[Congressional Bills 105th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3433 Introduced in House (IH)]







105th CONGRESS
  2d Session
                                H. R. 3433

  To amend the Social Security Act to establish a Ticket to Work and 
   Self-Sufficiency Program in the Social Security Administration to 
  provide beneficiaries with disabilities meaningful opportunities to 
return to work and to extend Medicare coverage for such beneficiaries, 
and to amend the Internal Revenue Code of 1986 to provide a tax credit 
                 for impairment-related work expenses.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 11, 1998

Mr. Bunning  (for himself and Mrs. Kennelly of Connecticut) introduced 
  the following bill; which was referred to the Committee on Ways and 
                                 Means

_______________________________________________________________________

                                 A BILL


 
  To amend the Social Security Act to establish a Ticket to Work and 
   Self-Sufficiency Program in the Social Security Administration to 
  provide beneficiaries with disabilities meaningful opportunities to 
return to work and to extend Medicare coverage for such beneficiaries, 
and to amend the Internal Revenue Code of 1986 to provide a tax credit 
                 for impairment-related work expenses.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Ticket to Work and Self-Sufficiency 
Act of 1998''.

SEC. 2. 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 at the end the following new 
section:

           ``the ticket to work and self-sufficiency program

    ``Sec. 1147. (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 agree to 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) Periodic elections.--Each State agency described in 
        section 222 or 1615 may elect to participate in the Program (or 
        to revoke any such election) as an employment network. The 
        Commissioner shall provide for periodic opportunities for 
        exercising such elections (and revocations).
            ``(2) Treatment of state agencies.--Any such election (or 
        revocation) by a State agency described in section 222 or 1615 
        taking effect during any period for which an individual 
        residing in the State is a disabled beneficiary and a client of 
        the State agency shall not be effective with respect to such 
        individual to the extent that such election (or revocation) 
        would result in any change in the method of payment to the 
        State agency with respect to the individual from the method of 
        payment to the State agency with respect to the individual in 
        effect immediately before such election (or revocation).
            ``(3) Effect of participation by state agency.--
                    ``(A) State agencies participating.--In any case in 
                which a State agency described in section 222 or 1615 
                elects under paragraph (1) to participate in the 
                Program--
                            ``(i) 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, and
                            ``(ii) the provisions of section 222(d) and 
                        the provisions of section 1615 shall not apply 
                        with respect to such State.
                    ``(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.
    ``(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 one 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 terms. 
        Such performance standards shall include (but are not limited 
        to)--
                    ``(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.--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).
            ``(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 take into account 
        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 the performance of periodic surveys of 
        beneficiaries receiving services under the Program designed to 
        measure customer service satisfaction.
            ``(7) Dispute resolution.--The Commissioner shall provide 
        for a mechanism for resolving disputes between beneficiaries 
        and employment networks and between program managers and 
        employment networks. 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 
for good cause, as determined by the Commissioner, without being deemed 
to have rejected services under the Program. The program manager shall 
establish and maintain lists of employment networks available to 
beneficiaries and shall make such lists generally available to the 
public.
            ``(4) Ensuring availability of adequate services.--The 
        program manager shall ensure that employment networks provide 
        employment services, vocational rehabilitation services, or 
        other support services to beneficiaries throughout specified 
        service areas, 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 their services under the Program has 
        reasonable access to employment services, vocational 
        rehabilitation services, or other support services. Such 
        services may include case management, 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.
    ``(f) Employment Networks.--
            ``(1) Qualifications for employment networks.--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, which 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). No employment network may serve under the 
        Program unless it demonstrates to the Commissioner substantial 
        expertise and experience in the field of employment services, 
        vocational rehabilitation services, or other support services 
        for individuals with disabilities and provides an array of such 
        services. 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,
                    ``(B) meet, and maintain compliance with, both 
                general selection criteria (such as professional and 
                governmental certification and educational credentials) 
                and specific selection criteria (such as the extent of 
                work experience by the provider with specific 
                populations), and
                    ``(C) 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 employment 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 pertaining to the 
        beneficiary. 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 Employment Plans.--
            ``(1) In general.--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 employment 
plans as defined by the Commissioner, and
                    ``(B) develop and implement each such individual 
                employment plan, in the case of 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.
        A beneficiary's individual employment plan shall take effect 
        upon approval by the beneficiary.
            ``(2) Employment evaluation.--In devising the employment 
        plan, the employment network shall undertake an employment 
        evaluation with respect to the beneficiary. Each employment 
        evaluation shall set forth in writing such elements and shall 
        be in such format as the Commissioner shall prescribe.
    ``(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) Method of payment to employment networks.--
                Any such election by an employment network taking 
                effect during any period for which a disabled 
                beneficiary is receiving services from such employment 
                network shall not be effective with respect to such 
                beneficiary to the extent that such election would 
                result in any change in the method of payment to the 
                employment network with respect to services provided to 
                such beneficiary from the method of payment to the 
                employment network with respect to services provided to 
                such beneficiary as of immediately before such 
                election.
            ``(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 described in paragraph (4)(B) in 
                connection with such individual which occurs during the 
                individual's outcome payment period.
                    ``(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 of the 60 months 
                        during the outcome payment period which are 
                        described in paragraph (4)(B) 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 one or more 
                milestones, with respect to beneficiaries receiving 
                services from an employment network under the Program, 
                which are directed toward the goal of permanent 
                employment. Such milestones shall form a part of a 
                payment structure which 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.--For purposes of 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) to 
                        all beneficiaries having attained 18 years of 
                        age for months during the preceding calendar 
                        year.
                    ``(B) Outcome payment period.--The term `outcome 
                payment period' means, in connection with an individual 
                who is a disabled beneficiary, a period--
                            ``(i) beginning with the first month--
                                    ``(I) for which benefits are not 
                                payable to such individual by reason of 
                                engagement in substantial gainful 
                                activity, and
                                    ``(II) which ends after such 
                                beneficiary has assigned a ticket to 
                                work and self-sufficiency to an 
                                employment network, and
                            ``(ii) ending with the 60th month 
                        (consecutive or otherwise) following the first 
                        month for which benefits are not payable to 
                        such individual by reason of engagement in work 
                        activity.
            ``(5) Periodic review and alterations of prescribed 
        schedules.--
                    ``(A) Percentages and periods.--The Commissioner of 
                Social Security shall periodically review the 
                percentages specified in paragraphs (2)(C) and (3)(C) 
                and the period of time specified in paragraph (4)(B) to 
                determine whether such percentages 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 any of such percentages 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 initially established by 
                the Commissioner pursuant to this section to determine 
                whether to allow 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 Self-Sufficiency Advisory Panel, 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 Self-Sufficiency Advisory Panel, or other reliable 
                sources.
    ``(i) Authorizations.--
            ``(1) 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 as may be 
        necessary to carry out the provisions of this section with 
        respect to title II disability beneficiaries. 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. The Commissioner of 
        Social Security shall determine according to such methods and 
        procedures as shall be prescribed under this section--
                    ``(A) the total amount to be paid to program 
                managers and employment networks under this section, 
                and
                    ``(B) subject to the provisions of the preceding 
                sentence, the amount which should be charged to each of 
                the Trust Funds.
            ``(2) 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.
    ``(j) Definitions.--For purposes of this section--
            ``(1) Disabled beneficiary.--The term `disabled 
        beneficiary' means a title II disability beneficiary or a title 
        XVI disability beneficiary.
            ``(2) 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.
            ``(3) 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.
    ``(k) Regulations.--The Commissioner of Social Security 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 222(a) of such Act (42 U.S.C. 422(a)) 
                is repealed.
                    (B) Section 222(b) of such Act is repealed.
                    (C) 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 1147 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 is repealed.
    (c) Effective Date.--Subject to subsection (d), the amendments made 
by subsections (a) and (b) shall take effect with the first month 
following one year after the date of the enactment of this Act.
    (d) Graduated Implementation of Program.--
            (1) In general.--Not later than 360 days 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)(B) 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.
            (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 the Program is fully implemented as soon as practicable on 
        or after the effective date specified in subsection (c) but not 
        later than six 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) Methodology.--
                            (i) Design and implementation.--The 
                        Commissioner shall design the series of 
                        evaluations after receiving relevant advice 
                        from experts in the fields of disability, 
                        vocational rehabilitation, and program 
                        evaluation. In designing and carrying out such 
                        evaluations, the Commissioner shall consult 
                        with the Comptroller General of the United 
States and other agencies of the Federal Government and with private 
organizations with appropriate expertise. Before provision of services 
begins under any phase of Program implementation, the Commissioner 
shall ensure that plans for such evaluations and data collection 
methods are in place and ready for implementation.
                            (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 
                                providers whose services are provided 
                                within an employment network under the 
                                Program;
                                    (VII) the extent (if any) to which 
                                employment networks display a greater 
                                willingness to provide services to 
                                disabled beneficiaries;
                                    (VIII) 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; and
                                    (IX) measures of satisfaction among 
                                beneficiaries in receipt of tickets 
                                under the Program.
                    (C) 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 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.
    (e) The Ticket to Work and Self-Sufficiency Advisory Panel.--
            (1) Establishment.--There is established in the Social 
        Security Administration a panel to be known as the ``Ticket to 
        Work and Self-Sufficiency 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 Commissioner of Social Security on 
                establishing phase-in sites for the Ticket to Work and 
                Self-Sufficiency Program and on fully implementing the 
                Program thereafter,
                    (B) advise the Commissioner with respect to 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,
                    (C) advise the Commissioner regarding the most 
                effective designs for research and demonstration 
                projects associated with the Program or conducted 
                pursuant to subsection (h), and
                    (D) furnish progress reports on the Program to the 
                President and each House of the Congress.
            (3) Membership.--
                    (A) Number and appointment.--The Panel shall be 
                composed of 6 members as follows:
                            (i) 1 member appointed by the Chairman of 
                        the Committee on Ways and Means of the House of 
                        Representatives;
                            (ii) 1 member appointed by the ranking 
                        minority member of the Committee on Ways and 
                        Means of the House of Representatives;
                            (iii) 1 member appointed by the Chairman of 
                        the Committee on Finance of the Senate;
                            (iv) 1 member appointed by the ranking 
                        minority member of the Committee on Finance of 
                        the Senate; and
                            (v) 2 members appointed by the President, 
                        not more than 1 of whom may be of the same 
                        political party.
                    (B) Representation.--Of the members appointed under 
                subparagraph (A)--
                            (i) at least one shall represent the 
                        interests of recipients of employment services, 
                        vocational rehabilitation services, and other 
                        support services,
                            (ii) at least one shall represent the 
                        interests of providers of employment services, 
                        vocational rehabilitation services, and other 
                        support services, and
                            (iii) at least one shall represent the 
                        interests of private employers.
                    (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).
                            (ii) Terms of initial appointees.--As 
                        designated by the President at the time of 
                        appointment, of the members first appointed--
                                    (I) 3 of the members appointed 
                                under subparagraph (A) shall be 
                                appointed for a term of 2 years, and
                                    (II) 3 of the 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 equal to the daily equivalent of the rate of basic 
                pay for level 4 of the Senior Executive Service, as in 
                effect from time to time under section 5382 of title 5, 
                United States Code, for each day (including travel 
                time) during which they are engaged in the actual 
                performance of duties vested in the Panel.
                    (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.
                    (F) Quorum.--4 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. The Director shall be 
                paid at a rate not to exceed the maximum rate of pay 
                payable for GS-15 of the General Schedule.
                    (B) Staff.--Subject to rules prescribed by the 
                Panel, 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 Panel, 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.
                    (D) Administrative support services.--Upon the 
                request of the Panel, the Administrator of General 
                Services shall provide to the Panel, on a reimbursable 
                basis, the administrative support services necessary 
                for the Panel to carry out its duties under this 
                subsection.
            (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.
    (f) 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 (but are not limited to)--
                    (A) the form and manner in which tickets to work 
                and self-sufficiency may be distributed to existing 
                beneficiaries pursuant to section 1147(b)(1) of such 
                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 (and revoke such an election) 
                pursuant to section 1147(c)(1) of such Act and 
                provision for periodic opportunities for exercising 
                such elections (and revocations);
                    (D) the status of State agencies under section 
                1147(c)(2) at the time that State agencies exercise 
                elections (and revocations) under such section 
                1147(c)(1);
                    (E) the terms of agreements to be entered into with 
                program managers pursuant to section 1147(d) of such 
                Act, including (but not limited to)--
                            (i) the terms by which program managers are 
                        precluded from direct participation in the 
                        delivery of services pursuant to section 
                        1147(d)(3) of such Act,
                            (ii) standards which must be met by quality 
                        assurance measures referred to in paragraph (6) 
                        of section 1147(d) and methods of recruitment 
                        of employment networks utilized pursuant to 
                        paragraph (2) of section 1147(e), and
                            (iii) the format under which dispute 
                        resolution will operate under section 
                        1147(d)(7).
                    (F) the terms of agreements to be entered into with 
                employment networks pursuant to section 1147(d)(4) of 
                such Act, including (but not limited to)--
                            (i) the manner in which service areas are 
                        specified pursuant to section 1147(f)(2)(A) of 
                        such Act,
                            (ii) the general selection criteria and the 
                        specific selection criteria which are 
                        applicable to employment networks under section 
                        1147(f)(2)(B) of such Act in selecting service 
                        providers,
                            (iii) specific requirements relating to 
                        annual financial reporting by employment 
                        networks pursuant to section 1147(f)(3) of such 
                        Act, and
                            (iv) the national model to which periodic 
                        outcomes reporting by employment networks must 
                        conform under section 1147(f)(4) of such Act;
                    (G) standards which must be met by individual 
                employment plans pursuant to section 1147(g) of such 
                Act;
                    (H) standards which must be met by payment systems 
                required under section 1147(h) of such Act, including 
                (but not limited to)--
                            (i) the form and manner in which elections 
                        by employment networks of payment systems are 
                        to be exercised pursuant to section 
                        1147(h)(1)(A),
                            (ii) the terms which must be met by an 
                        outcome payment system under section 
                        1147(h)(2);
                            (iii) the terms which must be met by an 
                        outcome-milestone payment system under section 
                        1147(h)(3);
                            (iv) any revision of the percentage 
                        specified in paragraph (2)(C) of section 
                        1147(h) of such Act or the period of time 
                        specified in paragraph (4)(B) of such section 
                        1147(h); 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.
    (g) Work Incentive Specialists.--The Commissioner shall establish a 
corps of trained, accessible, and responsive work incentive specialists 
to specialize in title II and title XVI disability work incentives for 
the purpose of disseminating accurate information to disabled 
beneficiaries (as defined in section 1147(j)(1) of the Social Security 
Act as amended by this Act) with respect to inquiries and issues 
relating to work incentives.
    (h) Demonstration Projects Providing for Reductions in Disability 
Insurance Benefits Based on Earnings. --
            (1) Authority.--The Commissioner shall conduct 
        demonstration projects for the purpose of evaluating, through 
        the collection of data, a program for title II disability 
        beneficiaries (as defined in section 1147(j)(2) of the Social 
        Security Act, as amended by this Act) under which each $1 of 
        benefits payable under section 223, or under section 202 based 
        on the beneficiary's disability, is reduced for each $2 of such 
        beneficiary's earnings that is above a level to be determined 
        by the Commissioner. Such projects shall be conducted at a 
        number of localities which the Commissioner shall determine is 
        sufficient to adequately evaluate the appropriateness of 
        national implementation of such a program. Such projects shall 
        identify reductions in Federal expenditures that may result 
        from the permanent implementation of such a program.
            (2) Scope and scale and matters to be determined.--
                    (A) In general.--The demonstration projects 
                developed under paragraph (1) shall be of sufficient 
                duration, shall be of sufficient scope, and shall be 
                carried out on a wide enough scale to permit a thorough 
                evaluation of the project to determine--
                            (i) the effects, if any, of induced entry 
                        and reduced exit,
                            (ii) the extent, if any, to which the 
                        project being tested is affected by whether it 
                        is in operation in a locality within an area 
                        under the administration of the Ticket to Work 
                        and Self-Sufficiency Program, and
                            (iii) the savings that accrue to the Trust 
                        Funds under the project being tested.
                The Commissioner shall take into account advice 
                provided by the Ticket to Work and Self-Sufficiency 
                Advisory Panel pursuant to subsection (e)(2)(C).
                    (B) Additional matters.--The Commissioner shall 
                also determine with respect to each project--
                            (i) the annual cost (including net cost) of 
                        the project and the annual cost (including net 
                        cost) that would have been incurred in the 
                        absence of the project,
                            (ii) the determinants of return to work, 
                        including the characteristics of the 
                        beneficiaries who participate in the project, 
                        and
                            (iii) the employment outcomes, including 
                        wages, occupations, benefits, and hours worked, 
                        of beneficiaries who return to work as a result 
                        of participation in the project.
            (3) Waivers.--The Commissioner may waive compliance with 
        the benefit requirements of title II of the Social Security 
        Act, and the Secretary of Health and Human Services may waive 
        compliance with the benefit requirements of title XVIII of such 
        Act, in so far as is necessary for a thorough evaluation of the 
        alternative methods under consideration. No such experiment or 
        project shall be actually placed in operation unless at least 
        90 days prior thereto a written report, prepared for purposes 
        of notification and information only and containing a full and 
        complete description thereof, has been transmitted by the 
        Commissioner to the Committee on Ways and Means of the House of 
        Representatives and to the Committee on Finance of the Senate. 
        Periodic reports on the progress of such experiments and 
        projects shall be submitted by the Commissioner to such 
        committees. When appropriate, such reports shall include 
        detailed recommendations for changes in administration or law, 
        or both, to carry out the objectives stated in paragraph (1).
            (4) Interim reports.--On or before June 9 in 2000 and each 
        of the succeeding years thereafter, the Commissioner shall 
        submit to the Congress an interim report on the progress of the 
        experiments and demonstration projects carried out under this 
        subsection together with any related data and materials which 
        the Commissioner may consider appropriate.
            (5) Final report.--The Commissioner shall submit to the 
        Congress a final report with respect to all experiments and 
        demonstration projects carried out under this section no later 
        than one year after their completion.
            (6) Expenditures.--Expenditures made for demonstration 
        projects under this subsection shall be made from the Federal 
        Disability Insurance Trust Fund and the Federal Old-Age and 
        Survivors Insurance Trust Fund, as determined appropriate by 
        the Commissioner, and from the Federal Hospital Insurance Trust 
        Fund and the Federal Supplementary Medical Insurance Trust 
        Fund, as determined appropriate by the Secretary of Health and 
        Human Services, to the extent provided in advance in 
        appropriation Acts.

SEC. 3. EXTENDING MEDICARE COVERAGE FOR OASDI DISABILITY BENEFIT 
              RECIPIENTS WHO ARE USING TICKETS TO WORK AND SELF-
              SUFFICIENCY.

    (a) In General.--The next to last sentence of section 226(b) of the 
Social Security Act (42 U.S.C. 426) is amended--
            (1) by striking ``throughout all of which'' and inserting 
        ``throughout the first 24 months of which'', and
            (2) by inserting after ``but not in excess of 24 such 
        months'' the following: ``(plus 24 additional such months in 
        the case of an individual who the Commissioner determines is 
        using a ticket to work and self-sufficiency issued under 
        section 1147, but only for additional months that occur in the 
        7-year period beginning on the date of the enactment of the 
        Ticket to Work and Self-Sufficiency Act of 1998)''.
    (b) Report.--Not later than 6 months prior to the end of the 7-year 
period beginning on the date of the enactment of this Act, the 
Secretary of Health and Human Services and the Commissioner of Social 
Security shall submit in writing to each House of the Congress their 
recommendations for further legislative action with respect to the 
amendments made by subsection (a), taking into account experience 
derived from efforts to achieve full implementation of the Ticket to 
Work and Self Sufficiency Program under section 1147 of the Social 
Security Act.

SEC. 4. CREDIT FOR IMPAIRMENT-RELATED WORK EXPENSES OF HANDICAPPED 
              INDIVIDUALS.

    (a) In General.--Subpart A of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to nonrefundable 
personal credits) is amended by inserting after section 25A the 
following new section:

``SEC. 25B. IMPAIRMENT-RELATED WORK EXPENSES OF HANDICAPPED 
              INDIVIDUALS.

    ``(a) Allowance of Credit.--In the case of a handicapped 
individual, there shall be allowed as a credit against the tax imposed 
by this chapter for the taxable year an amount equal to 50 percent of 
the impairment-related work expenses which are paid or incurred by the 
taxpayer during the taxable year.
    ``(b) Maximum Credit.--The credit allowed by subsection (a) with 
respect to the expenses of each handicapped individual shall not exceed 
$5,000 for the taxable year.
    ``(c) Definitions.--For purposes of this section--
            ``(1) Handicapped individual.--The term `handicapped 
        individual' has the meaning given such term by section 
        190(b)(3).
            ``(2) Impairment-related work expenses.--The term 
        `impairment-related work expenses' means expenses--
                    ``(A) of a handicapped individual for attendant 
                care services at the individual's place of employment 
                and other expenses in connection with such place of 
                employment which are necessary for such individual to 
                be able to work, and
                    ``(B) with respect to which a deduction is 
                allowable under section 162 (determined without regard 
                to this section).
    ``(d) Special Rules.--
            ``(1) Denial of double benefit.--The amount of impairment-
        related work expenses which is allowable as a deduction under 
        section 162 (determined without regard to this paragraph) for 
        the taxable year shall be reduced by the amount of credit 
        allowed under this section for such year.
            ``(2) Election to have section not apply.--No credit shall 
        be allowed under subsection (a) for the taxable year if the 
        taxpayer elects to not have this section apply for such year.''
    (b) Clerical Amendment.--The table of sections for such subpart A 
is amended by inserting after the item relating to section 25A the 
following new item:

                              ``Sec. 25B. Impairment-related work 
                                        expenses of handicapped 
                                        individuals.''
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 1997.
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