Number: 105-11
Date: June 4, 1998

On June 4, 1998, the House passed H.R. 3433, the Ticket to Work and Self-Sufficiency Act of 1998, by a vote of 4 10 to I with 2 members voting "present".

Below are descriptions of the provisions in H.R. 3433 as passed by the House:

General

• Directs the Commissioner to establish a Ticket to Work and Self-Sufficiency Program which would provide Social Security Disability Insurance (SSDI) beneficiaries and Supplemental Security Income (SSI) disability recipients with a ticket they may use to obtain vocational rehabilitation (VR) services, employment services, or other support services from an employment network of their choice.

Responsibilities of Commissioner of Social Security

• Select and enter into agreements with one or more program manager(s) to assist the Commissioner in administer ing the program.
  
• Terminate agreements with program manager(s) who fail to meet the performance standards specified in the agreements.
  
• Preclude program managers from direct participation in the delivery of services to beneficiaries or from holding a financial interest in an employment network in the service area covered by the program manager's agreement.
  
• Select, and enter into agreements with, employment networks to provide services
  under the program.
  
• Terminate agreements with employment networks whose performance is inadequate.
  
• Provide for such periodic reviews of employment networks as are necessary to ensure effective quality assurance in the provision of services by employment networks.

Responsibilities of the Program Manager(s)

• Perform such tasks as assigned by the Commissioner.
  
• Recruit, and recommend for selection by the Commissioner, employment networks which can provide services under the program.
  
• Monitor employment networ ks under its jurisdiction to ensure that beneficiaries have adequate choices of services and that employment networks comply with the terms of their agreements with the Commissioner.
  
• Ensure that payment by the Commissioner to an employment network is warranted.
  
• Establish and maintain lists of employment networks available to pro vide services and make such lists available to beneficiaries.
  
• Ensure that each beneficiary has reasonable access to services, i.e., case management, benefits counseling, supported employment, job training, placement, and follow-up services.

Employment Networks

• An employment network may consist either of a single provider of such services or a group of providers organized to combine their resources into a single entity.
  
• An employment network may provide services either directly or by entering into agreements with other providers which can appropriate services.
  
• To serve under the program, an employment network must:
  
  
  • Demonstrate to the Commissioner that it has substantial expertise and experience in the field of employment, vocational or other support services for individuals with disabilities.
    
• Employment networks must:
  • Meet and maintain compliance with general selection criteria such as professional and governmental certification and educational credentials, and specific selection criteria,
    
  • such as the extent of their work experience with specific populations.
    
  • Meet the financial report ing requirements prescribed by the Commissioner.
    
  • Prepare periodic reports, on at least an annual itemizing specific outcomes
    achieved with respect to services provided to beneficiaries.
    
  • Develop and implement an individual work plan which a written vocational evaluation which takes effect upon approval by the beneficiary.

Employment Network Payment Systems

• Authorizes the Commissioner to pay employment networ ks under either an outcome payment system or an outcome milestone payment system. Each employment network will select the payment system will be used hy the employment network for the duration of the agreement with the Commissioner.
  
  • Under the outcome payment system, an employment network shall be paid a fixed percentage, not to exceed 40% of the average SSDI or SSI payment, for 60 months during which he/she does not receive a benefit.
    
  • The outcome-milestone payment system provides for milestone payments in combination with outcome payments. However, the total of the outcome milestone payments shall be less than the total amount of payment to an employment network that has elected the outcome payment system.
    
• Requires the Commissioner to review periodically the specifications of the payment
  system (percentage and total payment) to ensure that the system provides an adequate
  incentive for employment networks to assist beneficiaries in entering the workforce.
  
• Allows the Commissioner to alter the percentage or total permissible payments as well as the number and amount of milestone payments to allow an adequate incentive form employment networks.

Continuing Disability Reyiews

• Prohibits the Commissioner from initiating continuing disability reviews or other reviews during the period that a beneficiary is using a ticket to work and selfsufficiency.

Financing

• Authorizes transfer of funds from the OASI and DI trust funds and the SSI general fund to carry out the provisions with respect to title II disability beneficiaries and title XVI recipients. Requires the Commissioner to determine the total amount to be paid to program managers and employment networks and the amounts which should be charged to each trust fund for title II beneficiaries.

Effective Date

• Effective with the first month following one year after enactment of the Act.

Program Implementation

• Directs the Commissioner to implement the amendments in graduated phases at phasein sites selected by the Commissioner so as to ensure prior to full implementation, the refinement of the program processes.
  
• Requires the Commissioner to fully implement the program as soon as practicable but not later than six years after the effective date.

Evaluation

• Requires the Commissioner to design and conduct a series of evaluations to assess the cost-effectiveness of the program and the work outcomes for benefic iaries receiving a ticket to work and self sufficiency under the program.

Reports

• Requires the Commissioner to report following the close of the third and fifth fiscal years ending after the effective date to the House Committee on Ways and Means and the Senate Committee on Finance on the Commissioner's evaluation of the progress of activities. as well as the success of the program and the Commissioner's conclusions on whether or how the program should be modified.

State VR Agencies

• Each State VR agency may elect to participate in the program as an employment network (or to revoke such an election). Also, directs the Commissioner to provide for periodic opportunities for State VR agencies to opt in or out of the program as an employment network.
  
• Services provided by State VR agencies participating in the program shall be governed by plans for VR services approved under title I of the Rehabilitation Act of 1973.
  
• Requires a written agreement between the State agency and the employment network to allow the State agency to accept any referral of a disabled beneficiary from the employment network initially assigned a ticket to work and self-sufficiency by the disabled beneficiary.
  
  • Directs the Commissioner and the Secretary of Education jointly to prescribe regulations specifying the terms of such agreements.
    
  • No payment shall be made to an employment network if employment network makes referrals to the States agency without entering into a written agreement or in violation of the terms of the written agreement.
  
  
• Requires the Commissioner, if the amendments have not been fully implemented in a State. to determine through regulations the extent to which the requirement concerning prompt refer ral to the State agency applies and the authority of the Commissioner to provide vocational rehabilitation services in such State by agreement or contract with other public or private agencies, etc.

Ticket to Work and Self-Sufiiciency Advisory Panel

• Establishes a Ticket to Work and Self-Sufficiency Advisory Panel, comprised of 6 members, 4 of whom must have experience or expert knowledge as a recipient, provider, employer, or employee in the field of employment services, VR services, and other supported services. The Panel shall be appointed within 90 days of enactment. The Panel is to advise the Commissioner on the following:
  
  • Phase -in s ites for implementation of the program,
    
  • Access of disabled beneficiaries to employment networks, payment systems, and management information systems to ensure the success of the program.
    
  • Development of performance measures for the employment networks.
    
  • The most effective designs for research and demonstration projects associated with the program or conducted with respect to the reduction of a beneficiary's disability benefits on account of earned income.
    
• Requires the Panel to provide annual progress reports to the President and Congress
  on the program.
  
• Requires the Panel to transmit a final report to the President and the Congress, not later than eight years after the date of enactment, which includes a detailed statement of the findings and conclusions of the Panel and its recommendations for legislation and administrative actions.
  
• Terminates the Panel 30 days after the date it submits its final report.

Regulations

• Directs the Commissioner to prescribe regulations necessary to implement the Ticket to Work and Self-Sufficiency Program.

Work Incentive Specialists

• Directs the Commissioner to establish a corps of work incentive specialists to specialize in title II and title XVI work incentives for the purpose of providing accurate information to disabled beneficiaries.

Demonstration Projects Involving the Reduction of Disability Benefits Based on Earnings

• Directs the Commissioner to conduct demonstration projects to evaluate the effects of a $1 for $2 withholding of SSDI payments for earnings over a level specified by the Commissioner.
  
• The demonstration projects shall be conducted in a sufficient number of localities to ensure a thorough evaluation of the appropriateness of national implementation of the $1 for $2 withholding for SSDI bencficiaries. The demonstration projects should determine:
  
  • The effects, if any, of induced entry and reduced exit;
    
  • The effect, if any, on a project being conducted in a locality under the administration of the Ticket to Work and Self-Sufficiency Program; and,
    
  • The savings to the Trust Funds and other Federal programs as a result of the project.
    
• Requires the Commissioner to determine the annual cost, the reasons for the return to work of beneficiaries who participate in the project, the employment outcomes, the merits of trial work periods and periods of extended eligibility for each project.
  
• Authorizes the Commissioner to waive compliance with the title II benefit provisions in so far as is necessary for a thorough evaluation of the alternative methods under consideration. Requires the Commissioner to submit a written report to the House Committee on Ways and Means and the Senate Committee on Finance 90 days prior to the start of a project. Also, require the Commissioner to submit periodic reports on the progress of the projcct(s) to the Congressional committees.
  
• Directs the Commissioner to suhmit (I ) an interim report on or before June 9, 2000, and each of the succeeding years thereafter, on the progress of the demonstration projects. and (2) a final report on the demonstration projects not later than one year after their completion.

General Accounting Office (GAO) Reports and Studies

• Requires the General Accounting Office (GAO) to study the extent to which existing tax credits and other employer incentives under current law encourage employers to hire and retain individuals with disabilities participating in the Ticket to Work and Self-Sufficiency Program and provide a written report no later than 3 years after the date of enactment of this Act.
  
• Requires the GAO to conduct a study to evaluate the coordination of ssm and SSI programs as they relate to individuals who are eli gible for both programs , or whose eligibility changes from one program to the other. The study should focus on the effecti veness of work incentives and medical coverage for these individuals. A report is due not later than 18 months after the date of enactment.

OTHER PROVISIONS OF INTEREST

Extension of Medicare Coverage

• Provides during the 7-year period beginning on the date of enactment, an additional two-year extension of Medicare beyond the current Medicare extension of 48 months for program participants.
  
• Requires SSA and the Department of Health and Human Services to submit their recommendations for further legislative action with respect to this extension of Medicare coverage to Congress not later than six months prior to the end of the 7-year period beginning on the date of enactment.

Technical Amendments Relating to Drug Addicts and Alcoholics

• Amends the Contract with America Advancement Act of 1996 (PL. 104-121) to clarify the meaning of the term "final adjudication" and clarifies SSA's authority to make SSI medical redeterminations after January 1, 1997. (A similar 55I provision was included in the Balanced Budget Act of 1997 [P.L. 105-33].)
  
• Expands the applicahility of the provisions in P.L. 104-121 which require treatment referrals and authorization of a $50 fee for organizations serving as representative payees for SSDl heneficiaries who arc incapahle and have a DA&A condition.

Extension of SSDI Program Demonstration Project Waiver Authority

• Extends the section 505 demonstration project waiver authority until June 10, 2001.
  
• Authorizes the Commissioner to expand the scope of any demonstration project to include applicants for benefits under the SSDl program with impairments which may reasonably be presumed to be disabling for purposes of the demonstration project and to conduct demonstration projects involving SSDl applicants only.

Perfecting Amendments Related to Withholding from Social Security Benefits

• Allows individual to request voluntary Federal income tax withholding from certain Federal payment, including Social Security benefits.

Treatment of Prisoners

• Provides incentive payments to correctional institutions for reporting incarceration of all title II beneficiaries.
  
• Replaces the criteria for barring SSDI benefits to prisoners from "an offense punishable by imprisonment for more than one year" to a "criminal offense."

Revocation by Members of th e Clergy of Exemption from Social Secnrity Coverage

• Creates a two-year window of opportunity to allow members of the clergy who initially revoked Social Security coverage to elect coverage.

Additional Technical Amendments Relating to Cooperative Research or Demonstration Projects Under Title II and Title XVI

• Clarities the Commissioner's authority to make grant" and payments under cooperative
  research or demonstration projects in advance or by way of reimbursement to carry
  out demonstration projects and cooperative research for title II and title XVI under
  section 1110(a).