SEC. 1148.
[42 U.S.C. 1320b-19] (a)
IN GENERAL.—The
Commissioner 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.—
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(1) DISTRIBUTION OF TICKETS.—The Commissioner
may issue a ticket to work and self-sufficiency to disabled
beneficiaries for participation in the Program.
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(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.
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(3) TICKET TERMS.—A ticket issued under
paragraph (1) shall consist of a document which evidences the
Commissioner's agreement to pay (as provided in paragraph (4))
an employment network, which is serving under the Program and to
which such ticket is assigned by the beneficiary, for such employment
services, vocational rehabilitation services, and other support
services as the employment network may provide to the beneficiary.
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(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.—
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(1) IN GENERAL.—Each State agency
administering or supervising the administration of the State plan
approved under title I of the Rehabilitation Act of 1973 (29 U.S.C.
720 et seq.) may elect to participate in the Program as an employment
network with respect to a disabled beneficiary. If the State agency
does elect to participate in the Program, the State agency also shall
elect to be paid under the outcome payment system or the outcome-milestone
payment system in accordance with subsection (h)(1). With respect
to a disabled beneficiary that the State agency does not elect
to have participate in the Program, the State agency shall be paid
for services provided to that beneficiary under the system for
payment applicable under section 222(d) and subsections (d) and
(e) of section 1615. The Commissioner shall provide for periodic
opportunities for exercising such elections.
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(2) EFFECT OF PARTICIPATION BY STATE AGENCY.—
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(A) STATE AGENCIES PARTICIPATING.—In
any case in which a State agency described in paragraph (1) elects
under that paragraph to participate in the Program, the employment
services, vocational rehabilitation services, and other support
services which, upon assignment of tickets to work and self-sufficiency,
are provided to disabled beneficiaries by the State agency acting
as an employment network shall be governed by plans for vocational
rehabilitation services approved under title I of the Rehabilitation
Act of 1973 (29 U.S.C. 720 et seq.).
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(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.
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(3) AGREEMENTS BETWEEN STATE AGENCIES AND EMPLOYMENT
NETWORKS.—State agencies and employment networks shall
enter into agreements regarding the conditions under which services
will be provided when an individual is referred by an employment
network to a State agency for services. The Commissioner shall
establish by regulations the timeframe within which such agreements
must be entered into and the mechanisms for dispute resolution
between State agencies and employment networks with respect to
such agreements.
(d)
RESPONSIBILITIES OF THE COMMISSIONER.—
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(1) SELECTION AND QUALIFICATIONS OF PROGRAM MANAGERS.—The Commissioner
shall enter into agreements with 1 or more organizations in the
private or public sector for service as a program manager to assist
the Commissioner in administering the Program. Any such program
manager shall be selected by means of a competitive bidding process,
from among organizations in the private or public sector with available
expertise and experience in the field of vocational rehabilitation
or employment services.
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(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—
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(A) measures for ease of access by beneficiaries to services;
and
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(B) measures for determining the extent to which failures in
obtaining services for beneficiaries fall within acceptable parameters,
as determined by the Commissioner.
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(3) PRECLUSION FROM DIRECT PARTICIPATION IN DELIVERY
OF SERVICES IN OWN SERVICE AREA.—Agreements under
paragraph (1) shall preclude—
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(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
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(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.
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(4) SELECTION OF EMPLOYMENT NETWORKS.—
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(A) IN GENERAL.—The Commissioner shall
select and enter into agreements with employment networks for
service under the Program. Such employment networks shall be in
addition to State agencies serving as employment networks pursuant
to elections under subsection (c).
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(B) ALTERNATE PARTICIPANTS.—In any
State where the Program is being implemented, the Commissioner
shall enter into an agreement with any alternate participant that
is operating under the authority of section 222(d)(2) in the State
as of the date of the enactment of this section and chooses to
serve as an employment network under the Program.
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(5) TERMINATION OF AGREEMENTS WITH EMPLOYMENT NETWORKS.—The
Commissioner shall terminate agreements with employment networks for
inadequate performance, as determined by the Commissioner.
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(6) QUALITY ASSURANCE.—The Commissioner
shall provide for such periodic reviews as are necessary to provide
for effective quality assurance in the provision of services by
employment networks. The Commissioner shall solicit and consider
the views of consumers and the program manager under which the
employment networks serve and shall consult with providers of services
to develop performance measurements. The Commissioner shall ensure
that the results of the periodic reviews are made available to beneficiaries
who are prospective service recipients as they select employment
networks. The Commissioner shall ensure that the periodic surveys
of beneficiaries receiving services under the Program are designed
to measure customer service satisfaction.
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(7) DISPUTE RESOLUTION.—The Commissioner
shall provide for a mechanism for resolving disputes between beneficiaries
and employment networks, between program managers and employment
networks, and between program managers and providers of services.
The Commissioner shall afford a party to such a dispute a reasonable
opportunity for a full and fair review of the matter in dispute.
(e)
PROGRAM MANAGERS.—
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(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.
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(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.
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(3) FACILITATION OF ACCESS BY BENEFICIARIES TO
EMPLOYMENT NETWORKS.—A program manager shall facilitate
access by beneficiaries to employment networks. The program manager
shall ensure that each beneficiary is allowed changes in employment
networks without being deemed to have rejected services under the
Program. When such a change occurs, the program manager shall reassign
the ticket based on the choice of the beneficiary. Upon the request
of the employment network, the program manager shall make a determination
of the allocation of the outcome or milestone-outcome
payments based on the services provided by each employment network.
The program manager shall establish and maintain lists of employment
networks available to beneficiaries and shall make such lists
generally available to the public. The program manager shall ensure
that all information provided to disabled beneficiaries pursuant
to this paragraph is provided in accessible formats.
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(4) ENSURING AVAILABILITY OF ADEQUATE SERVICES.—The
program manager shall ensure that employment services, vocational
rehabilitation services, and other support services are provided
to beneficiaries throughout the geographic area covered under the
program manager's agreement, including rural areas.
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(5) REASONABLE ACCESS TO SERVICES.—The
program manager shall take such measures as are necessary to ensure
that sufficient employment networks are available and that each
beneficiary receiving services under the Program has reasonable
access to employment services, vocational rehabilitation services,
and other support services. Services provided under the Program
may include case management, work incentives planning, supported
employment, career planning, career plan development, vocational
assessment, job training, placement, follow-up services,
and such other services as may be specified by the Commissioner
under the Program. The program manager shall ensure that such services
are available in each service area.
(f)
EMPLOYMENT NETWORKS.—
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(1) QUALIFICATIONS FOR EMPLOYMENT NETWORKS.—
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(A) IN GENERAL.—Each employment network
serving under the Program shall consist of an agency or instrumentality
of a State (or a political subdivision thereof) or a private entity,
that assumes responsibility for the coordination and delivery of
services under the Program to individuals assigning to the employment
network tickets to work and self-sufficiency issued under
subsection (b).
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(B) ONE-STOP DELIVERY SYSTEMS.—An
employment network serving under the Program may consist of a
one-stop delivery system established under subtitle B of
title I of the Workforce Investment Act of 1998 (29 U.S.C. 2811
et seq.).
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(C) COMPLIANCE WITH SELECTION CRITERIA.—No
employment network may serve under the Program unless it meets
and maintains compliance with both general selection criteria
(such as professional and educational qualifications, where applicable)
and specific selection criteria (such as substantial expertise
and experience in providing relevant employment services and supports).
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(D) SINGLE OR ASSOCIATED PROVIDERS ALLOWED.—An
employment network shall consist of either a single provider of
such services or of an association of such providers organized
so as to combine their resources into a single entity. An employment
network may meet the requirements of subsection (e)(4) by providing
services directly, or by entering into agreements with other individuals
or entities providing appropriate employment services, vocational
rehabilitation services, or other support services.
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(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—
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(A) serve prescribed service areas; and
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(B) take such measures as are necessary to ensure that employment services,
vocational rehabilitation services, and other support services provided
under the Program by, or under agreements entered into with, the
employment network are provided under appropriate individual work
plans that meet the requirements of subsection (g).
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(3) ANNUAL FINANCIAL REPORTING.—Each
employment network shall meet financial reporting requirements
as prescribed by the Commissioner.
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(4) PERIODIC OUTCOMES REPORTING.—Each
employment network shall prepare periodic reports, on at least
an annual basis, itemizing for the covered period specific outcomes
achieved with respect to specific services provided by the employment
network. Such reports shall conform to a national model prescribed
under this section. Each employment network shall provide a copy
of the latest report issued by the employment network pursuant
to this paragraph to each beneficiary upon enrollment under the Program
for services to be received through such employment network. Upon
issuance of each report to each beneficiary, a copy of the report
shall be maintained in the files of the employment network. The
program manager shall ensure that copies of all such reports issued
under this paragraph are made available to the public under reasonable
terms.
(g)
INDIVIDUAL WORK PLANS.—
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(1) REQUIREMENTS.—Each employment network
shall—
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(A) take such measures as are necessary to ensure that employment services,
vocational rehabilitation services, and other support services provided
under the Program by, or under agreements entered into with, the
employment network are provided under appropriate individual work
plans that meet the requirements of subparagraph (C);
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(B) develop and implement each such individual work plan, in
partnership with each beneficiary receiving such services, in a
manner that affords such beneficiary the opportunity to exercise
informed choice in selecting an employment goal and specific services
needed to achieve that employment goal;
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(C) ensure that each individual work plan includes at least—
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(i) a statement of the vocational goal developed with the beneficiary,
including, as appropriate, goals for earnings and job advancement;
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(ii) a statement of the services and supports that have been
deemed necessary for the beneficiary to accomplish that goal;
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(iii) a statement of any terms and conditions related to the
provision of such services and supports; and
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(iv) a statement of understanding regarding the beneficiary's
rights under the Program (such as the right to retrieve the ticket
to work and self-sufficiency if the beneficiary is dissatisfied
with the services being provided by the employment network) and
remedies available to the individual, including information on
the availability of advocacy services and assistance in resolving
disputes through the State grant program authorized under section 1150;
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(D) provide a beneficiary the opportunity to amend the individual work
plan if a change in circumstances necessitates a change in the plan;
and
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(E) make each beneficiary's individual work plan available to
the beneficiary in, as appropriate, an accessible format chosen
by the beneficiary.
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(2) EFFECTIVE UPON WRITTEN APPROVAL.—A
beneficiary's individual work plan shall take effect upon written
approval by the beneficiary or a representative of the beneficiary
and a representative of the employment network that, in providing
such written approval, acknowledges assignment of the beneficiary's
ticket to work and self-sufficiency.
(h)
EMPLOYMENT NETWORK PAYMENT SYSTEMS.—
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(1) ELECTION OF PAYMENT SYSTEM BY EMPLOYMENT NETWORKS.—
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(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)).
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(B) NO CHANGE IN METHOD OF PAYMENT FOR BENEFICIARIES
WITH TICKETS ALREADY ASSIGNED TO THE EMPLOYMENT NETWORKS.—Any
election of a payment system by an employment network that would
result in a change in the method of payment to the employment network
for services provided to a beneficiary who is receiving services
from the employment network at the time of the election shall not
be effective with respect to payment for services provided to that beneficiary
and the method of payment previously selected shall continue to
apply with respect to such services.
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(2) OUTCOME PAYMENT SYSTEM.—
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(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.
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(B) PAYMENTS MADE DURING OUTCOME PAYMENT PERIOD.—The outcome
payment system shall provide for a schedule of payments to an
employment network, in connection with each individual who is a beneficiary,
for each month, during the individual's outcome payment period,
for which benefits (described in paragraphs (3) and (4) of subsection
(k)) are not payable to such individual because of work or earnings.
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(C) COMPUTATION OF PAYMENTS TO EMPLOYMENT NETWORK.—The
payment schedule of the outcome payment system shall be designed
so that—
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(i) the payment for each month during the outcome payment period
for which benefits (described in paragraphs (3) and (4) of subsection
(k)) are not payable is equal to a fixed percentage of the payment
calculation base for the calendar year in which such month occurs;
and
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(ii) such fixed percentage is set at a percentage which does
not exceed 40 percent.
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(3) OUTCOME-MILESTONE PAYMENT SYSTEM.—
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(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.
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(B) EARLY PAYMENTS UPON ATTAINMENT OF MILESTONES
IN ADVANCE OF OUTCOME PAYMENT PERIODS.—The outcome-
milestone payment system shall provide for 1 or more milestones,
with respect to beneficiaries receiving services from an employment network
under the Program, that are directed toward the goal of permanent
employment. Such milestones shall form a part of a payment structure
that provides, in addition to payments made during outcome payment
periods, payments made prior to outcome payment periods in amounts
based on the attainment of such milestones.
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(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.
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(4) DEFINITIONS.—In this subsection:
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(A) PAYMENT CALCULATION BASE.—The term
“payment calculation base” means, for any calendar
year—
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(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
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(ii) in connection with a title XVI disability beneficiary (who
is not concurrently a title II disability beneficiary), the average payment
of supplemental security income benefits based on disability payable
under title XVI (excluding State supplementation) for months during
the preceding calendar year to all beneficiaries who have attained
18 years of age but have not attained 65 years of age.
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(B) OUTCOME PAYMENT PERIOD.—The term
“outcome payment period” means, in connection
with any individual who had assigned a ticket to work and self-sufficiency
to an employment network under the Program, a period—
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(i) beginning with the first month, ending after the date on
which such ticket was assigned to the employment network, for which
benefits (described in paragraphs (3) and (4) of subsection (k))
are not payable to such individual by reason of engagement in substantial
gainful activity or by reason of earnings from work activity; and
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(ii) ending with the 60th month (consecutive or otherwise),
ending after such date, for which such benefits are not payable
to such individual by reason of engagement in substantial gainful activity
or by reason of earnings from work activity.
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(5) PERIODIC REVIEW AND ALTERATIONS OF PRESCRIBED
SCHEDULES.—
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(A) PERCENTAGES AND PERIODS.—The Commissioner
shall periodically review the percentage specified in paragraph
(2)(C), the total payments permissible under paragraph (3)(C),
and the period of time specified in paragraph (4)(B) to determine
whether such percentages, such permissible payments, and such period
provide an adequate incentive for employment networks to assist
beneficiaries to enter the workforce, while providing for appropriate
economies. The Commissioner may alter such percentage, such total
permissible payments, or such period of time to the extent that
the Commissioner determines, on the basis of the Commissioner's
review under this paragraph, that such an alteration would better
provide the incentive and economies described in the preceding
sentence.
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(B) NUMBER AND AMOUNTS OF MILESTONE PAYMENTS.—The Commissioner
shall periodically review the number and amounts of milestone payments
established by the Commissioner pursuant to this section to determine
whether they provide an adequate incentive for employment networks
to assist beneficiaries to enter the workforce, taking into account
information provided to the Commissioner by program managers,
the Ticket to Work and Work Incentives Advisory Panel established
by section 101(f) of the Ticket to Work and Work Incentives Improvement
Act of 1999, and other reliable sources. The Commissioner may from
time to time alter the number and amounts of milestone payments
initially established by the Commissioner pursuant to this section
to the extent that the Commissioner determines that such an alteration
would allow an adequate incentive for employment networks to assist
beneficiaries to enter the workforce. Such alteration shall be
based on information provided to the Commissioner by program managers,
the Ticket to Work and Work Incentives Advisory Panel established
by section 101(f) of the Ticket to Work and Work Incentives Improvement
Act of 1999, or other reliable sources.
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(C) REPORT ON THE ADEQUACY OF INCENTIVES.—The
Commissioner shall submit to the Congress not later than 36 months
after the date of the enactment of the Ticket to Work and Work
Incentives Improvement Act of 1999 a report with recommendations
for a method or methods to adjust payment rates under subparagraphs
(A) and (B), that would ensure adequate incentives for the provision
of services by employment networks of—
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(i) individuals with a need for ongoing support and services;
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(ii) individuals with a need for high-cost accommodations;
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(iii) individuals who earn a subminimum wage; and
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(iv) individuals who work and receive partial cash benefits.
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The Commissioner shall consult with the Ticket to Work and
Work Incentives Advisory Panel established under section 101(f)
of the Ticket to Work and Work Incentives Improvement Act of 1999
during the development and evaluation of the study. The Commissioner
shall implement the necessary adjusted payment rates prior to full
implementation of the Ticket to Work and Self-Sufficiency
Program.
(i)
SUSPENSION OF DISABILITY REVIEWS.—During
any period for which an individual is using, as defined by the
Commissioner, a ticket to work and self-sufficiency issued
under this section, the Commissioner (and any applicable State
agency) may not initiate a continuing disability review or other
review under section 221 of whether the individual is or is not
under a disability or a review under title XVI similar to any
such review under section 221.
(j)
AUTHORIZATIONS.—
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(1) PAYMENTS TO EMPLOYMENT NETWORKS.—
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(A) TITLE II DISABILITY BENEFICIARIES.—There
are authorized to be transferred from the Federal Old-Age
and Survivors Insurance Trust Fund and the Federal Disability
Insurance Trust Fund each fiscal year such sums as may be necessary
to make payments to employment networks under this section. Money
paid from the Trust Funds under this section with respect to title
II disability beneficiaries who are entitled to benefits under
section 223 or who are entitled to benefits under section 202(d)
on the basis of the wages and self-employment income of
such beneficiaries, shall be charged to the Federal Disability
Insurance Trust Fund, and all other money paid from the Trust Funds
under this section shall be charged to the Federal Old-Age
and Survivors Insurance Trust Fund.
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(B) TITLE XVI DISABILITY BENEFICIARIES.—Amounts
authorized to be appropriated to the Social Security Administration
under section 1601 (as in effect pursuant to the amendments made
by section 301 of the Social Security Amendments of 1972) shall
include amounts necessary to carry out the provisions of this section
with respect to title XVI disability beneficiaries.
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(2) ADMINISTRATIVE EXPENSES.—The costs
of administering this section (other than payments to employment
networks) shall be paid from amounts made available for the administration
of title II and amounts made available for the administration of
title XVI, and shall be allocated among such amounts as appropriate.
(k)
DEFINITIONS.—In
this section:
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(1) COMMISSIONER.—The term “Commissioner” means
the Commissioner of Social Security.
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(2) DISABLED BENEFICIARY.—The term
“disabled beneficiary” means a title II disability
beneficiary or a title XVI disability beneficiary.
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(3) TITLE II DISABILITY BENEFICIARY.—The
term “title II disability beneficiary” means
an individual entitled to disability insurance benefits under
section 223 or to monthly insurance benefits under section 202 based
on such individual's disability (as defined in section 223(d)).
An individual is a title II disability beneficiary for each month
for which such individual is entitled to such benefits.
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(4) TITLE XVI DISABILITY BENEFICIARY.—The
term “title XVI disability beneficiary” means
an individual eligible for supplemental security income benefits
under title XVI on the basis of blindness (within the meaning of
section 1614(a)(2)) or disability (within the meaning of section 1614(a)(3)). An individual is a title XVI disability beneficiary
for each month for which such individual is eligible for such
benefits.
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(5) SUPPLEMENTAL SECURITY INCOME BENEFIT.—The
term “supplemental security income benefit under title
XVI” means a cash benefit under section 1611 or 1619(a),
and does not include a State supplementary payment, administered
federally or otherwise.
(l)
REGULATIONS.—Not
later than 1 year after the date of the enactment of the Ticket
to Work and Work Incentives Improvement Act of 1999, the Commissioner
shall prescribe such regulations as are necessary to carry out
the provisions of this section.