SSI: A Lifeline for Children with Disabilities
End Notes
[1] Sahil Kapur and Erik Wasson, “House GOP Eyes Fast-Tracking $500 Billion in Federal Budget Cuts,” Bloomberg, May 3, 2017, https://www.bloomberg.com/news/articles/2017-05-03/house-gop-eyes-fast-tracking-500-billion-in-federal-budget-cuts; Kathleen Romig, “GOP Poverty Plan Would Hurt Some of Most Vulnerable Children,” Center on Budget and Policy Priorities, June 15, 2016, https://www.cbpp.org/blog/gop-poverty-plan-would-hurt-some-of-most-vulnerable-children.
[2] Rebecca Ullrich, “Cuts to Medicaid Would Harm Young Children with Disabilities,” Center for American Progress, May 3, 2017, https://www.americanprogress.org/issues/early-childhood/reports/2017/05/03/431766/cuts-medicaid-harm-young-children-disabilities/; Jessica Schubel, “Medicaid Helps Schools Help Children,” Center on Budget and Policy Priorities, April 18, 2017, https://www.cbpp.org/research/health/medicaid-helps-schools-help-children.
[3] Social Security Administration (SSA), “SSI Monthly Statistics, December 2016,” https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/; Office of the Chief Actuary, Annual Report of the Supplemental Security Income Program, 2016, Table IV.B7, https://www.ssa.gov/oact/ssir/SSI16/ssi2016.pdf.
[4] Center on Budget and Policy Priorities, “Policy Basics: Introduction to Supplemental Security Income,” December 2, 2015, https://www.cbpp.org/research/social-security/policy-basics-introduction-to-supplemental-security-income.
[5] The family’s countable income must be under $735 per month, or less than $9,000 a year. Countable income is essentially half of earnings over $65 a month, plus all unearned income with minor exceptions, minus amounts allocated (or “deemed”) to other family members for their own needs. For more information, see https://www.ssa.gov/ssi/text-child-ussi.htm. Although SSI does not explicitly use the federal poverty guidelines to weigh eligibility, the deeming rules mean that working families may qualify for a full benefit for a disabled child with earnings up to about 100 percent of poverty, and may qualify for a small SSI benefit with earnings up to about 200 percent of poverty.
[6] Federal SSI benefits top out at $735 in 2017. Many states supplement the federal SSI benefit, though some have cut those additional payments over the years.
[7] National Survey of Children with Special Health Care Needs, 2009-10, data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website, http://childhealthdata.org/browse/survey/results?q=1792&r=1.
[8] Susan L. Parish, Subharati Ghosh, and Leah Igdalsky, “Hardship among Low-income US Families that receive Children’s Supplemental Security Income (SSI),” Brandeis University, Lurie Institute for Disability Policy, October 2013, http://lurie.brandeis.edu/pdfs/SSI%20hardship%20pol%20brief%20final.pdf.
[9] SSA, SSI Annual Report, Table V.C2, https://www.ssa.gov/oact/ssir/SSI16/V_C_AllowanceData.html#220522.
[10] SSI is distinct from Old-Age, Survivors, and Disability Insurance, commonly known as Social Security, although the Social Security Administration (SSA) runs both programs. Social Security pays benefits to certain adults with disabilities — disabled workers, disabled widow(er)s, and disabled adult children (of retired, deceased, or disabled workers) whose disabilities began before age 22 — but pays no benefits to younger children with disabilities. Social Security Administration, “Benefits for Children with Disabilities,” 2016, https://www.ssa.gov/pubs/EN-05-10026.pdf.
[11] Testimony of Robert Finch, Secretary of the Department of Health, Education and Welfare, “Social Security and Welfare Proposals” H.R. Rep. No. 231, 92nd Cong., 2d Sess., U.S.C.C.A. News 4989, 5133 (1972).
[12] Thomas F. Boat and Joel T. Wu, Mental Disorders and Disabilities Among Low-Income Children, National Academies of Sciences, Engineering, and Medicine, 2015, https://doi.org/10.17226/21780.
[13] Eric Fombonne, “Epidemiology of Pervasive Developmental Disorders,” Pediatric Research, 2009, http://www.nature.com/pr/journal/v65/n6/full/pr2009131a.html.
[14] At the same time, the number of children receiving SSI for intellectual disability (formerly known as mental retardation) decreased, suggesting some diagnostic substitution.
[15] The official rate of child poverty rose gradually from 16 percent in 2000 to 19 percent in 2008, then spiked to about 22 percent from 2010-12 before returning to about 20 percent in 2015. See Table 3 in the Census Bureau’s historical poverty tables here: http://www.census.gov/data/tables/time-series/demo/income-poverty/historical-poverty-people.html. The percentage of children with incomes less than 200 percent of poverty — which is roughly the cutoff for SSI eligibility for working families — is consistently about twice as high.
[16] National Academies of Sciences, Engineering, and Medicine, Mental Disorders and Disabilities Among Low-Income Children, The National Academic Press, 2015, https://www.nap.edu/catalog/21780/mental-disorders-and-disabilities-among-low-income-children.
[17] SSA, SSI Annual Report, 2016, Table IV.B7, https://www.ssa.gov/oact/ssir/SSI16/ssi2016.pdf.
[18] SSA, Program Operations Manual System (POMS), https://secure.ssa.gov/poms.nsf/lnx/0204440008.
[19] Code of Federal Regulations, § 416.994a, https://www.ssa.gov/OP_Home/cfr20/416/416-0994a.htm,
[20] Annual Report, Table V.D4, https://www.ssa.gov/oact/ssir/SSI16/V_D_Redet_CDRdata.html#389380.
[21] National Institutes of Health, National Institute of Deafness and Other Communication Disorders, “Science Capsule — Cochlear Implants,” July 2, 2014, https://www.nidcd.nih.gov/about/strategic-plan/2012-2016/science-capsule-cochlear-implants.
[22] In 1975, only about half of children diagnosed with cancer survived at least five years. In 2004-2010, more than 80 percent did. National Cancer Institute, “Cancer in Children and Adolescents,” https://www.cancer.gov/types/childhood-cancers/child-adolescent-cancers-fact-sheet.
[23] Susan Parish et al., “Material Hardship in U.S. Families Raising Children with Disabilities,” Exceptional Children, Vol. 75:1, 71-92 (2008) and “Material Hardship in U.S. Families Raising Children with Disabilities: Research Summary and Policy Implications,” University of North Carolina, March 2009.
[24] National Commission on Hunger, Freedom from Hunger: An Achievable Goal for the United States of America, 2015, https://www.aei.org/wp-content/uploads/2016/01/Hunger_Commission_Final_Report.pdf.
[25] Consortium for Citizens with Disabilities, “Preserve Supplemental Security Income for Children with Disabilities: Speaker Ryan’s Poverty Plan Proposes Harmful Elimination of Benefits,” June 7, 2016, http://www.c-c-d.org/fichiers/Preserve-SSI-for-Children-and-Families-06-07-16.pdf.
[26] CBPP analysis of the March 2014 Current Population Survey and SSI income data from the Urban Institute/HHS Transfer Income Model version 3, downloaded from the TRIM3 project website, trim3.urban.org, on January 12, 2017.
[27] Research shows that child SSI benefits have “potentially played a large role in lowering child poverty rates” overall, as well. Mark Duggan and Melissa Schettini Kearney, “The Impact of Child SSI Enrollment on Household Outcomes: Evidence from the Survey of Income and Program Participation,” National Bureau of Economic Research, August 2005.
[28] Kathy Ruffing, “Rich Man, Poor Man: Lawmakers Should Raise and Index the SSI Asset Limits,” CBPP, January 17, 2013, https://www.cbpp.org/blog/rich-man-poor-man-lawmakers-should-raise-and-index-the-ssi-asset-limits.
[29] Greg J. Duncan and Katherine Magnuson, “The Long Reach of Early Childhood Poverty,” Pathways, Winter 2011, http://inequality.stanford.edu/sites/default/files/PathwaysWinter11_Duncan.pdf; Kristen Butcher, “Assessing the Long-Run Benefits of Transfers to Low-Income Families,” Hutchins Center Working Paper #26, The Brookings Institution, January 2017, pp. 31, https://www.brookings.edu/wp-content/uploads/2017/01/wp26_butcher_transfers_final.pdf; Kerris Cooper and Kitty Stewart, “Does Money Affect Children’s Outcomes?,” Joseph Rowntree Foundation, October 22, 2013, https://www.jrf.org.uk/report/does-money-affect-children%E2%80%99s-outcomes; Kathleen M. Ziol-Guest et al., “Early Childhood Poverty, Immune-Mediated Disease Processes, and Adult Productivity,” Proceedings of the National Academy of Sciences, Vol. 109, October 16, 2012, pp. 17289–17293, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477379/.
[30] Jason Fletcher, “Adolescent Depression and Adult Labor Market Outcomes,” NBER Working Paper No. 18216, July 2012, http://www.nber.org/papers/w18216, Jason Fletcher, “The Effects of Childhood ADHD on Adult Labor Market Outcomes,” NBER Working Paper No. 18689, January 2013, http://www.nber.org/papers/w18689.
[31] Gina A. Livermore and Todd C. Honeycutt, “Employment and Economic Well-Being of People With and Without Disabilities before and After the Great Recession,” Journal of Disability Policy Studies, Vol. 26, No. 2, 2015.
[32] Jeffrey Hemmeter, “Earnings and Disability Program Participation of Youth Transition Demonstration Participants after 24 Months,” Social Security Administration, 2014, https://www.ssa.gov/policy/docs/ssb/v74n1/v74n1p1.html; PROMISE is a joint initiative of the Departments of Education, Health and Human Services, and Labor, as well as the Social Security Administration. Through multi-year state grants, PROMISE partners with state agencies to develop and implement six model projects that provide coordinated services and supports to the families of children receiving SSI in order to improve the children’s education and career outcomes. For more, see http://www.promisetacenter.org/home.
[33] Norma Coe and Matthew Rutledge, “What is the Long-Term Impact on Zebley Kids?” Boston College Center for Retirement Research, Working Paper No. 2013-3, January 1, 2013, https://ssrn.com/abstract=2196648.
[34] Michael Levere, “The Labor Market Consequences of Receiving Disability Benefits During Childhood,” Mathematica Policy Research, February 6, 2017, https://www.mathematica-mpr.com/our-publications-and-findings/publications/the-labor-market-consequences-of-receiving-disability-benefits-during-childhood.
[35] Paul J. Chung et al., “Need for and Use of Family Leave Among Parents of Children With Special Health Care Needs,” Pediatrics, May 2007, http://pediatrics.aappublications.org/content/119/5/e1047.
[36] Mark Stabile and Sara Allin, “The Economic Costs of Childhood Disability,” The Future of Children, Spring 2012.
[37] Kalman Rupp et al., “A Profile of Children with Disabilities Receiving SSI: Highlights from the National Survey of SSI Children and Families,” Social Security Bulletin, 2005/2006, https://www.ssa.gov/policy/docs/ssb/v66n2/v66n2p21.html.
[38] Kristin N. Ray et al., “Opportunity Costs of Ambulatory Medical Care in the United States,” The American Journal of Managed Care, August 18, 2015, http://www.ajmc.com/journals/issue/2015/2015-vol21-n8/opportunity-costs-of-ambulatory-medical-care-in-the-united-states.
[39] Rupp et al., 2005/2006.
[40] Autism Speaks, Applied Behavior Analysis (ABA), available at: https://www.autismspeaks.org/what-autism/treatment/applied-behavior-analysis-aba.
[41] Rupp et al., 2005/2006.
[42] RTI Action Network, “What is RTI?,” available at http://www.rtinetwork.org/learn/what/whatisrti.
[43] Rupp et al., 2005/2006.
[44] Kalman Rupp and Steve Ressler, “Family Caregiving and Employment Among Parents of Children with Disabilities on SSI,” Journal of Vocational Rehabilitation, September 30, 2009, https://www.mathematica-mpr.com/our-publications-and-findings/publications/family-caregiving-and-employment-among-parents-of-children-with-disabilities-on-ssi.
[45] Ibid.
[46] Jiyean Park, Ann P. Turnbull, and H. Rutherford Turnbull III, “Impacts of Poverty on Quality of Life in Families of Children with Disabilities,” Council for Exceptional Children, Winter 2002; Susan L. Parish, “Why Dismantling the Safety Net for Children with Disabilities and Their Families Is a Poor Idea,” Health Social Work, 2013, https://academic.oup.com/hsw/article/38/4/195/830208/Why-Dismantling-the-Safety-Net-for-Children-with.
[47] Lisa Clemans-Cope et al., “Access to and Use of Paid Sick Leave Among Low-Income Families With Children,” Pediatrics, August 2008, http://pediatrics.aappublications.org/content/122/2/e480; Leila Morsy and Richard Rothstein, “Parents’ Non-Standard Work Schedules Make Adequate Childrearing Difficult,” Economic Policy Institute, August 6, 2015, http://www.epi.org/publication/parents-non-standard-work-schedules-make-adequate-childrearing-difficult-reforming-labor-market-practices-can-improve-childrens-cognitive-and-behavioral-outcomes/.
[48] Stabile and Allin.
[49] Mark Duggan and Melissa Schettini Kearney, “The Impact of Child SSI Enrollment on Household Outcomes: Evidence from the Survey of Income and Program Participation,” National Bureau of Economic Research, August 2005.
[50] Manasi Deshpande, “The Effect of Disability Payments on Household Earnings and Income: Evidence from the Supplemental Security Income Children’s Program,” The Review of Economics and Statistics, October 2016.
[51] Melanie Guldi et al., “Supplemental Security Income and Child Outcomes: Evidence from Birth Weight Eligibility Cutoffs,” Williams College Working Paper, March 2017.
[52] SSA, SSI Annual Statistical Report, 2015, Tables 25 and 26, available at: https://www.ssa.gov/policy/docs/statcomps/ssi_asr/.
[53] A summary of these so-called “deeming” rules may be found at http://www.socialsecurity.gov/ssi/text-child-ussi.htm.