South Carolina General Assembly
114th Session, 2001-2002

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Bill 4727


Indicates Matter Stricken
Indicates New Matter


                    Current Status

Bill Number:                      4727
Type of Legislation:              General Bill GB
Introducing Body:                 House
Introduced Date:                  20020214
Primary Sponsor:                  Barrett
All Sponsors:                     Barrett
Drafted Document Number:          l:\council\bills\gjk\20805djc02.doc
Residing Body:                    House
Current Committee:                Ways and Means Committee 30 HWM
Subject:                          Work Incentives Improvement Act of 2002, 
                                  to enhance employment opportunities for 
                                  individuals with disabilities


                        History

Body    Date      Action Description                     Com     Leg Involved
______  ________  ______________________________________ _______ ____________
House   20020214  Introduced, read first time,           30 HWM
                  referred to Committee


              Versions of This Bill

View additional legislative information at the LPITS web site.


(Text matches printed bills. Document has been reformatted to meet World Wide Web specifications.)

A BILL

TO AMEND CHAPTER 28, TITLE 44, CODE OF LAWS OF SOUTH CAROLINA, 1976, RELATING TO THE SELF-SUFFICIENCY AND DISABILITY TRUST FUNDS AND AID FOR DEVELOPMENTALLY DISABLED, MENTALLY ILL, AND PHYSICALLY HANDICAPPED PERSONS, BY ADDING ARTICLE 5 SO AS TO ENACT THE WORK INCENTIVES IMPROVEMENT ACT OF 2002, INCLUDING PROVISIONS FOR THE DEPARTMENT OF DISABILITIES AND SPECIAL NEEDS TO PROMULGATE REGULATIONS ADMINISTERING CERTAIN MEDICAID BUY-IN PROGRAMS, AND TO APPLY FOR DEMONSTRATION PROJECTS UNDER THE SOCIAL SECURITY DISABILITY INSURANCE AND SUPPLEMENTAL SECURITY INCOME PROGRAMS, TO PROVIDE FOR APPLICATIONS BY THE DEPARTMENT FOR WAIVERS RELATING TO MEDICAID BUY-IN PROGRAMS, TO PROVIDE FOR APPLICATIONS FOR GRANTS TO SUPPORT STATE INFRASTRUCTURES TO SUPPORT WORKING INDIVIDUALS WITH DISABILITIES, TO PROVIDE FOR THE ESTABLISHMENT, COORDINATION, AND AUTHORIZATION FOR APPROPRIATIONS FOR A COMMUNITY-BASED WORK INCENTIVE OUTREACH PROGRAM FOR DISSEMINATING INFORMATION TO INDIVIDUALS WITH DISABILITIES ON WORK INCENTIVES, TO PROVIDE FOR THE ESTABLISHMENT OF CRITERIA FOR DETERMINING THE EFFECTIVENESS OF THE STATE'S WORK INCENTIVE INITIATIVES, TO PROVIDE FOR DEVELOPMENT OF A STRATEGY FOR ENHANCING EMPLOYMENT OPPORTUNITIES FOR INDIVIDUALS WITH DISABILITIES, AND TO PROVIDE FOR THE ESTABLISHMENT, DUTIES, AND MEMBERSHIP OF THE "WORK AND WORK INCENTIVES ADVISORY PANEL".

Be it enacted by the General Assembly of the State of South Carolina:

SECTION    1.    Chapter 28, Title 44 of the 1976 Code is amended by adding:

"Article 5

Work Incentives Improvement Act of 2002

    Section 44-28-510.    This chapter may be cited as the 'Work Incentives Improvement Act of 2002'.

    Section 44-28-520.    (A)    The General Assembly finds:

        (1)    Individuals with disabilities have greater opportunities for employment than ever before aided by advancements in public understanding of disabilities and innovations in assistive technology, medical treatment, and rehabilitation and important public policy initiatives such as the current work incentive provisions in Section 1619 of the Social Security Act, the Ticket to Work and Work Incentives Improvement Act of 1999, the Individuals with Disabilities Education Act, the Rehabilitation Act, and the Americans with Disabilities Act.

        (2)    There is a growing recognition that disability is a natural part of the human experience that in no way diminishes an individual's right to live independently, enjoy self-determination, make choices, contribute to society, and enjoy full inclusion and integration in the mainstream of American society.

        (3)    Coverage under Medicaid of personal assistance services, prescription drugs, durable medical equipment, and basic health care remove many of the barriers between significant disability and work and are powerful and proven tools facilitating the ability of individuals with significant disabilities to obtain and retain employment.

        (4)    Despite the historic opportunities and the desire of millions of disability recipients to work and support themselves, few Social Security Disability Insurance and Supplemental Security Income recipients return to work.

        (5)    Individuals with significant disabilities often are unable to obtain health insurance in the private sector that provides coverage of the services and supports that enable them to live independently and enter, remain in, or rejoin the workforce. Therefore, there is a need to supplement private insurance or rely on Medicaid for necessary services and supports.

        (6)    For individuals with disabilities currently receiving health care under Medicaid, the fear of losing health care and related services is one of the greatest barriers keeping individuals from maximizing their employment, earning potential, and independence.

        (7)    For many individual recipients under the Social Security Disability Insurance and Supplemental Security Income programs, the risk of losing Medicare and Medicaid coverage that is linked to their cash benefits, is a risk that is an equal or greater work disincentive than the loss of cash benefits associated with working.

        (8)    For some individuals with disabilities who are currently working and not currently recipients under the Social Security Disability Insurance and Supplemental Security Income programs, there is a significant likelihood that without receiving the types of services and supports provided under Medicaid they will stop working and become recipients of the programs.

        (9)    In addition to the fear of loss of health care coverage, individuals with disabilities cite as barriers to employment the cumulative effect of the following: financial disincentives to work and earn income, lack of adequate employment training and placement services, continuing discrimination, complexity of existing work incentives, and the lack of benefits counseling providing accurate and easy to understand information about their options. In addition, individuals cite the lack of a comprehensive integrated system of short and long-term services and supports that address the individuals' overall needs including education, training, health care, housing, food, and transportation.

        (10)    Eliminating such barriers to work by, among other things, creating financial incentives to work and by providing individuals with disabilities real choice in obtaining services and supports, including technology they need to find, enter, and maintain employment, can greatly improve their short and long-term financial independence and personal well-being.

        (11)    In addition to the enormous advantages these changes promise for individuals with disabilities, redesigning government programs to assist individuals with disabilities in entering or returning to work or increasing the amount of work may result in significant savings to the state treasury as well as extend the life of the Social Security Disability Insurance Trust Fund.

    (B)    This article shall be implemented consistent with the following policies:

        (1)    The act shall be implemented consistent with the state's goals regarding individuals with disabilities to assure equality of opportunity, full participation, independent living, and economic self-sufficiency of such individuals.

        (2)    The State shall adopt a comprehensive approach for enhancing employment opportunities for persons with disabilities that focus on the needs of the individuals with disabilities, not the jurisdictions of various agencies administering separate programs.

        (3)    Income assistance and medical care entitlement programs must be responsive to disability-related variations in ability to work over time. Certain persons with significant disabilities are only able to work part time or their ability to work varies over time because of the episodic nature of their disability.

        (4)    Individuals with disabilities should have the option to contribute to their own support for daily living expenses by being allowed to work and not be limited to being totally dependent on public income assistance programs or publicly-financed health benefits.

        (5)    Individuals with disabilities should have the opportunity to increase their disposable income for daily living costs as well as to increase their long-term financial security and independence by savings for housing, education, and long-term services and supports such as assistive technology and retirement.

        (6)    Certain individuals with disabilities who are working and have reduced income assistance benefits should be required to contribute to the cost of their health care and other supports and services. At the same time, these individuals should be allowed to have more assets and resources than those not contributing to their own self-support.

        (7)    Public programs which assist individuals with significant disabilities who work should provide for gradual instead of precipitous changes in the amount and form of public support provided to such persons when their ability to work, their earnings level, and their needs for services and benefits change over time.

        (8)    Work incentive initiatives should include accurate and timely information on the impact of the change in work status on the individual's income, benefits, and services available to the individual.

        (9)    In adopting a policy framework for reducing worker disincentives, the following criteria should be considered: keep it as simple as possible for persons with disabilities; make it as easy as possible to administer; make any fee schedules used as progressive as possible (higher percent at higher income); and make it complementary to private programs.

        (10)    No decisions regarding the development, implementation, and evaluation of policies and procedures developed under this act shall be made without reviewing current policies and research studies and soliciting and seriously considering input from persons with disabilities, their families and representatives, representatives of businesses in the State with employment opportunities, and other persons involved in the development of policies and the provision of services and supports.

    (C)    The purposes of this article are to:

        (1)    provide health care to individuals with disabilities, including the option of allowing individuals with disabilities to purchase Medicaid coverage that will enable those individuals to maintain employment and reduce their dependency on cash benefit programs;

        (2)    remove work disincentives that inhibit individuals with disabilities from engaging in work that is commensurate with their abilities and capabilities;

        (3)    develop an infrastructure within and outside state government that supports efforts to enhance employment opportunities for individuals with disabilities;

        (4)    ensure meaningful input in the design, implementation, and evaluation of programs, policies, and procedures developed under the act by individuals with disabilities, family members and representatives, businesses, and other interested parties.

    Section 44-28-530.    (A)    The Department of Disabilities and Special Needs shall apply to the Secretary of the United States Department of Health and Human Services for approval of amendments to the state Medicaid plan creating categories of eligibility described in subsections (B) and (C) and for approval of a demonstration project described in subsection (D).

    (B)    A category of eligibility shall be established under the Medicaid program that provides an opportunity to buy into Medicaid consistent with Section 1902(a)(10)(A)(ii)(XV) of the Social Security Act for workers with disabilities who, except for earnings, would be eligible for the Supplemental Security Income program and meet income, assets, and resource limitations established by the department.

    (C)    A category of eligibility shall be established under the Medicaid program that provides an opportunity to buy into Medicaid consistent with Section 1902(a)(10)(A)(ii)(XVI) of the Social Security Act for workers with a medically improved disability who meet income, assets, and resource limitations established by the department.

    (D)    The department shall apply to the Secretary of the United States Department of Health and Human Services for approval of a demonstration project providing an opportunity to buy into the Medicaid program for a specified number of individuals who are workers with a potentially severe disability, as determined by the department, consistent with Section 204 of the Ticket to Work and Work Incentives Improvement Act of 1999, P.L. 106-170. The term 'worker with a potentially severe disability' means an individual who is at least sixteen years of age but less than sixty-five years of age, has a physical or mental impairment that, as defined by the department, is reasonably expected, but for the receipt of items and services under the state Medicaid plan, to become blind or disabled as defined under Section 1614(a) of the Social Security Act.

    (E)    The department shall promulgate regulations for and administer the categories of eligibility for the Medicaid program described in subsections (B) and (C) and the Medicaid demonstration project described in subsection (D). Criteria established by the department concerning income, assets, and resource limitations and the establishment of appropriate premium and cost sharing charges on a sliding scale based on income shall be consistent with the general policies described in Section 44-28-520(B) and shall reflect the recommendations made by the advisory panel established under Section 44-28-600.

    (F)    Notwithstanding any other provision of law, this section shall be implemented only if, and to the extent that, the department determines that federal financial participation is available under the Medicaid program.

    Section 44-28-540.    (A)(1)    The department shall propose to the commissioner of the Social Security Administration to establish in the State demonstration projects described in subsections (B)-(F).

        (2)    Proposals shall request that in determining the fiscal impact of a demonstration project, the commissioner, in addition to projected fiscal impact on the Social Security Disability Insurance program and the Supplemental Security Income program, also shall include the fiscal impact on other federal programs.

        (3)    Proposals shall satisfy the requirements of Section 1110(b)(2) of the Social Security Act, including the provisions specifying that a state may not carry out any project that would result in a substantial reduction in any individual's total income and resources as a result of the individual's participation in the project or require an individual to participate in a project.

    (B)    The department shall propose to the commissioner to establish a demonstration project in the State under which payments to Social Security Disability Income beneficiaries would be reduced one dollar for every two dollars of beneficiary earnings above a level to be determined by the commissioner consistent with Section 302 of the Ticket to Work and Work Incentives Improvement Act of 1999, P.L. 106-170. The demonstration project shall be coordinated with policies established by the State in its work incentive initiatives involving cost sharing by persons with earnings, including Medicaid buy-in programs established under Section 44-28-530.

    (C)    The department shall propose to the commissioner to establish a demonstration project in the State that enables adults who are eligible under the Supplemental Security Income program to retain a larger amount of benefits under the program for each dollar of savings and allow higher resources tests.

    (D)    The department shall propose to the commissioner to establish a demonstration project in the State that enables young adults aged eighteen to twenty-two, as defined under the Social Security Act for purposes of the Supplemental Security Income program, to retain a larger amount of benefits under the program for each dollar of savings. The demonstration shall also propose a change to the age used under the Social Security Act to define those individuals for purposes of encouraging participation in post-secondary education and training leading to work.

    (E)    The department shall propose to the commissioner to establish a demonstration project in the State that provides the following protections for persons participating in one of the Medicaid buy-in programs described in Section 44-28-530:

        (1)    for recipients under the Social Security Disability Insurance program, any month during which an individual is enrolled in one of the state's Medicaid buy-in programs would not count towards the person's extended period of eligibility under the program;

        (2)    for recipients of the Supplemental Security Income program, any month during which an individual is enrolled in a state's Medicaid buy-in program and is not eligible because of earned or unearned income or excess resources to be in Supplemental Security Income status would not count towards the twelve-month suspension period an individual can be reinstated to Supplemental Security Income status without a new application.

    (F)    The department shall propose to the commissioner to establish a demonstration project in the State that provides authority to allow an individual with a disability to retain eligibility for the Social Security Disability Insurance or Supplemental Security Income program, regardless of earnings under Section 301 of the Social Security Act as long as they are participating in Ticket to Work and Self-Sufficiency programs or a vocational rehabilitation program under Title I of the Rehabilitation Act.

    Section 44-28-550.    (A)    The department shall apply to the Secretary of the United States Department of Health and Human Services for authority to permit an individual participating in one of the Medicaid buy-in programs described in Section 44-28-530 to return to eligibility under a nonMedicaid buy-in program when the individual is no longer able to maintain his work effort without a new application for Medicaid if:

        (1)    the individual meets the eligibility criteria for the nonMedicaid buy-in program even if the individual has excess resources used for retirement or to enable the individual to live independently (as defined by the State in its Medicaid buy-in program); and

        (2)    the reinstatement is requested within twelve months of the individual leaving the Medicaid buy-in program.

    (B)    In determining budget neutrality of a request for a waiver under Section 1115 of the Social Security Act that is for the purpose of conducting an experimental, pilot, or demonstration project that is designed to reduce work disincentives for individuals with disabilities, the department shall request that the Secretary take into account reductions in payments made to such individuals under the Social Security Disability Insurance program and the Supplemental Security Income program and other reductions in federal expenditures made to, or on behalf of the individuals, when the reductions are a result of employment and earned income of the individuals.

    Section 44-28-560.    The department shall apply to the Secretary of the United States Department of Health and Human Services for a grant, established under Section 203 of the Ticket to Work and Work Incentives Improvement Act of 1999, P.L. 106-170, to support the design, establishment, and operation of infrastructures that provide items and services to support working individuals with disabilities and to conduct outreach campaigns regarding the existence of the infrastructures to support working individuals with disabilities.

    Section 44-28-570.    (A)    The department shall establish a community-based work incentives planning and assistance program for the purpose of disseminating accurate information to individuals with disabilities on work incentives. Under the program, the department shall:

        (1)    establish a program of grants, cooperative agreements, or contracts to nonprofit organizations, particularly consumer-directed organizations, and public agencies to provide benefits planning and assistance including information on the availability of protection and advocacy services to individuals with disabilities and outreach to individuals with disabilities who are potentially eligible for work incentive programs and related state employment initiatives. Eligible organizations include, but are not limited to, centers for independent living, protection and advocacy systems, client assistance programs, and developmental disabilities councils;

        (2)    establish a corps of work incentive specialists located within state agencies providing services and supports for individuals with disabilities of working age.

    (B)    Projects funded under subsection (A) shall set forth the steps that will be taken to maximize the coordination with projects funded under the Federal Work Incentives Outreach Program as contained in Section 1149 of the Social Security Act, to the extent agencies and organizations within the State apply for and receive funds under the act.

    Section 44-28-580.    The department shall establish criteria to determine the effectiveness of the state's work incentive initiatives. The criteria shall include, but not be limited to:

    (1)    an increase in the percentage of a state's employment initiative recipients who have earnings from employment;

    (2)    an increase in the level of disposable income because of earnings by participants in the state employment initiatives;

    (3)    an increase in the percentage of a state's employment initiative participants who have some of their health care needs and related services covered with employer-based benefit programs;

    (4)    an increase in the number of Supplemental Security Income and Social Security Disability Insurance recipients who are no longer dependent on public assistance or health care entitlement services;

    (5)    a decrease in dependence on public benefits and services by all persons with severe disabilities because they have access to adequate income from employment and access to needed services related to their employment activities.

    Section 44-28-590.    The Governor working with the department shall establish a mechanism to create a coordinated and aggressive state policy to:

    (1)    bring adults with disabilities into gainful employment at a rate that is as close as possible to that of the general adult population;

    (2)    support the goals of equality of opportunity, full participation, independent living, and economic self-sufficiency for these individuals; and

    (3)    ensure that state government is a model employer of individuals with disabilities.

    Section 44-28-600.    (A)    There is established a panel to be known as the 'Work and Work Incentives Advisory Panel'. The panel shall be advisory in nature with its members to be appointed by the Governor to serve at his pleasure.

    (B)    The panel shall advise the Governor and appropriate agencies regarding issues relating to implementation of this act, including issues related to access to health care and long-term services and supports for workers with disabilities, work incentives programs, planning, and assistance and the most effective designs for research and demonstration projects.

    (C)    The panel shall consist of members with experience or expert knowledge related to employment including representatives of businesses with policymaking or hiring authority, employment services, vocational rehabilitation, acute health care and long-term services and supports including Medicaid, and other support services. At least one-half of the members must be individuals with disabilities or representatives of individuals with disabilities, with consideration given to current or former Social Security Disability Insurance or Supplemental Security Income recipients."

SECTION    2.    This act takes effect upon approval by the Governor.

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