42 U.S.C. § 1382i — Medical and social services for certain

Page 2851 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1382i Subsecs. (c), (d). Pub. L. 101–508, § 5039(a), added sub- sec. (c) and redesignated former subsec. (c) as (d). 1986—Subsec. (a). Pub. L. 99–643, § 4(a), amended sub- sec. (a) generally. Prior to amendment, subsec. (a) read as follows: ‘‘Any individual who is an eligible indi- vidual (or eligible spouse) by reason of being under a disability and was eligible to receive benefits under section 1382(b) of this title or under this section for the month preceding the month for which eligibility for benefits under this section is now being determined, and who would otherwise be denied benefits by reason of section 1382(e)(4) of this title or ceases to be an eligi- ble individual (or eligible spouse) because his earnings have demonstrated a capacity to engage in substantial gainful activity, shall nevertheless qualify for a month- ly benefit equal to an amount determined under section 1382(b)(1) of this title (or, in the case of an individual who has an eligible spouse, under section 1382(b)(2) of this title), and for purposes of subchapter XIX of this chapter shall be considered a disabled individual receiv- ing supplemental security income benefits under this subchapter, for so long as the Secretary determines that— ‘‘(1) such individual continues to have the disabling physical or mental impairment on the basis of which such individual was found to be under a disability, and continues to meet all non-disability-related re- quirements for eligibility for benefits under this sub- chapter; and ‘‘(2) the income of such individual, other than in- come excluded pursuant to section 1382a(b) of this title, is not equal to or in excess of the amount which would cause him to be ineligible for payments under section 1382(b) of this title (if he were otherwise eligi- ble for such payments).’’ Subsec. (a)(1). Pub. L. 99–643, § 4(c)(2)(A), substituted ‘‘Except as provided in section 1383(j) of this section, any individual’’ for ‘‘Any individual’’. Subsec. (b). Pub. L. 99–643, § 4(b)(1)–(4), substituted ‘‘meets’’ for ‘‘continues to meet’’ in former par. (1) and ‘‘(including any federally administered State supple- mentary payments), benefits under subchapter XIX, and publicly funded attendant care services (including personal care assistance),’’ for ‘‘and subchapter XIX’’ in former par. (4), redesignated former pars. (1) to (4) as subpars. (A) to (D), respectively, of par. (1), and sub- stituted introductory provisions of such par. (1) for former undesignated introductory provisions which read as follows: ‘‘For purposes of subchapter XIX, any individual under age 65 who, for the month preceding the first month in the period to which this subsection applies, received— ‘‘(i) a payment of supplemental security income benefits under section 1382(b) of this title on the basis of blindness or disability, ‘‘(ii) a supplementary payment under section 1382e of this title or under section 212 of Public Law 93–66 on such basis, ‘‘(iii) a payment of monthly benefits under sub- section (a) of this section, or ‘‘(iv) a supplementary payment under section 1382e(c)(3) of this title, shall be considered to be a blind or disabled individual receiving supplemental security income benefits for so long as the Secretary determines under regulations that—’’. Subsec. (b)(1). Pub. L. 99–643, § 4(c)(2)(B), substituted ‘‘Except as provided in section 1383(j) of this title, for purposes of’’ for ‘‘For purposes of’’. Subsec. (b)(2). Pub. L. 99–643, § 4(b)(5), added par. (2). Subsec. (b)(3). Pub. L. 99–643, § 7(a), added par. (3). 1984—Subsec. (c). Pub. L. 98–460 added subsec. (c). 1981—Subsec. (a). Pub. L. 97–35, § 2353(o)(1), sub- stituted in provision preceding par. (1) ‘‘subchapter XIX’’ for ‘‘subchapters XIX and XX’’. Subsec. (b). Pub. L. 97–35, § 2353(o), substituted in pro- vision preceding cl. (i) and in par. (4) ‘‘subchapter XIX’’ for ‘‘subchapters XIX and XX’’ and in par. (3) ‘‘sub- chapter XIX’’ for ‘‘subchapter XIX or XX’’. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1994 AMENDMENT Amendment by section 107(a)(1), (4) of Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title. Pub. L. 103–296, title II, § 205(b), Aug. 15, 1994, 108 Stat. 1509, provided that: ‘‘The amendment made by sub- section (a) [amending this section] shall apply to eligi- bility determinations for months after December 1994.’’ EFFECTIVE DATE OF 1990 AMENDMENT Pub. L. 101–508, title V, § 5032(b), Nov. 5, 1990, 104 Stat. 1388–224, provided that: ‘‘The amendment made by sub- section (a) [amending this section] shall apply with re- spect to benefits for months beginning on or after the first day of the 6th calendar month following the month in which this Act is enacted [November 1990].’’ Pub. L. 101–508, title V, § 5039(c), Nov. 5, 1990, 104 Stat. 1388–226, provided that: ‘‘The amendments made by this section [amending this section and section 1383 of this title] shall take effect on the date of the enactment of this Act [Nov. 5, 1990].’’ EFFECTIVE DATE OF 1986 AMENDMENT Amendment by Pub. L. 99–643 effective July 1, 1987, except as otherwise provided, see section 10(b) of Pub. L. 99–643, set out as a note under section 1396a of this title. EFFECTIVE DATE OF 1981 AMENDMENT Amendment by Pub. L. 97–35 effective Oct. 1, 1981, ex- cept as otherwise explicitly provided, see section 2354 of Pub. L. 97–35, set out as an Effective Date note under section 1397 of this title. EFFECTIVE DATE Pub. L. 96–265, title II, § 201(d), June 9, 1980, 94 Stat. 449, as amended by Pub. L. 98–460, § 14(a), Oct. 9, 1984, 98 Stat. 1808; Pub. L. 99–643, § 2, Nov. 10, 1986, 100 Stat. 3574, provided that: ‘‘The amendments made by subsections (a) and (b) [enacting this section and amending section 1382e of this title and provisions set out as a note under section 1382 of this title] shall become effective on Jan- uary 1, 1981.’’ [Pub. L. 99–643, § 10(a), Nov. 10, 1986, 100 Stat. 3580, pro- vided that: ‘‘The amendment made by section 2 [amending section 201(d) of Pub. L. 96–265, set out above] shall become effective on the date of the enact- ment of this Act [Nov. 10, 1986].’’] SEPARATE ACCOUNTS WITH RESPECT TO BENEFITS PAYABLE; EVALUATION OF PROGRAM Pub. L. 96–265, title II, § 201(e), June 9, 1980, 94 Stat. 449, provided that: ‘‘The Secretary shall provide for sep- arate accounts with respect to the benefits payable by reason of the amendments made by subsections (a) and (b) [enacting this section and amending section 1382e of this title and provisions set out as a note under section 1382 of this title] so as to provide for evaluation of the effects of such amendments on the programs estab- lished by titles II, XVI, XIX, and XX of the Social Secu- rity Act [42 U.S.C. 401 et seq., 1381 et seq., 1396 et seq., 1397 et seq.].’’ § 1382i. Medical and social services for certain handicapped persons (a) Authorization of appropriations for pilot pro- gram There are authorized to be appropriated such sums as may be necessary to establish and carry out a 3-year Federal-State pilot program to pro- vide medical and social services for certain handicapped individuals in accordance with this section. (b) State allotments (1) The total sum of $18,000,000 shall be allotted to the States for such program by the Commis- Page 2852 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1382i sioner of Social Security, during the period be- ginning September 1, 1981, and ending Sep- tember 30, 1984, as follows: (A) The total sum of $6,000,000 shall be allot- ted to the States for the fiscal year ending September 30, 1982 (which for purposes of this section shall include the month of September 1981). (B) The total sum of $6,000,000, plus any amount remaining available (after the appli- cation of paragraph (4)) from the allotment made under subparagraph (A), shall be allotted to the States for the fiscal year ending Sep- tember 30, 1983. (C) The total sum of $6,000,000, plus any amount remaining available (after the appli- cation of paragraph (4)) from the allotments made under subparagraphs (A) and (B), shall be allotted to the States for the fiscal year ending September 30, 1984. (2) The allotment to each State from the total sum allotted under paragraph (1) for any fiscal year shall bear the same ratio to such total sum as the number of individuals in such State who are over age 17 and under age 65 and are receiv- ing supplemental security income benefits as disabled individuals in such year (as determined by the Commissioner of Social Security on the basis of the most recent data available) bears to the total number of such individuals in all the States. For purposes of the preceding sentence, the term ‘‘supplemental security income bene- fits’’ includes payments made pursuant to an agreement under section 1382e(a) of this title or under section 212(b) of Public Law 93–66. (3) At the beginning of each fiscal year in which the pilot program under this section is in effect, each State that does not intend to use the allotment to which it is entitled for such year (or any allotment which was made to it for a prior fiscal year), or that does not intend to use the full amount of any such allotment, shall certify to the Commissioner of Social Security the amount of such allotment which it does not intend to use, and the State’s allotment for the fiscal year (or years) involved shall thereupon be reduced by the amount so certified. (4) The portion of the total amount available for allotment for any particular fiscal year under paragraph (1) which is not allotted to States for that year by reason of paragraph (3) (plus the amount of any reductions made at the beginning of such year in the allotments of States for prior fiscal years under paragraph (3)) shall be reallocated in such manner as the Com- missioner of Social Security may determine to be appropriate to States which need, and will use, additional assistance in providing services to severely handicapped individuals in that par- ticular year under their approved plans. Any amount reallocated to a State under this para- graph for use in a particular fiscal year shall be treated for purposes of this section as increasing such State’s allotment for that year by an equivalent amount. (c) Requisite features of State plans In order to participate in the pilot program and be eligible to receive payments for any pe- riod under subsection (d), a State (during such period) must have a plan, approved by the Com- missioner of Social Security as meeting the re- quirements of this section, which provides med- ical and social services for severely handicapped individuals whose earnings are above the level which ordinarily demonstrates an ability to en- gage in substantial gainful activity and who are not receiving benefits under section 1382 or 1382h of this title or assistance under a State plan ap- proved under section 1396a of this title, and which— (1) declares the intent of the State to par- ticipate in the pilot program; (2) designates an appropriate State agency to administer or supervise the administration of the program in the State; (3) describes the criteria to be applied by the State in determining the eligibility of any in- dividual for assistance under the plan and in any event requires a determination by the State agency to the effect that (A) such indi- vidual’s ability to continue his employment would be significantly inhibited without such assistance and (B) such individual’s earnings are not sufficient to allow him to provide for himself a reasonable equivalent of the cash and other benefits that would be available to him under this subchapter and subchapters XIX and XX in the absence of those earnings; (4) describes the process by which the eligi- bility of individuals for such assistance is to be determined (and such process may not in- volve the performance of functions by any State agency or entity which is engaged in making determinations of disability for pur- poses of disability insurance or supplemental security income benefits except when the use of a different agency or entity to perform those functions would not be feasible); (5) describes the medical and social services to be provided under the plan; (6) describes the manner in which the med- ical and social services involved are to be pro- vided and, if they are not to be provided through the State’s medical assistance and so- cial services programs under subchapters XIX and XX (with the Federal payments being made under subsection (d) of this section rath- er than under those subchapters), specifies the particular mechanisms and procedures to be used in providing such services; and (7) contains such other provisions as the Commissioner of Social Security may find to be necessary or appropriate to meet the re- quirements of this section or otherwise carry out its purpose. (d) Payments to States; computation of payments (1) From its allotment under subsection (b) for any fiscal year (and any amounts remaining available from allotments made to it for prior fiscal years), the Commissioner of Social Secu- rity shall from time to time pay to each State which has a plan approved under subsection (c) an amount equal to 75 per centum of the total sum expended under such plan (including the cost of administration of such plan) in providing medical and social services to severely handi- capped individuals who are eligible for such services under the plan. (2) The method of computing and making pay- ments under this section shall be as follows: Page 2853 TITLE 42—THE PUBLIC HEALTH AND WELFARE § 1382j (A) The Commissioner of Social Security shall, prior to each period for which a pay- ment is to be made to a State, estimate the amount to be paid to the State for such period under the provisions of this section. (B) From the allotment available therefor, the Commissioner of Social Security shall pay the amount so estimated, reduced or in- creased, as the case may be, by any sum (not previously adjusted under this subsection) by which the Commissioner finds that the Com- missioner’s estimate of the amount to be paid the State for any prior period under this sec- tion was greater or less than the amount which should have been paid to the State for such period under this section. (e) Rules and regulations Within nine months after June 9, 1980, the Commissioner of Social Security shall prescribe and publish such regulations as may be nec- essary or appropriate to carry out the pilot pro- gram and otherwise implement this section. (f) Reports Each State participating in the pilot program under this section shall from time to time re- port to the Commissioner of Social Security on the operation and results of such program in that State, with particular emphasis upon the work incentive effects of the program. On or be- fore October 1, 1983, the Commissioner of Social Security shall submit to the Congress a report on the program, incorporating the information contained in the State reports along with the Commissioner’s findings and recommendations. (Aug. 14, 1935, ch. 531, title XVI, § 1620, as added Pub. L. 96–265, title II, § 201(c), June 9, 1980, 94 Stat. 446; amended Pub. L. 97–35, title XXIII, § 2353(p), Aug. 13, 1981, 95 Stat. 874; Pub. L. 103–296, title I, § 107(a)(4), Aug. 15, 1994, 108 Stat. 1478.) Editorial Notes REFERENCES IN TEXT Section 212(b) of Public Law 93–66, referred to in sub- sec. (b)(2), is section 212(b) of Pub. L. 93–66, title II, July 9, 1973, 87 Stat. 155, which is set out as a note under sec- tion 1382 of this title. AMENDMENTS 1994—Subsecs. (b) to (f). Pub. L. 103–296, § 107(a)(4), substituted ‘‘Commissioner of Social Security’’ for ‘‘Secretary’’ wherever appearing, ‘‘the Commissioner finds that the Commissioner’s’’ for ‘‘he finds that his’’ in subsec. (d)(2)(B), and ‘‘the Commissioner’s’’ for ‘‘his’’ in subsec. (f). 1981—Subsec. (c). Pub. L. 97–35 struck out provision following par. (7) that the plan under this section may be developed and submitted as a separate State plan or may be submitted in the form of an amendment to the State’s plan under section 1397b(d) of this title. Statutory Notes and Related Subsidiaries EFFECTIVE DATE OF 1994 AMENDMENT Amendment by Pub. L. 103–296 effective Mar. 31, 1995, see section 110(a) of Pub. L. 103–296, set out as a note under section 401 of this title. EFFECTIVE DATE OF 1981 AMENDMENT Amendment by Pub. L. 97–35 effective Oct. 1, 1981, ex- cept as otherwise explicitly provided, see section 2354 of Pub. L. 97–35, set out as an Effective Date note under section 1397 of this title. § 1382j. Attribution of sponsor’s income and re- sources to aliens (a) Attribution as unearned income For purposes of determining eligibility for and the amount of benefits under this subchapter for an individual who is an alien, the income and re- sources of any person who (as a sponsor of such individual’s entry into the United States) exe- cuted an affidavit of support or similar agree- ment with respect to such individual, and the income and resources of the sponsor’s spouse, shall be deemed to be the income and resources of such individual (in accordance with sub- sections (b) and (c)) for a period of 3 years after the individual’s entry into the United States. Any such income deemed to be income of such individual shall be treated as unearned income of such individual. (b) Determination of amount and resources (1) The amount of income of a sponsor (and his spouse) which shall be deemed to be the un- earned income of an alien for any year shall be determined as follows: (A) The total yearly rate of earned and un- earned income (as determined under section 1382a(a) of this title) of such sponsor and such sponsor’s spouse (if such spouse is living with the sponsor) shall be determined for such year. (B) The amount determined under subpara- graph (A) shall be reduced by an amount equal to (i) the maximum amount of the Federal benefit under this subchapter for such year which would be payable to an eligible indi- vidual who has no other income and who does not have an eligible spouse (as determined under section 1382(b)(1) of this title), plus (ii) one-half of the amount determined under clause (i) multiplied by the number of individ- uals who are dependents of such sponsor (or such sponsor’s spouse if such spouse is living with the sponsor), other than such alien and such alien’s spouse. (C) The amount of income which shall be deemed to be unearned income of such alien shall be at a yearly rate equal to the amount determined under subparagraph (B). The pe- riod for determination of such amount shall be the same as the period for determination of benefits under section 1382(c) of this title. (2) The amount of resources of a sponsor (and his spouse) which shall be deemed to be the re- sources of an alien for any year shall be deter- mined as follows: (A) The total amount of the resources (as de- termined under section 1382b of this title) of such sponsor and such sponsor’s spouse (if such spouse is living with the sponsor) shall be determined. (B) The amount determined under subpara- graph (A) shall be reduced by an amount equal to (i) the applicable amount determined under section 1382(a)(3)(B) of this title in the case of a sponsor who has no spouse with whom he is living, or (ii) the applicable amount deter- mined under section 1382(a)(3)(A) of this title in the case of a sponsor who has a spouse with whom he is living.