42 U.S.C. § 1382i: Medical and social services…

Summary

Establish a three-year federal-state pilot program to pay for medical and social services for certain severely handicapped people. Congress authorized funding as needed and the Commissioner of Social Security must allot a total of $18,000,000 for the period beginning September 1, 1981, and ending September 30, 1984. The money is divided as $6,000,000 for the fiscal year ending September 30, 1982 (this includes September 1981 for the program), $6,000,000 plus any unused amounts from the first year for the fiscal year ending September 30, 1983, and $6,000,000 plus any unused amounts from the earlier years for the fiscal year ending September 30, 1984. Each State’s share is based on how many disabled people ages over 17 and under 65 in that State receive supplemental security income benefits, using the latest data. States must tell the Commissioner if they will not use all or part of their allotment; unused funds can be reallocated to other States that will use them. The Commissioner pays States from their allotments 75% of what the State spends under an approved plan (including administration). The Commissioner estimates payments ahead of time and adjusts later if the estimate was off. To get payments, a State must have an approved plan that serves severely handicapped people whose earnings are above the usual limit that shows ability to do substantial work and who are not getting benefits under sections 1382 or 1382h or assistance under section 1396a. The plan must say the State wants to join the pilot, name the agency that will run it, explain who is eligible (including a finding that the person needs help to keep working and that their earnings don’t give them the same cash and other benefits they would otherwise have), explain how eligibility is decided, list the medical and social services to be provided and how they will be delivered, and include any other items the Commissioner requires. The Commissioner must write rules within nine months after June 9, 1980. States must report on how the program is working, especially its effects on work, and the Commissioner must report to Congress by October 1, 1983. Defined term: “supplemental security income benefits” — includes payments made under agreements described in section 1382e(a) or section 212(b) of Public Law 93–66.

Title 42, §1382i

The Public Health and Welfare, Source: USLM XML via OLRC

(a)Authorization of appropriations for pilot program

There are authorized to be appropriated such sums as may be necessary to establish and carry out a 3-year Federal-State pilot program to provide medical and social services for certain handicapped individuals in accordance with this section.

(b)State allotments

(1)The total sum of $18,000,000 shall be allotted to the States for such program by the Commissioner of Social Security, during the period beginning September 1, 1981, and ending September 30, 1984, as follows:

(A)The total sum of $6,000,000 shall be allotted to the States for the fiscal year ending September 30, 1982 (which for purposes of this section shall include the month of September 1981).

(B)The total sum of $6,000,000, plus any amount remaining available (after the application of paragraph (4)) from the allotment made under subparagraph (A), shall be allotted to the States for the fiscal year ending September 30, 1983.

(C)The total sum of $6,000,000, plus any amount remaining available (after the application of paragraph (4)) from the allotments made under subparagraphs (A) and (B), shall be allotted to the States for the fiscal year ending September 30, 1984.

(2)The allotment to each State from the total sum allotted under paragraph (1) for any fiscal year shall bear the same ratio to such total sum as the number of individuals in such State who are over age 17 and under age 65 and are receiving supplemental security income benefits as disabled individuals in such year (as determined by the Commissioner of Social Security on the basis of the most recent data available) bears to the total number of such individuals in all the States. For purposes of the preceding sentence, the term “supplemental security income benefits” includes payments made pursuant to an agreement under section 1382e(a) of this title or under section 212(b) of Public Law 93–66.

(3)At the beginning of each fiscal year in which the pilot program under this section is in effect, each State that does not intend to use the allotment to which it is entitled for such year (or any allotment which was made to it for a prior fiscal year), or that does not intend to use the full amount of any such allotment, shall certify to the Commissioner of Social Security the amount of such allotment which it does not intend to use, and the State’s allotment for the fiscal year (or years) involved shall thereupon be reduced by the amount so certified.

(4)The portion of the total amount available for allotment for any particular fiscal year under paragraph (1) which is not allotted to States for that year by reason of paragraph (3) (plus the amount of any reductions made at the beginning of such year in the allotments of States for prior fiscal years under paragraph (3)) shall be reallocated in such manner as the Commissioner of Social Security may determine to be appropriate to States which need, and will use, additional assistance in providing services to severely handicapped individuals in that particular year under their approved plans. Any amount reallocated to a State under this paragraph for use in a particular fiscal year shall be treated for purposes of this section as increasing such State’s allotment for that year by an equivalent amount.

(c)Requisite features of State plans

In order to participate in the pilot program and be eligible to receive payments for any period under subsection (d), a State (during such period) must have a plan, approved by the Commissioner of Social Security as meeting the requirements of this section, which provides medical and social services for severely handicapped individuals whose earnings are above the level which ordinarily demonstrates an ability to engage in substantial gainful activity and who are not receiving benefits under section 1382 or 1382h of this title or assistance under a State plan approved under section 1396a of this title, and which—

(1)declares the intent of the State to participate in the pilot program;

(2)designates an appropriate State agency to administer or supervise the administration of the program in the State;

(3)describes the criteria to be applied by the State in determining the eligibility of any individual for assistance under the plan and in any event requires a determination by the State agency to the effect that (A) such individual’s ability to continue his employment would be significantly inhibited without such assistance and (B) such individual’s earnings are not sufficient to allow him to provide for himself a reasonable equivalent of the cash and other benefits that would be available to him under this subchapter and subchapters XIX and XX in the absence of those earnings;

(4)describes the process by which the eligibility of individuals for such assistance is to be determined (and such process may not involve the performance of functions by any State agency or entity which is engaged in making determinations of disability for purposes of disability insurance or supplemental security income benefits except when the use of a different agency or entity to perform those functions would not be feasible);

(5)describes the medical and social services to be provided under the plan;

(6)describes the manner in which the medical and social services involved are to be provided and, if they are not to be provided through the State’s medical assistance and social services programs under subchapters XIX and XX (with the Federal payments being made under subsection (d) of this section rather than under those subchapters), specifies the particular mechanisms and procedures to be used in providing such services; and

(7)contains such other provisions as the Commissioner of Social Security may find to be necessary or appropriate to meet the requirements of this section or otherwise carry out its purpose.

(d)Payments to States; computation of payments

(1)From its allotment under subsection (b) for any fiscal year (and any amounts remaining available from allotments made to it for prior fiscal years), the Commissioner of Social Security shall from time to time pay to each State which has a plan approved under subsection (c) an amount equal to 75 per centum of the total sum expended under such plan (including the cost of administration of such plan) in providing medical and social services to severely handicapped individuals who are eligible for such services under the plan.

(2)The method of computing and making payments under this section shall be as follows:

(A)The Commissioner of Social Security shall, prior to each period for which a payment is to be made to a State, estimate the amount to be paid to the State for such period under the provisions of this section.

(B)From the allotment available therefor, the Commissioner of Social Security shall pay the amount so estimated, reduced or increased, as the case may be, by any sum (not previously adjusted under this subsection) by which the Commissioner finds that the Commissioner’s estimate of the amount to be paid the State for any prior period under this section was greater or less than the amount which should have been paid to the State for such period under this section.

(e)Rules and regulations

Within nine months after June 9, 1980, the Commissioner of Social Security shall prescribe and publish such regulations as may be necessary or appropriate to carry out the pilot program and otherwise implement this section.

(f)Reports

Each State participating in the pilot program under this section shall from time to time report to the Commissioner of Social Security on the operation and results of such program in that State, with particular emphasis upon the work incentive effects of the program. On or before October 1, 1983, the Commissioner of Social Security shall submit to the Congress a report on the program, incorporating the information contained in the State reports along with the Commissioner’s findings and recommendations.

Notes & Related Subsidiaries

Editorial Notes

References in Text

section 212(b) of Public Law 93–66, referred to in subsec. (b)(2), is section 212(b) of Pub. L. 93–66, title II, July 9, 1973, 87 Stat. 155, which is set out as a note under section 1382 of this title.

Amendments

1994—Subsecs. (b) to (f). Pub. L. 103–296, § 107(a)(4), substituted “Commissioner of Social Security” for “Secretary” wherever appearing, “the Commissioner finds that the Commissioner’s” for “he finds that his” in subsec. (d)(2)(B), and “the Commissioner’s” for “his” in subsec. (f). 1981—Subsec. (c). Pub. L. 97–35 struck out provision following par. (7) that the plan under this section may be developed and submitted as a separate State plan or may be submitted in the form of an amendment to the State’s plan under section 1397b(d) of this title.

Statutory Notes and Related Subsidiaries

Effective Date

of 1994 AmendmentAmendment by Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title.

Effective Date

of 1981 AmendmentAmendment by Pub. L. 97–35 effective Oct. 1, 1981, except as otherwise explicitly provided, see section 2354 of Pub. L. 97–35, set out as an

Effective Date

note under section 1397 of this title.

§1382i Medical and Social Services for Certain Handicapped Persons

Summary

Title 42, §1382i

Notes & Related Subsidiaries

Editorial Notes

References in Text

Amendments

Statutory Notes and Related Subsidiaries

Effective Date

Effective Date

Effective Date

Citations & Metadata