program who are not accepted for services and, to the extent reasonably determinable, the reasons for which such beneficiaries were not accepted for services; (VII) the characteristics of providers whose services are provided within an employment network under the Program; (VIII) the extent (if any) to which employment networks display a greater willingness to provide services to beneficiaries with a range of disabilities; (IX) the characteristics (including employment outcomes) of those beneficiaries who receive services under the outcome payment system and of those beneficiaries who receive services under the outcome-milestone payment system; (X) measures of satisfaction among beneficiaries in receipt of tickets under the Program; and (XI) reasons for (including comments solicited from beneficiaries regarding) their choice not to use their tickets or their inability to return to work despite the use of their tickets. (D) Periodic evaluation reports.--Following the close of the third and fifth fiscal years ending after the effective date under subsection (c), and prior to the close of the seventh fiscal year ending after such date, the Commissioner shall transmit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report containing the [[Page H10245]] Commissioner's evaluation of the progress of activities conducted under the provisions of this section and the amendments made thereby. Each such report shall set forth the Commissioner's evaluation of the extent to which the Program has been successful and the Commissioner's conclusions on whether or how the Program should be modified. Each such report shall include such data, findings, materials, and recommendations as the Commissioner may consider appropriate. (5) Extent of state's right of first refusal in advance of full implementation of amendments in such state.-- (A) In general.--In the case of any State in which the amendments made by subsection (a) have not been fully implemented pursuant to this subsection, the Commissioner shall determine by regulation the extent to which-- (i) the requirement under section 222(a) for prompt referrals to a State agency; and (ii) the authority of the Commissioner under section 222(d)(2) of the Social Security Act to provide vocational rehabilitation services in such State by agreement or contract with other public or private agencies, organizations, institutions, or individuals, shall apply in such State. (B) Existing agreements.--Nothing in subparagraph (A) or the amendments made by subsection (a) shall be construed to limit, impede, or otherwise affect any agreement entered into pursuant to section 222(d)(2) of the Social Security Act before the date of the enactment of this Act with respect to services provided pursuant to such agreement to beneficiaries receiving services under such agreement as of such date, except with respect to services (if any) to be provided after 3 years after the effective date provided in subsection (c). (e) Specific Regulations Required.-- (1) In general.--The Commissioner of Social Security shall prescribe such regulations as are necessary to implement the amendments made by this section. (2) Specific matters to be included in regulations.--The matters which shall be addressed in such regulations shall include-- (A) the form and manner in which tickets to work and self- sufficiency may be distributed to beneficiaries pursuant to section 1148(b)(1) of the Social Security Act; (B) the format and wording of such tickets, which shall incorporate by reference any contractual terms governing service by employment networks under the Program; (C) the form and manner in which State agencies may elect participation in the Ticket to Work and Self-Sufficiency Program pursuant to section 1148(c)(1) of such Act and provision for periodic opportunities for exercising such elections; (D) the status of State agencies under section 1148(c)(1) of such Act at the time that State agencies exercise elections under that section; (E) the terms of agreements to be entered into with program managers pursuant to section 1148(d) of such Act, including-- (i) the terms by which program managers are precluded from direct participation in the delivery of services pursuant to section 1148(d)(3) of such Act; (ii) standards which must be met by quality assurance measures referred to in paragraph (6) of section 1148(d) of such Act and methods of recruitment of employment networks utilized pursuant to paragraph (2) of section 1148(e) of such Act; and (iii) the format under which dispute resolution will operate under section 1148(d)(7) of such Act; (F) the terms of agreements to be entered into with employment networks pursuant to section 1148(d)(4) of such Act, including-- (i) the manner in which service areas are specified pursuant to section 1148(f)(2)(A) of such Act; (ii) the general selection criteria and the specific selection criteria which are applicable to employment networks under section 1148(f)(1)(C) of such Act in selecting service providers; (iii) specific requirements relating to annual financial reporting by employment networks pursuant to section 1148(f)(3) of such Act; and (iv) the national model to which periodic outcomes reporting by employment networks must conform under section 1148(f)(4) of such Act; (G) standards which must be met by individual work plans pursuant to section 1148(g) of such Act; (H) standards which must be met by payment systems required under section 1148(h) of such Act, including-- (i) the form and manner in which elections by employment networks of payment systems are to be exercised pursuant to section 1148(h)(1)(A) of such Act; (ii) the terms which must be met by an outcome payment system under section 1148(h)(2) of such Act; (iii) the terms which must be met by an outcome-milestone payment system under section 1148(h)(3) of such Act; (iv) any revision of the percentage specified in paragraph (2)(C) of section 1148(h) of such Act or the period of time specified in paragraph (4)(B) of such section 1148(h) of such Act; and (v) annual oversight procedures for such systems; and (I) procedures for effective oversight of the Program by the Commissioner of Social Security, including periodic reviews and reporting requirements. (f) The Ticket to Work and Work Incentives Advisory Panel.-- (1) Establishment.--There is established within the Social Security Administration a panel to be known as the ``Ticket to Work and Work Incentives Advisory Panel'' (in this subsection referred to as the ``Panel''). (2) Duties of panel.--It shall be the duty of the Panel to-- (A) advise the President, the Congress, and the Commissioner of Social Security on issues related to work incentives 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 (42 U.S.C. 401 et seq., 1301 et seq., 1381 et seq., 1395 et seq., 1396 et seq.); and (B) with respect to the Ticket to Work and Self-Sufficiency Program established under section 1148 of such Act-- (i) advise the Commissioner of Social Security with respect to establishing phase-in sites for such Program and fully implementing the Program thereafter, the refinement of access of disabled beneficiaries to employment networks, payment systems, and management information systems, and advise the Commissioner whether such measures are being taken to the extent necessary to ensure the success of the Program; (ii) advise the Commissioner regarding the most effective designs for research and demonstration projects associated with the Program or conducted pursuant to section 302 of this Act; (iii) advise the Commissioner on the development of performance measurements relating to quality assurance under section 1148(d)(6) of the Social Security Act; and (iv) furnish progress reports on the Program to the Commissioner and each House of Congress. (3) Membership.-- (A) Number and appointment.--The Panel shall be composed of 12 members as follows: (i) 4 members appointed by the President, not more than 2 of whom may be of the same political party; (ii) 2 members appointed by the Speaker of the House of Representatives, in consultation with the Chairman of the Committee on Ways and Means of the House of Representatives; (iii) 2 members appointed by the minority leader of the House of Representatives, in consultation with the ranking member of the Committee on Ways and Means of the House of Representatives; (iv) 2 members appointed by the majority leader of the Senate, in consultation with the Chairman of the Committee on Finance of the Senate; and (v) 2 members appointed by the minority leader of the Senate, in consultation with the ranking member of the Committee on Finance of the Senate. (B) Representation.--Of the members appointed under subparagraph (A), at least 8 shall have experience or expert knowledge as a recipient, provider, employer, or employee in the fields of, or related to, employment services, vocational rehabilitation services, and other support services, of whom-- (i) at least 2 shall represent the interests of recipients of employment services, vocational rehabilitation services, and other support services; (ii) at least 2 shall represent the interests of providers of employment services, vocational rehabilitation services, and other support services; (iii) at least 2 shall represent the interests of private employers; and (iv) at least 2 shall represent the interests of employees. At least \1/2\ of the members described in each clause of subparagraph (A) shall be individuals with disabilities, or representatives of individuals with disabilities, with consideration to current or former title II disability beneficiaries or title XVI disability beneficiaries (as such terms are defined in section 1148(k) of the Social Security Act (as added by subsection (a)). (C) Terms.-- (i) In general.--Each member shall be appointed for a term of 4 years (or, if less, for the remaining life of the Panel), except as provided in clauses (ii) and (iii). The initial members shall be appointed not later than 90 days after the date of the enactment of this Act. (ii) Terms of initial appointees.--As designated by the President at the time of appointment, of the members first appointed-- (I) \1/2\ of the members appointed under subparagraph (A) shall be appointed for a term of 2 years; and (II) the remaining members appointed under subparagraph (A) shall be appointed for a term of 4 years. (iii) Vacancies.--Any member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member's term until a successor has taken office. A vacancy in the Panel shall be filled in the manner in which the original appointment was made. (D) Basic pay.--Members shall each be paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (E) Travel expenses.--Each member shall receive travel expenses, including per diem in lieu of subsistence, in accordance with sections 5702 and 5703 of title 5, United States Code. [[Page H10246]] (F) Quorum.--8 members of the Panel shall constitute a quorum but a lesser number may hold hearings. (G) Chairperson.--The Chairperson of the Panel shall be designated by the President. The term of office of the Chairperson shall be 4 years. (H) Meetings.--The Panel shall meet at least quarterly and at other times at the call of the Chairperson or a majority of its members. (4) Director and staff of panel; experts and consultants.-- (A) Director.--The Panel shall have a Director who shall be appointed by the Panel, and paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (B) Staff.--Subject to rules prescribed by the Commissioner of Social Security, the Director may appoint and fix the pay of additional personnel as the Director considers appropriate. (C) Experts and consultants.--Subject to rules prescribed by the Commissioner of Social Security, the Director may procure temporary and intermittent services under section 3109(b) of title 5, United States Code. (D) Staff of federal agencies.--Upon request of the Panel, the head of any Federal department or agency may detail, on a reimbursable basis, any of the personnel of that department or agency to the Panel to assist it in carrying out its duties under this Act. (5) Powers of panel.-- (A) Hearings and sessions.--The Panel may, for the purpose of carrying out its duties under this subsection, hold such hearings, sit and act at such times and places, and take such testimony and evidence as the Panel considers appropriate. (B) Powers of members and agents.--Any member or agent of the Panel may, if authorized by the Panel, take any action which the Panel is authorized to take by this section. (C) Mails.--The Panel may use the United States mails in the same manner and under the same conditions as other departments and agencies of the United States. (6) Reports.-- (A) Interim reports.--The Panel shall submit to the President and the Congress interim reports at least annually. (B) Final report.--The Panel shall transmit a final report to the President and the Congress not later than eight years after the date of the enactment of this Act. The final report shall contain a detailed statement of the findings and conclusions of the Panel, together with its recommendations for legislation and administrative actions which the Panel considers appropriate. (7) Termination.--The Panel shall terminate 30 days after the date of the submission of its final report under paragraph (6)(B). (8) Authorization of appropriations.--There are authorized to be appropriated from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the general fund of the Treasury, as appropriate, such sums as are necessary to carry out this subsection. Subtitle B--Elimination of Work Disincentives SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN INDIVIDUAL'S DISABLED STATUS. (a) In General.--Section 221 of the Social Security Act (42 U.S.C. 421) is amended by adding at the end the following: ``(m)(1) In any case where an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)) has received such benefits for at least 24 months-- ``(A) no continuing disability review conducted by the Commissioner may be scheduled for the individual solely as a result of the individual's work activity; ``(B) no work activity engaged in by the individual may be used as evidence that the individual is no longer disabled; and ``(C) no cessation of work activity by the individual may give rise to a presumption that the individual is unable to engage in work. ``(2) An individual to which paragraph (1) applies shall continue to be subject to-- ``(A) continuing disability reviews on a regularly scheduled basis that is not triggered by work; and ``(B) termination of benefits under this title in the event that the individual has earnings that exceed the level of earnings established by the Commissioner to represent substantial gainful activity.''. (b) Effective Date.--The amendment made by subsection (a) shall take effect on January 1, 2003. SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS. (a) OASDI Benefits.--Section 223 of the Social Security Act (42 U.S.C. 423) is amended-- (1) by redesignating subsection (i) as subsection (j); and (2) by inserting after subsection (h) the following: ``Reinstatement of Entitlement ``(i)(1)(A) Entitlement to benefits described in subparagraph (B)(i)(I) shall be reinstated in any case where the Commissioner determines that an individual described in subparagraph (B) has filed a request for reinstatement meeting the requirements of paragraph (2)(A) during the period prescribed in subparagraph (C). Reinstatement of such entitlement shall be in accordance with the terms of this subsection. ``(B) An individual is described in this subparagraph if-- ``(i) prior to the month in which the individual files a request for reinstatement-- ``(I) the individual was entitled to benefits under this section or section 202 on the basis of disability pursuant to an application filed therefor; and ``(II) such entitlement terminated due to the performance of substantial gainful activity; ``(ii) the individual is under a disability and the physical or mental impairment that is the basis for the finding of disability is the same as (or related to) the physical or mental impairment that was the basis for the finding of disability that gave rise to the entitlement described in clause (i); and ``(iii) the individual's disability renders the individual unable to perform substantial gainful activity. ``(C)(i) Except as provided in clause (ii), the period prescribed in this subparagraph with respect to an individual is 60 consecutive months beginning with the month following the most recent month for which the individual was entitled to a benefit described in subparagraph (B)(i)(I) prior to the entitlement termination described in subparagraph (B)(i)(II). ``(ii) In the case of an individual who fails to file a reinstatement request within the period prescribed in clause (i), the Commissioner may extend the period if the Commissioner determines that the individual had good cause for the failure to so file. ``(2)(A)(i) A request for reinstatement shall be filed in such form, and containing such information, as the Commissioner may prescribe. ``(ii) A request for reinstatement shall include express declarations by the individual that the individual meets the requirements specified in clauses (ii) and (iii) of paragraph (1)(B). ``(B) A request for reinstatement filed in accordance with subparagraph (A) may constitute an application for benefits in the case of any individual who the Commissioner determines is not entitled to reinstated benefits under this subsection. ``(3) In determining whether an individual meets the requirements of paragraph (1)(B)(ii), the provisions of subsection (f) shall apply. ``(4)(A)(i) Subject to clause (ii), entitlement to benefits reinstated under this subsection shall commence with the benefit payable for the month in which a request for reinstatement is filed. ``(ii) An individual whose entitlement to a benefit for any

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TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999
(House of Representatives - October 19, 1999)

Text of this article available as: TXT PDF [Pages H10241-H10266] TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT OF 1999 Mr. ARCHER. Mr. Speaker, I move to suspend the rules and pass the bill (H.R. 1180) 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, as amended. The Clerk read as follows: H.R. 1180 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 [[Page H10242]] 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 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. ``(5) Reasonable access to services.--The program manager shall take such measures as are necessary to ensure that sufficient employment networks are available and that each beneficiary receiving services under the Program has reasonable access to employment services, vocational rehabilitation services, and other support services. Services provided under the Program may include case management, work incentives planning, supported employment, career planning, career plan development, vocational assessment, job training, placement, follow-up services, and such other services as may be specified by the Commissioner under the Program. The program manager shall ensure that such services are available in each service area. ``(f) Employment Networks.-- ``(1) Qualifications for employment networks.-- ``(A) In general.--Each employment network serving under the Program shall consist of an agency or instrumentality of a State (or a political subdivision thereof) or a private entity, that assumes responsibility for the coordination and delivery of services under the Program to individuals assigning to the employment network tickets to work and self- sufficiency issued under subsection (b). ``(B) One-stop delivery systems.--An employment network serving under the Program may consist of a one-stop delivery system established under subtitle B of title I of the Workforce Investment Act of 1998. ``(C) Compliance with selection criteria.--No employment network may serve under the Program unless it meets and maintains compliance with both general selection criteria (such as professional and educational qualifications, where applicable) and specific selection criteria (such as substantial expertise and experience in providing relevant employment services and supports). ``(D) Single or associated providers allowed.--An employment network shall consist of either a single provider of such services or of an association of such providers organized so as to combine their resources into a single entity. An employment network may meet the requirements of subsection (e)(4) by providing services directly, or by entering into agreements with other individuals or entities providing appropriate employment services, vocational rehabilitation services, or other support services. ``(2) Requirements relating to provision of services.--Each employment network serving under the Program shall be required under the terms of its agreement with the Commissioner to-- ``(A) serve prescribed service areas; and ``(B) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans meeting the requirements of subsection (g). ``(3) Annual financial reporting.--Each employment network shall meet financial reporting requirements as prescribed by the Commissioner. ``(4) Periodic outcomes reporting.--Each employment network shall prepare periodic reports, on at least an annual basis, itemizing for the covered period specific outcomes achieved with respect to specific services provided by the employment network. Such reports shall conform to a national model prescribed under this section. Each employment network shall provide a copy of the latest report issued by the employment network pursuant to this paragraph to each beneficiary upon enrollment under the Program for services to be received through such employment network. Upon issuance of each report to each beneficiary, a copy of the report shall be maintained in the files of the employment network. The program manager shall ensure that copies of all such reports issued under this paragraph are made available to the public under reasonable terms. ``(g) Individual Work Plans.-- ``(1) Requirements.--Each employment network shall-- ``(A) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subparagraph (C); ``(B) develop and implement each such individual work plan, in partnership with each beneficiary receiving such services, in a manner that affords such beneficiary the opportunity to exercise informed choice in selecting an employment goal and specific services needed to achieve that employment goal; ``(C) ensure that each individual work plan includes at least-- ``(i) a statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement; ``(ii) a statement of the services and supports that have been deemed necessary for the beneficiary to accomplish that goal; [[Page H10243]] ``(iii) a statement of any terms and conditions related to the provision of such services and supports; and ``(iv) a statement of understanding regarding the beneficiary's rights under the Program (such as the right to retrieve the ticket to work and self-sufficiency if the beneficiary is dissatisfied with the services being provided by the employment network) and remedies available to the individual, including information on the availability of advocacy services and assistance in resolving disputes through the State grant program authorized under section 1150; ``(D) provide a beneficiary the opportunity to amend the individual work plan if a change in circumstances necessitates a change in the plan; and ``(E) make each beneficiary's individual work plan available to the beneficiary in, as appropriate, an accessible format chosen by the beneficiary. ``(2) Effective upon written approval.--A beneficiary's individual work plan shall take effect upon written approval by the beneficiary or a representative of the beneficiary and a representative of the employment network that, in providing such written approval, acknowledges assignment of the beneficiary's ticket to work and self-sufficiency. ``(h) Employment Network Payment Systems.-- ``(1) Election of payment system by employment networks.-- ``(A) In general.--The Program shall provide for payment authorized by the Commissioner to employment networks under either an outcome payment system or an outcome-milestone payment system. Each employment network shall elect which payment system will be utilized by the employment network, and, for such period of time as such election remains in effect, the payment system so elected shall be utilized exclusively in connection with such employment network (except as provided in subparagraph (B)). ``(B) No change in method of payment for beneficiaries with tickets already assigned to the employment networks.--Any election of a payment system by an employment network that would result in a change in the method of payment to the employment network for services provided to a beneficiary who is receiving services from the employment network at the time of the election shall not be effective with respect to payment for services provided to that beneficiary and the method of payment previously selected shall continue to apply with respect to such services. ``(2) Outcome payment system.-- ``(A) In general.--The outcome payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Payments made during outcome payment period.--The outcome payment system shall provide for a schedule of payments to an employment network, in connection with each individual who is a beneficiary, for each month, during the individual's outcome payment period, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual because of work or earnings. ``(C) Computation of payments to employment network.--The payment schedule of the outcome payment system shall be designed so that-- ``(i) the payment for each month during the outcome payment period for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable is equal to a fixed percentage of the payment calculation base for the calendar year in which such month occurs; and ``(ii) such fixed percentage is set at a percentage which does not exceed 40 percent. ``(3) Outcome-milestone payment system.-- ``(A) In general.--The outcome-milestone payment system shall consist of a payment structure governing employment networks electing such system under paragraph (1)(A) which meets the requirements of this paragraph. ``(B) Early payments upon attainment of milestones in advance of outcome payment periods.--The outcome-milestone payment system shall provide for 1 or more milestones, with respect to beneficiaries receiving services from an employment network under the Program, that are directed toward the goal of permanent employment. Such milestones shall form a part of a payment structure that provides, in addition to payments made during outcome payment periods, payments made prior to outcome payment periods in amounts based on the attainment of such milestones. ``(C) Limitation on total payments to employment network.-- The payment schedule of the outcome milestone payment system shall be designed so that the total of the payments to the employment network with respect to each beneficiary is less than, on a net present value basis (using an interest rate determined by the Commissioner that appropriately reflects the cost of funds faced by providers), the total amount to which payments to the employment network with respect to the beneficiary would be limited if the employment network were paid under the outcome payment system. ``(4) Definitions.--In this subsection: ``(A) Payment calculation base.--The term `payment calculation base' means, for any calendar year-- ``(i) in connection with a title II disability beneficiary, the average disability insurance benefit payable under section 223 for all beneficiaries for months during the preceding calendar year; and ``(ii) in connection with a title XVI disability beneficiary (who is not concurrently a title II disability beneficiary), the average payment of supplemental security income benefits based on disability payable under title XVI (excluding State supplementation) for months during the preceding calendar year to all beneficiaries who have attained 18 years of age but have not attained 65 years of age. ``(B) Outcome payment period.--The term `outcome payment period' means, in connection with any individual who had assigned a ticket to work and self-sufficiency to an employment network under the Program, a period-- ``(i) beginning with the first month, ending after the date on which such ticket was assigned to the employment network, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity; and ``(ii) ending with the 60th month (consecutive or otherwise), ending after such date, for which such benefits are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity. ``(5) Periodic review and alterations of prescribed schedules.-- ``(A) Percentages and periods.--The Commissioner shall periodically review the percentage specified in paragraph (2)(C), the total payments permissible under paragraph (3)(C), and the period of time specified in paragraph (4)(B) to determine whether such percentages, such permissible payments, and such period provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, while providing for appropriate economies. The Commissioner may alter such percentage, such total permissible payments, or such period of time to the extent that the Commissioner determines, on the basis of the Commissioner's review under this paragraph, that such an alteration would better provide the incentive and economies described in the preceding sentence. ``(B) Number and amount of milestone payments.--The Commissioner shall periodically review the number and amounts of milestone payments established by the Commissioner pursuant to this section to determine whether they provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, taking into account information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, and other reliable sources. The Commissioner may from time to time alter the number and amounts of milestone payments initially established by the Commissioner pursuant to this section to the extent that the Commissioner determines that such an alteration would allow an adequate incentive for employment networks to assist beneficiaries to enter the workforce. Such alteration shall be based on information provided to the Commissioner by program managers, the Ticket to Work and Work Incentives Advisory Panel established by section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999, or other reliable sources. ``(C) Report on the adequacy of incentives.--The Commissioner shall submit to Congress not later than 36 months after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999 a report with recommendations for a method or methods to adjust payment rates under subparagraphs (A) and (B), that would ensure adequate incentives for the provision of services by employment networks of-- ``(i) individuals with a need for ongoing support and services; ``(ii) individuals with a need for high-cost accommodations; ``(iii) individuals who earn a subminimum wage; and ``(iv) individuals who work and receive partial cash benefits. The Commissioner shall consult with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f) of the Ticket to Work and Work Incentives Improvement Act of 1999 during the development and evaluation of the study. The Commissioner shall implement the necessary adjusted payment rates prior to full implementation of the Ticket to Work and Self-Sufficiency Program. ``(i) Suspension of Disability Reviews.--During any period for which an individual is using, as defined by the Commissioner, a ticket to work and self-sufficiency issued under this section, the Commissioner (and any applicable State agency) may not initiate a continuing disability review or other review under section 221 of whether the individual is or is not under a disability or a review under title XVI similar to any such review under section 221. ``(j) Authorizations.-- ``(1) Payments to employment networks.-- ``(A) Title ii disability beneficiaries.--There are authorized to be transferred from the Federal Old-Age and Survivors Insurance Trust Fund and the Federal Disability Insurance Trust Fund each fiscal year such sums [[Page H10244]] as may be necessary to make payments to employment networks under this section. Money paid from the Trust Funds under this section with respect to title II disability beneficiaries who are entitled to benefits under section 223 or who are entitled to benefits under section 202(d) on the basis of the wages and self-employment income of such beneficiaries, shall be charged to the Federal Disability Insurance Trust Fund, and all other money paid from the Trust Funds under this section shall be charged to the Federal Old- Age and Survivors Insurance Trust Fund. ``(B) Title xvi disability beneficiaries.--Amounts authorized to be appropriated to the Social Security Administration under section 1601 (as in effect pursuant to the amendments made by section 301 of the Social Security Amendments of 1972) shall include amounts necessary to carry out the provisions of this section with respect to title XVI disability beneficiaries. ``(2) Administrative expenses.--The costs of administering this section (other than payments to employment networks) shall be paid from amounts made available for the administration of title II and amounts made available for the administration of title XVI, and shall be allocated among such amounts as appropriate. ``(k) Definitions.--In this section: ``(1) Commissioner.--The term `Commissioner' means the Commissioner of Social Security. ``(2) Disabled beneficiary.--The term `disabled beneficiary' means a title II disability beneficiary or a title XVI disability beneficiary. ``(3) Title ii disability beneficiary.--The term `title II disability beneficiary' means an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)). An individual is a title II disability beneficiary for each month for which such individual is entitled to such benefits. ``(4) Title xvi disability beneficiary.--The term `title XVI disability beneficiary' means an individual eligible for supplemental security income benefits under title XVI on the basis of blindness (within the meaning of section 1614(a)(2)) or disability (within the meaning of section 1614(a)(3)). An individual is a title XVI disability beneficiary for each month for which such individual is eligible for such benefits. ``(5) Supplemental security income benefit.--The term `supplemental security income benefit under title XVI' means a cash benefit under section 1611 or 1619(a), and does not include a State supplementary payment, administered federally or otherwise. ``(l) Regulations.--Not later than 1 year after the date of the enactment of the Ticket to Work and Work Incentives Improvement Act of 1999, the Commissioner shall prescribe such regulations as are necessary to carry out the provisions of this section.''. (b) Conforming Amendments.-- (1) Amendments to title ii.-- (A) Section 221(i) of the Social Security Act (42 U.S.C. 421(i)) is amended by adding at the end the following: ``(5) For suspension of reviews under this subsection in the case of an individual using a ticket to work and self- sufficiency, see section 1148(i).''. (B) Section 222(a) of such Act (42 U.S.C. 422(a)) is repealed. (C) Section 222(b) of such Act (42 U.S.C. 422(b)) is repealed. (D) Section 225(b)(1) of such Act (42 U.S.C. 425(b)(1)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (2) Amendments to title xvi.-- (A) Section 1615(a) of such Act (42 U.S.C. 1382d(a)) is amended to read as follows: ``Sec. 1615. (a) In the case of any blind or disabled individual who-- ``(1) has not attained age 16; and ``(2) with respect to whom benefits are paid under this title, the Commissioner of Social Security shall make provision for referral of such individual to the appropriate State agency administering the State program under title V.''. (B) Section 1615(c) of such Act (42 U.S.C. 1382d(c)) is repealed. (C) Section 1631(a)(6)(A) of such Act (42 U.S.C. 1383(a)(6)(A)) is amended by striking ``a program of vocational rehabilitation services'' and inserting ``a program consisting of the Ticket to Work and Self-Sufficiency Program under section 1148 or another program of vocational rehabilitation services, employment services, or other support services''. (D) Section 1633(c) of such Act (42 U.S.C. 1383b(c)) is amended-- (i) by inserting ``(1)'' after ``(c)''; and (ii) by adding at the end the following: ``(2) For suspension of continuing disability reviews and other reviews under this title similar to reviews under section 221 in the case of an individual using a ticket to work and self-sufficiency, see section 1148(i).''. (c) Effective Date.--Subject to subsection (d), the amendments made by subsections (a) and (b) shall take effect with the first month following 1 year after the date of the enactment of this Act. (d) Graduated Implementation of Program.-- (1) In general.--Not later than 1 year after the date of the enactment of this Act, the Commissioner of Social Security shall commence implementation of the amendments made by this section (other than paragraphs (1)(C) and (2)(B) of subsection (b)) in graduated phases at phase-in sites selected by the Commissioner. Such phase-in sites shall be selected so as to ensure, prior to full implementation of the Ticket to Work and Self-Sufficiency Program, the development and refinement of referral processes, payment systems, computer linkages, management information systems, and administrative processes necessary to provide for full implementation of such amendments. Subsection (c) shall apply with respect to paragraphs (1)(C) and (2)(B) of subsection (b) without regard to this subsection. (2) Requirements.--Implementation of the Program at each phase-in site shall be carried out on a wide enough scale to permit a thorough evaluation of the alternative methods under consideration, so as to ensure that the most efficacious methods are determined and in place for full implementation of the Program on a timely basis. (3) Full implementation.--The Commissioner shall ensure that ability to provide tickets and services to individuals under the Program exists in every State as soon as practicable on or after the effective date specified in subsection (c) but not later than 3 years after such date. (4) Ongoing evaluation of program.-- (A) In general.--The Commissioner shall design and conduct a series of evaluations to assess the cost-effectiveness of activities carried out under this section and the amendments made thereby, as well as the effects of this section and the amendments made thereby on work outcomes for beneficiaries receiving tickets to work and self-sufficiency under the Program. (B) Consultation.--The Commissioner shall design and carry out the series of evaluations after receiving relevant advice from experts in the fields of disability, vocational rehabilitation, and program evaluation and individuals using tickets to work and self-sufficiency under the Program and consulting with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), the Comptroller General of the United States, other agencies of the Federal Government, and private organizations with appropriate expertise. (C) Methodology.-- (i) Implementation.--The Commissioner, in consultation with the Ticket to Work and Work Incentives Advisory Panel established under section 101(f), shall ensure that plans for evaluations and data collection methods under the Program are appropriately designed to obtain detailed employment information. (ii) Specific matters to be addressed.--Each such evaluation shall address (but is not limited to)-- (I) the annual cost (including net cost) of the Program and the annual cost (including net cost) that would have been incurred in the absence of the Program; (II) the determinants of return to work, including the characteristics of beneficiaries in receipt of tickets under the Program; (III) the types of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and to those who do not return to work; (IV) the duration of employment services, vocational rehabilitation services, and other support services furnished to beneficiaries in receipt of tickets under the Program who return to work and the duration of such services furnished to those who do not return to work and the cost to employment networks of furnishing such services; (V) the employment outcomes, including wages, occupations, benefits, and hours worked, of beneficiaries who return to work after receiving tickets under the Program and those who return to work without receiving such tickets; (VI) the characteristics of individuals in possession of tickets under the Program who are not accepted for services and, to the extent reasonably determinable, the reasons for which such beneficiaries were not accepted for services; (VII) the characteristics of providers whose services are provided within an employment network under the Program; (VIII) the extent (if any) to which employment networks display a greater willingness to provide services to beneficiaries with a range of disabilities; (IX) the characteristics (including employment outcomes) of those beneficiaries who receive services under the outcome payment system and of those beneficiaries who receive services under the outcome-milestone payment system; (X) measures of satisfaction among beneficiaries in receipt of tickets under the Program; and (XI) reasons for (including comments solicited from beneficiaries regarding) their choice not to use their tickets or their inability to return to work despite the use of their tickets. (D) Periodic evaluation reports.--Following the close of the third and fifth fiscal years ending after the effective date under subsection (c), and prior to the close of the seventh fiscal year ending after such date, the Commissioner shall transmit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report containing the [[Page H10245]] Commissioner's evaluation of the progress of activities conducted under the provisions of this section and the amendments made thereby. Each such report shall set forth the Commissioner's evaluation of the extent to which the Program has been successful and the Commissioner's conclusions on whether or how the Program should be modified. Each such report shall include such data, findings, materials, and recommendations as the Commissioner may consider appropriate. (5) Extent of state's right of first refusal in advance of full implementation of amendments in such state.-- (A) In general.--In the case of any State in which the amendments made by subsection (a) have not been fully implemented pursuant to this subsection, the Commissioner shall determine by regulation the extent to which-- (i) the requirement under section 222(a) for prompt referrals to a State agency; and (ii) the authority of the Commissioner under section 222(d)(2) of the Social Security Act to provide vocational rehabilitation services in such State by agreement or contract with other public or private agencies, organizations, institutions, or individuals, shall apply in such State. (B) Existing agreements.--Nothing in subparagraph (A) or the amendments made by subsection (a) shall be construed to limit, impede, or otherwise affect any agreement entered into pursuant to section 222(d)(2) of the Social Security Act before the date of the enactment of this Act with respect to services provided pursuant to such agreement to beneficiaries receiving services under such agreement as of such date, except with respect to services (if any) to be provided after 3 years after the effective date provided in subsection (c). (e) Specific Regulations Required.-- (1) In general.--The Commissioner of Social Security shall prescribe such regulations as are necessary to implement the amendments made by this section. (2) Specific matters to be included in regulations.--The matters which shall be addressed in such regulations shall include-- (A) the form and manner in which tickets to work and self- sufficiency may be distributed to beneficiaries pursuant to section 1148(b)(1) of the Social Security Act; (B) the format and wording of such tickets, which shall incorporate by reference any contractual terms governing service by employment networks under the Program; (C) the form and manner in which State agencies may elect participation in the Ticket to Work and Self-Sufficiency Program pursuant to section 1148(c)(1) of such Act and provision for periodic opportunities for exercising such elections; (D) the status of State agencies under section 1148(c)(1) of such Act at the time that State agencies exercise elections under that section; (E) the terms of agreements to be entered into with program managers pursuant to section 1148(d) of such Act, including-- (i) the terms by which program managers are precluded from direct participation in the delivery of services pursuant to section 1148(d)(3) of such Act; (ii) standards which must be met by quality assurance measures referred to in paragraph (6) of section 1148(d) of such Act and methods of recruitment of employment networks utilized pursuant to paragraph (2) of section 1148(e) of such Act; and (iii) the format under which dispute resolution will operate under section 1148(d)(7) of such Act; (F) the terms of agreements to be entered into with employment networks pursuant to section 1148(d)(4) of such Act, including-- (i) the manner in which service areas are specified pursuant to section 1148(f)(2)(A) of such Act; (ii) the general selection criteria and the specific selection criteria which are applicable to employment networks under section 1148(f)(1)(C) of such Act in selecting service providers; (iii) specific requirements relating to annual financial reporting by employment networks pursuant to section 1148(f)(3) of such Act; and (iv) the national model to which periodic outcomes reporting by employment networks must conform under section 1148(f)(4) of such Act; (G) standards which must be met by individual work plans pursuant to section 1148(g) of such Act; (H) standards which must be met by payment systems required under section 1148(h) of such Act, including-- (i) the form and manner in which elections by employment networks of payment systems are to be exercised pursuant to section 1148(h)(1)(A) of such Act; (ii) the terms which must be met by an outcome payment system under section 1148(h)(2) of such Act; (iii) the terms which must be met by an outcome-milestone payment system under section 1148(h)(3) of such Act; (iv) any revision of the percentage specified in paragraph (2)(C) of section 1148(h) of such Act or the period of time specified in paragraph (4)(B) of such section 1148(h) of such Act; and (v) annual oversight procedures for such systems; and (I) procedures for effective oversight of the Program by the Commissioner of Social Security, including periodic reviews and reporting requirements. (f) The Ticket to Work and Work Incentives Advisory Panel.-- (1) Establishment.--There is established within the Social Security Administration a panel to be known as the ``Ticket to Work and Work Incentives Advisory Panel'' (in this subsection referred to as the ``Panel''). (2) Duties of panel.--It shall be the duty of the Panel to-- (A) advise the President, the Congress, and the Commissioner of Social Security on issues related to work incentives 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 (42 U.S.C. 401 et seq., 1301 et seq., 1381 et seq., 1395 et seq., 1396 et seq.); and (B) with respect to the Ticket to Work and Self-Sufficiency Program established under section 1148 of such Act-- (i) advise the Commissioner of Social Security with respect to establishing phase-in sites for such Program and fully implementing the Program thereafter, the refinement of access of disabled beneficiaries to employment networks, payment systems, and management information systems, and advise the Commissioner whether such measures are being taken to the extent necessary to ensure the success of the Program; (ii) advise the Commissioner regarding the most effective designs for research and demonstration projects associated with the Program or conducted pursuant to section 302 of this Act; (iii) advise the Commissioner on the development of performance measurements relating to quality assurance under section 1148(d)(6) of the Social Security Act; and (iv) furnish progress reports on the Program to the Commissioner and each House of Congress. (3) Membership.-- (A) Number and appointment.--The Panel shall be composed of 12 members as follows: (i) 4 members appointed by the President, not more than 2 of whom may be of the same political party; (ii) 2 members appointed by the Speaker of the House of Representatives, in consultation with the Chairman of the Committee on Ways and Means of the House of Representatives; (iii) 2 members appointed by the minority leader of the House of Representatives, in consultation with the ranking member of the Committee on Ways and Means of the House of Representatives; (iv) 2 members appointed by the majority leader of the Senate, in consultation with the Chairman of the Committee on Finance of the Senate; and (v) 2 members appointed by the minority leader of the Senate, in consultation with the ranking member of the Committee on Finance of the Senate. (B) Representation.--Of the members appointed under subparagraph (A), at least 8 shall have experience or expert knowledge as a recipient, provider, employer, or employee in the fields of, or related to, employment services, vocational rehabilitation services, and other support services, of whom-- (i) at least 2 shall represent the interests of recipients of employment services, vocational rehabilitation services, and other support services; (ii) at least 2 shall represent the interests of providers of employment services, vocational rehabilitation services, and other support services; (iii) at least 2 shall represent the interests of private employers; and (iv) at least 2 shall represent the interests of employees. At least \1/2\ of the members described in each clause of subparagraph (A) shall be individuals with disabilities, or representatives of individuals with disabilities, with consideration to current or former title II disability beneficiaries or title XVI disability beneficiaries (as such terms are defined in section 1148(k) of the Social Security Act (as added by subsection (a)). (C) Terms.-- (i) In general.--Each member shall be appointed for a term of 4 years (or, if less, for the remaining life of the Panel), except as provided in clauses (ii) and (iii). The initial members shall be appointed not later than 90 days after the date of the enactment of this Act. (ii) Terms of initial appointees.--As designated by the President at the time of appointment, of the members first appointed-- (I) \1/2\ of the members appointed under subparagraph (A) shall be appointed for a term of 2 years; and (II) the remaining members appointed under subparagraph (A) shall be appointed for a term of 4 years. (iii) Vacancies.--Any member appointed to fill a vacancy occurring before the expiration of the term for which the member's predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member's term until a successor has taken office. A vacancy in the Panel shall be filled in the manner in which the original appointment was made. (D) Basic pay.--Members shall each be paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (E) Travel expenses.--Each member shall receive travel expenses, including per diem in lieu of subsistence, in accordance with sections 5702 and 5703 of title 5, United States Code. [[Page H10246]] (F) Quorum.--8 members of the Panel shall constitute a quorum but a lesser number may hold hearings. (G) Chairperson.--The Chairperson of the Panel shall be designated by the President. The term of office of the Chairperson shall be 4 years. (H) Meetings.--The Panel shall meet at least quarterly and at other times at the call of the Chairperson or a majority of its members. (4) Director and staff of panel; experts and consultants.-- (A) Director.--The Panel shall have a Director who shall be appointed by the Panel, and paid at a rate, and in a manner, that is consistent with guidelines established under section 7 of the Federal Advisory Committee Act (5 U.S.C. App.). (B) Staff.--Subject to rules prescribed by the Commissioner of Social Security, the Director may appoint and fix the pay of additional personnel as the Director considers appropriate. (C) Experts and consultants.--Subject to rules prescribed by the Commissioner of Social Security, the Director may procure temporary and intermittent services under section 3109(b) of title 5, United States Code. (D) Staff of federal agencies.--Upon request of the Panel, the head of any Federal department or agency may detail, on a reimbursable basis, any of the personnel of that department or agency to the Panel to assist it in carrying out its duties under this Act. (5) Powers of panel.-- (A) Hearings and sessions.--The Panel may, for the purpose of carrying out its duties under this subsection, hold such hearings, sit and act at such times and places, and take such testimony and evidence as the Panel considers appropriate. (B) Powers of members and agents.--Any member or agent of the Panel may, if authorized by the Panel, take any action which the Panel is authorized to take by this section. (C) Mails.--The Panel may use the United States mails in the same manner and under the same conditions as other departments and agencies of the United States. (6) Reports.-- (A) Interim reports.--The Panel shall submit to the President and the Congress interim reports at least annually. (B) Final report.--The Panel shall transmit a final report to the President and the Congress not later than eight years after the date of the enactment of this Act. The final report shall contain a detailed statement of the findings and conclusions of the Panel, together with its recommendations for legislation and administrative actions which the Panel considers appropriate. (7) Termination.--The Panel shall terminate 30 days after the date of the submission of its final report under paragraph (6)(B). (8) Authorization of appropriations.--There are authorized to be appropriated from the Federal Old-Age and Survivors Insurance Trust Fund, the Federal Disability Insurance Trust Fund, and the general fund of the Treasury, as appropriate, such sums as are necessary to carry out this subsection. Subtitle B--Elimination of Work Disincentives SEC. 111. WORK ACTIVITY STANDARD AS A BASIS FOR REVIEW OF AN INDIVIDUAL'S DISABLED STATUS. (a) In General.--Section 221 of the Social Security Act (42 U.S.C. 421) is amended by adding at the end the following: ``(m)(1) In any case where an individual entitled to disability insurance benefits under section 223 or to monthly insurance benefits under section 202 based on such individual's disability (as defined in section 223(d)) has received such benefits for at least 24 months-- ``(A) no continuing disability review conducted by the Commissioner may be scheduled for the individual solely as a result of the individual's work activity; ``(B) no work activity engaged in by the individual may be used as evidence that the individual is no longer disabled; and ``(C) no cessation of work activity by the individual may give rise to a presumption that the individual is unable to engage in work. ``(2) An individual to which paragraph (1) applies shall continue to be subject to-- ``(A) continuing disability reviews on a regularly scheduled basis that is not triggered by work; and ``(B) termination of benefits under this title in the event that the individual has earnings that exceed the level of earnings established by the Commissioner to represent substantial gainful activity.''. (b) Effective Date.--The amendment made by subsection (a) shall take effect on January 1, 2003. SEC. 112. EXPEDITED REINSTATEMENT OF DISABILITY BENEFITS. (a) OASDI Benefits.--Section 223 of the Social Security Act (42 U.S.C. 423) is amended-- (1) by redesignating subsection (i) as subsection (j); and (2) by inserting after subsection (h) the following: ``Reinstatement of Entitlement ``(i)(1)(A) Entitlement to benefits described in subparagraph (B)(i)(I) shall be reinstated in any case where the Commissioner determines that an individual described in subparagraph (B) has filed a request for reinstatement meeting the requirements of paragraph (2)(A) during the period prescribed in subparagraph (C). Reinstatement of such entitlement shall be in accordance with the terms of this subsection. ``(B) An individual is described in this subparagraph if-- ``(i) prior to the month in which the individual files a request for reinstatement-- ``(I) the individual was entitled to benefits under this section or section 202 on the basis of disability pursuant to an application filed therefor; and ``(II) such entitlement terminated due to the performance of substantial gainful activity; ``(ii) the individual is under a disability and the physical or mental impairment that is the basis for the finding of disability is the same as (or related to) the physical or mental impairment that was the basis for the finding of disability that gave rise to the entitlement described in clause (i); and ``(iii) the individual's disability renders the individual unable to perform substantial gainful activity. ``(C)(i) Except as provided in clause (ii), the period prescribed in this subparagraph with respect to an individual is 60 consecutive months beginning with the month following the most recent month for which the individual was entitled to a benefit described in subparagraph (B)(i)(I) prior to the entitlement termination described in subparagraph (B)(i)(II). ``(ii) In the case of an individual who fails to file a reinstatement request within the period prescribed in clause (i), the Commissioner may extend the period if the Commissioner determines that the individual had good cause for the failure to so file. ``(2)(A)(i) A request for reinstatement shall be filed in such form, and containing such information, as the Commissioner may prescribe. ``(ii) A request for reinstatement shall include express declarations by the individual that the individual meets the requirements specified in clauses (ii) and (iii) of paragraph (1)(B). ``(B) A request for reinstatement filed in accordance with subparagraph (A) may constitute an application for benefits in the case of any individual who the Commissioner determines is not entitled to reinstated benefits under this subsection. ``(3) In determining whether an individual meets the requirements of paragraph (1)(B)(ii), the provisions of subsection (f) shall apply. ``(4)(A)(i) Subject to clause (ii), entitlement to benefits reinstated under this subsection shall commence with the benefit payable for the month in which a request for reinstatement is filed. ``(ii) An individual whose entitlement to a benef