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690.7203 -7755 SSI Issees I ssees CLINTON LIBRARY PHOTOCOPY June 12, 1995 TO: Carol Rasco Bruce Reed Jeremy Ben-Ami FR: Diana Fortuna Steve Warnath BCW Here is a draft response to the President's question about a Washington Post article on elderly immigrants on SSI. Sorry it took so long, but there were some developments on this issue last week that we wanted to reflect in the responsé. DRAFT June 12, 1995 MEMORANDUM FOR THE PRESIDENT FROM: Carol Rasco SUBJECT: Attached Clipping on SSI and Elderly Immigrants You had sent me the attached Washington Post article on the growth in the number of elderly permanent residents on SSI and noted that we need a careful position on the issue. In our welfare reform bill, we took the position that the income of an immigrant's sponsor should be deemed available to the immigrant for a period of five years for the purposes of determining eligibility for SSI, as well as AFDC and food stamps. This period would be longer if the sponsor's annual income was above the U.S. median family income. In that case, the immigrant would not be eligible for benefits until citizenship. However, since that time, the House and the Senate Finance Committee have both acted on this issue as part of their welfare reform bills. As the article notes, the House would bar legal immigrants from receipt of Medicaid, SSI, school lunch, and other Federal programs, with an exception for those older than 75 who have lived in the U.S. for at least five years. The Senate Finance Committee approach is tougher. It would bar legal immigrants from receipt of SSI, except those who are older than 65 who have worked in the U.S. at least 10 years (long enough to qualify for SSDI and old-age benefits). Both would also exempt recent refugees and veterans. These measures result in significant savings within each bill: $6 billion out of $69 billion in savings in the House welfare reform bill, and approximately $10-11 billion out of $32 billion in savings in the Senate Finance version. One very recent development is Senator Simpson's immigration proposal. Senator Simpson would require an immigrant's sponsor to agree to financially support the sponsored individual until the sponsored individual has worked in the U.S. for 40 qualifying quarters. The bill would save $8.5 billion over five years. In our comments on Simpson's bill, we said that, while the Administration strongly supports making the affidavit of support legally binding, we have reservations about setting the period of obligation and deeming at 40 qualifying quarters, as it could lead to deeming even after the immigrant becomes a naturalized citizen. This feature of Simpson's bill was criticized by others in the attached Washington Post article over the weekend. 2 We offered to work with Simpson's Subcommittee to establish a reasonable deeming policy that addresses these concerns. We suggested that one option could be to deem sponsored immigrants for 10 years or until citizenship with certain exemptions. We have not made this issue a priority in our comments on the welfare reform bill to date, and have therefore not been actively pushing our deeming proposal during the recent debate on the Hill. The conference will be a more appropriate time for us to weigh in, once we have ascertained how much support Senator Simpson is garnering. CC: Leon Panetta Anthony Lake Immigrant groups and others pro- Day said Simpson had disagreed tested the House provisions affect- with the House provisions creating Senate Measure ing legal immigrants, arguing they an outright ban on benefits to noncit- are living in this country legally and izens, arguing there should be a "lim- paying taxes and should be eligible fied safety net" for immigrants who On Immigrants for the same programs as other fallion hard times. Americans But when that happens, sponsors To some extent. those provisions who have pledged to help support Draws Protest were softened in the legislation ap- unmigrants should be held to that proved by the Senate Finance Com- greement, Day said. Taking into ac- mittee last month. Under the Senate Count the income of the sponsors in bill, for example, noncitizens would determining eligibility is similar to The Washington Post, 11. 1995 Benefits Limits Apply be barred from only one program, considering the alimony or child sup- Even After Citizenship SSI, rather than the five programs in port other welfare applicants may be the House bill. receivido he said. But in other ways, the Senate bill "It's just like another asset that is 'more restrictive than the House should be considered," Day said. By Barbara Vobejda "version. Folks who are their relatives should Washington Post Staff Writer The issue most disturbing to im- be responsible for them, not the The Senate welfare reform bill migrant groups is the Senate provi- American taxpayer." would make it more difficult for legal sion that would make it more diffi- immigrants to receive benefits even "cult for legal immigrants to qualify after they become citizens, which for benefits even after they become immigrant groups claim would vio- citizens. The added barrier to bene- late long-standing tradition by creat- fits is a requirement that states, ing two classes of citizens. when determining eligibility, take in- Republican legislation in the to account the income not only of the House and Senate calls for restrict- Immigrants applying for assistance, ing welfare aid to legal immigrants. but the income of the sponsors of But only in the Senate bill do the re- those immigrants, and the sponsors' strictions extend beyond the point at spouses. which immigrants become citizens. For the most part, sponsors are It means that a naturalized citi- relatives of the immigrants. zen doesn't have all the rights of a Advocacy groups argue that few citizen who was born here," said Josh immigrants could qualify for assis- Bernstein, a policy analyst with the tance under the proposed provisions, National Immigration Law Center. known as "deeming" rules. Also, "We're asking people to pledge alle- these groups say, the relatives of im- giance to the country, take on the migrants are often struggling finan- full responsibilities of citizenship, but cially, and supporting another family we withholding some of the bene- would send them into further eco- fits of citizens." nomic difficulty. A spokesman for Sen. Alan K. Under current law, the income of Simpson (R-Wyo.), who proposed sponsors must be "deemed" when a the language, dismissed arguments noncitizen applies for three pro- that the policy would be unfair to im- grams: AFDC, food stamps and SSI. migrants who become citizens. In the House version, the deeming For Simpson, said Richard W. requirement would end when an im- Day, chief counsel to the Judiciary migrant became a citizen. In the immigration subcommittee, "it's a Senate bill, the deeming require- matter of principle that newcomers ment would apply even after an im- should be self-supporting." migrant becomes a citizen. "To create this distinction be- Under the welfare bill approved by the House in March, most legal tween naturalized citizens and other immigrants who have not become citizens is a huge departure from a couple hundred years' worth of tra- citizens would be barred from re- dition in this country," said Cecilia ceiving benefits under the major Munoz, deputy vice president at the welfare programs-including Aid to National Council of La Raza. Families with Dependent Children, That argument was supported by food stamps, Medicaid and Supple- David Martin, University of Virginia mental Security Income (SSI) for the professor of law. "Traditionally, the elderly and disabled. dividing line has been obtaining citi- Illegal immigrants are not eligible Lenship," Martin said. "Virtually ev- for most programs under current ery, kind of restriction that applies to law, nor would they be under the aliens ceases to apply when you be- proposed changes. come a citizen." MAY of refugees during the Cold War and therefore AN UNCERTAIN OLD AGE tract With America. has a special obligation to help them once they "They live in your home town. They go to are here. THE IMMIGRANT ELDERLY the Rotary Club. They're in the service club," Proponents of the bill say the United States Simpson said. "They are in every sense part of should not use welfare to compensate for misery us-except for one thing, the right to vote." under communism. Renefit Lifeline The House version of welfare reform would The group most frequently criticized by propo- produce savings of between $18 billion and $21 nents of restricting benefits are elderly immi- billion over five years by barring most legal immi- grants coming to the United States to join their May Be Severed grants from receiving a range of federally funded American-citizen children. Many are too old or benefits, from Medicaid to school lunches. disabled to work. Advocates of welfare reform Exceptions would be made for legal immi- say children who sponsor their parents to come grants over 75 who have lived here five years, re- to the United States, not American taxpayers, For Noncitizens cent refugees and veterans, among others. Un- should take care of them. documented aliens would continue to be barred Opponents say elderly immigrants who are eli- from welfare programs and non-emergency gible for SSI are not cheating the system but as of three articles health care welfare programs. making normal use of a benefit that native-born The Senate version of the welfare bill adopted Americans would not deny their own families. By Lena H. Sun last week by the Finance Committee would give In the Washington area, where foreign-born Washington Post Sulf Writer states the option of barring legal immigrants residents make up 12 percent of the general pop- from the basic cash welfare program, Aid to Fam- ulation-higher than the national average-the han Hue rolls up his pants and ilies with Dependent Children. P two largest groups of legal residents receiving sleeves to show the scars from But, like the House bill, the Senate legislation SSI are from Vietnam and South Korea, accord- four bullet and shrapnel wounds, targets the federal program that has been used ing to the Social Security Administration. reminders of his days in the South by increasing numbers of elderly immigrants and Vietnamese army. Now living in Falls refugees in the last decade: the Supplemental Se- When Families Can't Help Church, Phan, 74, and his wife survive on curity Income program, which provides assis- $680 a month in federal benefits for the tance to the nation's disabled and elderly poor. Du Won Kim, a retired South Korean auto elderly poor, known as Supplemental The Senate version of welfare reform would parts salesman, came to the United States 10 Security Income, or SSI. They stretch produce savings of between $10 billion and $11 years ago to be with his grown daughter and those dollars by turning the heat down in billion over five years by keeping most elderly im- son. Kim, now 74, stayed briefly with his the winter, sitting outside in the sun to migrants from receiving aid under SSI. daughter in her Silver Spring home but moved keep warm, and seldom buying meat. Exceptions would be made for legal immi- out because he did not want to live in the same The two refugees are among hundreds grants who have worked in 'the United States house with his son-in-law's mother. He lives of thousands of elderly immigrants, all of long enough to qualify for Social Security disabili- alone in a subsidized apartment in Rockville. them legally admitted into the country, ty income or old-age benefits-at least 10 He worked for about a year in a delicatessen who would lose such benefits under the years-and for recent refugees and veterans. but stopped when he turned 65 and was eligible Republican-sponsored welfare reform bill An estimated 738,000 legal aliens received to receive SSI. His monthly check is $458. He that passed the House in March and under SSI benefits in December 1994. Legal aliens ac- can pay his $128 monthly rent, but he relies on another bill pending in the Senate. These count for nearly 12 percent of all SSI recipients his daughter for additional money to cover liv- and 30 percent of all recipients 65 or older. Since cuts are an essential part of the GOP ing expenses. 1982, the number of legal residents receiving proposals because they produce roughly The daughter, Chong Hong, 51, is an American has risen 580 percent, reflecting a surge in immi- one-third of the $66 billion in savings over citizen. She owns a Rockville sandwich shop; her gration husband is an auto mechanic. With three daugh- five years that backers expect to glean Robert Rector, a policy analyst with the Heri- from the House welfare plan, and about 4( ters in college, she said, she is unable to provide tage Foundation who favors the new restrictions, full financial support for her father. percent of the $26 billion in savings from says knowledge about these benefits has spread "I can't cover all his expenses," she said. "In the Senate version. in immigrant communities here and overseas, at- Korea, the wives stay home, but in America, my The impact of the legislation goes far tracting foreign-born elderly who are turning the husband and I both work hard, and still we do not beyond dollars and cents. Already these U.S. welfare system into a "deluxe retirement have enough for everything." money-saving proposals have prompted a home." Her brother, recently divorced, is also strug- wide-ranging debate over the place of Critics of the legislation say the bills, particu- gling and cannot provide for his father. legal immigrants in American society. For larly the broader House legislation, would hurt the needy and vulnerable. For immigrants who. Kim turns 75 next year and would be exempt the first time, they are being judged substantially in relation to their use of arrive too late in life to work enough time to qual- from the ban under the House bill, but unprotec- ify for Social Security, there is virtually no other ted under the Senate version. He is taking no publicly funded health care and other way to get affordable health insurance except chances. He is applying for citizenship. entitlements, as opposed to their See ELDERLY, A5, Col. 3 through SSI. In most states, elderly people re- Other elderly immigrants may not be as fortu- ceiving SSI automatically qualify for Medicaid, nate. ELDERLY, From A1 the government health insurance program for the Phan, the former South Vietnamese army ser- economic, social and cultural contributions to poor and disabled. geant, has a third-grade education and little Another category of immigrants that oppo- chance of learning enough English to pass the citi- ciety. "When did we change the definition of Ameri- nents of the cutbacks consider particularly de- zenship test. In 1987, he fled his village in central can? From Albert Einstein to Martina Navra- serving are those who worked in the United Vietnam for the Philippines on a fishing boat with tilova; from An Wang, the founder of Wang com- States long enough to get Social Security but six of his nine children and their families. puters, to Elie Wiesel, winner of the Nobel Peace were employed in such low-wage, low-benefit A year later, they arrived in the United States. Prize-all have come to this country and been ac- jobs that they now need SSI to keep them out of The children are working-some as carpenters, cepted as Americans," said Rep. Norman Y. Mi- poverty. About one of every four legal immi- one as a custodian-but their wages are low, and neta (D-Calif.) during the House floor debate. grants receiving SSI, many of them former work- they cannot help their parents financially. The But advocates of the new restrictions insist ers in the garment and service industries, also $680 in monthly SSI benefits barely covers rent, that legal immigrants must accept substantial gets Social Security retirement benefits. utilities and food for Phan and his wife, Truong sacrifices at a time of widespread cuts in federal Juan Martinez, 71, a retired day laborer, lives Thi Ty, 68, who arrived last year. spending on assistance programs. in Weslaco, Tex., in the Rio Grande valley. Origi- The blue couch in their one-bedroom Falls "Quite frankly, 1 do not think that when we're nally from Mexico, Martinez worked for 16 years cutting benefits and cutting welfare for our citi- picking cucumbers, tomatoes, strawberries and Church apartment is threadbare. A white Frisbee oranges in Ohio, Florida and Michigan. He retired turned upside down is the tray for chipped tea- zens, 1 don't see why we should stretch and say that we have an obligation to those that aren't four years ago after he became ill with diabetes. cups. One recent afternoon, the fiance of one of He receives $287 a month in Social Security, and their granddaughters brought them a bag of even citizens of our own country," said Rep. E. Clay Shaw Jr. (R-Fla.), an author of the House $178 in SSI. His wife, also a retired farm worker, shrimp, a treat they seldom buy themselves. receives an additional spousal Social Security Truong has frequent migraines, and may have welfare plan. The issue is likely to be a major point of con- check of $139 a month. diabetes. Phan suffers from severe arthritis. Be- tention in coming months now that the welfare Martinez would be protected under the Senate cause of his age, Phan would keep his benefits un- reform debate has moved to the Senate, where welfare reform bill. but the House version would der the House bill, but his wife would lose her SSI some prominent Republicans favor either adopt- cut off his SSI income and force the couple to live stipend and Medicaid coverage. Under the Senate ing less restrictive measures or letting individual on an annual income of $5,112, substantially be- version, the couple would lose their entire month- states decide on immigrants' eligibility. low the poverty line. ly income of $680. "They can check with my bosses, they can find "If the government does not help out the old 'In Every Sense Part of Us' out if I worked or not," said Martinez, his words people, I don't see how we can survive," said tumbling out in Spanish. "If they get rid of the Phan, speaking agitatedly in Vietnamese. "The Sen. Alan K. Simpson, (R-Wyo.), a longtime check, I couldn't pay the electric, I couldn't pay Americans helped the Vietnamese fight the Com- leader on immigration policy, often argues that the water, I couldn't pay for the old car I got-1 munists. I don't really don't understand about the legal immigrants enter into a contract with the couldn't pay for anything." politics here. But if America had won the war, government when they come to the United Others who would be hard-hit are refugees, then all the Vietnamese soldiers would be leading States. They pay taxes and serve in the mili- with the largest numbers having fled the former a much happier life everywhere." tary. To take the safety net from them, he said, Soviet Union and Southeast Asia. Refugee advo- "would be a very grave mistake" and goes cates say the United States played a central role Staff writers Guy Gugliotta and Peter Pae against the spirit of House Republicans' "Con- in the political upheavals that produced the flow contributed to this rebort. THE WASHINGTON POST TUESDAY. MAY 30, 1995 THE PRESIDENT HAS SEEN 5/31 Leon ( coz/Tonyc we new Ce caupus position on Mai- also rught have Sorm freign policy carplications BR - REGO II - -SSI Up to the shots - Privatiting Soc.Sec. - Greater Die of 3rd party 2 BACKLOG - ser up don - acc on moiling lisv for repels. s Apers - Peg Clare think we're done 4 INFO from Treas my : ST by st. breandown of who pass the 85% EXECUTIVE OFFICE OF THE PRESIDENT OFFICE OF MANAGEMENT AND BUDGET Washington, D.C. 20503 May 20, 1994 LEGISLATIVE REFERRAL MEMORANDUM LRM #I-2778 TO: Legislative Liaison Officer - HHS - Frances White - (202)690-7760 - 328 JUSTICE - Sheila F. Anthony - (202)514-2141 - 217 TREASURY - Richard S. Carro - (202) 622-1146 - 228 AGRICULTURE - Marvin Shapiro - (202) 720-1516 - 312 LABOR - Robert A. Shapiro - (202) 219-8201 - 330 ONDCP - Babette Hankey - (202)395-6739 - 257 FROM: Assistant JANET R. FORSGREN Director (for) for prit Legislative R. Forsyxence OMB CONTACT: Melissa COOK (395-3924) Secretary's line (for simple responses) : 395-7362 SUBJECT: OMB Request for Views RE: HR 4419, To modify the Supplemental Security Income program under title XVI of the Social Security Act DEADLINE: C.O.B. June 1, 1994 OMB requests the views of your agency on the above subject before advising on its relationship to the program of the President, in accordance with OMB Circular A-19. Please advise us if this item will affect direct spending or receipts for purposes of the the "Pay-As-You-Go" provisions of Title XIII of the Omnibus Budget Reconciliation Act of 1990. CC: Bernie Martin Keith Fontenot Bob Damus Richard Popper Art Stigile Mike Ruffner Ellen Seidman Barry Clendenin (2 Bill-Dickens copies) Jeremy Benami Doug Steiger Cookie Walden Barbara Selfridge Clarissa Cerda Ken Schwartz Greg Simon Jim Duke/Martha Lorraine Miller Gagne Jennifer Palmieri Lin Liu Janet Forsgren Laura Oliven Chris Mustain LRM #I-2778 RESPONSE TO LEGISLATIVE REFERRAL MEMORANDUM If your response to this request for views is simple (e.g., concur/no comment) we prefer that you respond by faxing us this response sheet. If the response is simple and you prefer to call, please call the branch-wide line shown below (NOT the analyst's line) to leave a message with a secretary. You may also respond by (1) calling the analyst/attorney's direct line (you will be connected to voice mail if the analyst does not answer) i (2) sending us a memo or letter; or (3) if you are an OASIS user in the Executive Office of the President, sending an E-mail message. Please include the LRM number shown above, and the subject shown below. TO: Melissa COOK Office of Management and Budget Fax Number: (202) 395-6148 Analyst/Attorney's Direct Number: (202) 395-3924 Branch-Wide Line (to reach secretary) : (202) 395-7362 FROM: (Date) (Name) (Agency) (Telephone) SUBJECT: OMB Request for Views RE: HR 4419, To modify the Supplemental Security Income program under title XVI of the Social Security Act The following is the response of our agency to your request for views on the above-captioned subject: Concur No objection No comment See proposed edits on pages Other: FAX RETURN of pages, attached to this response sheet I 103D CONGRESS 2D SESSION H. R. 4419 To modify the supplemental security income program under title XVI of the Social Security Act. IN THE HOUSE OF REPRESENTATIVES MAY 12, 1994 Mr. SANTORUM (for himself, Mr.ARCHER, Mr.GINGRICH, Mr.THOMAS of California, Mr.SHAW, Mr.CAMP, Mr. HERGER, Mr.MCCRERY, Mrs. JOHNSON of Connecticut, Mr.CASTLE, Mr. GEKAS, Mr. SMITH of Michigan, and Mr. ISTOOK) introduced the following bill; which was referred jointly to the Committees on Ways and Means and Energy and Commerce A BILL To modify the supplemental security income program under title XVI of the Social Security Act. //Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, !!TITLE I--RESTRICTIONS FOR ALIENS!! !!SEC. 101. CERTAIN ALIENS INELIGIBLE FOR SUPPLEMENTAL SECURITY INCOME BENEFITS. !! (a) IN GENERAL. Section 1614 (a) of the Social Security Act (42 U.S.C. 1382c (a)) is amended by adding at the end the following: " (5) (A) An alien otherwise eligible for benefits under this title who has qualified for entry pursuant to section 207 of the Immigration and Nationality Act shall not be eligible for such benefits after the 6-year period that begins with the date the alien arrives in the United.States. " (B) Subparagraph (A) shall not apply to an alien who-- " (i) has been lawfully admitted to the United States for permanent residence; " (ii) has attained 75 years of age; and " (iii) has resided in the United States for at least 5 years. " (C) Subparagraph (A) shall not apply to an alien who, on the date of the enactment of this paragraph, is residing in the United 2 States and eligible for benefits under this title, until 1 year after such date of enactment. (b) NOTIFICATION OF AFFECTED ALIENS. Social Security Administration shall, directly or through the States, notify each alien receiving supplemental security income benefits under title XVI of the Social Security Act whose eligibility for such benefits is or will be terminated by reason of the amendment made by subsection (a). !!SEC. 102. STATE AFDC AGENCIES REQUIRED TO PROVIDE INFORMATION ON ILLEGAL ALIENS TO THE IMMIGRATION AND NATURALIZATION SERVICE. !! Section 402 (a) of the Social Security Act (42 U.S.C. 602 (a)) is amended-- (1) by striking "and" at the end of paragraph (44) i (2) by striking the period at the end of paragraph (45) and inserting "; and"; and (3) by inserting after paragraph (45) the following: " (46) require the State agency to provide to the Immigration and Naturalization Service the name, address, and other identifying information that the agency has with respect to any individual unlawfully in the United States any of whose children is a citizen of the United States." !!TITLE II--RESTRICTIONS FOR DRUG ADDICTS AND ALCOHOLICS!! !!SEC. 201. TIME-LIMITED BENEFITS. !! (a) IN GENERAL. Section 1614 (a) of the Social Security Act (42 U.S.C. 1382c (a) ) is amended by adding at the end the following: " (5) (A) The Secretary shall identify all recipients of benefits under this title by reason of disability whose disability is a result of addiction to illegal drugs. " (B) The Secretary shall periodically, on a random basis, test each recipient identified under subparagraph (A) (including any recipient who had become temporarily ineligible for benefits by reason of subparagraph (c)) to determine whether the recipient is using illegal drugs. " (C) (i) Notwithstanding any other provision of this title, any individual who is determined under subparagraph (B) to be using illegal drugs, or who refuses to submit to testing as provided for under subparagraph (B) shall not be eligible for benefits under this title during the period described in clause (ii). " (ii) The period described in this clause begins with the date of the determination referred to in clause (i) and ends with the passage by the individual of 2 tests administered by the Secretary (and paid for by the individual) to determine whether the individual is using illegal drugs, which tests occur-- " (I) at least 2 months apart; and " (II) after the 1-year period that begins with the date of the determination. 3 "(6) (A) The Secretary shall identify all recipients of benefits under this title by reason of disability whose disability is a result of addiction to alcohol. " (B) The Secretary shall periodically, on a random basis, test each recipient identified under subparagraph (A) (including any recipient who had become temporarily ineligible for benefits by reason of subparagraph (c)) to determine whether the recipient is using alcohol. " (C) (i) Notwithstanding any other provision of this title, any individual who is determined under subparagraph (B) to be using alcohol, or who refuses to submit to testing as provided for under subparagraph (B), shall not be eligible for benefits under this title during the period described in clause (ii). "(ii) The period described in this clause begins with the date of the determination referred to in clause (i) and ends with the passage by the individual of 2 tests administered by the Secretary (and paid for by the individual) to determine whether the individual is using alcohol, which tests occur-- '(I) at least 2 months apart; and "(II) after the 6-month period that begins with the date of the determination. (b) PRESERVATION OF ELIGIBILITY FOR MEDICAID BENEFITS. Section 1634 of the Social Security Act (42 U.S.C. 1383c) is amended by adding at the end the following: " (e) For purposes of title XIX, an individual is deemed to be receiving benefits under this title if the individual is ineligible for such benefits solely by reason of paragraph (5) or (6) of section 1614 (a) .". !!SEC. 202. RESTRICTIONS ON PAYMENT OF BENEFITS BASED ON DISABILITY TO SUBSTANCE ABUSERS. !! (a) REQUIRED PAYMENT OF BENEFITS TO REPRESENTATIVE PAYEES. (1) IN GENERAL. Section 1631 (a) (2) (A) of the Social Security Act (42 U.S.C. 1383 (a) (2) (A)) is amended-- (A) in clause (ii), by adding at the end the following: "In the case of an individual entitled to benefits under this title by reason of disability, if alcoholism or drug addiction is a contributing factor material to the Secretary's determination that the individual is disabled, the payment of such benefits to a representative payee shall be deemed to serve the interest of such individual under this title. and (B) in clause (iii), by striking "to the individual or eligible spouse or to an alternative representative payee of the individual or eligible spouse" and inserting "to an alternative representative payee of the individual or eligible spouse or, if the interest of the individual under this title would be served thereby, to the individual or eligible spouse". (2) CONFORMING AMENDMENT. Section 1631 (a) (2) (B) (viii) (II) 4 of such Act (42 U.S.C. 1383 (a) (2) (B) (viii) (II)) is amended by striking "15 years" and all that follows and inserting "of 15 years, or (if alcoholism or drug addition is a contributing factor material to the Secretary's determination that the individual is disabled) is entitled to benefits under this title by reason of disability." (3) EFFECTIVE DATE. The amendments made by this subsection shall apply with respect to benefits for months beginning after 180 days after the date of the enactment of this Act. (b) INCREASED RELIANCE ON PROFESSIONAL REPRESENTATIVE PAYEES. (1) PREFERENCE REQUIRED FOR ORGANIZATIONAL REPRESENTATIVE PAYEES. Section 1631 (a) (2) (B) of such Act (42 U.S.C. 1383 (a) (2) (B)) is amended-- (A) by redesignating clauses (vii) through (xii) as clauses (viii) through (xiii), respectively; (B) by inserting after clause (vi) the following: "(vii) In the case of an individual entitled to benefits under this title by reason of disability, if alcoholism or drug addiction is a contributing factor material to the Secretary's determination that the individual is disabled, when selecting such individual's representative payee, preference shall be given to a-- " (I) community-based nonprofit social service agency licensed or bonded by the State; " (II) State or local government agency whose mission is to carry out income maintenance, social service, or health care- related activities; or " (III) State or local government agency with fiduciary responsibilities, (or a designee of such an agency if the Secretary deems it appropriate), unless the Secretary determines that selection of such an agency would not be appropriate." (C) in clause (viii) (as so redesignated), by striking "clause (viii) and inserting "clause (ix) (D) in clause (ix) (as so redesignated), by striking "(vii)" and inserting " (viii)' (E) in clause (xiii) (as so redesignated) -- (i) by striking " (xi) " and inserting " (xii) and (ii) by striking "(x)" and inserting " (xi) (2) AVAILABILITY OF PUBLIC AGENCIES AND OTHER QUALIFIED ORGANIZATIONS TO SERVE AS REPRESENTATIVE PAYEES. Section 1631 (a) (2) (D) of such Act (42 U.S.C. 1383 (a) (2) (D)) is amended-- (A) in clause (i) (i) by striking "exceed the lesser of--" and inserting "exceed--"; and (ii) by striking subclauses (I) and (II) and inserting the following: " (I) in any case in which an individual is entitled to benefits under this title by reason of disability and alcoholism or drug addiction is a contributing factor material to the Secretary's determination that the individual is disabled, 10 percent of the monthly benefit involved, or "(II) in any other case, the lesser of-- " (aa) 10 percent of the monthly benefit involved, or " (bb) $25.00 per month. 5 (B) in clause (ii) (i) by inserting "State or local government agency whose mission is to carry out income maintenance, social service, or health care-related activities, any State or local government agency with fiduciary responsibilities, or any" after "means any"; (ii) by inserting a comma after "service agency"; (iii) by adding "and" at the end of subclause (I) i and (iv) in subclause (II) (I) by adding "and" at the end of item (aa) ; (II) by striking "; and" at the end of item (bb) and inserting a period; and (III) by striking item (cc) ; and (C) by striking clause (iv), effective July 1, 1994. (c) NONPAYMENT OR TERMINATION OF BENEFITS. (1) IN GENERAL. Section 1611 (e) (3) of such Act (42 U.S.C. 1382 (e) (3) ) is amended by redesignating subparagraph (B) as subparagraph (C) and by inserting after subparagraph (A) the following: " (B) (i) Notwithstanding any other provision of this title, in the case of any individual entitled to benefits under this title solely by reason of disability, if alcoholism or drug addiction is a contributing factor material to the Secretary's determination that such individual is disabled and such individual is determined by the Secretary not to be in compliance with the requirements of this subparagraph for a month, such benefits shall be suspended for a period commencing with such month and ending with the month preceding the first month, after the determination of noncompliance, in which such individual demonstrates that he or she has reestablished and maintained compliance with such requirements for the applicable period specified in clause (iii). "(ii) (I) An individual described in clause (i) is in compliance with the requirements of this subparagraph for a month if the individual in such month undergoes any medical or psychological treatment that may be appropriate, for the individual's condition diagnosed as substance abuse or alcohol abuse and for the stage of the individual's rehabilitation, at an institution or facility approved for purposes of this subparagraph by the Secretary, and complies in such month with the terms, conditions, and requirements of such treatment and with requirements imposed by the Secretary under subparagraph (C). " (II) An individual described in clause (i) shall not be determined to be not in compliance with the requirements of this subparagraph for a month if access by such individual to such treatment is not reasonably available for the month, as determined under regulations of the Secretary. " (iii) The applicable period specified in this clause is-- " (I) 2 consecutive months, in the case of a 1st determination that an individual is not in compliance with the requirements of this subparagraph; "(II) 3 consecutive months, in the case of the 2nd such 6 determination with respect to the individual; or "(III) 6 consecutive months, in the case of the 3rd or subsequent such determination with respect to the individual. "(iv) An individual shall not be an eligible individual for purposes of this title for the 12-month period that begins with the end of any period of 12 consecutive months for which the benefits of the individual under this title have been suspended by reason of this subparagraph. "(v) In the case of any individual entitled to benefits under this title by reason of disability, if alcoholism or drug addiction is a contributing factor material to the Secretary's determination that such individual is disabled, such individual may not be entitled to such benefits by reason of disability (or any past-due benefits under such entitlement) for any month after the 36-month period beginning with such individual's first month of such entitlement, notwithstanding section 1619 (a). "(vi) (I) The Secretary shall not, in a month, pay to an individual described in clause (i) benefits under this title the payment of which is past due, in an amount that exceeds the amount of benefits under this title which are payable to the individual for the month and the payment of which is not past due. "(II) As used in subclause (I) of this clause, the term 'benefits under this title' includes supplementary payments of the type described in section 1616 (a) and payments pursuant to an agreement entered into under section 212 (a) of Public Law 93-66.". (2) REFERRAL, MONITORING, AND TREATMENT. -Section 1611 (e) (3) (C) of such Act (42 U.S.C. 1382 (e) (3) (C) ) as so designated by the amendment made by paragraph (1) of this subsection, is amended-- (A) by adding at the end the following: "Each such annual report shall include the number and percentage of such individuals who did not receive regular drug testing during the year covered by the report. (B) by inserting "(i)" after "(C)"; and (C) by adding after and below the end following: "(ii) The Secretary, in consultation with drug and alcohol treatment professionals, shall issue regulations-- " (I) defining appropriate treatment for alcoholics and drug addicts who are subject to required medical or psychological treatment under this subparagraph; and " (II) establishing guidelines to be used to review and evaluate their compliance, including measures of the progress of participants in such programs. "(iii) (I) For purposes of carrying out the requirements of clauses (i) and (ii), the Secretary shall establish in each State a referral and monitoring agency for the State. "(II) Each referral and monitoring agency for a State shall-- (aa) identify appropriate placements, for individuals residing in the State who are entitled to benefits under this title by reason of disability and with respect to whom 7 alcoholism or drug addiction is a contributing factor material to the Secretary's determination that they are disabled, where they may obtain treatment described in subparagraph (B) (ii) (I) i " (bb) refer such individuals to such placements for such treatment; and (cc) monitor compliance with the requirements of subparagraph (B) by individuals who are referred by the agency to such placements, and promptly report to the Secretary any failure to comply with such requirements." (3) PRESERVATION OF MEDICAID BENEFITS. Section 1634 of such Act (42 U.S.C. 13283c) is amended by adding at the end the following: "(e) Each person to whom benefits under this title by reason of disability are not payable for any month solely by reason of section 1611 (e) (3) (B) shall be treated, for purposes of title XIX, as receiving benefits under this title for such month. (4) CONFORMING AMENDMENTS. Section 1611 (e) (3) of such Act (42 U.S.C. 1382 (e) (3) ) as amended by paragraphs (1) and (2) of this subsection, is amended-- (A) in subparagraph (A), by striking "(B)" and inserting "(C)"; and (B) in subparagraph (c), by inserting "or (B)" after "(A)". (5) EFFECTIVE DATE. (A) IN GENERAL. Except as provided in subparagraphs (B) and (c), the amendments made by this subsection shall apply with respect to benefits for months beginning after 180 days after the date of the enactment of this Act. (B) TIME LIMITATION ON BENEFITS. Section 1611 (e) (3) (B) (v) of the Social Security Act (as added by the amendment made by paragraph (1) of this subsection) shall apply with respect to benefits for months ending after 180 days after the date of the enactment of this Act, and, for purposes of such section, in the case of any individual entitled to benefits by reason of disability for the first month ending after 180 days after the date of the enactment of this Act, such month shall be treated as such individual's first month of entitlement to such benefits. (C) ESTABLISHMENT OF REFERRAL AND MONITORING AGENCIES.- Section 1611 (e) (3) (C) (iii) of the Social Security Act (as added by the amendment made by paragraph (2) (c) of this subsection) shall take effect 180 days after the date of the enactment of this Act. (d) IRRELEVANCE OF LEGALITY OF SUBSTANTIAL GAINFUL ACTIVITY (1) IN GENERAL. Section 1614 (a) (3) (D) of such Act (42 U.S.C. 1382c (a) (3) (D) ) is amended by adding at the end the following: "The Secretary shall make determinations under this title with respect to substantial gainful activity, without regard to the legality of the activity." (2) EFFECTIVE DATE. The amendment made by paragraph (1) shall take effect on the date of the enactment of this Act. (e) EFFECTIVE DATE. Except as otherwise provided in this section, the amendments made by this section shall apply to benefits payable for months beginning 180 or more days after the date of the enactment of this Act. !!TITLE III--BENEFITS FOR CHILDREN!! !!SEC. 301. REPLACEMENT OF CASH BENEFIT WITH MEDICAL VOUCHER. !! (a) IN GENERAL. Section 1611 (b) of the Social Security Act (42 U.S.C. 1382 (b) ) is amended by adding at the end the following: "(3) Notwithstanding paragraphs (1) and (2), the benefit under this title for a child who has not attained 18 years of age shall be vouchers issued pursuant to subsection (j) .". (b) ISSUANCE OF VOUCHERS FOR TREATMENT OF DISABLING CONDITIONS OF CHILDREN ELIGIBLE FOR SSI BENEFITS. Section 1611 of such Act (42 U.S.C. 1382 (b)) is amended by adding at the end the following: " (j) (1) The Secretary of Health and Human Services shall issue to each child eligible for benefits under this title who has not attained 18 years of age a voucher which may be used to cover the cost of any item-- " (A) that is associated with treating the blindness or disability of the child; " (B) for which a medical expense deduction may be claimed under section 213 of the Internal Revenue Code of 1986 by the child or any taxpayer who may claim the child as a dependent; and " (C) the cost of which is not covered by the program of medical assistance approved under title XIX of the State in which the child resides. " (2) The face dollar amount of the voucher issued with respect to a child shall not exceed the amount of the cash benefit to which the child would (but for section 1611 (b) (3) have been entitled under this title. " (3) The Secretary shall pay to each provider of health care goods or services that is licensed by a State, or by a professional health care organization approved by the Secretary, that submits to the Secretary a voucher issued under this subsection an amount equal to the face dollar amount of the voucher. !!SEC. 302. DISABILITY REVIEW REQUIRED FOR SSI RECIPIENTS WHO ARE 18 YEARS OF AGE. !! (a) IN GENERAL. Section 1614 (a) (3) (G) of the Social Security Act (42 U.S.C. 1382c (a) (3) (G)) is amended-- (1) by inserting "(i)" after "(G)"; and (2) by adding after and below the end the following: " (ii) (I) During the 1-year period that begins on the date a recipient of benefits under this title by reason of disability attains 18 years of age, the applicable State agency or the Secretary (as may be appropriate) shall redetermine the eligibility of the recipient for such benefits by reason of disability, by applying the criteria used in determining eligibility for such benefits of applicants who have attained 18 years of age. 9 '(II) A review under subclause (I) of this clause shall be considered a substitute for a review required under clause (i) .". (b) EFFECTIVE DATE. The amendments made by subsection (a) shall apply to individuals who attain 18 years of age in or after the 9th month after the month in which this Act is enacted. !TITLE IV--FRAUD!! !!SEC. 401. EXPANSION OF THE AUTHORITY OF THE SOCIAL SECURITY ADMINISTRATION TO PREVENT, DETECT, AND TERMINATE FRAUDULENT CLAIMS FOR SSI BENEFITS. (a) PREVENTION OF FRAUD IN THE SSI PROGRAM BY TRANSLATORS OF FOREIGN LANGUAGES. (1) IN GENERAL.--Section 1631 (e) of the Social Security Act (42 U.S.C. 1383 (e)) is amended by inserting after paragraph (3) the following: " (4) A translation into English by a third party of a statement made in a foreign language by an applicant for or recipient of benefits under this title shall not be regarded as reliable unless the third party, under penalty of perjury-- " (A) certifies that the translation is accurate; and " (B) discloses the nature and scope of the relationship between the third party and the applicant or recipient, as the case may be. (2) EFFECTIVE DATE. The amendment made by paragraph (1) shall take effect on October 1, 1994. (b) CIVIL MONETARY PENALTIES, ASSESSMENTS, AND EXCLUSIONS FOR TITLE XVI. (1) IN GENERAL.--Title XI of such Act (42 U.S.C. 1301-1320b- 14) is amended by inserting after section 1128B the following: !! "SEC. 1129. CIVIL MONETARY PENALTIES AND ASSESSMENTS FOR TITLE XVI. !! " (a) Any person (including an organization, agency, or other entity) who makes, or causes to be made, a statement or representation of a material fact for use in determining any initial or continuing right to benefits or payments under title XVI that the person knows or should know is false or misleading or knows or should know omits a material fact shall be subject to, in addition to any other penalties that may be prescribed by law, a civil money penalty of not more than $5,000 for each such statement or representation. Such person also shall be subject to an assessment, in lieu of damages sustained by the United States because of such statement or representation, of not more than twice the amount of benefits or payments paid as a result of such a statement or representation. In addition, the Secretary may make a determination in the same proceeding to exclude the person from participation in the programs under title XVIII and to direct the appropriate State agency to exclude the person from participation in any State health care program. 10 " (b) (1) The Secretary may initiate a proceeding to determine whether to impose a civil money penalty, assessment, or exclusion under subsection (a) only as authorized by the Attorney General pursuant to procedures agreed upon by the Secretary and the Attorney General. The Secretary may not initiate an action under this section with respect to any violation described in subsection (a) later than 6 years after the date the violation was committed. The Secretary may initiate an action under this section by serving notice of the action in any manner authorized by Rule 4 of the Federal Rules of Civil Procedure. " (2) The Secretary shall not make a determination adverse to any person under this section until the person has been given written notice and an opportunity for the determination to be made on the record after a hearing at which the person is entitled to be represented by counsel, to present witnesses, and to cross-examine witnesses against the person. " (3) In a proceeding under this section which-- " (A) is against a person who has been convicted (whether upon a verdict after trial or upon a plea of guilty or nolo contendere) of a Federal crime charging fraud or false statements; and " (B) involves the same transaction as in the criminal action, the person is estopped from denying the essential elements of the criminal offense. " (4) The official conducting a hearing under this section may sanction a person, including any party or attorney, for failing to comply with an order or procedure, failing to defend an action, or other misconduct as would interfere with the speedy, orderly, or fair conduct of the hearing. Such sanction shall reasonably relate to the severity and nature of the failure or misconduct. Such sanction may include-- " (A) in the case of refusal to provide or permit discovery, drawing negative factual inference or treating such refusal as an admission by deeming the matter, or certain facts, to be established; " (B) prohibiting a party from introducing certain evidence or otherwise supporting a particular claim or defense; " (C) striking pleadings, in whole or in part; " (D) staying the proceedings; " (E) dismissal of the action; " (F) entering a default judgment; " (G) ordering the party or attorney to pay attorneys' fees and other costs caused by the failure or misconduct; and " (H) refusing to consider any motion or other action which is not filed in a timely manner. " (c) In determining the amount or scope of any penalty, assessment, or exclusion imposed pursuant to this section, the Secretary shall take into account-- " (1) the nature of the statements and representations referred to in subsection (a) and the circumstances under which they occurred; " (2) the degree of culpability, history of prior offenses, and financial condition of the person committing the offense; and " (3) such other matters as justice may require. " (d) (1) Any person adversely affected by a determination of the Secretary under this section may obtain a review of such determination in the United States Court of Appeals for the circuit in which the person resides, or in which the statement or representation referred to in subsection (a) was made, by filing in such court (within 60 days following the date the person is notified of the Secretary's determination) a written petition requesting that the determination be modified or set aside. A copy of the petition shall be forthwith transmitted by the clerk of the court to the Secretary, and thereupon the Secretary shall file in the court the record in the proceeding as provided in section 2112 of title 28, United States Code. Upon such filing, the court shall have jurisdiction of the proceeding and of the question determined therein, and shall have the power to make and enter upon the pleadings, testimony, and proceedings set forth in such record a decree affirming, modifying, remanding for further consideration, or setting aside, in whole or in part, the determination of the Secretary and enforcing the same to the extent that such order is affirmed or modified. No objection that has not been urged before the Secretary shall be considered by the court, unless the failure or neglect to urge such objection shall be excused because of extraordinary circumstances. " (2) The findings of the Secretary with respect to questions of fact, if supported by substantial evidence on the record considered as a whole, shall be conclusive in the review described in paragraph (1) If any party shall apply to the court for leave to adduce additional evidence and shall show to the satisfaction of the court that such additional evidence is material and that there were reasonable grounds for the failure to adduce such evidence in the hearing before the Secretary, the court may order such additional evidence to be taken before the Secretary and to be made a part of the record. The Secretary may modify its findings as to the facts, or make new findings, by reason of additional evidence so taken and filed, and the Secretary shall file with the court such modified or new findings, which findings with respect to questions of fact, if supported by substantial evidence on the record considered as a whole shall be conclusive, and his recommendations, if any, for the modification or setting aside of his original order. " (3) Upon the filing of the record with the Secretary's original or modified order, the jurisdiction of the court shall be exclusive and its judgment and decree shall be final, except that the same shall be subject to review by the Supreme Court of the United States, as provided in section 1254 of title 28, United States Code. " (e) (1) Civil money penalties and assessments imposed under this section may be compromised by the Secretary and may be recovered-- II (A) in a civil action in the name of the United States brought in United States district court for the district where 12 the statement or representation referred to in subsection (a) was made, or where the person resides, as determined by the Secretary; " (B) by means of reduction in tax refunds to which the person is entitled, based on notice to the Secretary of the Treasury as permitted under section 3720A of title 31, United States Code; " (c) by decrease of any payment under title XVI to which the person is entitled, notwithstanding section 207 of this Act, as made applicable to this title by reason of section 1631 (d) (1) i " (D) by authorities provided under the Debt Collection Act of 1982, as amended, to the extent applicable to debts arising under the Social Security Act; " (E) by deduction of the amount of such penalty or assessment, when finally determined, or the amount agreed upon in compromise, from any sum then or later owing by the United States to the person against whom the penalty or assessment has been assessed; or " (F) by any combination of the foregoing. " (f) A determination by the Secretary to impose a penalty, assessment, or exclusion under this section shall be final upon the expiration of the 60-day period referred to in subsection (d) Matters that were raised or that could have been raised in a hearing before the Secretary or in an appeal pursuant to subsection (d) may not be raised as a defense to a civil action by the United States to collect a penalty and assessment imposed under this section. " (g) Whenever the Secretary's determination to impose a penalty, assessment, or exclusion under this section with respect to a medical provider or physician becomes final, the provisions of section 1128A (h) shall apply. " (h) Whenever the Secretary has reason to believe that any person has engaged, is engaging, or is about to engage in any activity which makes the person subject to a civil monetary penalty under this section, the Secretary may bring an action in an appropriate district court of the United States (or, if applicable, a United States court of any territory) to enjoin such activity, or to enjoin the person from concealing, removing, encumbering, or disposing of assets which may be required in order to pay a civil monetary penalty and assessment if any such penalty were to be imposed or to seek other appropriate relief. " (i) (1) The provisions of subsections (d) and (e) of section 205 shall apply with respect to this section to the same extent as they are applicable with respect to title II. The Secretary may delegate the authority granted by section 205 (d) (as made applicable to this section) to the Inspector General of the Department of Health and Human Services for purposes of any investigation under this section. " (2) The Secretary may delegate authority granted under this section to the Inspector General of the Social Security Administration. 13 "(j) For purposes of this section, the term 'State agency' shall have the same meaning as in section 1128A (i) (1). " (k) A principal is liable for penalties, assessments, and exclusions under this section for the actions of the principal's agent acting within the scope of the agency. (2) CONFORMING AMENDMENTS. Section 1128 of such Act (42 U.) is amended-- (A) in subsection (b) (7), by striking "or section 1128B" and inserting ", section 1128B, or section 1129"; (B) in subsection (b) (8) (B) (ii), by inserting "and section 1129" after "section 1128A"; (C) in subsection (c) (1), by striking "or under section 1128A" and inserting ", section 1128A, or section 1129"; (D) in subsection (c) (3) (A), by inserting "or section 1129" after "section 1128A"; (E) in subsection (d) (1), by striking "and section 1128A" and inserting ", section 1128A, and section 1129"; (F) in subsection (d) (2) (A), by striking "or section 1128A" and inserting ", section 1128A, or section 1129"; (G) in subsection (e) (1), by striking "or section 1128A" and inserting ", section 1128A, or section 1129"; (H) in subsection (f) (3), by inserting ", 1129, after "sections 1128A"; (I) in subsection (g) (1), by striking "or section 1128A" each place such term appears and inserting ", section 1128A, or section 1129"; (J) in subsection (g) (2) (A), by inserting "and section 1129 (a) after "section 1128A (a) "; and (K) in subsection (h), by striking "1128A and 1128B" and inserting "1128A, 1128B, and 1129". (c) SSI FRAUD CONSIDERED A FELONY. (1) IN GENERAL Section 1632 (a) of such Act (42 U.S.C. 1383a (a) ) is amended by striking "shall" the 1st place such term appears and all that follows and inserting "shall be fined under title 18, United States Code, imprisoned not more than 5 years, or both.". (2) CONFORMING AMENDMENT. Section 1632 (b) of such Act (42 U.S.C. 1383a (b) ) is amended to read as follows: (b) (1) If a person or entity violates subsection (a) in the person's or entity's role as, or in applying to become, a payee under section 1631 (a) (2) on behalf of another individual (other than the person's eligible spouse), and the violation includes a willful misuse of funds by the person or entity, the court may also require that full or partial restitution of funds be made to such other individual. " (2) Any person or entity convicted of a violation of subsection (a) of this section or of section 208 may not be certified as a payee under section 1631 (a) (2) .". (d) AUTHORITY TO REDETERMINE ELIGIBILITY IN DISABILITY CASES IF FRAUD IS INVOLVED, AND TO TERMINATE BENEFITS IF THERE IS INSUFFICIENT RELIABLE EVIDENCE OF DISABILITY. (1) IN GENERAL. Section 1631 (e) of such Act (42 U.S.C. 14 1383 (e)) is amended by adding at the end the following: " (6) (A) The Secretary shall immediately redetermine the eligibility of an individual for benefits under this title by reason of disability, disregarding any unreliable evidence of disability, if there is reason to believe that fraud was involved in the application of the individual for such benefits, unless a United States attorney, or equivalent State prosecutor, with jurisdiction over potential or actual related criminal cases, certifies, in writing, that there is a substantial risk that redetermining such eligibility would jeopardize the criminal prosecution of any person who is a subject of the investigation from which the information is derived. " (B) If, after redetermining the eligibility of an individual for benefits under this title by reason of disability, the Secretary determines that there is insufficient reliable evidence of disability, the Secretary may terminate such eligibility. (2) EFFECTIVE DATE.-The amendment made by paragraph (1) shall take effect on October 1, 1994, and shall apply to eligibility determinations made before, on, or after such date. (e) AVAILABILITY OF RECIPIENT IDENTIFYING INFORMATION FROM THE INSPECTOR GENERAL, DEPARTMENT OF HEALTH AND HUMAN SERVICES. (1) IN GENERAL. Section 1631 (e) of such Act (42 U.S.C. 1383 (e)), as amended by subsection (d) of this section, is amended by adding at the end the following: " (7) As soon as the Inspector General, Social Security Administration, has reason to believe that fraud was involved in the application of a recipient for benefits under this title, the Inspector General shall make available to the Secretary information identifying the recipient, unless a United States attorney, or equivalent State prosecutor, with jurisdiction over potential or actual related criminal cases, certifies, in writing, that there is a substantial risk that making the information so available or redetermining the eligibility of the recipient for such benefits would jeopardize the criminal prosecution of any person who is a subject of the investigation from which the information is derived. (2) EFFECTIVE DATE. The amendment made by paragraph (1) shall take effect on October 1, 1994. (f) AUTHORITY TO USE AVAILABLE PREADMISSION IMMIGRANT AND REFUGEE MEDICAL INFORMATION (1) IN GENERAL Section 1631 (e) of such Act (42 U.S.C. 1383 (e) ) as amended by the preceding provisions of this Act, is amended by adding at the end the following: " (8) The Secretary shall request the Immigration and Naturalization Service and the Centers for Diease Control to provide the Secretary with whatever medical information either such entity has with respect to any alien who has applied for benefits under this title to the extent that the information is relevant to any determination relating to such eligibility." (2) EFFECTIVE DATE. The amendment made by paragraph (1) shall take effect on October 1, 1994. 15 (g) ANNUAL REPORTS ON REVIEWS OF SSI CASES. The Secretary shall annually submit to the Committee on Ways and Means of the House of Representatives and the Committee on Finance of the Senate a report on the extent to which the Secretary has exercised its authority to review supplemental security income cases under title XVI of the Social Security Act, and the extent to which the cases reviewed were those that involved a high likelihood or probability of fraud. (h) DEVELOPMENT OF PROFILES; PERIODIC TARGETED REDETERMINATIONS. Part B of title XVI of such Act (42 U.S.C. 1383- 1383d) is amended by adding at the end the following: !! "SEC. 1636. DEVELOPMENT OF PROFILES; PERIODIC TARGETED REDETERMINATIONS.! ! "The Social Security Administration shall develop profiles of the kinds of cases that have a high probability of fraud, and shall conduct periodic targeted redeterminations based on such profiles. THE WHITE HOUSE WASHINGTON April 27, 1994 MEMORANDUM FOR BRUCE REED FROM: SUSAN BROPHY SM LEGISLATIVE AFFAIRS SUBJECT: Presidential Correspondence Enclosed please find a copy of the letter that was sent to the President from several members of Congress. The President has requested that he see and sign every letter being sent to Capitol Hill. Since we did not want to respond to this letter without your guidance, I am requesting that your office draft a response and return it to LeeAnn Inadomi (WH-East Wing) within 48 hours. She will then print the letter in final form and have it sent to the President for his signature. Thank you very much for your assistance with this matter. If you have any questions, please feel free to call LeeAnn at 456-7500. Enclosure 04-26-94 06:11PM FROM CONG. KLECZKA WDC TO 94566221# P001/002 Congress of the United States Mashington, DC 20515 April 26, 1994 President William J. Clinton The White House 1600 Pennsylvania Avenue NW Washington, D.C. 20006-9900 Dear Mr. President: The Supplemental Security Income program (SSI) is intended to provide assistance to low-income disabled, blind, and aged individuals. In Fiscal Year 1993, the federal government spent almost $20 billion on SSI payments. That is over $7 billion more than the federal benefits paid under the Aid to Families with Dependent Children program. "with this amount of taxpayer dollars going towards SSI payments, it is our responsibility to ensure that these benefits are being used appropriately. Unfortunately, this has not been happening. We have seen widespread reports of abuses in the SSI programs for both children and substance abusers. Recent government reports, Congressional hearings, and media attention have confirmed that SSI, as it, is currently administered, is flawed. Let us stress that we do not wish to see deserving recipients negatively affected in any way; we would simply like to see SSI reformed so that it serves to help the disabled, blind, and aged recipients it was intended to assist, while preventing opportunities for abuse. We urge you to either address this matter in your welfare reform plan or to support our efforts to include SSI reform during Congressional consideration of your plan. Together, we can ensure that these needy individuals receive the assistance they deserve, while protecting valuable taxpayer resources from misuse. We thank you for your prompt consideration of this matter. Sincerely, Mersed LI Keylen Nancy L. Johnson J.Ches Rick Santown 04-26-94 06:11PM FROM CONG. KLECZKA WDC TO 94566221# P002/002 Mile Park Shays Mike Kreidlen Town Banett Leshi Byme George Hakbweckner Nick Smile Bart Gordon Peter Barca Tom Ben this Dobe Sile Hagher Tom Lewis Body Daulen You Success Karen Shepherd Wally Henger TV 94566221 P002/002 Hon. Gerald D. Kleczka Hon. J.J. Pickle Hon. Nancy L. Johnson Hon. Rick Santorum Hon. Mike Parker Hon. Mike Kreidler Hon. Leslie Byrne Hon. Nick Smith Hon. Peter Barca Hon. William Orton Hon. Pat Roberts Hon. Bill Hughes Hon. Glenn Poshard Hon. Jim Sensenbrenner Hon. Wally Herger Hon. Christopher Shays Hon. Tom Barrett Hon. George Hochbrueckner Hon. Bart Gordon Hon. Austin Murphy Hon. Tom Petri Hon. Tim Johnson Hon. Tom Lewis Hon. Buddy Darden Hon. Karen Shepherd SENT BY:Xerox Telecopier 7020 ; 4- 6-94 ; 10:24 ; The White House- 202 456 7028:# 3 FED-22-1994 02:21 FROM DEP SEC HHS TO 94562878 P.01 the DEPARTMENT OF HEALTH & HUMAN SERVICES Chief of Staff MEALTH Washington D.C. 20201 8 DEPARTMENT Donsia-fy fyi FACSIMILE any : CHR FFR ?? 100/1 DATE JACK CAMILLERI TO: (NAME, ORGANIZATION, CITY/STATE AND PHONE NUMBER) : 690-7160 7753 Carol Rasco Assistant to the President for Domestic Policy 456-2216 FROM: (NAME, ORGANIZATION, CITY/STATE AND PHONE NUMBER): Kevin Thurm Chief of Staff 690-6133 RECIPIENTS FAX NUMBER: ( ) 456-2878 NUMBER OF PAGES TO SEND (INCLUDING COVER SHEET): 2 COMMENTS: SENT BY:Xerox Telecopier 7020 ; 4- 6-94 ; 10:24 ; The White House- 202 456 7028;# 4 FEE-22-1994 02:22 FROM DEP SEC HHS TO 94562878 P.02 DEPARTMENT OF HEALTH a HUMAN SERVICES Chief of Statf Washington, D.C. 20201 FEB , 2 1994 MEMORANDUM FOR CAROL RASCO 18 you know, there has been considerable publicity in the news media about fraud involving foreign language interpreters in the implemental Security Income (SSI) disability program in the states of California and Washington. In a typical case of fraud, interpreters aggressively market their services to immigrants and coach claimants in actions necessary to support a finding of disability. They usually collect substantial fees. on January 7, 1994, the television program "20/20" also aired a egment on fraudulent activity in the California public assistance, Medical, and SSI programs. The program reached no conclusions, but acknowledged the difficulty of assessing the edical condition of some recent immigrants who are applying for 1sh benefits or MediCal assistance. Many persons from Southeast sian countries, for example, are culturally disadvantaged, have ten severely traumatized, have basic fear and distrust of overnment in general, and may also be under-educated or illiterate. Representatives Harold Ford and J.J. Pickle, respective chairman the Subcommittees on Human Resources and Oversight of the emmittee on Ways and Means, have scheduled a joint hearing on he issue for February 24, 1994. The hearing will focus on the ature and extent of fraudulent activity in the SSI program, and range of options and possible administrative and legislative clutions the Department of Health and Human Services and the Committee on Ways and Means should consider to address the deuation. missioner Chater will testify at the hearing. In our estimony, we will provide background on the use of interpreters Social Security Administration field offices, and describe our forts to improve service to our non-English speaking clients rough increased hiring of bilingual employees and other means help detect and deter fraudulent activity. pector General (IG) June Gibbs Brown will also testify at the ring and describe the IG's involvement in this issue. I will P you advised of any further 96-sh significant developments. Kevin Thurm Christine Varney SENT BY:Xcrox Telecopier 7020 ; 4- 6-94 : 10:25 : The White House- 202 456 7028:# 5 Feb. 8, 1994 11:39PM WH CABINET AFFAIRS DPCPmaram No. 5333 P. 2/3 Staff FACT SHEET: SSI BENEFITS FOR ALCOHOLICS/DRUG ADDICTS On Tuesday night, February 8. 1994, the NBC program Dateline ran a segment about benefits being paid to alcoholics and drug abusers through the Social Security Administration's disability program. The Washington Post ran a story on this topic on February 7. 1994. Below are some key facts regarding this issue. THE PROBLEM: Supplemental Security Income (SSI) benefits for drug addicts and alcoholics are mandated by statute. Since Congressional enactment In 1972. individuals have received SSI benefits for disabling conditions that will last at least 12 months and will keep them from working. Drug addiction and alcoholism are included. Current law requires substance-addicted SSI recipients to accept treatment and that their benefit be paid to a legal guardian or "representative payee." However, it it often difficult to find decent representatives, or any representatives at all, for some SSI recipients. Recent reports have indicated that some SSI recipients addicted to drugs and alcohol may use benefits to sustain their habits. This is a serious concurn. THE RESPONSE: The Social Security Administration (SSA) has already improved its referrals to treatment programs and its monitoring systems. In October, 1993, SSA had referral and monitoring contracts in only 18 states. Today, such systems are in place in 33 states and the District of Columbia. By the end of FY 1995. all states will be involved. These new contracts will require recipients to undergo regular substance abuse testing. SSA is also working aggressively to find more and better representative payees. The FY 1995 Hudget reflects a determination to solve this problem. The FY 1995 budget requests $36 million for referral and monitoring activities. an 80% increase from the FY 1994 level, and an 800% increase over the Bush Administration figure of $4 million in FY 1993. The FY 1995 budget also requests $345 million for the treatment of hard-core drug abusers. The Administration will work with Congress to make appropriate changes to the program. The public has a right to expect those disabled by substance addiction to take responsibility for themselves, seak treatment and do all they can to cure themselves of their addiction. 6 A Takings Excep on Jessica Mathews's venomous attack on rights, but worth nothing without them. Ms. Surely this increase in value is attribe what she calls my "poisonous" view of the Mathews insists that il is unconscionable for to changes in local conditions, 202 456 7028:# takings clause of the Constitution pop-ed, any landowner to demand compensation for preexisting highway. Second, whateve the total wipeout in value if be is left in ae Lucas received from the highway I Feb. 14] calls for a clear response. Her column ignores my oft-stated convic- possession of land be cannot use. paid for through federal income ga CRASTS unitay 3 tion that the takings clause was carefully Why? Surely this building prohibition does taxes, tike his neighbors. Yet Ms. Ma craited to strike a balance between individu- not offer reasonable protection against any never explains why the pay THE PRESIDENT HAS SEEN at rights and social needs. Unfortunately, present or threatened harm. The environ- while his more fortunate meighbors P Ms. Mathews misconstrues my position to mentalists argued in Lucas that the building once. hold that the state is obligated to compen- ban prevented flying bits of a house from Most ominous, her argument justifi sate owners in cash whenever its regulations damaging nearby land. This improbable outright confiscation of all or of L reduce the value of their land. But this claim would at most authorize uniform build- land, for if these supposed highway be characterization overlooks my view that two ing codes for specific purposes. However, compensate him for loss of value justifications for uncompensated takings are this logic unwisely justifies ripping down they also compensate him for the I in principle available to the government in all without compensation every home along the possession. What 2 royal to The White House- cases. It can show that regulation is reason- South Carolina Coast, or preventing any new tional evasion: Build one public highw: ably calculated to prevent the infliction of ones from being built. the just compensation clause is aullifie nome present or threatened harm to others; Ms. Mathews then makes the add sugges- ever after. or it can show that the in-kind benefits the tion that DO compensation is required be- Ms. Mathews's unlikely readition regulation provides the landowner offect the cause Lucas has benefited from the con- takings clause undermines any losses that it imposes. struction of Interstate 95 and the availability effort to discipline indirectly In the recent Lucas case (to which she of subsidized flood insurance. Her I-95 arge- mechanism the "arrogant, blunderin refers, but not by name) South Carolina ment makes x least three extors. First, I-95 reancracies" whose misdeeds the ad sought to prohibit the construction of am was built years ago, and yes the value of edges. Having to pay just compes ordinary single-family home on a beachfront Lucas's buildable lot surged nearly 30 per- rightly forces elected officials to CO William S. Cohen lot worth more than $500,000 with building cent in the four years after be bought it. the public benefit obtained with the I Playing Social Security for a Sucker k would maler Nome Peterson from drugs, then diluted them into small died of a lethal drug overdose bought dicts theraselves . cial Committee on Aging and the Gen- doses and realized bage profits by re- with thousands of dollars in retroactive store owner in Dem "Cheers" put down the beer mule and sit eral Accounting Office. The investige- tion examined the payment of benefits selling them on the street. One mental benefits. An alcoholic was awarded worthy guardians of up on his bar stool: The federal govern- lump SMIR benefits of $26,000. After SENT BY:Xerox Telecopier 7020 4- 6-94 10:25 ment has sent checks totaling more under the Social Security Disability for health worker said his caseload of ille- The than $160,000 per year directly to a suraoce (SSDD and Supplemental Seon- gel drug users was 99.5 percent SSI turying two care and a van, be went on a has abdicated its R Denver fiquor store owner, who then rity Income (SSI) programs. recipients, and be reported several drinking binge, wrecked the care and ing to adequately . uses those taxpayer dollars to run a tab The GAO has estimated that last deaths from drug overdoses. landed, penniless, in a veterans' hospi- cipients I tre year the federal government paid $1.4 The purpose of the Social Security tzl. example, is of for 40 alcoholics who me supposed to be using the government money to get billion to 250,000 drug addicts and disability programs is to provide bene- Congress has tried with little success have never help for their problem. alcoholica who receive benefits under fits to people who can't work because to build controls into the system. To SSA to refer addic these two programs. But only of medically certified physical or mental stop payments from feeding addictions, treatment and m That's just one example of how a 78,000-leas than one-third-are re- impairments. Drug addiction and aloo- is required that all SSI payments to dance. federal program has gone startlingly quired to receive treatment or have a bolism are qualifying disabilities under addicts and alcoholica be paid to a third wrong. Across the country, the gov- The investigation both programs. Determining disability party-or "representative payee"- ernment is paying hundreds of millions third party manage their benefits for cases in which ad of dollars each year to feed the habits of them, and those controls are 50 lax that is a Eve-step process, and if benefits friend, relative, social service agency or benefits active drug addicts and alcoholics. Under this abuses abound. The other 172,000 are are desied, there are avenues of sp- other responsible person. Congress # inal activities such cockeyed policy. addicts and alcoholics not required to receive treatment and peal Since is often takes a year or so required that a disabled drug addict armed robbery. To aften their cash benefits to buy more to award benefits, and because or alcoholic participate in a substance receive federal benefits because they more drugs and alcohol. abuse treatment program, I such treat- benefits, they opi are disabled by their substance abuse. benefits are retroactive to the date of The director of a homeless shelter in ment is available, as a condition of were supporting 1 But the benefits often are then used to application, it in not termsual for lump crieninal activity. perpetuate the addictions, rather than Denver reported that SSI is, in effect, sums as large as $15,000 or $20,000 receiving SSI benefits. cure them, and the addicts and alcohol- "surcide as the installment nbm" be- to the awarded 10 substance to is ride (M) a drug-taden train to e upheal the day of a Astonishingly, a re- heir habits through nly admitted they realse their case case for for dy engaged in crim- diets who received mitor their atten- 8 e alcoholica B agency approved by anitor whether re- sponsibility by fail- city Administration cash payments. r, like the liquor inpare antion -Moth g be- price the of d for- stitu- of then nefits И the = but: twice: roline & , to a table . dealing drug E also uncovered states that Maine, for than trust- 108 sap age. Thryzap Hrup profit from sech intration to conduct continuing reviews . Requiring the Social Security Admin- holics receive treatment. of Eminent Domain." D Removing from the rolls those who able for substance abusers. . Making additional treatment avail- tor addicts and alcoholics. governments to have agencies to moni- of individuals' eligibility and all state D Requiring that all addicts and alco- abusers until treatment is completed. a psyments to substance institution or approved agency to man- crs. Benefits would be directed to - directly in the hands of substance abus- a Stopping the practice of putting cash program by: Probibiting I distribution of I quirements and revemp the disability Takings: Private Property and the Power University of Chicago, and anthor distinguished service professor of law at the The cariter is James Parker Hall City of Tigard, its first major takings case when the Supreme Court considers Delan a debate will be reinvigorated next month debate on the takings question. Perhaps that issue-the further need for open and robust Mathews and I do agree on at lieast one the wealthy that my positions prohibit. Ms. That's just the kind of government abuse for Oh, as for subsidies by flood insurance? that Lucas had demanded! who of course got the same right to build commission sold it off to the highest bidder, paid for Lucas's lot with hard cash, the Commission into honest brokers. Having Losing the case in fact converted the Coastal benefits for stopping Lucas from building. sons with extravagant claims of supposed and pay. the state sidesteps these compari- costs imposed. Without this principle of take 3S WEDNESDAY. FEBRUARY 23. 1994 THE B'ASHINGTON POST