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[79 STAT.

self-care, there is hereby authorized to be appropriated for each fiscal year a sum sufficient to carry out the purposes of this title. The sums made available under this section shall be used for making payments to States which have submitted, and had approved by the Secretary of Health, Education, and Welfare, State plans for medical assistance. U STATE P L A N S FOR MEDICAL

n^ y,^^ f°a;

306, 1381-1385.

ASSISTANCE

"SEC. 1902. (a) A State plan for medical assistance must— "(1) provide that it shall be in effect in all political subdivisions of the State, and, if administered by them, be mandatory upon them; "(2) provide for financial participation by the State equal to not less than 40 per centum of uie non-Federal share of the expenditures under the plan with respect to which payments under section 1903 are authorized by this title; and, effective July 1, 1970, provide for financial participation by the State equal to all of such non-Federal share or provide for distribution of funds from Federal or State sources, for carrying out the State plan, on an equalization or other basis which will assure that the lack of adequate funds from local sources will not result in lowering the amount, duration, scope, or quality of care and services available under the plan; "(3) provide for granting an opportunity for a fair hearing before the State agency to any individual whose claim for medical assistance under the plan is denied or is not acted upon with reasonable promptness; "(4) provide such methods of administration (including methods relating to the establishment and maintenance of personnel standards on a merit basis, except that the Secretary shall exercise no authority with respect to the selection, tenure or office, and compensation of any individual employed in accordance with such methods, and including provision for utilization of professional medical personnel in the administration and, where administered locally, supervision of administration of the plan) as are found by the Secretary to be necessary for the proper and efficient operation of the plan; "(5) either provide for the establishment or designation of a single State agency to administer the plan, or provide for the establishment or designation of a single State agency to supervise the administration of the plan, except that the determination of eligibility for medical assistance under the plan shall be made by the State or local agency administering the State plan approved under title I or X VI (insofar as it relates to the a g e d); "(6) provide that the State agency will make such reports, in such form and containing such information, as the Secretary may from time to time require, and comply with such provisions as the Secretary may from time to time find necessary to assure the correctness and verification of such reports; "(7) provide s a f e ^ a r d s which restrict the use or disclosure of information concerning applicants and recipients to purposes directly connected with the administration of the plan; "(8) provide that all individuals wishing to make application for medical assistance under the plan shall have opportunity to do so, and that such assistance shall be furnished with reasonable promptness to all eligible individuals;

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PUBLIC LAW 89-97-JULY 30, 1965

"(9) provide for the establishment or designation of a State authority or authorities which shall be responsible for establishing and maintaining standards for private or public institutions in which recipients of medical assistance under the plan may receive care or services; "(10) provide for making medical assistance available to all individuals receiving aid or assistance under State plans approved under titles I, IV, X, X IV, and X VI; and— izolTs^'^'ist'' " (A) provide that the medical assistance made available to individuals receiving aid or assistance under any such State plan— "(i) shall not be less in amount, duration, or scope than the medical assistance made available to individuals receiving aid or assistance under any other such State plan, and "(ii) shall not be less in amount, duratioUj or scope than the medical or remedial care and services made available to individuals not receiving aid or assistance under any such plan; and " (B) if medical or remedial care and services are included for any group of individuals who are not receiving aid or assistance under any such State plan and who do not meet the income and resources requirements of the one of such State plans which is appropriate, as determined in accordance with standards prescribed by the Secretary, provide— " (i) for making medical or remedial care and services available to all individuals who would, if needy, be eligible for aid or assistance under any such State plan and who have insufficient (as determined in accordance with comparable standards) income and resources to meet the costs of necessary medical or remedial care and services, and "(ii) that the medical or remedial care and services made available to all individuals not receiving aid or assistance under any such State plan shall be equal in amount, duration, and scope; except that the making available of the services described in paragraph (4) or (14) of section 1905(a) to individuals meet- Post, p. ssi. m ^ the age requirement prescribed therein shall not, by reason of this paragraph (10), require the making available of any such services, or the making available of such services of the same amount, duration, and scope, to individuals of any other ages; "(11) provide for entering into cooperative arrangements with the State agencies responsible for administering or supervising the administration of health services and vocational rehabilitation services in the State looking toward maximum utilization of such services in the provision of medical assistance under the plan; "(12) provide that, in determining whether an individual is blind, there shall be an examination by a physician skilled in the diseases of the eye or by an optometrist, whichever the individual may select; "(13) provide for inclusion of some institutional and some noninstitutional care and services, and, effective July 1, 1967, provide (A) for inclusion of at least the care and services listed m clauses (1) through (5) of section 1905(a), and (B) for

49-850 0-66—25

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PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan; "(14) provide that (A) no deduction, cost sharing, or similar charge will be imposed under the plan on the individual with respect to inpatient hospital services furnished him under the plan, and (B) any deduction, cost sharing, or similar charge imposed under the plan with respect to any other medical assistance furnished him thereunder, and any enrollment fee, premium, or similar charge imposed under the plan, shall be reasonably related (as determined in accordance with standards approved by the Secretary and included in the plan) to the recipient's income or his income and resources; "(15) in the case of eligible individuals 65 years of age or older who are covered by either or both of the insurance programs established by title X VIII, provide— " (A) for meeting the full cost of any deductible imposed with respect to any such individual under the insurance program established by part A of such title; and " (B) where, under the plan, all of any deductible, cost sharing, or similar charge imposed with respect to any such individual under the insurance program established by part B of such title is not met, the portion thereof which is met shall be determined on a basis reasonably related (as determined in accordance with standards approved by the Secretary and included in the plan) to such individual's income or his income and resources; "(16) provide for inclusion, to the extent required by regulations prescribed by the Secretary, of provisions (conforming to such regulations) with respect to the furnishing of medical assistance under the plan to individuals who are residents of the State but are absent therefrom; " (17) include reasonable standards (which shall be comparable for all groups) for determining eligibility for and the extent of medical assistance under the plan which (A) are consistent with the objectives of this title, (B) provide for taking into account only such income and resources as are, as determined in accordance with standards prescribed by the Secretary, available to the applicant or recipient and (in the case of any applicant or recipient who would, if he met the requirements as to need, be eligible for aid or assistance in the form of money payments under a State P l ^ approved under title I, IV, X, X IV, or X VI) as would not be disregarded (or set aside for future needs) in determining his eligibility for and amount of such aid or assistance under such plan, (C) provide for reasonable evaluation of any such income or resources, and (D) do not take into account the financial responsibility of any individual for any applicant or recipient of assistance under the plan unless such applicant or recipient is such individual's spouse or such individual's child who is under age 21 or is blind or permanently^ and totally disabled; and provide for flexibility in the application of such standards with respect to income by taking into account, except to the extent prescribed by the Secretary, the costs (whether in the form of insurance premiums or otherwise) incurred for medical care or for any other type of remedial care recognized under State law;

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PUBLIC LAW 89-97-JULY 30, 1965

" (18) provide that no lien may be imposed against the property of any individual prior to his death on account of medical assistance paid or to be paid on his behalf under the plan (except pursuant to the judgment of a court on account of benefits incorrectly paid on behalf of such individual), and that there shall be no adjustment or recovery (except, in the case of an individual who was 65 years of age or older when he received such assistance, from his estate, and then only after the death of his surviving spouse, if any, and only at a time when he has no surviving child who is under age 21 or is blind or permanently and totally disabled) of any medical assistance correctly paid on behalf or such individual under the plan; "(19) provide such safeguards as may be necessary to assure that eligibility for care and services under the plan will be determined, and such care and services will be provided, in a manner consistent with simplicity of administration and the best interests of the recipients; "(20) if the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in institutions for mental diseases— " (A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; " (B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will be given appropriate medical treatment within the institution, and that there will be a periodical determination of his need for continued treatment in the institution; " (C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients 65 years of age or older who would otherwise need care in such institutions, including appropriate medical treatment and other aid or assistance; for services referred to in section 3 fa)(4)(A)(i) and (ii) or section 1603(a)(4)(A) (i) and (ii) which are appropriate for such recipients and ^6 Stat. 173, for such patients; and for methods of administration neces- 42 USC 303, sary to assure that the responsibilities of the State agency i383. under the State plan with respect to such recipients and such patients will be effectively carried out; and " (D) provide methods of determining the reasonable cost of institutional care for such patients; "(21) if the State plan includes medical assistance in behalf of individuals 65 years of age or older who are patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases; and

347

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[79 STAT.

" (22) include descriptions of (A) the kinds and numbers of professional medical personnel and supporting staff that will be used in the administration of the plan and of the responsibilities they will have, (B) the standards, for private or public institutions in which recipients of medical assistance under the plan may receive care or services, that will be utilized by the State authority or authorities responsible for establishing and maintaining such standards, (C) the coop|erative arrangements with State health agencies and State vocational rehabilitation agencies entered into with a view to maximum utilization of and coordination of the provision of medical assistance with the services administered or supervised by such agencies, and (D) other standards and methods that the State will use to assure that medical or remedial care and services provided to recipients of medical assistance are of high quality. Notwithstanding paragraph (5), if on January 1, 1965, and on the date on which a State submits its plan for approval under this title, the State agency which administered or supervised the administration of 1206 "fas/AVs's ^^^ P^^^ ^^ ^^^^ State approved under title X (or title X VI, insofar as it relates to the blind) was different from the State agency which administered or supervised the administration of the State plan 42 USC 301-306. approvcd under title I (or title X VI, insofar as it relates to the aged), the State agency which administered or supervised the administration of such plan approved under title X (or title X VI, insofar as it relates to the blind) may be designated to administer or supervise the administration of the portion of the State plan for medical assistance which relates to blind individuals and a different State agency may be established or designated to administer or supervise the administration of the rest of the State plan for medical assistance; and in such case the part, of the plan which each such agency administers, or the administration of which each such agency supervises, shall be regarded as a separate plan for purposes of this title (except for purposes of paragraph (10)). " (b) The Secretary shall approve any plan which fulfills the conditions specified in subsection (a), except that he shall not approve any plan which imposes, as a condition of eligibility for medical assistance under the plan— "(1) an age requirement of more than 65 years; or "(2) effective July 1, 1967, any age requirement which excludes any individual who has not attained the age of 21 and is or would, 78 Stat. 1042. except for the provisions of section 406(a)(2), be a dependent I 2 S? 6211609. child under title IV; or .,..., "(3) any residence requirement which excludes any individual who resides in the State; or "(4) any citizenship requirement which excludes any citizen of the United States. " (c) Notwithstanding subsection (b), the Secretary shall not approve any State plan for medical assistance if he determines that the approval and operation of the plan will result in a reduction in aid or assistance (other than so much of the aid or assistance as is provided for under the plan of the State approved under this title) provided for eligible individuals under a plan of such State approved 42 USC 301 et ^^^^^j, ^jtle I, IV, X, X IV, Or X VI.

seq.

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349

"PAYMENT TO STATES

"SEC. 1903. (a) From the sums appropriated therefor, the Secretary (except as otherwise provided m this section and section 1117) P°«'' P- ^^2O. shall pay to each State which has a plan approved under this title, for each quarter, beginning with the quarter commencing January 1, 1966— "(1) an amount equal to the Federal medical assistance percentage (as defined in section 1905(b)) of the total amoiint expended during such quarter as medical assistance under the State plan (including expenditures for premiums under part B of title X VIII, for individuals who are recipients of money pay- ^"f^' P- ''oi. ments under a State plan approved under title I, IV, X, X l V, or X VI, and other insurance premiums for medical or any other 120^1 "f35f'VasV' type of remedial care or the cost thereof); plus " (2) an amount equal to 75 per centum of so much of the sums expended during such quarter (as found necessary by the Secretary for the proper and efficient administration of the State plan) as are attributable to compensation or training of skilled professional medical personnel, and staff directly supporting such personnel, of the State agency (or of the local agency administering the State plan in the political subdivision); plus " (3) an amount equal to 50 per centum of the remainder of the amounts expended during such quarter as found necessary by the Secretary for the proper and efficient administration of the State plan. "(b) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to individuals 65 years of age or older who are patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactory to the Secretary that total expenditures from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures from such sources for such services under such programs for each quarter of the fiscal year ending June 30, 1965. For purposes of this subsection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes of this subsection. " (c)(1) If the Secretary finds, on the basis of satisfactory information furnished by a State, that the Federal medical assistance percentage for such State applicable to any quarter in the period beginning January 1, 1966, and ending with the close of June 30, 1969, is less than 105 per centum of the Federal share of medical expenditures by the State during the fiscal year ending June 30, 1965 (as determined under paragraph (2)), then 105 per centum of such Federal share shall be the Federal medical assistance percentage (instead of the percentage determined under section 1905(b)) for such State for

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[79 STAT.

such quarter and each quarter thereafter occurring in such period and prior to the first quarter with respect to which such a finding is not applicable. "(2) For purposes of paragraph (1), the Federal share of medical expenditures by a State during the fiscal year ending June 30, 1965, means the percentage which the excess of— " (A) the total of the amounts determined under sections 3, 42 USC 303,603, 403, 1003, 1403, and 1603 with respect to expenditures by such 1203, 1353, 1383. State during such year as aid or assistance under its State plans approved under titles I, IV, X, X IV, and X VI, over " (B) the total of the amounts which would have been determined under such sections with respect to such expenditures during such year if expenditures as aid or assistance in the form of medical or any other type of remedial care had not been counted, is of the total expenditures as aid or assistance in the form of medical or any other tjj^pe of remedial care under such plans during such year. " (d)(1) Prior to the beginning of each quarter, the Secretary shall estimate the amount to which a State will be entitled under subsections (a), (b), and (c) for such quarter, such estimates to be based on (A) a report filed by the State containing its estimate of the total sum to be expended in such quarter in accordance with the provisions of such subsections, and stating the amount appropriated or made available by the State and its political subdivisions for such expenditures in such quarter, and if such amount is less than the State's proportionate share of the total sum of such estimated expenditures, the source or sources from which the difference is expected to be derived, and (B) such other investigation as the Secretary may find necessary. "(2) The Secretary shall then pay to the State, in such installments as he may determine, the amount so estimated, reduced or increased to the extent of any overpayment or underpayment which the Secretary determines was made under this section to such State for any prior quarter and with respect to which adjustment has not already been made under this subsection. "(3) The pro rata share to which the United States is equitably entitled, as determined by the Secretary, of the net amount recovered during any quarter by the State or any political subdivision thereof with respect to medical assistance furnished under the State plan shall be considered an overpayment to be adjusted under this subsection. " (4) Upon the making of any estimate by the Secretary under this subsection, any appropriations available for payments under this section shall be deemed obligated. "(e) The Secretary shall not make payments under the preceding ]Drovisions of this section to any State unless the State makes a satisfactory showing that it is making efforts in the direction of broadening the scope of the care and services made available under the plan and in the direction of liberalizing the eligibility requirements for medical assistance, with a view toward furnishing by July 1, 1975, comprehensive care and services to substantially all individuals who meet the plan's eligibility standards with respect to income and resources, including services to enable such individuals to attain or retain indepeiidence or self-care.

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351

"OPERATION OF STATE PLANS

"SEC. 1904. If the Secretary, after reasonable notice and opportunity for hearing to the State agency administering or supervising the administration of the State plan approved under this title, finds— "(1) that the plan has been so changed that it no longer complies with the provisions of section 1902; or "(2) that in the administration of the plan there is a failure to comply substantially with any such provision; the Secretary shall notify such State agency that further payments will not be made to the State (or, in his discretion, that payments will be limited to categories under or parts of the State plan not affected by such failure), until the Secretary is satisfied that there will no longer be any such failure to comply. Until he is so satisfied he shall make no further payments to such State (or shall limit payments to categories under or parts of the State plan not affected by such failure). "DEFINITIONS

"SEC. 1905. For purposes of this title— "(a) The term 'medical assistance' means payment of part or all of the cost of the following care and services (if provided m or after the third month before the month in which the recipient makes application for assistance) for individuals who are— " ri) under the age of 21, "(ii) relatives specified in section 406(b)(1) with whom a j^tttt^\^g^%o child is living if such child, except for section 406(a)(2), is (or 42 USC eoe. would, if needy, be) a dependent child under title IV, „ 78 Stat. 1042; U/"K

ntf

J

1J3

Post, p. 422,

(ill) 65 years of age or older, 42 USC eo 1-609. "fiv) blind, or "(v) 18 years of age or older and permanently and totally disabled, but whose income and resources are insufficient to meet all of such cost— "(1) inpatient hospital services (other than services in an institution for tuberculosis or mental diseases); " ^2) outpatient hospital services; "(3) other laboratory and X-ray services; "(4) skilled nursing home services (other than services in an institution for tuberculosis or mental diseases) for individuals 21 years of a ^ or older; "(6) physicians' services, whether furnished in the office, the patient's home, a hospital, or a skilled nursing home, or elsewhere; "(6) medical care, or any other tyjpe of remedial care recognized under State law, furnished by licensed practitioners withm the scope of their practice as defined by State law; f7) home health care services; 19) clinic services; 10) dental services; ^11^ physical therapy and related services; 12) prescribed drugs, dentures, and prosthetic devices; and eyeglasses prescribed by a physician skilled in diseases of the eye or by an optometrist, whichever the individual may select; " (13) other diagnostic, screening, preventive, and rehabilitative services;
 * 8) private duty nursing services;

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[79 STAT.

"(14) inpatient hospital services and skilled nursing home services for individuals 65 years of age or over in an institution for tuberculosis or mental diseases; and "(15) anj other medical care, and any other type of remedial care recognized under State law, specified by the Secretary; except that such term does not include— "(A) any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution); or "(B) any such payments with respect to care or services for any individual who has not attained 65 years of age and who is a patient in an institution for tuberculosis or mentafdiseases. "(b) The term 'Federal medical assistance percentage' for any State shall be 100 per centum less the State percentage; and the State percentage shall be that percentage which bears the same ratio to 45 per centum as the square of the ^er capita income of such State bears to the square of the per capita income of the continental United States (including Alaska) and Hawaii; except that (1) the Federal medical assistance percentage shall in no case be less than 50 per centum or more than 83 per centum, and (2) the Federal medical assistance per-^ centage for Puerto Rico, the Virgin Islands, and Guam shall be 55 per centum. The Federal medical assistance percentage for any State shall be determined and promulgated in accordance with the provisions 42 u^c u ^1*' ^^ subparagraph (B) of section 1101(a)(8); except that the Secretary shall promulgate such percentage as soon as possible after the enactment of this title, which promulgation shall be conclusive for each of the six quarters in the period beginning January 1, 1966, and ending with the close of June 30, 1967." (b) No payment may be made to any State under title I, IV, X, 42 USC 301 et XIV, or XVI of the Social Security Act with respect to aid or assist^*'^' ance in the form of medical or any other type of remedial care for Ante, p. 343. any period for which such State receives payments under title X IX of such Act, or for any period after December 31, 1969. (c)(1) Effective January 1, 1966, section 1101(a)(1) of the Social -rJL^l^^^^I^' Security Act is amended by striking out "and XVI" and inserting in 76 Stat. 20|6.

42 USC 1301. 42 USC 139 ^0

..

. J

< «-V-TTT

J

-VTV?)

lieu thereof "XVI, and XIX". (^) Section 1109 of such Act is amended to read as follows: " A M O U N T S DISREGARDED N O T TO BE T A K E N I N TO ACCOUNT I N DETERMINING E L I G I B I L I T R OF OTHER INDIVIDUALS

76 Stat. 192. 42 USC 1315.

"SEC. 1109. Any amount which is disregarded (or set aside for future needs) in determining the eligibility of and amount of the aid or assistance for any individual under a State plan approved under title I, IV, X, XIV, XVI, or X IX shall not be taken mto consideration in determining the eligibility of and amount of aid or assistance for any other individual under a State plan approved under any other of such titles." (3) Effectivo JaixuaTy 1, 1966, section 1115 of such Act is amended ^y striking out "or XVI", "or 1602", and "or 1603" and inserting in lieu thereof "XVI, or XIX", "1602, or 1902", and "1603, or 1903", respectively.

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353

PAYMENT BY STATES OF PREMIUMS FOR SUPPLEMENTARY MEDICAL INSURANCE

SEC. 122. Sections 3(a), 403(a), 1003(a), 1403(a), and 1603(a) of the Social Security Act are each amended by inserting "premiums 174^ fng^j^^'*' under part B of title X VIII for individuals who are recipients of 42 USC 303', 603, money payments under such plan and other" after "expenditures for" 1203, 1353, isss. in the parenthetical phrase appearing in so much of paragraph (1) thereof as precedes clause (A), and in the parenthetical phrase appearing in paragraph (2) thereof. TITLE II — OTHER AMENDMENTS R E L A T I N G TO H E A L T H CARE PART 1—MATERNAL AND CHILD HEALTH AND CRIPPLED CHILDREN'S SERVICES I N C R E A S E I N MATERNAL AND CHILD HEALTH SERVICES

SEC. 201. (a) The first sentence of section 501 of the Social Security Act is amended by striking out "$40,000,000" and all that follows and inserting in lieu thereof "$45,000,000 for the fiscal year ending June 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending JiHie 30, 1970, and each fiscal year thereafter." (b) Section 504 of such Act is amended by adding at the end thereof the loilowing new subsection: " (d) Notwithstanding the preceding provisions of this section, no payment shall be made to any State thereunder for any period after June 30, 1966, unless it makes a satisfactory showing that the State is extending the provision of maternal and child health services in the State with a view to making such services available by July 1, 1975, to children in all parts of the State."

77 staj. 273. ^^ ^°^"

'•^ ^^^^- ^^°-

42 USC 704.

INCREASE I N CRIPPLED CHILDREN'S SERVICES

SEC. 202. (a) The first sentence of section 511 of the Social Security Act is amended by striking out "$40,000,000" and all that follows and 77 st^au 273. inserting in lieu thereof "$45,000,000 for the fiscal year ending June "^^ ' ^^^' 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending June 30, 1970, and each fiscal year thereafter." (b) Section 514 of such Act is amended by adding at the end sg'^ltatIs"^' thereof the following new subsection: 42 USC 714*. " (d) Notwithstanding the preceding provisions of this subsection, no payment shall be made to any State thereunder for any period after June 30, 1966, unless it makes a satisfactory showing that the State is extending the provision of crippled children'services in the State with a view to making such services available by July 1, 1975, to children in all parts of the State." TRAINING OF PROFESSIONAL PERSONNEL FOR THE CARE OF CRIPPLED CHILDREN

SEC. 203. (a) Part 2 of title V of the Social Security Act is amended by adding at the end thereof the following new section:

^9 stau 63 u^ ^^

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42 u^c 7\^4 ^

[79 STAT.

OF PROFESSIONAL P E R S O N N E L

"SEC. 516. There are authorized to be appropriated $5,000,000 for the fiscal year ending June 30, 1967, $10,000,000 for the fiscal year ending June 30, 1968, and $17,500,000 for each fiscal year thereafter, for grants hj the Secretary to public or other nonprofit institutions of higher learning for training professional personnel for health and related care of crippled children, particularly mentally retarded children and children with multiple handicaps." (^) '^^^ second sentence of section 514(c) of such Act is amended by striking out "section 512(b)" and inserting in lieu thereof "section 512(b) or 516". P A Y M E N T FOR I N P A T I E N T H O S P I T A L SERVICES

42 us^c 7?3*

42 USC 713.

^^^' ^9^' (^) Section 503(a) of the Social Security Act is amended by striking out "and" before clause (7) and by inserting before the period at the end thereof the following new clause: "; and (8) effective July 1, 1967, provide for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan". ^|3^ Section 513(a) of such Act is amended by striking out "and" before clause (6) and by inserting before the period at the end thereof the following new clause: "; and (7) effective July 1, 1967, provide for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary and included in the plan) of inpatient hospital services provided under the plan". SPECIAL

42 USC'729^729a.

PROJECT

GRANTS

FOR H E A L T H CHILDREN

OF

SCHOOL

AND

PRESCHOOL

^^C- ^05. Part 4 of title V of the Social Security Act is amended (1) by revising the heading thereof to read as follows: " P A R T 4— GRANTS FOR SPECIAL MATERNITY AND INFANT CARE PROJECTS, FOR PROJECTS FOR HEALTH OF SCHOOL AND PRESCHOOL CHILDREN, AND FOR KESEARCH PROJECTS"; (2) by redesignating section 532 as section

533; and (3) by inserting after section 531 the following new section: "SPECIAL PROJECT GRANTS FOR HEALTH OF SCHOOL AND PRESCHOOL CHILDREN

"SEC. 532. (a) I n order to promote the health of children and youth of school or preschool age, particularly in areas with concentrations of low-income families, there are authorized to be appropriated $15,000,000 for the fiscal year ending June 30, 1966, $35,000,000 for the fiscal year ending June 30, 1967, $40,000,000 for the fiscal year ending June 30, 1968, $45,000,000 for the fiscal year ending June 30, 1969, and $50,000,000 for the fiscal year ending June 30, 1970, for grants as provided in this section. " (b) From the sums appropriated pursuant to subsection (a), the Secretary is authorized to make grants to the State health agency of any State and (with the consent of such agency) to the health agency of any political subdivision of the State, to the State agency of the State administering or supervising the administration of the State plan approved under section 513, to any school of medicine (with appropriate participation by a school of dentistry), and to any teaching hospital affiliated with such a school, to pay not to exceed 75 per centum of the cost of projects of a comprehensive nature for health

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355

care and services for children and youth of school age or for preschool children (to help them prepare to start school). No projept shall be eligible for a grant under this section unless it provides (1) for the coordination of health care and services provided under it with, and utilization (to the extent feasible) of, other State or local health, welfare, and education programs for such children, (2) for payment of the reasonable cost (as determined in accordance with standards approved by the Secretary) of inpatient hospital services provided under the project, and (3) that any treatment, correction of defects, or aftercare provided under the project is available only to children who would not otherwise receive it because they are from low-income families or for other reasons beyond their control; and no such project for children and youth of school age shall be considered to be of a comprehensive nature for purposes of this section unless it includes (subject to the limitation in the preceding provisions of this sentence) at least such screening, diagnosis, preventive services, treatment, correction of defects, and aftercare, both medical and dental, as may be provided for in regulations of the Secretary. "(c) Payment of grants under this section may be made (after necessary adjustment on account of previously made underpayments or overpayments) in advance or by way of reimbursement, and in such installments and on such conditions, as the Secretary may determine.-' EVALUATION A N D REPORT

SEC. 206. The Secretary shall submit to the President for transmis- ^^^^°^^ corress sion to the Congress before July 1, 1969, a full report of the adminis- " ^" ongress. tration of the provisions of section 532 of the Social Security Act (as added by section 205 of this Act), together with an evaluation of the program established thereby and his recommendations as to continuation of and modifications in that program. INCREASE I N C H I L D WELFARE SERVICES

SEC. 207. Section 621 of the Social Security Act is amended by striking out "$40,000,000" and all that follows and inserting in lieu thereof "$40,000,000 for the fiscal year ending June 30, 1965, $45,000,000 for the fiscal year ending June 30, 1966, $50,000,000 for the fiscal year ending June 30, 1967, $55,000,000 for the fiscal year ending June 30, 1968, $55,000,000 for the fiscal year ending June 30, 1969, and $60,000,000 for the fiscal year ending June 30, 1970, and each fiscal year thereafter."

'^^ use 721.

D A T CARE SERVICES

SEC. 208. (a)(1) Part 3 of title V of the Social Security Act is amended by striking out section 527. (2) The second sentence of section 1108 of such Act is amended by striking out "522(a), and 527(a)" and inserting in lieu thereof "and 522(a)" and by striking out " ( o r, in the case of section 527(a), the minimum)". (b) Section 522 of such Act is amended to read as follows: "ALLOTMENTS TO STATES

"SEC. 522. The sum appropriated pursuant to section 521 for each fiscal year shall be allotted by the Secretary for use by cooperating State public welfare agencies which have plans developed jointly by the State agency and the Secretary, as follows: H e shall allot $70,000

76 stat^. iss.

42 USC 727. 42 USC 1.308.

'^'^ ^^^ -'^s

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42 USC 724. 42 USC 723.

Effective date.

PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

to each State, and shall allot to each State an amount which bears the same ratio to the remainder of the smn so appropriated for such year as the product of (1) the population of such State under the age of 21 and (2) the allotment percentage of such State (as determined under section 524) bears to the sum of the corresponding products of all the States." (c) Section 523(a)(1)(B) of such Act is amended by striking out "and" at the end of clause (lii) and by inserting after clause (iv) the following new clause: "(v) that day care provided under the plan will be provided only in facilities (including private homes) which are licensed by the State, or approved (as meeting the standards established for such licensing) by the State agency responsible for licensing facilities of this type, and", (d) The amendments made by this section shall take effect on January 1, 1966. PART 2—IMPLEMENTATION OF MENTAL EETTARDATION PLANNING AUTHORIZATION OP APPROPRIATIONS

42 us^c 1 3 1 ^9

42 USC 139 2.

^^^'?^^' (^) Section 1701 of the Social Security Act is amended by adding at the end thereof the following new sentence: "There are also authorized to be appropriatedj for assisting such States in initiating the implementation and carrying out of planning and other steps to combat mental retardation, $2,750,000 for the fiscal year ending June 30, 1966, and $2,750,000 for the fiscal year ending June 30, 1967.^' (b) xjie first sentence of section 1702 of such Act is amended by inserting "the first sentence of" before "section 1701" and by inserting the following before the period at the end thereof "; and the sums appropriated pursuant to the second sentence of such section for the fiscal year ending June 30, 1966, shall be available for such grants during such year and the next two fiscal years, and sums appropriated pursuant thereto for the fiscal year ending June 30, 1967, shall be available for such grants during such year and the succeeding fiscal year". PART 3—PUBLIC ASSISTANCE AMENDMENTS RELATING TO HEALTH CARE REMOVAL o r L I M I T A T I O N S ON FEDERAL PARTICIPATION IN ASSISTANCE TO INDIVIDUALS WITH TUBERCULOSIS OR MENTAL DISEASE

^ 64 s^tat^ M9; Post^p. 415. 42 USC 306.

SEC. 221. (a)(1) Section 6(a) of the Social Security Act is amended to read as follows: '<(a) For the purposes of this title, the term 'old-age assistance' means money payments to, or (if provided in or after the third month before the month in which the recipient makes application for assistance) medical care in behalf of or any t^pe of remedial care recognized under State law in behalf of, needy individuals who are 65 years of age or older, but does not include any such payments to or care m behalf of any individual who is an inmate of a public institution (except as a patient in a medical institution)." (2) Section 6(b) of such Act is amended by striking out all that follows clause (12) and inserting in lieu thereof the following: "except that such term does not include any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution)."

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357

(8) Section 2(a) of such Act is amended (A) by striking out "and" 42 USC 3^2' ^ at the end of paragraph (10); (B) by striking out the period at the end of p a r a ^ a p h (11) and inserting in lieu thereof a semicolon; and (C) by adding after paragraph (11) the following new paragraphs: "(12) if the State plan includes assistance to or m bSialf of individuals who are patients in institutions for mental diseases— " (A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; " (B) provide for an individual plan for each such patient to assure that the institutional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will oe given appropriate medical treatment within the institution, and that there will be a periodic determination of his need for continued treatment in the institution; " (C) provide for the development of alternate plans of care, making maximum utilization of available resources^ for recipients vmo would otherwise need care in such institutions, including appropriate medical treatment and other assistance; for services referred to in section 3(a)(4)(A)(i) and (ii) ''^ ^*sc 3^3^' which are appropriate for such recipients and for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and " (D) provide methods of determining the reasonable cost of institutional care for such patients; and "(13) if the State plan includes assistance to or in behalf of patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including l)rovision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases." (4) Section 3 of such Act is amended by adding at the end thereof yg^ltat^Y//^^' the following new subsection: 42 USC 3o'3. " (d) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactoir to the Secretary that total expenditures in the State from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures m the State from such sources for such services under such programs for each Quarter of the fiscal year ending June 30, 1965. For purposes of this suosection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the

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Pott^T-^416^' 42'use 1206. 42 USC'1355*. plltfIT416^' 42 USC 1385,

Post, p. 418.

PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

case of any State shall be determined on the basis of the latest data, satisfactor;^ to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes of this subsection." i^) Section 1006 of such Act is amended by striking out clauses (a) and (b) and inserting in lieu thereof the following: "who is a patient in an institution for tuberculosis or mental diseases". (^) Section 1405 of such Act is amended by striking out clauses (a) and (b) and inserting in lieu thereof the following: "who is a patient in an institution for tuberculosis or mental diseases". (d)(1) Section 1605(a) of such Act is amended to read as follows: " (a) For purposes of this title, the term 'aid to the aged, blind, or disabled' means money payments to, or (if provided in or after the third month before the month in which the recipient makes application for aid) medical care in behalf of or any type of remedial care recognized under State law in behalf of, needy individuals who are 65 years of age or older, are blind, or are 18 years of age or over and permanently and totally disabled, but such term does not include— "(1) any such payments to or care in behalf of any individual who is an inmate of a public institution (except as a patient in a medical institution); or "(2) any such payments to or care in behalf of any individual who has not attained 65 jedivs of age and who is a patient in an institution for tuberculosis or m e n t S diseases." (2) Section 1605(b) of such Act is amended by striking out all that follows clause (12) and inserting in lieu thereof the following: "except that such term does not include any such payments with respect to care or services for any individual who is an inmate of a public institution (except as a patient in a medical institution)." (3) Section 1602(a) of such Act (as amended by section 403(e) of this Act) is amended (A) by striking out "and" at the end of paragraph (14); (B) by striking out the period at the end of paragraph (15) and inserting in lieu thereof a semicolon; and (C) by adding after paragraph (15) the following new paragraphs: " (16) if the State plan includes aid or assistance to or in behalf of individuals 65 years of age or older who are patients in institutions for mental diseases— " (A) provide for having in effect such agreements or other arrangements with State authorities concerned with mental diseases, and, where appropriate, with such institutions, as may be necessary for carrying out the State plan, including arrangements for joint planning and for development of alternate methods of care, arrangements providing assurance of immediate readmittance to institutions where needed for individuals under alternate plans of care, and arrangements providing for access to patients and facilities, for furnishing information, and for making reports; " (B) provide for an individual plan for each such patient to assure that the instit-itional care provided to him is in his best interests, including, to that end, assurances that there will be initial and periodic review of his medical and other needs, that he will oe given appropriate medical treatment

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PUBLIC LAW 89-97-JULY 30, 1965

within the institution, and that there will be a periodic determination of his need for continued treatment in the institution; " (C) provide for the development of alternate plans of care, making maximum utilization of available resources, for recipients 65 years of age or older who would otherwise need care in such institutions, including appropriate medical treatment and other aid or assistance; for services referred to in section 1603(a)(4)(A)(i) and (ii) which are appropriate for such recipients and for such patients; and for methods of administration necessary to assure that the responsibilities of the State agency under the State plan with respect to such recipients and such patients will be effectively carried out; and " (D) provide methods of determining the reasonable cost of institutional care for such patients; and "(17) if the State plan includes aid or assistance to or in behalf of individuals 65 years of a^e or older who are patients in public institutions for mental diseases, show that the State is making satisfactory progress toward developing and implementing a comprehensive mental health program, including provision for utilization of community mental health centers, nursing homes, and other alternatives to care in public institutions for mental diseases." (4) Section 1603 of such Act is amended by adding at the end thereof the following new subsection: " (d) Notwithstanding the preceding provisions of this section, the amount determined under such provisions for any State for any quarter which is attributable to expenditures with respect to individuals 65 years of age or older who are patients in institutions for mental diseases shall be paid only to the extent that the State makes a showing satisfactory to the Secretary that total expenditures in the State from Federal, State, and local sources for mental health services (including payments to or in behalf of individuals with mental health problems) under State and local public health and public welfare programs for such quarter exceed the average of the total expenditures in the State from such sources for such services under such programs for each quarter of the fiscal year ending June 30, 1965. For purposes of this subsection, expenditures for such services for each quarter in the fiscal year ending June 30, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the first determination by him under this subsection for such State; and expenditures for such services for any quarter beginning after December 31, 1965, in the case of any State shall be determined on the basis of the latest data, satisfactory to the Secretary, available to him at the time of the determination under this subsection for such State for such quarter; and determinations so made shall be conclusive for purposes of this subsection.'' (e) The amendments made by this section shall apply in the case of expenditures made after D u m b e r 31, 1965, under a State plan approved under title I, X, X IV, or X VI of the Social Security Act.

359

76 Stat. 200. '^^ ^^^^'

^2 USC 301 et acq.

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PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

AMENDMENT TO DEFINITION OF MEDICAL ASSISTANCE FOR THE AGED 74 Stat. 991. 42 USC 306.

76 Stat, 204. 42 USC 1385.

42 USC 301, 1385.

SEC. 222. (a^ Section 6(b) of the Social Security Act is amended by striking out "who are not recipients of old-age assistance" and inserting in lieu thereof "who are not recipients of old-age assistance (except, for any month, for recipients of old-age assistance who are admitted to or discharged from a medical institution during such month)". (b) Section 1605(b) of such Act is amended by striking out "who are not recipients of aid to the a ^ d, blind, or disabled" and inserting in lieu thereof "who are not recipients of aid to the aged, blind, or disabled (except, for any month, for recipients of aid to the aged, blind, or disabled who are admitted to or discharged from a medical institution during such month)". (c) The amendments made by this section shall apply in the case of expenditures under a State plan approved under title I or XVI of the Social Security Act with respect to care and services provided under such plan after June 1965. PART 4—MISCELLANEOUS AMENDMENTS RELATING TO HEALTH CARE H E A L T H STUDY O F RESOURCES RELATING TO CHILDREN'S EMOTIONAL ILLNESS

Program grants.

"Organization.'*

Appropriation.

Reports to Congress.

ggc. 231. (a) Tho Secretary of Health, Education, and Welfare is authorized, upon the recommendation of the National Advisory Mental Health Council and after securing the advice of experts in pediatrics and child welfare, to make grants for carrying out a program of research into and study of our resources, methods, and practices for diagnosing or preventing emotional illness in children and of treating, caring for, and rehabilitating children with emotional illnesses. (b) Such grants may be made to one or more organizations, but only on condition that the organization will undertake and conduct, or if more than one organization is to receive such grants, only on condition that such organizations have agreed among themselves to undertake and conduct, a coordinated program of research into and study of all aspects of the resources, methods, and practices referred to in subsection (a). (c) As used m subsection (b), the term "organization" means a nongovernmental agency, or^nization, or commission, composed of representatives of leading national medical, welfare, educational, and other professional associations, organizations, or agencies active in the field of mental health of children. (d) There are authorized to be appropriated for the fiscal year ending June 30, 1966, the sum of $500,000 to be used for a grant or grants to help initiate the research and study provided for in this section; and the sum of $500,000 for the succeeding fiscal year for the making of such grants as may be needed to carry the research and study to completion. The terms of any such grant shall provide that the research and study shall be completed not later than two years from the date it is inaugurated; that the grantee shall file annual reports with the Congress, the Secretary, and the Governors of the several States, among others that the grantee may select; and that the final report shall be similarly filed.

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361

TITLE III—SOCIAL SECUEITY AMENDMENTS SHORT TITLE

SEC. 300. This title may be cited as the "Old-Age, Survivors, and Disability Insurance Amendments of 1965".

Old-Age, Survivors, ancJ Disability Insurance Amendments of 1965.

INCREASE I N OLD-AGE, SURVIVORS, AND D I S A B I U T T INSURANCE BENEFITS

SEC. 301. (a) Section 215(a) of the Social Security Act is amended by striking out the table and inserting in lieu thereof the following: "TABLE FOB DETERMINING PRIMARY INSURANCE AMOUNT AND MAXIMUM FAMILY BENEFITS "I (Primary Insurance benefit under 1939 Act, as modified)

(Primary insurance amount under 1958 Act, as modified)

m

IV

V

(Average monthly wage)

(Primary insurance amount)

(Maximum family benefits)

II

If an individual's primary insurance benefit (as determined under subsec. (d))is-

At least—

But not more than—

$13.49 14.01 14.49 15.01 16.61 16.21 16.86 17.61 18.41 19.26 20.01 20.65 21.29 21.89 22.29 22.69 23.09 23.45 23.77 24.21 24.61 25.01 26.49 26.93 26.41 26.95 27.47 28.01 28.69 29.26 29.69 30.37 30.93 31.37 32.01 32.61 33.21 33.89 34.61 36.01 35.81 36.41 37.09 37.61 38.21 39.13 39.69 40.34 41.13 4L77 42.46

$13.48 14.00 14.48 16.00 15.60 16.20 16.84 17,60 18.40 19.24 20.00 20.64 21.28 21.88 22.28 22.68 23.08 23.44 23.76 24.20 24.60 25.00 25.48 25.92 26.40 26.94 27.46 28.00 28.68 29.26 29.68 30.36 30.92 31.36 32.00 32.60 33.20 33.88 34.50 35.00 35.80 36.40 37.08 37.60 38.20 39.12 39.68 40.33 41.12 41.76 42.44 43.20

49-850 0-66—26

Or his primary insurance amount (as determined under subsec. (c)) i s $40 41 42 43 44 45 46 47 48 49 50 51 52 53 64 66 56 57 58 59 60 61 62 63 64 66 66 67 68 69 70 71 72 73 74 76 76 77 78 79 80 81 82 83 84 86 86 87 88 89 90 91

Or his average monthly wage (as determined under subsec. (b)) is—

At least—

$68 70 71 73 76 77 79 81 82 84 86 88 90 91 93 95 97 98 100 102 103 105 107 108 110 114 119 123 128 133 137 142 147 151 156 161 165 170 175 179 184 189 194 193 203 208 212 217 222 226 231

And the maximum amount of benefits The amount payable (as referred to in provided the preceding sec. 203(a))in paragraphs of the basis of on his this subsection wages and But not shall be— more than— self-employment income shall be— $67 69 70 72 74 76 78 80 81 83 85 87 89 90 92 94 96 97 99 101 102 104 106 107 109 113 118 122 127 132 136 141 146 150 155 160 164 169 174 178 183 188 193 197 202 207 211 216 221 225 230 236

$44.00 45.00 46.00 47.00 48.00 49.00 50.00 51.00 52.00 63.00 54.00 55.00 56.00 57.00 58.00 59.00 60.00 61.00 62.10 63.20 64.20 65.30 66.40 67.50 68.50 69.60 70.70 71.70 72.80 73.90 74.90 76.00 77.10 78.20 79.20 80.30 81.40 82.40 83.60 84.60 85.60 86.70 87.80 88.90 89.90 91.00 92.10 93.10 94.20 95.30 9&30 97.40

$66.00 67.50 69.00 70.60 72.00 73.60 75.00 76.50 78.00 79.50 81.00 82.60 84.00 85.60 87.00 88.50 90.00 91.60 93.20 9180 96.30 98.00 99.60 101.30 102.80 104.40 106.10 107.60 109.20 110.90 112.40 11400 116.80 120.00 124.00 128.00 131.20 135.20 139.20 142.40 146.40 160.40 154.40 157.60 161.60 165.60 168.80 172.80 176.80 180.00 184.00 188.00

72 Stat. 1014. 42 USC 415.

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PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

"TABLE FOR DETERMINING P R I M A R Y INSURANCE A M O U N T A N D FAMILY BENEFITS—Continued

"I

II

(Primary insurance benefit under 1939 Act, as modified)

(Primary Insurance amount under 1958 Act, as modified)

If an individual's primary Insurance benefit (as determined under subsec. (d)) i s -

A t least—

But not more than—

$43.21 43.77 44.45 44.89

$43.76 4144 44.88 45.60

Or his primary insurance amount (as determined under subsec. (c)) i s -

$92 93 94 95 96 97 98 99 100 101 102 103 104 106 106 107 108 109 110 111 112 113 114 116 116 117 118 119 120 121 122 123 124 125 126 127

MAXIMUM

III

IV

V

(Average monthly wage)

(Primary insurance amount)

(Maximum family benefits)

Or his average monthly wage (as determined under subsec. (b)) is—

A t least—

B u t not more than—

$236

$-239

240 246 250 264 269 264 268 273 278 282 287 292 296 301 306 310 316 320 324 329 334 338 343 348 352 357 362 366 371 376 380 386 390 394 399 404 408 413 418 422 427 432 437 441 446 461 456 460 465 469 474 479 483 488 493 497 602 607 511 616 621 625 630 635 639 644 649

244 249 253 268 263 267 272 277 281 286 291 295 300 306 309 314 319 323 328 333 337 342 347 351 356 361 366 370 376 379 384 389 393 398 403 407 412 417 421 426 431 436 440 446 450 454 459 464 468 473 478 482 487 492 496 501 506 510 516 620 624 529 634 538 643 648 660

And the maximum amount of benefits The amount payable (as referred to in provided in the preceding sec. 203(a)) on paragraphs of this subsection the basis of his wages and shall be— self-employment income shall be— $98.50 99.60 100.60 101.70 102.80 103.80 104.90 106.00 107.00 108.10 109.20 110.30 111.30 112.40 113.50 114.60 115.60 116.70 117.70 118.80 119.90 121.00 122.00 123.10 124.20 125.20 126.30 127.40 128.40 129.50 130.60 131.70 132.70 133.80 134.90 135.90 137.00 138.00 139.00 140.00 141.00 142.00 143.00 144.00 146.00 146.00 147.00 148.00 149.00 150.00 151.00 152.00 163.00 154.00 156.00 156.00 167.00 168.00 159.00 160.00 161.00 162.00 163.00 164.00 166.00 166.00 167.00 168.00

$191.20 195.20 199.20 202.40 206.40 210.40 213.60 217.60 221.60 224.80 228.80 232.80 236.00 240.00 244.00 247.20 251.20 255.20 258.40 262.40 266.40 269.60 273.60 277.60 280.80 284.80 288.80 292.00 296.00 298.00 299.60 301.60 303.60 305.20 307.20 309.20 310.80 312.80 314.80 316.40 318.40 320.40 322.40 324.00 326.00 328.00 329.60 331.60 333.60 335.20 337.20 339.20 340.80 342.80 344.80 346.40 348.40 350.40 362.00 364.00 356.00 367.60 359.60 361.60 363.20 366.20 367.20 368.00"

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(b) Section 215(c) of such Act is amended to read as follows:

363 ^ ^^^ ^f^^^^

"Primary Insurance Amount Under 1958 Act, as Modified "(c)(1) For the purposes of column II of the table appearing in subsection (a) of this section, an individual's primary insurance amount shall be computed as provided in, and subject to the limitations specified in, (A) this section as in effect prior to the enactment of the Social Security Amendments of 1965, and (B) the applicable provisions of the Social Security Amendments of 1960. "(2) The provisions of this subsection shall be applicable only in the case of an individual who became entitled to benefits under section 202(a) or section 223 before the date of enactment of the Social Security Amendments of 1965 or who died before such date." (c) Section 203(a) of such Act is amended by striking out paragraphs (2) and (3) and inserting in lieu thereof the following: "(2) when two or more persons were entitled (without the application of section 2 0 2 (j)(l) and section 223(b)) to monthly benefits under section 202 or 223 for any month which begins after December 1964 and before the enactment of the Social Security Amendments of 1965, on the basis of the wages and selfemployment income of such insured individual, such total of benefits for any month occurring after December 1964 shall not be reduced to less than the larger of— " (A) the amount determined under this subsection without regard to this paragraph, or " (B)(i) with respect to the month in which such Amendments are enacted or any prior month, an amount equal to the sum of the amounts derived by multiplying the benefit amount determined under this title (including this subsection, but without the application of section 222(b), section 202(q), and subsections (b), (c), and (d) of this section), as in effect prior to the enactment of such Amendments, for each such person (other than a person who would not be entitled to such benefits for such month without the application of the amendments made by section 306 of the Social Security Amendments of 1965), for such month, by 107 percent and raising each such increased amount, if it is not a multiple of $0.10, to the next higher multiple of $0,10, and "(ii) with respect to any month after the month in which such Amendments are enacted, an amount equal to the sum of the amounts derived by multiplying the benefit amount determined under this title (including this subsection, but without the application of section 222(b), section 202(q), and subsections (b), (c), and (d) of this section), as in effect prior to the enactment of such Amendments, for each such person (other than a person who would not be entitled to such benefits for such month without the application of the amendments made by section 306 of the Social Security Amendments of 1965) for the month of enactment, by 107 percent and raising each such increased amount, if it is not a multiple of $0.10, to the next higher multiple of $0.10; but in any such case (I) paragraph (1) of this subsection shall not be applied to such total of benefits after the application of subparagraph (B) of this paragraph, and ( II) if section 202(k) (2)(A) was applicable in the case of any of such benefits for any such month b%inning before the enactment of the Social Secu-

'^'* s*^*- 5'24. note. ^Q^staS^si?^' 42 USC 402,423. pj|^^*^*' ^°^'^' °4Vusc 403.

^H^^^^^l^'^' 42 USC 422,402.

^^ ^^^ ^^^j-

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PUBLIC LAW 89-97-JULY 30, 1965

42 USC 40 2.

42 USC 401.

42 u'sc 423^' 42 USC 402. ^75 Stat. 135: 42 u^e 415. Ante, p. 361.

[79 STAT.

rity Amendments of 1965, and ceases to apply after such month, the provisions of subparagraph (B) shall be applied, for and after the month in which such section 202(k)(2) (AJ ceases to apply, as though paragraph (1) had not been applicable to such total of benefits for such month beginning prior to such enactment." (d) The amendments made by subsections (a), (b), and (c) of this section shall apply with respect to monthly benefits under title II of ^i^e Social Security Act for months after December 1964 and with respect to lump-sum death payments under such title in the case of deaths occurring in or after the month in which this Act is enacted. (e) If an individual is entitled to a disability insurance benefit under section 223 of the Social Security Act for December 1964 on the basis of an application filed after enactment of this Act and is entitled to old-age insurance benefits under section 202(a) of such Act for January 1965, then, for purposes of section 215(a)(4) of the Social Security \(.t (if applicable) the amount in column IV of the table appearing iu such section 215(a) for such individual shall be the amount in such columu ou the line on which in column II appears his primary insurance amount (as determined under section 215(c) of such Act) instead of the amount in column IV equal to his disability insurance benefit. C O M P U T A T I O N A N D R E C O M P U T A T I G N OF B E N E F I T S

74 Stat. 960.

42 USC 402*

75 Stat. 135.

74 Stat. 960.

64 Stat. 482; '4fus'c402,423.

Post,

p. 365.

SEC. 302. (a)(1) Subparagraph (C) of section 215(b)(2) of the Social Sccurity Act is amended to read as follows: " (C) For purposes of subparagraph (B),'computation base years' include only calendar years in the period after 1950 and prior to the earlier of the following years— "(i) the year in which occurred (whether by reason of section ^02 (j)(1) or otherwise) the first month for which the individual was entitled to old-age insurance benefits, or "(ii) the year succeeding the year in which he died. Any calendar year all of which is included in a period of disability shall not be included as a computation base year." (2) Clauses (A), (B), and (C) of the first sentence of section 2 1 5 (b)(3) of such Act a r e amended to read as follows:

" (A) in the case of a woman, the year in which she died or, if it occurred earlier but after 1960, the year in which she attained age 62, " (B) in the case of a man who has died, the year in which he died or, if it occurred earlier but after 1960, the year in which he attained age 65, or " (C) in the case of a man who has not died, the year occurring after 1960 in which he attained (or would attain) age 65." (3) Paragraphs (4) and (5) of section 215(b) of such Act are amended to read as follows: "(4) The provisions of this subsection shall be applicable only in the case of an individual— " (A) who becomes entitled, after December 1965, to benefits under section 202(a) or section 223; or "(I^) ^ h o dies after December 1965 without being entitled to benefits under section 202(a) or section 223; or " (C) whose primary insurance amount is required to be recomputed under subsection (f)(2), as amended by the Social Security Amendments of 1965; except that it shall not apply to any such individual for purposes of monthly benefits for months before Januarv 1966.

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text:
Page:United States Statutes at Large Volume 79.djvu/405

 79 STAT. ]

PUBLIC LAW 89-97-JULY 30, 1965

365

"(5) For the purposes of column III of the table appearing in subsection (a) of this section, the provisions of this subsection, as in effect prior to the enactment of the Social Security Amendments of 1965, shall apply— "(A) in the case of an individual to whom the provisions of this subsection are not made applicable by paragraph (4), but who, on or after the date of the enactment of the Social Security Amendments of 1965 and prior to 1966, met the requirements of this paragraph or paragraph (4), as in effect prior to such enactment, and "(B) with respect to monthly benefits for months before January 1966, in the case of an individual to whom the provisions of this subsection are made applicable by paragraph (4)." (b)(1) Subparagraph (A) of section 215(d)(1) of such Act is 42 USC 4.f5' amended by striking out "(2)(C)(i) and (3)(A)(i)" and inserting in lieu thereof "(2)(C) and (3)", by stnking out "December 31, 1936," and inserting in lieu thereof "1936", and by striking out "December 31, 1950" and inserting in lieu thereof "1950". (2) Section 215(d)(3) of such Act is amended by striking out "1960" and inserting in lieu thereof "1965" and by stnking out "but without regard to whether such individual has six quarters of coverage after 1950'T (c) Section 215(e) of such Act is amended by inserting "and" ^"^ ^*^*- ^°^after the semicolon at the end of paragraph (1), by striking out "; and" at the end of paragraph (2) and inserting in lieu thereof a period, and by striking out paragraph (3). (d)(1) Paragraph (2) of section 215(f) of such Act is amended ^^ ^'^'' i°^^to read as follows: " (2) With respect to each year— " (A) which begins after December 31, 1964, and "(B) for any part of which an individual is entitled to old-age insurance benefits, the Secretary shall, at such time or times and within such period as he may by regulations prescribe, recompute the primary insurance amount of such individual. Such recomputation shall be made— "(C) as provided in subsection (a)(1) and (3) if such year is either the year in which he became entitled to such old-age insurance benefits or the year preceding such year, or "(D) as provided in subsection (a)(1) in any other case; and in all cases such recomputation shall be made as though the year with respect to which such recomputation is made is the last year of the period specified in paragraph (2)(C) of subsection (b). A recomputation under this paragraph with respect to any year shall be effective— "(E) in the case of an indiddual who did not die in such year, for monthly benefits beginning with benefits for January of the following year; or "(F) in the case of an individual who died in such year (including any individual whose increase in his primary insurance amount is attributable to compensation which, upon his death, is treated as remuneration for employment under section 205(o)), ^^ ^^^ ^^°' for monthly benefits beginning with benefits for the month in which he died." (2) Effective January 2, 1966, paragraphs (3), (4), and (7) of such section are repealed, and paragraphs (5) and (6] of such section are redesignated as paragraphs (3) and (4), respectively.

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text:
Page:United States Statutes at Large Volume 79.djvu/406

 366 pJ4 Stat. 964; V2 u^c 423.

It use 40 2.* 42 USC 401.

es^staTioe"'

42 USC 423' 74 Stat. 964.

PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

(e)(1) The first sentence of section 223(a)(2) of such Act is amended by inserting before the period at the end thereof "and was entitled to an old-a^e insurance benefit for each month for which (pursuant to subsection (b)) he was entitled to a disability insurance benefit". (2) The last sentence of section 223(a)(2) of such Act is amended by striking out "first year" and inserting in lieu thereof "year"; and by striking out the phrase "both was fully insured and had" both times it appears in such sentence. (f)(1) The amendments made by subsection (c) shall apply only to individuals who become entitled to old-age insurance benefits under section 202(a) of the Social Security Act after 1965. (2) Any individual who would, upon filing an application prior to January 2, 1966, be entitled to a recomputation of his monthly benefit amount for purposes of title II of the Social Security Act shall be deemed to have filed such application on the earliest date on which such application could have been filed, or on the day on which this Act is enacted, whichever is the later. (3) I n the case of an individual who died after 1960 and prior to 1966 and who was entitled to old-age insurance benefits under section 202(a) of the Social Security Act at the time of his death, the provi^^^^^ ^* sections 215(f)(3)(B) and 215(f)(4) of such Act as in effect before the enactment of this Act shall apply. (4) I n the case of a man who attains age 65 prior to 1966, or dies before such year, the provisions of section 215(f)(Y) of the Social Security Act as in effect before the enactment of this Act shall apply. (5) The amendments made by subsection (e) of this section shall apply in the case of individuals who become entitled to disability insurance benefits under section 223 of the Social Security Act after December 1965. (6) Section 303(g)(1) of the Social Security Amendments of 1960

42 USC 415note.

.

^ '

j

-,

^'^^ ^ '

'^

R^'p^^i42 USC*4i^5loU

IS amended— (A) by striking out "notwithstanding the amendments made by the preceding subsections of this section," in the first sentence and inserting in lieu thereof "notwithstanding the amendments made by the preceding subsections of this section, or the amendments made by section 302 of the Social Security Amendments of 1965,"; and (B) by striking out "Social Security Amendments of 1960," in the second sentence and inserting in lieu thereof "Social Security Amendments of 1960, or (if such individual becomes entitled to old-age insurance benefits after 1965, or dies after 1965 without becoming so entitled) as amended by the Social Security Amendments of 1965,". (7) Effective January 2, 1966, subparagraph (B) of section ^02 (f)(2) of the Social Security Amendments of 1954 is repealed. DISABILrrT INSURANCE BENEFITS

68 Stat. 1080. 42 USC 4 6.

SEC. 303. (a)(1) Clause (A) of the first sentence of section 216(1) ^j) Qf ^^Q Social Security Act is amended by striking out "or to be ^£ long-continued and indefinite duration" and inserting in lieu thereof "or has lasted or can be expected to last for a continuous period of not less than 12 months".

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text:
Page:United States Statutes at Large Volume 79.djvu/407

 79 STAT. ]

PUBLIC LAW 89-97-JULY 30, 1965

367

(2) So much of section 223(c)(2) of such Act as precedes the second pj°,^^^\il^' sentence thereof is amended to read as follows: 42 USC 423. "(2) The term 'disability'means— " (A) inability to engage in any substantial gainful activity by reason of any medically determinable physical or mental impairment which can be expected to result in death or which has lasted or can be expected to last for a continuous period of not less than 12 months; or". (b)(1) Paragraph (2) of section 216(i) of such Act is amended ^°USC 4]i6°' to read as follows: "Period "(2)(A) The term 'period of disability' means a continuous period ability." of dis(beginning and ending as hereinafter provided in this subsection) during which an individual was under a disability (as defined in paragraph (1)), but only if such period is of not less than 6 full calendar months' duration or such individual was entitled to benefits under section 223 for one or more months in such period. '^^ use 423, " (B) No period of disability shall begin as to any individual unless such individual files an application for a disability determination with respect to such period; and no such period shall oegin as to any individual after such individual attains the age of 65. " (C) A period of disability shall begin— " (i) on the day the disability began, but only if the individual satisfies the requirements of paragraph (3) on such day; or '(ii) if such individual does not satisfy the requirements of paragraph (3) on such day, then on the first day of the first quarter thereafter in which he satisfies such requirements. " (D) A period of disability shall end with the close of whichever of the following months is the earlier: (i) the month preceding the month in which the individual attains age 65, or (ii) the second month following the month in which the disability ceases. " (E) No application for a disability determination which is filed more than 12 months after the month prescribed by subparagraph (D) as the month in which the period of disability ends (determined without regard to subparagraph (B) and this subparagraph) shall be accepted as an application for purposes of this paragraph." (2) Section 216(i)(3) of such Act is amended by^ striking out p^^,^^^\^^^^ "clauses (A) and (B) of paragraph (2) " and inserting in lieu thereof ' ^' "clauses (i) and (ii) of paragraph (2)(C) ". (3) Subparagraph (D) of section 223(a)(1) of such Act is amended p^^^^^ ^A^ by striking out "at the time such application is filed,". So much of ' P- • such section 223(a)(1) as follows subparagraph (D) is amended by striking out "the first month for which he is entitled to old-age insurance benefits,". (4) Section 223(c)(3)(A) of such Act is amended by striking out ^2 stau ^1020 "which continues until such application is filed". (c) Section 223(b) of such Act is amended by striking out the last sentence and inserting in lieu thereof the following: "An individual who would have been entitled to a disability insurance benefit for any month had he filed application therefor before the end of such month shall be entitled to such benefit for such month if he files such application before the end of the 12th month immediately succeeding such month." (d) The second sentence of section 202( j)(1) of such Act is amended ^^ ^*|'!: '**,^by inserting "under this title" after "Any benefit". (e) So much of section 215(a)(4) of such Act as precedes "the pj^^^*^** ^^^' amount in column IV " is amended to read as follows: 42 u^'c 415. " (4) In the case of an individual who was entitled to a disability insurance benefit for the month before the month in which he died, became entitled to old-age insurance benefits, or attained age 65,".

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text:
Page:United States Statutes at Large Volume 79.djvu/408

 368

Ante, p. 367.

70 Stat. 815. 42 USC 423.

S3 Stat. 1370. 42 USC 405.

42 USC 401.

PUBLIC LAW 89-97-JULY 30, 1965

[79 SlA_T.

(f)(1) The amendments made by subsection (a), paragraphs (3) and (4) of subsection (b), and subsections (c) and (d), and the provisions of subparagraphs (B) and (E) of section 216(i)(2) of the Social Security Act (as amended by subsection (b)(1) of this section), shall be effective with respect to applications for disability insurance benefits under section 223, and for disability determinations under section 216(i), of the Social Security Act filed— (A) in or after the month in which this Act is enacted, or (B) before the month in which this Act is enacted, if the applicant has not died before such month and if— (i) notice of the final decision of the Secretary of Health, Education, and Welfare has not been given to the applicant before such month; or (ii) the notice referred to in subparagraph (i) has been so given before such month but a civil action with respect to such final decision is commenced under section 205(g) of the 3cxiial Security Act (whether before, in, or after such month) and the decision in such civil action has not become final before such month; except that no monthly insurance benefits under title II of the Social Security Act shall be payable or increased by reason of the amendments made b j subsections (a) and (b) for months before the second month following the month m which this Act is enacted. The preceding sentence shall also be applicable in the case of applications for monthly insurance benefits under title II of the Social Security Act based on the wages and self-employment income of an applicant with respect to whose application for disability insurance benefits under section 223 of such Act such preceding sentence is applicable. (2) The amendment made by subsection (e) shall apply in the case of the primary insurance amounts of individuals who attain age 65 after the date of enactment of this Act. PAYMENT OF DISABILITY INSURANCE BENEFFTS AFTER ENTITT^MENT TO OTHER MONTHLY INSURANCE BENEFITS

64 Stat. 487. 42 USC 402.

75 Stat. 131; Post, p. 374.

SEC. 304. (a) Section 202(k) of the Social Security Act is amended by adding at the end thereof the following new paragraph: "(4) Any individual who, under this section and section 223, is entitled for any month to both an old-age insurance benefit and a disability insurance benefit under this title shall be entitled to only the larger of such benefits for such month, except that, if such individual so elects, he shall instead be entitled to only the smaller of such benefits for such month." (b) The heading of section 202(q) of such Act is amended to read as follows: "Reduction of Old-Age, Disability, Wife's, Husband's, or Widow's Insurance Benefit Amounts" (c) Section 202(q) of such Act is further amended by renumbering paragraphs (2), (3), (4), (5), (6), and (7) as paragraphs (3), (4), (6), (6), (7), and (8), respectively, by renumbering the cross references in such section accordingly, and by inserting after paragraph (1) the following new paragraph: "(2) If an individual is entitled to a disability insurance benefit for a month after a month for which such individual was entitled to an old-age insurance benefit, such disability insurance benefit for each month shall be reduced by the amount such old-age insurance

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text:
Page:United States Statutes at Large Volume 79.djvu/409

 79

STAT.

]

PUBLIC LAW 89-97-JULY 30, 1965

benefit would be reduced under paragraphs (1) and (4) for such month had such individual attained age 65 in the first month for which he most recently became entitled to a disability insurance benefit." (d) Subparagraph (B) of paragraph (3) (as redesignated by subsection (c) of this section) of section 202(q) of such Act is amended by— (1) striking out "benefit," the first time it appears and inserting in lieu thereof "benefit and is not entitled to a disability insurance benefit,";. (2) striking out in clause (i) thereof "(1)," and inserting in lieu thereof "(1) for such month,"; and (3) striking out in clause (ii) thereof "(1)" and inserting in lieu thereof "(1) for such month". (e) Subparagraph (C) of paragraph (3) (as redesignated by subsection (c) of this section) of section 202(q) of such Act is amended to read as follows: "(C) For any month for which such individual is entitled to a disabil^,ty insurance benefit, such individual's wife's, husband's, or widow's insurance benefit shall be reduced by the sum of— "(i) the amount by which such disability insurance benefit is reduced under paragraph (2) for such month (if such paragraph applied to such benefit), and "(ii) the amount by which such wife's, husband's, or-widow's insurance benefit would be reduced under paragraph (1) for such month if it were equal to the excess of such wife's, husband's, or widow's insurance benefit (before reduction under this subsection) over such disability insurance benefit (before reduction under this subsection)." (f) Paragraph (3) (as redesignated by subsection (c) of this section) of section 202(q) is further amended by adding alter subparagraph (E) (added by section 307(b)(4) of this Act) the following new subparagraphs: "(F) If the first month for which an individual is entitled to a disability insurance benefit (when such first month occurs with or after the month in which such individual attains the age of 62) is a month for which such individual is also (or would, but for subsection (e] (1), be) entitled to a widow's insurance benefit to which such individual was first entitled for a month before she attained retirement age, then such disability insurance benefit for each month shall be reduced by whichever of the following is larger: "(i) the amount by which (but for this subparagraph) such disability insurance benefit would have been reduced under paragraph (2), or "(ii) the amount equal to the sum of the amount by which such widow's insurance benefit was reduced for the month in which such individual attained retirement age and the amount by which such disability insurance benefit would be reduced under paragraph (2) if it were equal to the excess of such disability insurance benefit (before reduction under this subsection) over such widow's insurance benefit (before reduction under this subsection). "(G) If the first month for which an individual is entitled to a disability insurance benefit (when such first month occurs before the month in which such individual attains the age of 62) is a month for which such individual is also (or would, but for subsection (e)(1), be) entitled to a widow's insurance benefit, then such disability insurance benefit for each month shall be reduced by the amount ^ c h widow's insurance benefit would be reduced under paragraphs (1) and

369

Post, p. 374.

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Page:United States Statutes at Large Volume 79.djvu/410

 370

75 Stat. 133. inJe! p.?68. ^A ^^^^'oiy ^' '42*'us"c 415. 42 USC 416. Ante, p. 367. 74 ^^^ Stat. 964; 42^'usc 423.

42 USC 401.

PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

(4) for such month had such individual attained age 62 in the first month for which he most recently became entitled to a disability insurance benefit." (g) Paragraph (4) (as redesignated by subsection (c) of this section) of section 202(q) of such Act is amended by striking out in subparagraph (A) thereof "under" and inserting in lieu thereof: "under paragraph (1) or (3) of". (h) Paragraph (7) (as redesignated by subsection (c) of this section and as amended by section 307(b)(7) of this Act) of section 202 (q) of such Act is amended by adding after subparagraph (E) the followingnew subparagraph: " (F) in the case of old-age insurance benefits, any month for which such individual was entitled to a disability insurance benefit." (i) Paragraph (8) (as redesignated by subsection (c) of this section) of section 202(q) of such Act is amended by striking out "(1)'* and inserting in lieu thereof " (1), (2),". (j) Section 202(r)(2) of such Act is amended by inserting after "eligible" the following: " (but for section 202(k)(4)) ". (^) Section 215(a)(4) of such Act is amended by striking out "such disability insurance benefit" and inserting in lieu thereof "the primary insurance amount upon which such disability insurance benefit is based". (1) Section 216(i)(2) of such Act is amended by striking out " (subject to section 223(a)(3)) ". (m) Section 223(a)(2) of such Act is amended by striking out the word "Such" and inserting in lieu thereof "Except as provided in section 202(q), such". ^n) Section 223(a)(3) of such Act is repealed. (o) The amendments made by this section shall apply with respect to monthly insurance benefits under title II of the Social Security Act for and after the second month following the month in which this Act is enacted, but only on the basis of applications filed in or after the month in which this Act is enacted. DISABILITY INSURANCE TRUST F U N D

70 Stat. 8^20.

SEC. 305, (a) Section 201(b)(1) of the Social Security Act is amended by inserting "and before January 1, 1966," after "December 31, 1956,", and by inserting after "1954," the following: "and 0.70 of 1 per centum of the wages (as so defined) paid after December 31, 1965, and so reported,". (b) Section 201(b)(2) of such Act is amended by inserting after "December 31, 1956," the following: "and before January 1, 1966, and 0.525 of 1 per centum of the amount of self-employment income (as so defined) so reported for any taxable year beginning after December 31, 1965,". P A Y M E N T OP C H I L D ' S INSURANCE B E N E F I T S AFTER A T T A I N M E N T OP AGE 1 8 I N CASE OF C H I L D A T T E N D I N G SCHOOL

II use ioT'

Ant^'^^'VeV

^^^- ^^^' (^) Section 202(d)(1)(B) of the Social Security Act is amended to read as follows: "(B) at the time such application was filed was unmarried and (i) either had not attained the age of 18 or was a full-time student and had not attained the age of 22, or (ii) is under a disability (as defined in section 223(c)) which began before he attained the age of 18, and".

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text: 1911 Encyclopædia Britannica/Amman, Paul


text:
Page:United States Statutes at Large Volume 79.djvu/411

 79

STAT.

]

PUBLIC LAW 89-97-JULY 30, 1965

(b)(1) So much of the first sentence of section 202(d)(1) of such Act as follows subparagraph (C) is amended to read as follows: "shall be entitled to a child's insurance benefit for each month, beginning with the first month after August 1950 in which such child becomes so entitled to such insurance benefits and ending with the month preceding whichever of the following first occurs— "(D) the month in which such child dies, marries, or is adopted (except for adoption by a stepparent, grandparent, aunt^ or uncle subsequent to the death of such fully or currently insured individual), "(E) the month in which such child attains the age of 18, but only if he (i) is not under a disability (as so defined) at the time he attains such age, and (ii) is not a luU-time student during any part of such month, "(F) if such child was not under a disability (as so defined) at the time he attained the age of 18, the earlier oi— "(i) the first month during no part of which he is a fulltime student, or "(ii) the month in which he attains the age of 22, or "(G) if such child was under a disability (as so defined) at the time he attained the age of 18, the third month following the month in which he ceases to be under such disability or (if later) the earlier of— "(i) the first month during no part of which he is a fulltime student, or "(ii) the mon^h in which he attains the age of 22." (2) The second sentence of section 202(d)(1) of such Act is repealed. (3) Section 202(d) of such Act is further amended by adding at the end thereof the fdllowing new paragraphs: "(7) A child whose entitlement to child's insurance benefits on the basis of the wages and self-employment income of an insured individual terminated with the month preceding the month in which such child attained the age of 18, or with a subsequent month, may again become entitled to such benefits (provided no event specified in paragraph (1)(D) has occurred) beginning with the first month thereafter in which he is a full-time student and has not attained the age of 22 if he has filed application for such rentitlement. Such rentitlement shall end with the month preceding whichever of the following first occurs: The first month during no part of which he is a full-time student, the month in which he attains the age of 22, or the first month in which an event specified in paragraph (1)(D) occurs. "(8) For the purposes of this subsection— "(A) A 'full-time student' is an individual who is in full-time attendance as a student at an educational institution, as determined by the Secretary (in accordance with regulations prescribed by him) in the light of the standards and practices of the institutions involved, except that no individual shall be considered a 'full-time studenr if he is paid by his employer while attending an educational institution at the request, or pursuant to a requirement, of his employer. "(B) Except to the extent provided in such regulations, an individual shall be deemed to be a full-time student during any period of nonattendance at an educational institution at which he has been in full-time attendance if (i) such period is 4 calendar months or less, and (ii) he shows to the satisfaction of the Secretary that he intends to continue to be in full-time attendance at an educational institution immediately following such period. An

371 72 Stat. 1022; Post, p. 397, 42 USC 402.

"Full-time student."

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Page:United States Statutes at Large Volume 79.djvu/412

 372

•'Educational institution."

42 USC 402.

PUBLIC LAW 89-97-JULY 30, 1965

[79 STAT.

individual who does not meet the requirement of clause (ii) with respect to such period of nonattendance shall be deemed to have met such requirement (as of the beginning of such period) if he is in full-time attendance at an educational institution immediately following such period. " (C) A n 'educational institution' is (i) a school or college or university operated or directly supported by the United States, or by any State or local government or political subdivision thereof, or (ii) a school or college or university which has been approved by a State or accredited by a State-reoo^ized or nationally-recognized accrediting agency or bodv, or (iii) a nonaccredited school or college or university whose credits are accepted, on transfer, by not less than three institutions which are so accredited, for credit on the same basis as if transferred from an institution so accredited." (c)(1) Section 202 of such Act is amended by inserting immediately after subsection (r) the following new subsection: "Child Aged 18 or Over Attending School

42 USC 403,

Ante, p. 367. 42 USC 423.

74 Stat. 954, 955;Post, p. 373. 42 USC 403. 7 2 Stat. 10 261028. 42 USC 416. 72 Stat. 1026; Post, p. 405. 42 USC 402.

" (s)(l) For the purposes of subsections (b)(1), (g)(1), (q)(5), and (q)(T) of this section and paragraphs (2), (3), and (4) of section 203(c), a child who is entitled to child's insurance benefits under subsection (d) for any month, and who has attained the age of 18 but is not in such month under a disability (as defined in section 223(c)) which began before he attained such age, shall be deemed not entitled to such benefits for such month, unless he was under such a disability m the third month before such month. "(2) Subsection (f)(4), and so much of subsections (b)(3), (d) (6), (e)(3), (g)(3), and (h)(4) of this section as precedes the semicolon, shall not apply in the case of any child unless such child, at the time of the marriage referred to therein, was under a disability (as defined in section 223(c)) which be^an before such child attained the age of 18 or had been under such a disability in the third month before the month in which such marriage occurred. "(3) Subsections (c)(2)(B) and (f)(2)(B) of this section, so much of subsections (b)(3), (d)(6), (e)(3), (g)(3), and (h)(4) of this section as follows the semicolon, the last sentence of subsection (c) of section 203, subsection (f)(1)(C) of section 203, and subsections (b)(3)(B), (c)(6)(B), (f)(3)(B), and (g)(6)(B) of section 216 shall not apply in the case of any child with respect to any month referred to therein unless in such month or the third month prior thereto such child was under a disability (as defined in section 223(c)) which began before such child attained the age of 18." (2) So much of subsection (c) (2] of such section 202 as precedes subparagraph (A) is amended by inserting "(subject to subsection (s)) " after "shall". (3) So much of subsection (d)(6) of such section 202 as follows subparagraph (B) is amended by inserting "but subject to subsection (s) " after "notwithstanding the provisions of paragraph (1)". (4) So much of subsection (e)(3) of such section 202 as follows subparagraph (B) is amended by inserting "but subject to subsection (s) " after "notwithstanding the provisions of paragraph (1)". (5) So much of subsection (f)(2) of such section 202 as precedes subparagraph (A) is amended by inserting "(subject to subsection (s)) " a f t « r "shall".

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