[Congressional Record Volume 144, Number 33 (Monday, March 23, 1998)]
[Senate]
[Pages S2424-S2428]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ROCKEFELLER (for himself, Ms. Snowe, Mr. Kerry, Mr. 
        Kennedy, Mr. Dodd, Mr. Jeffords, and Mr. Chafee):
  S. 1809. A bill to improve the performance outcomes of the child 
support enforcement program in order to increase the financial 
stability and well-being of children and families, and to require the 
Secretary of Health and Human Services and the Secretary of Labor to 
jointly develop a National Standardized Medical Support Notice and 
establish a working group to eliminate existing barriers to the 
effective establishment and enforcement of medical child support; to 
the Committee on Finance.


         the child support performance improvement act of 1998

  Mr. ROCKEFELLER. Mr. President, I am pleased to join with my 
colleagues to introduce the Child Support Performance Improvement Act 
of 1998. I believe this legislation, with its special emphasis on the 
enforcement of medical child support orders, will improve the financial 
security and health of thousands of American children. This bill also 
takes careful steps to ensure that vital Federal health programs such 
as Medicaid and the new Children's Health Insurance Program are not 
misused by parents who are able but unwilling to live up to their 
health care responsibilities. I want to take this opportunity to share 
my special thanks with Senator Snowe, who has shown a long-standing 
commitment to this important issue. I would also like to thank Senators 
Kerry, Kennedy, Dodd, Jeffords, and Chafee for their work on the issue 
of child support.
  As a nation, our most fundamental measure of success is how 
effectively we provide for our children. We have a collective 
responsibility to ensure that our children have the financial resources 
they need to live happy, healthy and stable lives. At the same time, 
the responsibility for addressing many of children's daily needs fall 
squarely at the feet of their parents. In my state of West Virginia and 
elsewhere, too many parents neglect their financial responsibilities, 
maintaining that because they are no longer living in the same house as 
their children, they no longer have to support them. With so many 
parents refusing to provide their children with adequate financial 
support and health care, between $15 and $25 billion dollars in child 
support remains uncollected each year.
  The Child Support Performance Improvement Act of 1998 takes several 
steps to make child support a dependable part of the continuum of 
private and public benefits available to American children. Since the 
child support enforcement system was created in 1975

[[Page S2425]]

to centralize state government collections, Congress has authorized 
Federal funding to improve and broaden state child support programs. In 
addition to general financial support, the Federal government also 
makes annual incentive payments to the states based on the cost 
effectiveness of their child support collections. That is, dollar for 
dollar, do the states show a significant return for the money they 
spend on child support collections.
  For several years, there has been a consensus among both state child 
support agencies and child advocates that basing incentive payments on 
cost effectiveness alone does no justice to the many other areas of 
state performance. Two years ago, the welfare reform law took a 
positive step forward by commissioning a task force composed of child 
support experts from the Department of Health and Human Services and 
state agencies to come up with a new set of incentives that would keep 
states on the road to more effective child support collections in a 
variety of areas. The Child Support Performance Improvement Act of 1998 
incorporates the consensus findings of this work group. For the first 
time, the new incentives structure takes into account not only a 
state's cost effectiveness but its ability to establish paternity and 
child support orders and to collect current and back child support 
payments.
  This legislation also increases the emphasis on a State's collection 
of medical child support and eliminates some of the barriers the States 
face in their efforts to enforce medical child support orders. With one 
out of seven American children unable to access basic health coverage, 
medical child support or ``medical support'' has become a vital part of 
child support enforcement. Medical support can take many forms 
including an order to a non-custodial parent to provide health 
insurance, to cover a portion of an insurance co-payment or a 
deductible, or to pay past medical bills. Since 1984, federal law has 
required state child support enforcement agencies to petition for and 
collect medical support as part of any general child support order if 
health care coverage is available to the non-custodial parent at a 
reasonable cost. Unfortunately, however, medical child support is still 
only collected in about 30% of all child support cases. If we fail to 
use this prime opportunity to re-establish medical support as a 
priority, enforcement of medical support might be even more dismal in 
the future.
  The Child Support Performance Improvement Act of 1998 will improve 
the collection of medical support in two significant ways. First, it 
requires the Secretary of Health and Human Services to create a sixth 
medical support criterion upon which Federal incentives payments will 
be based. This sixth medical support incentives factor will not only 
ensure that States do their best to collect medical support, but it 
will also send a message to the States that when creating and improving 
their overall collections systems, medical support is a top priority.
  Many of us have worked hard to make sure that all American children 
receive appropriate health care coverage through both public and 
private programs such as the newly-created Children's Health Insurance 
(or ``CHIPS'') Program. Although this and other Federal programs are 
vital, they were never intended and should not be used as a parachute 
for parents who could afford to cover their own children, but refuse to 
do so.
  This bill also helps improve medical support collections by 
eliminating some of the procedural barriers that the states face when 
they try to enforce medical support orders through health plans 
governed by the Employment Retirement Income Security Act of 1974 
(ERISA). Once a court issues a medical support order, the state child 
support enforcement agencies sends a notice of that order to the non-
custodial parent's health plan. Over 50 percent of American employers 
offer health plans that are governed by ERISA. As a result, there are 
over 700,000 children who are dependent on a medical support order 
through an ERISA-governed plan. Currently, there is a lack of 
uniformity in the way that state child support enforcement agency and 
the health plan administrators communicate with one another. Despite 
the fact that ERISA already defines the elements a medical support 
order must contain in order to be valid under federal law, there is 
still a lot of confusion by the state agencies and the plan 
administrators about what is required.
  After consultation with dozens of ERISA plan administrators, state 
agencies, and child advocates, this bill removes this procedural 
barrier by requiring the Secretaries of the Department of Health and 
Human Services and the Department of Labor to create and implement a 
standardized national medical support notice that states would be 
required to use and employers would be required to accept under ERISA. 
This standardized form will take into account the respective 
administrative needs of both states and employers. Second, the bill 
requires the Secretary of the Department of Labor, in consultation with 
the Department of Health and Human Services, to submit recommendations 
for any other necessary improvements to the medical child support 
provisions of ERISA. Finally, the bill commissions a work group 
composed of medical support experts from state agencies, employers, 
plan administrators and child advocates to identify and make 
recommendations for the elimination of any remaining medical support 
barriers.
  The Child Support Performance Improvement Act of 1998 is designed to 
improve States' overall child support collections with a special 
emphasis on the effective enforcement of medical support orders, so 
that all qualified children receive the health coverage that they 
deserve.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1809

       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 ``Child Support Performance 
     Improvement Act of 1998''.

     SEC. 2. INCENTIVE PAYMENTS TO STATES.

       (a) In General.--Part D of title IV of the Social Security 
     Act (42 U.S.C. 651-669) is amended by inserting after section 
     458 the following:

     ``SEC. 458A. INCENTIVE PAYMENTS TO STATES.

       ``(a) In General.--In addition to any other payment under 
     this part, the Secretary shall, subject to subsection (f), 
     make an incentive payment to each State for each fiscal year 
     in an amount determined under subsection (b).
       ``(b) Amount of Incentive Payment.--
       ``(1) In general.--The incentive payment for a State for a 
     fiscal year is equal to the incentive payment pool for the 
     fiscal year, multiplied by the State incentive payment share 
     for the fiscal year.
       ``(2) Incentive payment pool.--
       ``(A) In general.--In paragraph (1), the term `incentive 
     payment pool' means--
       ``(i) $422,000,000 for fiscal year 2000;
       ``(ii) $429,000,000 for fiscal year 2001;
       ``(iii) $450,000,000 for fiscal year 2002;
       ``(iv) $461,000,000 for fiscal year 2003;
       ``(v) $454,000,000 for fiscal year 2004;
       ``(vi) $446,000,000 for fiscal year 2005;
       ``(vii) $458,000,000 for fiscal year 2006;
       ``(viii) $471,000,000 for fiscal year 2007;
       ``(ix) $483,000,000 for fiscal year 2008; and
       ``(x) for any succeeding fiscal year, the amount of the 
     incentive payment pool for the fiscal year that precedes such 
     succeeding fiscal year, multiplied by the percentage (if any) 
     by which the CPI for such preceding fiscal year exceeds the 
     CPI for the 2nd preceding fiscal year.
       ``(B) CPI.--For purposes of subparagraph (A), the CPI for a 
     fiscal year is the average of the Consumer Price Index for 
     the 12-month period ending on September 30 of the fiscal 
     year. As used in the preceding sentence, the term `Consumer 
     Price Index' means the last Consumer Price Index for all-
     urban consumers published by the Department of Labor.
       ``(3) State incentive payment share.--In paragraph (1), the 
     term `State incentive payment share' means, with respect to a 
     fiscal year--
       ``(A) the incentive base amount for the State for the 
     fiscal year; divided by
       ``(B) the sum of the incentive base amounts for all of the 
     States for the fiscal year.
       ``(4) Incentive base amount.--In paragraph (3), the term 
     `incentive base amount' means, with respect to a State and a 
     fiscal year, the sum of the applicable percentages 
     (determined in accordance with paragraph (6)) multiplied by 
     the corresponding maximum incentive base amounts for the 
     State for the fiscal year, with respect to each of the 
     following measures of State performance for the fiscal year:
       ``(A) The paternity establishment performance level.
       ``(B) The support order performance level.
       ``(C) The current payment performance level.

[[Page S2426]]

       ``(D) The arrearage payment performance level.
       ``(E) The cost-effectiveness performance level.
       ``(5) Maximum incentive base amount.--
       ``(A) In general.--For purposes of paragraph (4), the 
     maximum incentive base amount for a State for a fiscal year 
     is--
       ``(i) with respect to the performance measures described in 
     subparagraphs (A), (B), and (C) of paragraph (4), 100 percent 
     of the State collections base for the fiscal year; and
       ``(ii) with respect to the performance measures described 
     in subparagraphs (D) and (E) of paragraph (4), 75 percent of 
     the State collections base for the fiscal year.
       ``(B) Data required to be complete and reliable.--
     Notwithstanding subparagraph (A), the maximum incentive base 
     amount for a State for a fiscal year with respect to a 
     performance measure described in paragraph (4) is zero, 
     unless the Secretary determines, on the basis of an audit 
     performed under section 452(a)(4)(C)(i), that the data which 
     the State submitted pursuant to section 454(15)(B) for the 
     fiscal year and which is used to determine the performance 
     level involved is complete and reliable.
       ``(C) State collections base.--For purposes of subparagraph 
     (A), the State collections base for a fiscal year is equal to 
     the sum of--
       ``(i) 2 times the sum of--

       ``(I) the total amount of support collected during the 
     fiscal year under the State plan approved under this part in 
     cases in which the support obligation involved is required to 
     be assigned to the State pursuant to part A or E of this 
     title or title XIX; and
       ``(II) the total amount of support collected during the 
     fiscal year under the State plan approved under this part in 
     cases in which the support obligation involved was so 
     assigned but, at the time of collection, is not required to 
     be so assigned; and

       ``(ii) the total amount of support collected during the 
     fiscal year under the State plan approved under this part in 
     all other cases.
       ``(6) Determination of applicable percentages based on 
     performance levels.--
       ``(A) Paternity establishment.--
       ``(i) Determination of paternity establishment performance 
     level.--The paternity establishment performance level for a 
     State for a fiscal year is, at the option of the State, the 
     IV-D paternity establishment percentage determined under 
     section 452(g)(2)(A) or the statewide paternity establishment 
     percentage determined under section 452(g)(2)(B).
       ``(ii) Determination of applicable percentage.--The 
     applicable percentage with respect to a State's paternity 
     establishment performance level is as follows:
       

------------------------------------------------------------------------
``If the paternity establishment performance level is:                  
-------------------------------------------------------  The applicable 
            At least:                 But less than:     percentage is: 
------------------------------------------------------------------------
80%..............................  ...................         100      
79%..............................  80%................         98       
78%..............................  79%................         96       
77%..............................  78%................         94       
76%..............................  77%................         92       
75%..............................  76%................         90       
74%..............................  75%................         88       
73%..............................  74%................         86       
72%..............................  73%................         84       
71%..............................  72%................         82       
70%..............................  71%................         80       
69%..............................  70%................         79       
68%..............................  69%................         78       
67%..............................  68%................         77       
66%..............................  67%................         76       
65%..............................  66%................         75       
64%..............................  65%................         74       
63%..............................  64%................         73       
62%..............................  63%................         72       
61%..............................  62%................         71       
60%..............................  61%................         70       
59%..............................  60%................         69       
58%..............................  59%................         68       
57%..............................  58%................         67       
56%..............................  57%................         66       
55%..............................  56%................         65       
54%..............................  55%................         64       
53%..............................  54%................         63       
52%..............................  53%................         62       
51%..............................  52%................         61       
50%..............................  51%................         60       
0%...............................  50%................         0.       
------------------------------------------------------------------------

     Notwithstanding the preceding sentence, if the paternity 
     establishment performance level of a State for a fiscal year 
     is less than 50 percent but exceeds by at least 10 percentage 
     points the paternity establishment performance level of the 
     State for the immediately preceding fiscal year, then the 
     applicable percentage with respect to the State's paternity 
     establishment performance level is 50 percent.
       ``(B) Establishment of child support orders.--
       ``(i) Determination of support order performance level.--
     The support order performance level for a State for a fiscal 
     year is the percentage of the total number of cases under the 
     State plan approved under this part in which there is a 
     support order during the fiscal year.
       ``(ii) Determination of applicable percentage.--The 
     applicable percentage with respect to a State's support order 
     performance level is as follows:
       

------------------------------------------------------------------------
     ``If the support order performance level is:                       
-------------------------------------------------------  The applicable 
            At least:                 But less than:     percentage is: 
------------------------------------------------------------------------
80%..............................  ...................         100      
79%..............................  80%................         98       
78%..............................  79%................         96       
77%..............................  78%................         94       
76%..............................  77%................         92       
75%..............................  76%................         90       
74%..............................  75%................         88       
73%..............................  74%................         86       
72%..............................  73%................         84       
71%..............................  72%................         82       
70%..............................  71%................         80       
69%..............................  70%................         79       
68%..............................  69%................         78       
67%..............................  68%................         77       
66%..............................  67%................         76       
65%..............................  66%................         75       
64%..............................  65%................         74       
63%..............................  64%................         73       
62%..............................  63%................         72       
61%..............................  62%................         71       
60%..............................  61%................         70       
59%..............................  60%................         69       
58%..............................  59%................         68       
57%..............................  58%................         67       
56%..............................  57%................         66       
55%..............................  56%................         65       
54%..............................  55%................         64       
53%..............................  54%................         63       
52%..............................  53%................         62       
51%..............................  52%................         61       
50%..............................  51%................         60       
0%...............................  50%................         0.       
------------------------------------------------------------------------

     Notwithstanding the preceding sentence, if the support order 
     performance level of a State for a fiscal year is less than 
     50 percent but exceeds by at least 5 percentage points the 
     support order performance level of the State for the 
     immediately preceding fiscal year, then the applicable 
     percentage with respect to the State's support order 
     performance level is 50 percent.
       ``(C) Collections on current child support due.--
       ``(i) Determination of current payment performance level.--
     The current payment performance level for a State for a 
     fiscal year is equal to the total amount of current support 
     collected during the fiscal year under the State plan 
     approved under this part divided by the total amount of 
     current support owed during the fiscal year in all cases 
     under the State plan, expressed as a percentage.
       ``(ii) Determination of applicable percentage.--The 
     applicable percentage with respect to a State's current 
     payment performance level is as follows:
       

------------------------------------------------------------------------
    ``If the current payment performance level is:                      
-------------------------------------------------------  The applicable 
            At least:                 But less than:     percentage is: 
------------------------------------------------------------------------
80%..............................  ...................         100      
79%..............................  80%................         98       
78%..............................  79%................         96       
77%..............................  78%................         94       
76%..............................  77%................         92       
75%..............................  76%................         90       
74%..............................  75%................         88       
73%..............................  74%................         86       
72%..............................  73%................         84       
71%..............................  72%................         82       
70%..............................  71%................         80       
69%..............................  70%................         79       
68%..............................  69%................         78       
67%..............................  68%................         77       
66%..............................  67%................         76       
65%..............................  66%................         75       
64%..............................  65%................         74       
63%..............................  64%................         73       
62%..............................  63%................         72       
61%..............................  62%................         71       
60%..............................  61%................         70       
59%..............................  60%................         69       
58%..............................  59%................         68       
57%..............................  58%................         67       
56%..............................  57%................         66       
55%..............................  56%................         65       
54%..............................  55%................         64       
53%..............................  54%................         63       
52%..............................  53%................         62       
51%..............................  52%................         61       
50%..............................  51%................         60       
49%..............................  50%................         59       
48%..............................  49%................         58       
47%..............................  48%................         57       
46%..............................  47%................         56       
45%..............................  46%................         55       
44%..............................  45%................         54       
43%..............................  44%................         53       
42%..............................  43%................         52       
41%..............................  42%................         51       
40%..............................  41%................         50       
0%...............................  40%................         0.       
------------------------------------------------------------------------

     Notwithstanding the preceding sentence, if the current 
     payment performance level of a State for a fiscal year is 
     less than 40 percent but exceeds by at least 5 percentage 
     points the current payment performance level of the State for 
     the immediately preceding fiscal year, then the applicable 
     percentage with respect to the State's current payment 
     performance level is 50 percent.
       ``(D) Collections on child support arrearages.--
       ``(i) Determination of arrearage payment performance 
     level.--The arrearage payment performance level for a State 
     for a fiscal year is equal to the total number of cases under 
     the State plan approved under this part in which payments of 
     past-due child support were received during the fiscal year 
     and part or all of the payments were

[[Page S2427]]

     distributed to the family to whom the past-due child support 
     was owed (or, if all past-due child support owed to the 
     family was, at the time of receipt, subject to an assignment 
     to the State, part or all of the payments were retained by 
     the State) divided by the total number of cases under the 
     State plan in which there is past-due child support, 
     expressed as a percentage.
       ``(ii) Determination of applicable percentage.--The 
     applicable percentage with respect to a State's arrearage 
     payment performance level is as follows:
       

------------------------------------------------------------------------
   ``If the arrearage payment performance level is:                     
-------------------------------------------------------  The applicable 
            At least:                 But less than:     percentage is: 
------------------------------------------------------------------------
80%..............................  ...................         100      
79%..............................  80%................         98       
78%..............................  79%................         96       
77%..............................  78%................         94       
76%..............................  77%................         92       
75%..............................  76%................         90       
74%..............................  75%................         88       
73%..............................  74%................         86       
72%..............................  73%................         84       
71%..............................  72%................         82       
70%..............................  71%................         80       
69%..............................  70%................         79       
68%..............................  69%................         78       
67%..............................  68%................         77       
66%..............................  67%................         76       
65%..............................  66%................         75       
64%..............................  65%................         74       
63%..............................  64%................         73       
62%..............................  63%................         72       
61%..............................  62%................         71       
60%..............................  61%................         70       
59%..............................  60%................         69       
58%..............................  59%................         68       
57%..............................  58%................         67       
56%..............................  57%................         66       
55%..............................  56%................         65       
54%..............................  55%................         64       
53%..............................  54%................         63       
52%..............................  53%................         62       
51%..............................  52%................         61       
50%..............................  51%................         60       
49%..............................  50%................         59       
48%..............................  49%................         58       
47%..............................  48%................         57       
46%..............................  47%................         56       
45%..............................  46%................         55       
44%..............................  45%................         54       
43%..............................  44%................         53       
42%..............................  43%................         52       
41%..............................  42%................         51       
40%..............................  41%................         50       
0%...............................  40%................         0.       
------------------------------------------------------------------------

     Notwithstanding the preceding sentence, if the arrearage 
     payment performance level of a State for a fiscal year is 
     less than 40 percent but exceeds by at least 5 percentage 
     points the arrearage payment performance level of the State 
     for the immediately preceding fiscal year, then the 
     applicable percentage with respect to the State's arrearage 
     payment performance level is 50 percent.
       ``(E) Cost-effectiveness.--
       ``(i) Determination of cost-effectiveness performance 
     level.--The cost-effectiveness performance level for a State 
     for a fiscal year is equal to the total amount collected 
     during the fiscal year under the State plan approved under 
     this part divided by the total amount expended during the 
     fiscal year under the State plan, expressed as a ratio.
       ``(ii) Determination of applicable percentage.--The 
     applicable percentage with respect to a State's cost-
     effectiveness performance level is as follows:
       

------------------------------------------------------------------------
   ``If the cost-effectiveness performance level is:                    
-------------------------------------------------------  The applicable 
            At least:                 But less than:     percentage is: 
------------------------------------------------------------------------
5.00.............................  ...................         100      
4.50.............................  4.99...............         90       
4.00.............................  4.50...............         80       
3.50.............................  4.00...............         70       
3.00.............................  3.50...............         60       
2.50.............................  3.00...............         50       
2.00.............................  2.50...............         40       
0.00.............................  2.00...............         0.       
------------------------------------------------------------------------

       ``(F) Medical support.--Subject to section 2(d)(2)(C) of 
     the Child Support Performance Improvement Act of 1998, the 
     medical support performance level for a State for a fiscal 
     year, and the applicable percentage for a State with respect 
     to such level, shall be determined in accordance with 
     regulations implementing the recommendations required to be 
     included in the report submitted under section 2(d)(2)(B) of 
     such Act.
       ``(c) Treatment of Interstate Collections.--In computing 
     incentive payments under this section, support which is 
     collected by a State at the request of another State shall be 
     treated as having been collected in full by both States, and 
     any amounts expended by a State in carrying out a special 
     project assisted under section 455(e) shall be excluded.
       ``(d) Administrative Provisions.--The amounts of the 
     incentive payments to be made to the States under this 
     section for a fiscal year shall be estimated by the Secretary 
     at or before the beginning of the fiscal year on the basis of 
     the best information available, as obtained in accordance 
     with section 452(a)(12). The Secretary shall make the 
     payments for the fiscal year, on a quarterly basis (with each 
     quarterly payment being made not later than the beginning of 
     the quarter involved), in the amounts so estimated, reduced, 
     or increased to the extent of any overpayments or 
     underpayments which the Secretary determines were made under 
     this section to the States involved for prior periods and 
     with respect to which adjustment has not already been made 
     under this subsection. Upon the making of any estimate by the 
     Secretary under the preceding sentence, any appropriations 
     available for payments under this section are deemed 
     obligated.
       ``(e) Regulations.--
       ``(1) In general.--The Secretary shall prescribe such 
     regulations as may be necessary governing the calculation of 
     incentive payments under this section, including directions 
     for excluding from the calculations certain closed cases and 
     cases over which the States do not have jurisdiction, and 
     regulations excluding from the calculations of the current 
     payment performance level and the arrearage payment 
     performance level any case in which the State used State 
     funds to make such payments for the primary purpose of 
     increasing the State's performance levels in such areas.
       ``(2) Regulations implementing the medical support 
     performance level.--Subject to section 2(d)(2)(C) of the 
     Child Support Performance Improvement Act of 1998, the 
     Secretary shall prescribe regulations implementing the 
     recommendations required to be included in the report 
     submitted under section 2(d)(2)(B) of such Act. To the extent 
     necessary to ensure that the implementation of such 
     recommendations does not result in total Federal expenditures 
     under this section in excess of the amount of such 
     expenditures in the absence of such implementation, such 
     regulations may increase or decrease the percentages 
     specified in clauses (i) and (ii) of subsection (b)(5)(A).
       ``(f) Reinvestment.--
       ``(1) In general.--Until such time as the State qualifies 
     for the maximum incentive amount possible, as determined 
     under subsection (b)(5), payments under this section and 
     section 458 shall supplement, not supplant, State child 
     support expenditures under the State program under this part 
     to the extent that such expenditures were funded by the State 
     in fiscal year 1997.
       ``(2) Penalty.--Failure to satisfy the requirement of 
     paragraph (1) shall result in a proportionate reduction, 
     determined by the Secretary, of future payments to the State 
     under this section and section 458.''.
       (b) Payments During Transition Period.--Notwithstanding 
     section 458A of the Social Security Act (42 U.S.C. 658A), as 
     added by subsection (a), the amount of an incentive payment 
     for a State under such section shall not be--
       (1) in the case of fiscal year 2000, less than 80 percent 
     or greater than 120 percent of the incentive payment for the 
     State determined under section 458 of the Social Security Act 
     (42 U.S.C. 658) for fiscal year 1999 (as such section was in 
     effect for such fiscal year);
       (2) in the case of fiscal year 2001, less than 60 percent 
     or greater than 140 percent of the incentive payment for the 
     State (as so determined);
       (3) in the case of fiscal year 2002, less than 40 percent 
     or greater than 160 percent of the incentive payment for the 
     State (as so determined); and
       (4) in the case of fiscal year 2003, less than 20 percent 
     or greater than 180 percent of the incentive payment for the 
     State (as so determined).
       (c) Regulations.--Within 9 months after the date of 
     enactment of this section, the Secretary of Health and Human 
     Services shall, in addition to the regulations required under 
     section 458A(e) of the Social Security Act, issue regulations 
     governing the implementation of section 458A of the Social 
     Security Act, when such section takes effect, and the 
     implementation of subsection (b) of this section.
       (d) Studies.--
       (1) General review of new incentive payment system.--
       (A) In general.--The Secretary of Health and Human Services 
     (in this subsection referred to as the ``Secretary'') shall 
     conduct a study of the implementation of the incentive 
     payment system established by section 458A of the Social 
     Security Act, in order to identify the problems and successes 
     of the system.
       (B) Reports to congress.--
       (i) Report on variations in state performance attributable 
     to demographic variables.--Not later than October 1, 2000, 
     the Secretary shall submit to Congress a report that 
     identifies any demographic or economic variables that account 
     for differences in the performance levels achieved by the 
     States with respect to the performance measures used in the 
     system, and contains the recommendations of the Secretary for 
     such adjustments to the system as may be necessary to ensure 
     that the relative performance of States is measured from a 
     baseline that takes account of any such variables.
       (ii) Interim report.--Not later than March 1, 2001, the 
     Secretary shall submit to Congress an interim report that 
     contains the findings of the study required by subparagraph 
     (A).
       (iii) Final report.--Not later than October 1, 2003, the 
     Secretary shall submit to Congress a final report that 
     contains the final findings of the study required by 
     subparagraph (A). The report shall include any 
     recommendations for changes in the system

[[Page S2428]]

     that the Secretary determines would improve the operation of 
     the child support enforcement program.
       (2) Development of medical support incentive.--
       (A) In general.--The Secretary, in consultation with State 
     directors of programs operated under part D of title IV of 
     the Social Security Act and representatives of children 
     potentially eligible for medical support, such as child 
     advocacy organizations, shall develop a new medical support 
     performance measure based on the effectiveness of States in 
     establishing and enforcing medical support obligations, and 
     shall make recommendations for the incorporation of the 
     measure, in a revenue neutral manner, into the incentive 
     payment system established by section 458A of the Social 
     Security Act.
       (B) Report.--Not later than October 1, 1999, the Secretary 
     shall submit to the Committee on Ways and Means of the House 
     of Representatives and the Committee on Finance of the 
     Senate, a report that describes the performance measure and 
     contains the recommendations required under subparagraph (A).
       (C) Congressional disapproval required.--
       (i) In general.--The Secretary shall, by regulation, 
     implement the recommendations required to be included in the 
     report submitted under subparagraph (B) unless a joint 
     resolution is enacted, in accordance with subparagraph (D), 
     disapproving such recommendations before the end of the 1-
     year period that begins on the date on which the Secretary 
     submits such report.
       (ii) Exclusion of certain days.--For purposes of clause (i) 
     and subparagraph (D), the days on which either House of 
     Congress is not in session because of an adjournment of more 
     than 3 days to a day certain shall be excluded from the 
     computation of the period.
       (D) Congressional consideration.--
       (i) Terms of the resolution.--For purposes of subparagraph 
     (C)(i), the term ``joint resolution'' means only a joint 
     resolution that is introduced within the 1-year period 
     described in such subparagraph and--

       (I) that does not have a preamble;
       (II) the matter after the resolving clause of which is as 
     follows: ``That Congress disapproves the recommendations of 
     the Secretary of Health and Human Services regarding the 
     implementation of a medical support performance measure 
     submitted on ________