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The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Jun 16, 1999.
TABLE OF CONTENTS: Title I: Expanded Availability of Health Care Services Title II: Ticket to Work and Self-Sufficiency and Related Provisions Subtitle A: Ticket to Work and Self-Sufficiency Subtitle B: Elimination of Work Disincentives Subtitle C: Work Incentives Planning, Assistance, and Outreach Title III: Demonstration Projects and Studies Title IV: Miscellaneous and Technical Amendments Work Incentives Improvement Act of 1999 - Title I: Expanded Availability of Health Care Services - Amends title XIX (Medicaid) of the Social Security Act (SSA) to provide for expanding State options under Medicaid for workers with disabilities, namely by creating State options to eliminate income, assets, and resource limitations for workers with disabilities who buy into Medicaid and to provide opportunity for employed individuals with a medically improved disability to make such a buy. Provides that Federal funds paid to a State for medical assistance provided to such individuals may not generally be used to supplant the level of State funds expended for a fiscal year for programs to enable working disabled individuals to work.(Sec. 102) Provides for certain continuation of Medicare coverage for working individuals with disabilities.(Sec. 103) Directs the Secretary of Health and Human Services to: (1) award grants to eligible States to support establishment of State infrastructures to support the working disabled as well as to enable State outreach campaigns on infrastructure existence; and (2) submit a recommendation to specified congressional committees on whether such grant program should be continued after FY 2010. Makes appropriations for FY 2000 through 2004.(Sec. 104) Authorizes State demonstration projects for certain Medicaid coverage of up to a specified maximum number of workers with a potentially severe disability, coverage equal to that afforded under the State option for eliminating income, assets, and resource limitations for disabled workers buying into Medicaid. Requires a State with an approved demonstration project to report annually to the Secretary on the use of grant funds for the project. Makes appropriations for FY 2000 through 2004.(Sec. 105) Allows disabled Medicare beneficiaries to request the suspension of Medicare supplemental policy (Medigap) insurance when covered under a group health plan.Title II: Ticket to Work and Self-Sufficiency and Related Provisions - Subtitle A: Ticket to Work and Self-Sufficiency - Amends part A (General Provisions) of SSA title XI to direct the Commissioner of Social Security to establish a Ticket to Work and Self-Sufficiency Program (TWSSP) under which a disabled beneficiary may use a TWSSP ticket issued by the Commissioner under a described system, designed to ensure quality assurance, to obtain employment, vocational rehabilitation services, or other support services, pursuant to an appropriate individual beneficiary work plan that meets specified requirements, at the Commission's expense, from a participating employment network, public or private, which: (1) meets specified qualifications and is under an agreement with the Commissioner who must select a program manager to assist in administering TWSSP; (2) is chosen by the beneficiary, and (3) is willing to accept assignment of the beneficiary's TWSSP ticket. Allows State agencies administering or supervising the administration of the State plan under title I of the Rehabilitation Act of 1973 to elect to participate as an employment network. Sets forth special requirements applicable to cross-referral to certain State agencies and requirements relating to provision of services. Describes employment network payment systems. Provides that during any period for which an individual is using a TWSSP ticket, the Commissioner and any applicable State agency may not initiate a continuing disability or similar review with regards to whether the individual is or is not disabled. Requires payments to employment networks to be made out of the social security trust funds in the case of ticketed SSA title II (Old Age, Survivors and Disability Insurance) (OASDI) disability beneficiaries who return to work, or from the appropriation made available for making Supplemental Security Income (SSI) payments under SSA title XVI, in the case of SSI disability beneficiaries who return to work. Provides for allocation of other costs.(Sec. 201) Establishes within the Social Security Administration the Work Incentives Advisory Panel to advise the President, Congress, and the Commissioner with respect to TWSSP work incentive issues, and those issues under OASDI, SSI, Medicare, and Medicaid as well. Provides that the costs for the Advisory Panel shall be paid from amounts available for OASDI and SSI administration, and shall be allocated among those amounts as appropriate.Subtitle B: Elimination of Work Disincentives - Amends SSA titles II and XVI (Procedural and General Provisions) to set forth a number of measures designed to eliminate work disincentives, namely prohibiting work activity as a basis for review of an individual's disability status and providing for expedited reinstatement of entitlement, or in the case of SSI, of eligibility, to, respectively, OASDI and SSI disability benefits.Subtitle C: Work Incentives Planning, Assistance, and Outreach - Amends SSA title XI part A (General Provisions) to direct the Commissioner to establish a community-based work incentives outreach program for disabled beneficiaries that includes the provision of technical assistance to organizations and entities that are designed to encourage disabled beneficiaries to return to work. Provides that the costs of carrying out this subtitle shall be paid from amounts made available for OASDI and SSI administration, and shall be allocated among such amounts as appropriate. Authorizes appropriations for FY 2000 through 2004.(Sec. 222) Authorizes the Commissioner to make certain minimum payments in each State to the protection and advocacy system established under the Developmental Disabilities Assistance and Bill of Rights Act for the purpose of providing services to disabled beneficiaries, services which may include advocacy or other services that such a beneficiary may need to secure or regain gainful employment. Authorizes appropriations for FY 2000 through 2004.Title III: Demonstration Projects and Studies - Amends SSA title II to provide for a permanent extension of disability insurance program demonstration project authority. Directs the Commissioner to develop and carry out experiments and demonstration projects, subject to specified guidelines which include the authority to waive compliance with benefits requirements, with regard to various alternative methods of treating the work activity of individuals entitled to OASDI disability benefits, altering other limitations and conditions applicable to such individuals, and implementing sliding scale benefit offsets. Authorizes the Commissioner to expand the scope of any such experiment or demonstration project to include any group of OASDI benefit applicants with impairments that reasonably may be presumed to be disabling for purposes of such demonstration project, and may limit any such demonstration project to any such group of applicants, subject to the terms of such demonstration project which shall define the extent of any such presumption.(Sec. 302) Directs the Commissioner to conduct certain demonstration projects designed to provide for specified reductions in disability insurance benefits based on earnings. Requires expenditures for such demonstration projects to come out of the social security and Medicare trust funds, as determined appropriate, to the extent provided in advance in appropriation Acts.(Sec. 303) Directs the Comptroller General to conduct and report to the Congress on the following studies concerning: (1) existing tax credits and other disability-related employment incentives; (2) coordination of the OASDI disability insurance (DI) program and the SSI program as they relate to individuals entering or leaving concurrent entitlement under them; and (3) the impact of the substantial gainful activity limit on return to work.Directs the Commissioner to report to the Congress on disregards under the DI and SSI programs.Title IV: Miscellaneous and Technical Amendments - Amends the Contract with America Advancement Act of 1996 with respect to the following: (1) final adjudication of denied claims by drug addicts and alcoholics for SSA title II disability benefits; and (2) the effective dates of certain requirements concerning representative payees and treatment referrals for such individuals.(Sec. 402) Amends SSA title II to provide for the following: (1) payments to State and local prisons for monthly reports on the identities of inmates whose OASDI benefits are determined by the Commissioner not to be payable as a result of such reports; (2) a 50 percent reduction in such payments under SSA titles II and XVI in cases involving a comparable payment under the other title with respect to the same prisoner; (3) transfer from the social security trust funds of any sums necessary to enable the Commissioner to make such payments; (4) elimination of the requirement that confinement stem only from a crime punishable by imprisonment for more than one year (thus denying OASDI benefits to individuals confined for any criminal offense); and (5) continued denial of benefits to sex offenders remaining confined to public institutions upon completion of prison term.(Sec. 403) Provides for a two-year open season for members of the clergy who wish to revoke their exemption from social security coverage.(Sec. 404) Amends SSA title XI to make a miscellaneous technical amendment relating to cooperative research or development projects under SSA titles II and XVI.(Sec. 405) Amends SSA title XI to make miscellaneous technical amendments to provisions concerning the requirements of State income and eligibility verification systems, among other changes allowing a State to permit certain employers that make returns with respect to domestic service employment taxes on a calendar year basis to instead make such reports on an annual basis.
