P.L. 100–203, Approved December 22, 1987 (101 Stat. 1330)

Omnibus Budget Reconciliation Act of 1987

*    *    *    *    *    *    *

SEC. 4001. [2 U.S.C. 902 note]  EXTENSION OF REDUCTIONS UNDER SEQUESTER ORDER.

Notwithstanding any other provision of law (including any other provision of this Act), the reductions in the amount of payments required under title XVIII of the Social Security Act made by the final sequester order issued by the President on November 20, 1987, pursuant to section 252(b) of the Balanced Budget Emergency Deficit Control Act of 1985 shall continue to be effective (as provided by sections 252(a)(4)(B) and 256(d)(2) of such Act) through—

(1)  March 31, 1988, with respect to payments for inpatient hospital services under such title (including payments under section 1886 of such title attributable or allocated to part A of such title); and

(2)  December 31, 1987, with respect to payments for other items and services under part A of such title.

SEC. 4002.  BASIC HOSPITAL PROSPECTIVE PAYMENT RATES.

*    *    *    *    *    *    *

(g) [42 U.S.C. 1395ww note]  Effective Dates.—

(1)  PPS hospitals, drg portion of payment.—In the case of a subsection (d) hospital (as defined in paragraph (6))—

(A)  the amendments made by subsections (a) and (c) shall apply to payments made under section 1886(d)(1)(A)(iii) of the Social Security Act on the basis of discharges occurring on or after April 1, 1988, and

(B)  for discharges occurring on or after October 1, 1988, the applicable percentage increase (described in section 1886(b)(3)(B) of such Act) for discharges occurring during fiscal year 1987 is deemed to have been such percentage increase as amended by subsection (a).

(2)  PPS sole community hospitals, hospital specific portion of payment.—In the case of a subsection (d) hospital which receives payments made under section 1886(d)(1)(A) of the Social Security Act because it is a sole community hospital—

(A)  the amendment made by subsections (a) and (c) shall apply to payments under section 1886(d)(1)(A)(ii)(I) of the Social Security Act made on the basis of discharges occurring during a cost reporting period of a hospital, for the hospital’s cost reporting period beginning on or after October 1, 1987;

(B)  notwithstanding subparagraph (A), for cost reporting period beginning during fiscal year 1988, the applicable percentage increase (as defined in section 1886(b)(3)(B) of such Act) for the—

(i)  first 51 days of the cost reporting period shall be 0 percent,

(ii)  next 132 days of such period shall be 2.7 percent, and

(iii)  remainder of such period of the cost reporting period shall be the applicable percentage increase (as so defined, as amended by subsection (a)); and

(C)  for cost reporting periods beginning on or after October 1, 1988, the applicable percentage increase (as so defined) with respect to the previous cost reporting period shall be deemed to have been the applicable percentage increase (as so defined, as amended by subsection (a)).

(3)  PPS-exempt hospitals.—In the case of a hospital that is not a subsection (d) hospital—

(A)  the amendments made by subsection (e) shall apply to cost reporting periods beginning on or after October 1, 1987;

(B)  notwithstanding subparagraph (A), for the hospital’s cost reporting period beginning during fiscal year 1988, payment under title XVIII of the Social Security Act shall be made as though the applicable percentage increase described in section 1886(b)(3)(B) of such Act were equal to the product of 2.7 percent and the ratio of 315 to 366; and

(C)  for cost reporting periods beginning on or after October 1, 1988, the applicable percentage increase (as so defined) with respect to the cost reporting period beginning during fiscal year 1988 shall be deemed to have been 2.7 percent.

*    *    *    *    *    *    *

(6)  Definition.—In this subsection, the term “subsection (d) hospital” has the meaning given such term in section 1886(d)(1)(B) of the Social Security Act.

SEC. 4003  INCREASE IN DISPROPORTIONATE SHARE ADJUSTMENT AND REDUCTION IN INDIRECT MEDICAL EDUCATION PAYMENTS.

*    *    *    *    *    *    *

(d) [None Assigned]  Special Rule.—In the case of a hospital which—

(1)  consists of 2 inpatient hospital facilities which are more than 4 miles apart and each of which is in a separate political jurisdiction within the same State and one of which meets the criteria under section 1886(d)(5)(F) of the Social Security Act for serving a significantly disproportionate number of low-income patients as if that facility were a separate hospital; and

(2)  receives payments (other than under section 1886(d)(5)(F) of such Act) for inpatient hospital services under title XVIII of the Social Security Act which are less than the hospital’s reasonable costs of such services,

the Secretary of Health and Human Services, upon application by the hospital, may treat each of the facilities of the hospital as separate hospitals for purposes of applying section 1886(d)(5)(F) of the Social Security Act, for discharges occurring on or after October 1, 1988.

*    *    *    *    *    *    *

SEC. 4004.  PROVISIONS RELATING TO WAGE INDEX.

*    *    *    *    *    *    *

(b) [42 U.S.C. 1395ww note]  Clinic Hospital Wage Indices.—In calculating the wage index under section 1886(d) of the Social Security Act for purposes of making payment adjustments after September 30, 1988, as required under paragraphs (2)(H) and (3)(E) of such section, in the case of any institution which received the waiver specified in section 602(k) of the Social Security Amendments of 1983, the Secretary of Health and Human Services shall include wage costs paid to related organization employees directly involved in the delivery and administration of care provided by the related organization to hospital inpatients. For purposes of the preceding sentence, the term “wage costs” does not include costs of overhead or home office administrative salaries or any costs that are not incurred in the hospital’s Metropolitan Statistical Area.

SEC. 4005.  RURAL HOSPITALS.

(a)  Revision of Standards for Including a Rural County in an Urban Area.—

*    *    *    *    *    *    *

(2) [None Assigned]  Location of hospital.—For purposes of section 1886 of the Social Security Act, Watertown Memorial Hospital in Watertown, Wisconsin is deemed to be located in Jefferson County, Wisconsin.

*    *    *    *    *    *    *

SEC. 4008.  OTHER PROVISIONS RELATING TO PAYMENT FOR INPATIENT HOSPITAL SERVICES.

*    *    *    *    *    *    *

(d) [42 U.S.C. 1395ww note] (3)  Report on outlier payments.—The Secretary of Health and Human Services shall include in the annual report submitted to the Congress pursuant to section 1875(b) of the Social Security Act a comparison with respect to hospitals located in an urban area and hospitals located in a rural area in the amount of reductions under section 1886(d)(3)(B) of the Social Security Act and additional payments under section 1886(d)(5)(A) of such Act.

*    *    *    *    *    *    *

SEC. 4009.  MISCELLANEOUS PROVISIONS.

*    *    *    *    *    *    *

(b) [42 U.S.C. 1395y note]  Designation of Pediatric Hospitals as Meeting Certification as Heart Transplant Facility.—For purposes of determining whether a pediatric hospital that performs pediatric heart transplants meets the criteria established by the Secretary of Health and Human Services for facilities in which the heart transplants performed will be considered to meet the requirement of section 1862(a)(1)(A) of the Social Security Act, the Secretary shall treat such a hospital as meeting such criteria if—

(1)  the hospital’s pediatric heart transplant program is operated jointly by the hospital and another facility that meets such criteria,

(2)  the unified program shares the same transplant surgeons and quality assurance program (including oversight committee, patient protocol, and patient selection criteria), and

(3)  the hospital demonstrates to the satisfaction of the Secretary that it is able to provide the specialized facilities, services, and personnel that are required by pediatric heart transplant patients.

*    *    *    *    *    *    *

SEC. 4012.  PAYMENTS FOR HOSPITAL SERVICES.

*    *    *    *    *    *    *

(c) [42 U.S.C. 1395mm note]  Implementation.—The Secretary of Health and Human Services shall provide (in machine readable form) to eligible organizations under section 1876 of the Social Security Act medicare DRG rates for payments required by the amendment made by subsection (a) and data on cost pass-through items for all inpatient services provided to medicare beneficiaries enrolled with such organizations.

*    *    *    *    *    *    *

SEC. 4048.  PAYMENT FOR PHYSICIAN ANESTHESIA SERVICES.

*    *    *    *    *    *    *

(b) [42 U.S.C. 1395u note]  Development of Uniform Relative Value Guide.—The Secretary of Health and Human Services, in consultation with groups representing physicians who furnish anesthesia services, shall establish by regulation a relative value guide for use in all carrier localities in making payment for physician anesthesia services furnished under part B of title XVIII of the Social Security Act on and after March 1, 1989. Such guide shall be designed so as to result in expenditures under such title for such services in an amount that would not exceed the amount of such expenditures which would otherwise occur.

*    *    *    *    *    *    *

SEC. 4063.  PAYMENT FOR INTRAOCULAR LENSES.

*    *    *    *    *    *    *

(d) [42 U.S.C. 1395u note]  Special Rule.—With respect to the establishment of a reasonable charge limit under section 1842(b)(11)(C)(ii) of the Social Security Act, in applying section 1842(j)(1)(D)(i) of such Act, the matter beginning with “plus” shall be considered to have been deleted.

*    *    *    *    *    *    *

SEC. 4071.  COVERAGE OF INFLUENZA VACCINE AND ITS ADMINISTRATION.

*    *    *    *    *    *    *

(b) [42 U.S.C. 1395x note]  Contingent Effective Date; Demonstration Project.—

(1)  The provisions of subsection (e) of section 4072 of this subpart shall apply to this section [amending Social Security Act §1861(s)(10)(A)][373] in the same manner as it applies to section 4072.

(2)  In conducting the demonstration project pursuant to paragraph (I), in order to determine the cost effectiveness of including influenza vaccine in the medicare program, the Secretary of Health and Human Services is required to conduct a demonstration of the provision of influenza vaccine as a service for medicare beneficiaries and to expend $25,000,000 each vear of the demonstration project for this purpose. In conducting this demonstration, the Secretary is authorized to purchase in bulk influenza vaccine and to distribute it in a manner to make it widely available to medicare beneficiaries, to develop projects to provide vaccine in the same manner as other covered medicare services in large scale demonstration projects, including statewide projects, and to engage in other appropriate use of moneys to provide influenza vaccine to medicare beneficiaries and evaluate the cost effectiveness of its use. In determining cost effectiveness, the Secretary shall consider the direct cost of the vaccine, the utilization of vaccine which might otherwise not have occurred, the costs of illnesses and nursing home days avoided, and other relevant factors, except that extended life for beneficiaries shall not be considered to reduce the cost effectiveness of the vaccine.

*    *    *    *    *    *    *

SEC. 4072. PAYMENT FOR THERAPEUTIC SHOES FOR INDIVIDUALS WITH SEVERE DIABETIC FOOT DISEASE.

*    *    *    *    *    *    *

(e) [42 U.S.C. 1395x note]  Contingent Effective Date; Demonstration Project.—

(1)  The amendments made by this section shall become effective (if at all) in accordance with paragraph (2).

(2)(A)  The Secretary of Health and Human (in this paragraph referred to as the “Secretary”), shall establish a demonstration project to begin on October 1, 1988, to test the cost-effectiveness of furnishing therapeutic shoes under the medicare program to the extent provided under the amendments made by this section to a sample group of medicare beneficiaries.

(B)(i)  The demonstration project under subparagraph (A) shall be conducted for an initial period of 24 months. Not later than Reports. October 1, 1990, the Secretary shall report to the Congress on the results of such project. If the Secretary finds, on the basis of existing data, that furnishing therapeutic shoes under the medicare program to the extent provided under the amendments made by this section is cost-effective, the Secretary shall include such finding in such report, such project shall be discontinued, and the amendments made by this section shall become effective on November 1,1990.

(ii)  If the Secretary determines that such finding cannot be made on the basis of existing data, such project shall continue for an additional 24 months. Not later than April 1, 1993, the Secretary shall submit a final report to the Congress on the results of such project. The amendments made by this section shall become effective on the first day of the first month to begin after such report is submitted to the Congress unless the report contains a finding by the Secretary that furnishing therapeutic shoes under the medicare program to the extent provided under the amendments made by this section is not cost-effective (in which case the amendments made by this section shall not become effective).

*    *    *    *    *    *    *

SEC. 4081.  SUBMISSION OF CLAIMS TO SUPPLEMENTAL INSURANCE CARRIERS.

(c)  *  *  *

(2) [42 U.S.C. 1395ss note]  (A) The amendments made by subsection (b) shall apply to medicare supplemental policies as of January 1, 1989 (or, if applicable, the date established under subparagraph (B)).

(B)  In the case of a State which the Secretary of Health and Human Services identifies as—

(i)  requiring State legislation (other than legislation appropriating funds) in order for medicare supplemental policies to be changed to meet the requirements of section 1882(c)(3) of the Social Security Act, and

(ii)  having a legislature which is not scheduled to meet in 1988 in a legislative session in which such legislation may be considered or which has not enacted such legislation before July 1, 1988,

the date specified in this subparagraph is the first day of the first calendar quarter beginning after the close of the first legislative session of the State legislature that begins on or after January 1, 1989, and in which legislation described in clause (i) may be considered.

*    *    *    *    *    *    *

SEC. 4091.  CONTRACT PROVISIONS.

(a)  Extensions of Peer Review Contract Period.—

(1) [42 U.S.C. 1320c-2 note]  One-time extensions to permit staggering of expiration dates.—

(A)  In general.—In order to permit the Secretary of Health and Human Services an adequate time to complete contract renewal negotiations with utilization and quality control peer review organizations under part B of title XI of the Social Security Act and to provide for a staggered period of contract expiration dates, notwithstanding section 1153(c) of such Act, the Secretary may provide for extensions of existing contracts, but the total of such extensions may not exceed 24 months for any contract.

(B)  Effective date.—The amendment made by subparagraph (A) shall apply to contracts expiring on or after the date of the enactment of this Act.

*    *    *    *    *    *    *

SEC. 4094.  PEER REVIEW NORMS AND EDUCATION.

*    *    *    *    *    *    *

(e) [42 U.S.C. 1320c-5 note]  Telecommunications Demonstration Projects.—The Secretary of Health and Human Services shall enter into agreements with entities submitting applications under this subsection (in such form as the Secretary may provide) to establish demonstration projects to examine the feasibility of requiring instruction and oversight of rural physicians, in lieu of imposing sanctions, through use of video communication between rural hospitals and teaching hospitals under this title. Under such demonstration projects, the Secretary may provide for payments to physicians consulted via video communication systems. No funds may be expended under the demonstration projects for the acquisition of capital items including computer hardware.

*    *    *    *    *    *    *

SEC. 4106. [None Assigned]  MEDICALLY NEEDY INCOME LEVELS FOR CERTAIN 2-MEMBER COUPLES IN CALIFORNIA.

For purposes of section 1903(f)(1)(B) of the Social Security Act, for payments made to California on or after July 1, 1983, in the case of a family consisting only of two individuals both of whom are adults and at least one of whom is aged, blind, or disabled, the “highest amount which would ordinarily be paid to a family of the same size” under the State’s plan approved under part A of title IV of such Act shall, at California’s option, be the amount determined by the State agency to be the amount of the aid which would ordinarily be payable under such plan to a family which consists of one adult and two children and which is without any income or resources. Section 1902(a)(10)(C)(i)(III) of the Social Security Act shall not prevent California from establishing (under the previous sentence) an applicable income limitation for families described in that sentence which is greater than the income limitation applicable to other families, if California has an applicable income limitation under section 1903(f) of such Act which is equal to the maximum applicable income limitation permitted consistent with paragraph (1)(B) of such section for families other than those described in the previous sentence.

*    *    *    *    *    *    *

SEC. 4113.  HMO-RELATED PROVISIONS.

*    *    *    *    *    *    *

(d) [None Assigned]  Continued Eligibility and Restriction on Disenrollment Without Cause for Metropolitan Health Plan HMO.—For purposes of sections 1902(e)(2)(A) and 1903(m)(2)(F)[374] of the Social Security Act, the Metropolitan Health Plan HMO operated by the New York City public hospitals shall be treated in the same manner as a qualified health maintenance organization (as defined in section 1310(d) of the Public Health Service Act).

*    *    *    *    *    *    *

SEC. 4205. [42 U.S.C. 1395i-3 note]  ANNUAL REPORT.

The Secretary of Health and Human Services shall report to the Congress annually on the extent to which skilled nursing facilities are complying with the requirements of subsections (b), (c), and (d) of section 1819 of the Social Security Act (as added by the amendments made by this part) and the number and type of enforcement actions taken by States and the Secretary under section 1819(h) of such Act (as added by section 4203 of this Act).

*    *    *    *    *    *    *

SEC. 4211.  REQUIREMENTS FOR NURSING FACILITIES.

*    *    *    *    *    *    *

(b)  Incorporating Requirements into State Plan.—

*    *    *    *    *    *    *

(2) [42 U.S.C. 1396a note]  State plan amendment required.—A plan of a State under title XIX of the Social Security Act shall not be considered to have met the requirement of section 1902(a)(13)(A) of the Social Security Act (as amended by paragraph (1)(A) of this subsection), as of the first day of a Federal fiscal year (beginning on or after October 1, 1990), unless the State has submitted to the Secretary of Health and Human Services, as of April 1 before the fiscal year, an amendment to such State plan to provide for an appropriate adjustment in payment amounts for nursing facility services furnished during the Federal fiscal year. Each such amendment shall include a detailed description of the specific methodology to be used in determining the appropriate adjustment in payment amounts for nursing facility services. The Secretary shall, not later than September 30 before the fiscal year concerned, review each such plan amendment for compliance with such requirement and by such date shall approve or disapprove each such amendment. If the Secretary disapproves such an amendment, the State shall immediately submit a revised amendment which meets such requirement. The absence of approval of such a plan amendment does not relieve the State or any nursing facility of any obligation or requirement under title XIX of the Social Security Act (as amended by this Act).

(d)  Funding.—

*    *    *    *    *    *    *

(2) [42 U.S.C. 1396b note]  Enhanced funding for nurse aide training.—For the 8 calendar quarters (beginning with the calendar quarter that begins on July 1, 1988), with respect to payment under section 1903(a)(2)(B) of the Social Security Act to a State for additional amounts expended by the State under its plan approved under title XIX of such Act for nursing aide training and competency evaluation programs, and competency evaluation programs, described in section 1919(e)(1) of such title, any reference to “50 percent” is deemed a reference to the sum of the Federal medical assistance percentage (determined under section 1905(b) of such Act) plus 25 percentage points, but not to exceed 90 percent.

*    *    *    *    *    *    *

(j) [42 U.S.C. 1396a note]  Technical Assistance.—The Secretary of Health and Human Services shall, upon request by a State, furnish technical assistance with respect to the development and implementation of reimbursement methods for nursing facilities that take into account the case mix of residents in the different facilities.

*    *    *    *    *    *    *

SEC. 4212.  SURVEY AND CERTIFICATION PROCESS.

*    *    *    *    *    *    *

(c)  *  *  *

(3) [42 U.S.C. 1396b note]  For purposes of section 1903(a) of the Social Security Act, proper expenses incurred by a State for medical review by independent professionals of the care provided to residents of nursing facilities who are entitled to medical assistance under title XIX of such Act shall be reimbursable as expenses necessary for the proper and efficient administration of the State plan under that title.

*    *    *    *    *    *    *

SEC. 4215. [42 U.S.C. 1396r note]  ANNUAL REPORT.

The Secretary of Health and Human Services shall report to the Congress annually on the extent to which nursing facilities are complying with the requirements of subsections (b), (c), and (d) of section 1919 of the Social Security Act (as added by the amendments made by this part) and the number and type of enforcement actions taken by States and the Secretary under section 1919(h) of such Act (as added by section 4213 of this Act). Each such report shall also include a summary of the information reported by States under section 1919(e)(7)(C)(iv) of such Act.

*    *    *    *    *    *    *

SEC. 4403. [42 U.S.C. 1396r note]  EXPERIMENTS AND DEMONSTRATION PROJECTS ON RURAL AND INNER-CITY HEALTH ISSUES.

(a)  Set-Asides for Issues of Health Care in Rural Areas and in Inner-City Areas.—

(1)  Not less than ten percent of the total amounts annually appropriated to, and expended by, the Health Care Financing Administration for the conduct of research and demonstration projects in fiscal years 1988, 1989, and 1990 shall be expended for research and demonstration projects relating exclusively or substantially to rural health issues, including (but not limited to) the impact of the payment methodology under section 1886(d) of the Social Security Act on the financial viability of small rural hospitals, the effect of medicare payment policies on the ability of rural areas (and rural hospitals in particular) to attract and retain physicians and other health professionals, the appropriateness of medicare conditions of participation and staffing requirements for small rural hospitals, and the impact of medicare policies on access to (and the quality of) health care in rural areas.

(2)  Not less than ten percent of the total amounts annually appropriated to, and expended by, the Health Care Financing Administration for the conduct of research and demonstration projects in fiscal years 1988, 1989, and 1990 shall be expended for research and demonstration projects relating exclusively or substantially to issues of providing health care in inner-city areas, including (but not limited to) the impact of the payment methodology under section 1886(d) of the Social Security Act on the financial viability of inner-city hospitals and the impact of medicare policies on access to (and the quality of) health care in inner-city areas.

(b)  The Secretary of Health and Human Services shall establish an agenda of research and demonstration projects, relating exclusively or substantially to rural health issues or to inner-city health issues, that are in progress or have been proposed, and shall include such agenda in the annual report submitted pursuant to section 1875(b) of the Social Security Act. The agenda shall be accompanied by a statement setting forth the amounts that have been obligated and expended with respect to such projects in the current and most recently completed fiscal years.

SEC. 9008. [42 U.S.C. 418 note]  MODIFICATION OF AGREEMENT WITH IOWA TO PROVIDE COVERAGE FOR CERTAIN POLICEMEN AND FIREMEN.

(a)  In General.—Notwithstanding subsection (d)(5)(A) of section 218 of the Social Security Act and the references thereto in subsections (d)(1) and (d)(3) of such section 218, the agreement with the State of Iowa heretofore entered into pursuant to such section 218 may, at any time prior to January 1, 1989, be modified pursuant to subsection (c)(4) of such section 218 so as to apply to services performed in policemen’s or firemen’s positions required to be covered by a retirement system pursuant to section 410.1 of the Iowa Code as in effect on July 1, 1953, if the State of Iowa has at any time prior to the date of the enactment of this Act paid to the Secretary of the Treasury, with respect to any of the services performed in such positions, the sums prescribed pursuant to subsection (e)(1) of such section 218 (as in effect on December 31, 1986, with respect to payments due with respect to wages paid on or before such date).

(b)  Service To Be Covered.—Notwithstanding the provisions of subsection (e) of section 218 of the Social Security Act (as so redesignated by section 9002(c)(1) of the Omnibus Budget Reconciliation Act of 1986))[375], any modification in the agreement with the State of Iowa under subsection (a) shall be made effective with respect to—

(1)  all services performed in any policemen’s or firemen’s position to which the modification relates on or after January 1, 1987, and

(2)  all services performed in such a position before January 1, 1987, with respect to which the State of Iowa has paid to the Secretary of the Treasury the sums prescribed pursuant to subsection (e)(1) of such section 218 (as in effect on December 31, 1986, with respect to payments due with respect to wages paid on or before such date) at the time or times established pursuant to such subsection (e)(1), if and to the extent that—

(A)  no refund of the sums so paid has been obtained, or

(B)  a refund of part or all of the sums so paid has been obtained but the State of Iowa repays to the Secretary of the Treasury the amount of such refund within 90 days after the date on which the modification is agreed to by the State and the Secretary of Health and Human Services.

*    *    *    *    *    *    *

SEC. 9116.  RETENTION OF MEDICAID WHEN SSI BENEFITS ARE LOST UPON ENTITLEMENT TO EARLY WIDOW’S OR WIDOWER’S INSURANCE BENEFITS.

*    *    *    *    *    *    *

(c) [42 U.S.C. 1383c note]  State Determinations.— Any determination required under section 1634(d) of the Social Security Act with respect to whether an individual would be eligible for benefits under title XVI of such Act (or State supplementary payments) in the absence of benefits under section 202 shall be made by the appropriate State agency.

*    *    *    *    *    *    *

SEC. 9117. [42 U.S.C. 1383 note]  DEMONSTRATION PROGRAM TO ASSIST HOMELESS INDIVIDUALS.

(a)  In General.—The Secretary of Health and Human Services (in this section referred to as the “Secretary”) is authorized to make grants to States for projects designed to demonstrate and test the feasibility of special procedures and services to ensure that homeless individuals are provided SSI and other benefits under the Social Security Act to which they are entitled and receive assistance in using such benefits to obtain permanent housing, food, and health care. Each project approved under this section shall meet such conditions and requirements, consistent with this section, as the Secretary shall prescribe.

(b)  Scope of Projects.—Projects for which grants are made under this section shall include, more specifically, procedures and services to overcome barriers which prevent homeless individuals (particularly the chronically mentally ill) from receiving and appropriately using benefits, including—

(1)  the creation of cooperative approaches between the Social Security Administration, State and local governments, shelters for the homeless, and other providers of services to the homeless;

(2)  the establishment, where appropriate, of multi-agency SSI Outreach Teams (as described in subsection (c)), to facilitate communication between the agencies and staff involved in taking and processing claims for SSI and other benefits by the homeless who use shelters;

(3)  special efforts to identify homeless individuals who are potentially eligible for SSI or other benefits under the Social Security Act;

(4)  the provision of special assistance to the homeless in applying for benefits, including assistance in obtaining and developing evidence of disability and supporting documentation for nondisability-related eligibility requirements;

(5)  the provision of special training and assistance to public and private agency staff, including shelter employees, on disability eligibility procedures and evidentiary requirements;

(6)  the provision of ongoing assistance to formerly homeless individuals to ensure their responding to information requests related to periodic redeterminations of eligibility for SSI and other benefits;

(7)  the provision of assistance in ensuring appropriate use of benefit funds for the purpose of enabling homeless individuals to obtain permanent housing, nutrition, and physical and mental health care, including the use, where appropriate, of the disabled individual’s representative payee for case management services; and

(8)  such other procedures and services as the Secretary may approve.

(c)  SSI Outreach Team Projects.—(1) If a State applies for funds under this section for the purpose of establishing a multi-agency SSI Outreach Team, the membership and functions of such Team shall be as follows (except as provided in paragraph (2)):

(A)  The membership of the Team shall include a social services case worker (or case workers, if necessary); a consultative medical examiner who is qualified to provide consultative examinations for the Disability Determination Service of the State; a disability examiner, from the State Disability Determination Service; and a claims representative from an office of the Social Security Administration.

(B)  The Team shall have designated members responsible for—

(i)  identification of homeless individuals who are potentially eligible for SSI or other benefits under the Social Security Act;

(ii)  ensuring that such individuals understand their rights under the programs;

(iii)  assisting such individuals in applying for benefits, including assistance in obtaining and developing evidence and supporting documentation relating to disability-and nondisability-related eligibility requirements;

(iv)  arranging transportation and accompanying applicants to necessary examinations, if needed; and

(v)  providing for the tracking and monitoring of all claims for benefits by individuals under the project.

(2)  If the Secretary determines that an application by a State for an SSI Outreach Team Project under this section which proposes a membership and functions for such Team different from those prescribed in paragraph (1) but which is expected to be as effective, the Secretary may waive the requirements of such paragraph.

(d)  [Repealed.[376]]

(e)  Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated to the Secretary—

(A)  the sum of $1,250,000 for the fiscal year 1988;

(B)  the sum of $2,500,000 for the fiscal year 1989; and

(C)  such sums as may be necessary for each fiscal year thereafter.

*    *    *    *    *    *    *

SEC. 9151. [26 U.S.C. 3304 note]  DETERMINATION OF AMOUNT OF FEDERAL SHARE WITH RESPECT TO CERTAIN EXTENDED BENEFITS PAYMENTS.

For the purpose of determining the amount of the Federal payment to any State under section 204(a)(1) of the Federal-State Extended Unemployment Compensation Act of 1970 with respect to the implementation of paragraph (3) of section 202(a) of such Act (as added by section 1024(a) of the Omnibus Reconciliation Act of 1980), such paragraph shall be considered to apply only with respect to weeks of unemployment beginning after October 31, 1981, except that for any State in which the State legislature did not meet in 1981, it shall be considered to apply for such purpose only with respect to weeks of unemployment beginning after October 31, 1982.

*    *    *    *    *    *    *

[Internal References.—SSAct §§711(b), 1848(b), 1861(s), and 1886(i) cite the Omnibus Budget Reconciliation Act of 1987. SSAct Titles IX, XI Part B, XVI (SSI), XVIII, and §§218, 1819, 1876, 1883, 1886, 1919 headings, 1819(h), 1834(a), 1842(i) and (j), 1862(a), 1866(c), 1869(b), 1886(d), 1902(e), 1903(f), and 1919(e), have footnotes referring to P.L. 100-203.]



[373]  The amendment became effective pursuant to final report dated Apr. 26, 1993. See Cong. Rec., vol. 139, pt. 7, p. 10460, Ex. Comm. 1254.

[374]  §1903(m)(2)(F) was stricken by P.L. 105-33, §4701(d)(2)(B) and §4703(b)(1)(A); 111 Stat. 494-495.

[375]  As in original. One closing parenthesis should be stricken.

[376]  P.L. 104-66, §1061(e); 109 Stat. 720.